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Deficiency of TRPM2 leads to embryonic neurogenesis defects in hyperthermia – Science Advances

INTRODUCTION

The cerebral cortex is the most evolved and complicated structure in the mammalian brain and has many physiological functions, such as attention, cognition, learning, and memory. The functions rely on the detailed cortex structure, which includes a six-layered architecture formed by migrating neurons in an inside-out pattern (1). These plentiful neurons are generated from various neural progenitor cells (NPCs). The primary progenitor cells are radial glial (RG) cells, which are mainly responsible for self-renewal and result in the expansion of the cortex, the differentiation of neurons, and the production of postmitotic neurons (2). The process of neuronal production, also known as neurogenesis, plays crucial roles in cerebral development and can affect the function of the neocortex. Generally, each process in neurogenesis, including self-renewal, differentiation, and the maturation of neurons, is strictly regulated, and any disturbance leads to severe disorders (3). The entire process is regulated by numerous extracellular and intracellular signals and factors. Any stress or unusual stimulus may lead to abnormalities in brain function.

During pregnancy, various stimuli can lead to abnormal neural development (4, 5). Among them, heat stress is an important stimulus for both the mother and fetus during pregnancy, and maternal thermal homeostasis is critical for fetal survival and ontogenesis. For example, maternal fever during the gestation period is associated with congenital heart defects and neural tube defects (6, 7). However, it is largely unknown whether heat stress, such as hyperthermia, disturbs neurogenesis and cortical development.

A series of thermally activated ion channels has been reported to detect the entire thermal range (8, 9). Among them, transient receptor potential channel M2 (TRPM2) is a plasma membrane calcium-permeable cation channel and is a unique member of the TRP family that is sensitive to various signals. Recently, studies have reported that TRPM2 can be activated by heat and that the deletion of TRPM2 in mice results in a remarkable deficit in their perception of nonpainful warm stimuli in the range of 33 to 38C (10). TRPM2 has been implicated in several neurodevelopmental/neurological disorders including bipolar disorder, neuropathic pain, and Parkinsons disease (11). In addition, TRPM2 has been shown to participate in various biological processes, including insulin secretion, H2O2-induced cell apoptosis, and brain damage following ischemic insults in adult and neonatal mice (1214). Therefore, it is crucial to investigate the precise functions and molecular mechanisms of the hyperthermia-related protein TRPM2 and characterize the proteins role in the regulation of brain development during heat stress and maternal hyperthermia.

Several pieces of evidence have demonstrated that canonical Wnt signaling, including -catenin, which acts as a core downstream effector, determines the transition from neuronal proliferation to differentiation during cortical neurogenesis. In the early stages of neurogenesis, the overexpression of -catenin in NPCs promotes their proliferation, whereas a deficiency in -catenin in NPCs facilitates neurogenesis (15). The precise signal transductions that modulate neurogenesis are unclear and need further elucidation. The transcription factor SP5 (specificity protein 5) is a member of the SP transcription factor family (16), and previous studies have shown that SP5 plays a crucial role in governing mouse embryonic stem cell pluripotency (17) and neural crest specification (18). During vertebrate development, SP5 acts downstream of Wnt/-catenin signaling in neuroectoderm patterning (19). In addition, the hypermethylation of SP5 has been implicated in schizophrenia, a neuropsychiatric disorder associated with the dysregulation of neural stem cell (NSC) proliferation and differentiation (20, 21). However, the role of SP5 in hyperthermia during neurogenesis has never been reported.

Here, we demonstrate that the thermo-sensor protein TRPM2 is enriched in the embryonic cerebral cortex and that its expression gradually increases during heat stress. We also show that TRPM2-deficient mice exposed to heat show reduced NSC proliferation and a premature shift in RG differentiation. Mechanistically, this study identifies an important role of TRPM2 in modulating SP5 expression by inhibiting the phosphorylation of -catenin in sustaining neural progenitor self-renewal during heat stress. In addition, the heat-induced proliferation defects caused by TRPM2 knockdown or knockout can be partially rescued by the overexpression of SP5. Collectively, these findings reveal that the heat sensor protein TRPM2 has a previously unidentified role in modulating cortical neurogenesis during hyperthermia conditions. These findings provide previously unknown insights to further elucidate neurological disorders associated with heat stress and reveal previously unidentified strategies for treatment.

To determine the effect of heat stress on the developing cortex, we performed stress experiments in which pregnant mice were placed in a thermostatic biochemical incubator (fig. S1A) set to 38C for 2 hours from embryonic day 13.5 (E13.5) to E15.5; the control group was kept at room temperature. After heat stress, E15.5 brain slices were stained with an antibody against mitotic index PH3. Compared with that in the control group, the number of PH3-positive cells residing at both the apical and basal positions was notably augmented, indicating that heat stress promoted mitotic activity (Fig. 1, A to C). Consistently, double staining for bromodeoxyuridine (BrdU) with PAX6 (one type of neural progenitor marker) (Fig. 1, D and E) and TBR2 (an intermediate progenitor marker) (Fig. 1, F and G) revealed that the number of cells in the proliferative state was increased in hyperthermia. Collectively, these results indicate that heat stress promotes neural progenitor self-renewal. In a second group of pregnant mice, similar heat stress was induced at E13.5 to E16.5; then, in utero electroporation (IUE) was performed to analyze embryonic brain development. When embryos were electroporated with a green fluorescent protein (GFP)encoding plasmid, which was used as a control plasmid on E13.5 and collected on E16.5, the hyperthermia group showed an abnormal distribution, which manifested as an increase in the number of cells in the ventricular zone/subventricular zone (VZ/SVZ) and a reduction in the number of GFP-positive cells in the cortical plate (CP) compared with those in the room temperature group (Fig. 1, H and I). In our research, the control mice were maintained in the vivarium at room temperature. We also conducted IUE experiments when mice were maintained in an incubator or in the vivarium at room temperature and found that the stress experienced by the mother due to moving to a new environment did not play a role in the observed phenotypes (fig. S1, B and C). Together, these results demonstrate that heat stress may disturb neurogenesis during embryonic brain development.

(A to C) E15.5 brain sections from the room temperature and hyperthermia groups were immunolabeled with the mitotic marker PH3 and 4,6-diamidino-2-phenylindole (DAPI). The graphs show the number of PH3+cells per 100 m2 at the apical and basal positions (n = 6). Scale bar, 20 m. (D to G) Mice underwent 2 hours of BrdU pulse labeling and were euthanized at E15.5. Brain slices were then double stained with antibodies against BrdU/PAX6 and BrdU/TBR2. The graphs show the populations of BrdU+PAX6+ and BrdU+TBR2+ cells relative to the total population of BrdU+ cells (n = 6). Scale bars, 20 m. (H and I) Thermal stimuli lead to the abnormal distribution of GFP-positive cells in the developing neocortex. An electroporation experiment was conducted at E13.5, and embryonic brains were collected on E16.5. The percentage of GFP-positive cells in each region is displayed in the bar graph (n = 6 embryos from four different mothers). Scale bar, 50 m. IZ, intermediate zone. (J) Reverse transcription polymerase chain reaction (RT-PCR) results showing the relative mRNA levels of members of the TRP family in the heat stress experiment (n = 3). n.s., not significant. (K) TRPM2 is abundantly enriched in NESTIN-positive NSCs in the embryonic cerebral cortex. E13.5 and E15.5 brain slices were immunostained with anti-NESTIN and anti-TRPM2 antibodies (VZ/SVZ) (n = 5). Scale bars, 20 m. (L) TRPM2 is expressed and colocalized with SOX2 and NESTIN in primary NSCs. The cells were collected from the cerebral cortex of E12.5 mouse brains and maintained in proliferative medium for 24 hours (n = 4). Scale bars, 20 m. (M and N) TRPM2 expression increases at warm temperatures in the E15.5 cerebral cortex. E15.5 brain sections were stained with an antibody against TRPM2. The graph shows the relative expression intensities of TRPM2 (n = 6). The intensity of TRPM2 was quantified with ImageJ. Scale bar, 20 m. The data are shown as means SEM; two-tailed Students t tests; *P < 0.05, **P < 0.01, and ***P < 0.001 versus the indicated group.

It has been reported that many receptors are thermally sensitive (10). To verify heat sensitivity, we housed pregnant mice with E13.5 fetuses at 38C for 2 hours for 3 days. Control pregnant mice were kept at room temperature. After 3 days (i.e., E15.5), RNA was extracted from the cerebral tissues of fetal mice. We detected the RNA levels of several receptors associated with heat (10, 22) and observed that in mice subjected to heat stress, the mRNA levels of only TRPM2, among the numbers of the TRP family, increased significantly (Fig. 1J). Molecular markers of heat-sensitive neurons within the preoptic hypothalamus were also affected. BDNF and PACAP mRNA levels increased (fig. S1D), which is consistent with previous studies (23). To examine the specific expression pattern of TRPM2 in the early embryonic brain, we conducted immunofluorescence and colocalization analyses. In vivo, the brain sections of E13.5 and E15.5 mice were collected and stained with antibodies against TRPM2 and the two neural progenitor markers, namely, NESTIN (24) and SOX2 (sex-determining region Yrelated HMG box 2). TRPM2 was observed to be colocalized with NESTIN-positive and SOX2-positive progenitor cells and resided in the VZ/SVZ of the cerebral cortex in both E13.5 and E15.5 brain sections from mice housed at room temperature (Fig. 1K and fig. S1E). In addition, in vitro, we observed that TRPM2 was coexpressed with NESTIN and SOX2 in primary mouse NSCs derived from E12.5 cerebral tissues and cultured in proliferation medium for 2 days (Fig. 1L). Next, to investigate TRPM2 expression at different developmental stages, we harvested cerebral tissues from E13.5, E15.5, and E18.5 and analyzed them using Western blotting. The results revealed that TRPM2 expression gradually increased from E13.5 to E18.5 (fig. S1, F and G). We also investigated TRPM2 transcription in vivo using cortical tissues and in vitro using NPCs cultured under differential or proliferative conditions. Reverse transcription polymerase chain reaction (RT-PCR) was performed on RNA extracted from the tissues or the NPCs. All data indicated that the mRNA levels of TRPM2 showed an obvious up-regulation as embryonic development proceeded (fig. S1, H to J). In addition, another group of pregnant mice was housed at 38C for 2 hours for 3 days at E15.5. Heat-treated mice showed a marked augmentation of TRPM2 expression in the VZ/SVZ of the neocortex compared with that in control mice (Fig. 1, M and N). Overall, these findings suggest that TRPM2, especially during heat stress, plays an important role in modulating NSC neurogenesis during embryonic cortical development.

On the basis of the distinctive expression pattern of TRPM2 in NSCs, we explored whether TRPM2 plays a unique role in neurogenesis during embryonic brain development. We generated a TRPM2-targeting short hairpin RNA (shRNA) plasmid and a TRPM2-overexpressing lentiviral-based vector to effectively silence and augment TRPM2 expression, respectively, in neural progenitors. In NPCs (Fig. 2, A and B, and fig. S1M), N2A cells (fig. S1, L and O), and 293FT cells (fig. S1N) treated with our constructs, Western blotting confirmed TRPM2 knockdown or overexpression. To verify our strategy, we further confirmed TRPM2 shRNA knockdown efficiency by real-time PCR analysis in NSCs, and the analysis showed that TRPM2 levels were effectively suppressed (fig. S1K). Next, we investigated whether TRPM2 disturbs cell distribution in vivo using IUE. In E13.5 mice, brains were injected and electroporated with the TRPM2 shRNA or control plasmid, and the mice were sacrificed at E16.5 for phenotypic analysis. We observed no obvious change in the distribution of GFP-positive cells across the cerebral cortex (fig. S2, A and B). However, the more interesting observation was that when maternal mice were placed in a 38C temperature-controlled incubator for 2 hours from E14.5 to E16.5, TRPM2 knockdown resulted in an obvious reduction in the number of GFP-positive cells in the VZ/SVZ and a corresponding increase in the number of GFP-positive cells in the CP (Fig. 2, C and D). When a 39C temperature-controlled incubator was used, similar results were obtained (fig. S2, C and D). To observe more long-term effects, we performed IUE at E13.5 to E17.5 and comparable GFP-positive cell distributions were observed (fig. S2, E and F). In addition, we also sought to determine whether the knockdown of TRPM2 has a possible effect on cell migration. IUE experiments are frequently used to monitor cell migration during embryonic cerebral development (2527). Then, we performed an E15.5-to-E19.5 IUE experiment in mice at room temperature and an E14.5-to-E18.5 IUE experiment in mice exposed to heat (fig. S2, G to I) and found that there was nearly no difference in GFP distribution from the VZ/SVZ to the CP between the control and TRPM2 knockdown groups. These results jointly eliminated the influence of TRPM2 depletion on cell migration. Thus, the data suggest that TRPM2 may take part in regulating neurogenesis during heat stress.

(A) Western blot analysis confirmed the knockdown (empty pSicoR shRNA was used as a control) of TRPM2 in cultured NSCs. -Actin was used as a control. (B) The graph shows that TRPM2 expression levels were effectively knocked down in primary NSCs by TRPM2-shRNA (n = 6). (C and D) TRPM2 knockdown alters the distribution of cells in the cerebral cortex during heat stress. A control or TRPM2 shRNA plasmids were microinjected and electroporated into the brains of E13.5 mice, and brains were collected on E16.5. During the process, the mice were exposed to 38C for 2 hours per day from E14.5 to E16.5. The GFP-positive cell populations in each region are displayed in the bar graph (n = 6 embryos from four different mothers). Scale bar, 50 m. (E and F) The number of TUJ1+GFP+ cells is augmented in TRPM2 shRNAtreated animals subjected to heat stress. Brain slices from E16.5 mice were stained with an antibody against TUJ1. The population of TUJ1+GFP+ cells relative to the total population of GFP+ cells is shown in the bar graph (n = 6 embryos from four different mothers). Scale bar, 50 m. (G and H) The number of MAP2+GFP+ cells is slightly increased in TRPM2 shRNAtreated animals in hyperthermia. E16.5 brain slices were stained with an anti-MAP2 antibody. The population of MAP2+GFP+ cells relative to the total population of GFP+ cells is shown in the bar graph (n = 6 embryos from four different mothers). Scale bar, 50 m. (I) Silencing TRPM2 induces NPC terminal mitosis during heat stress. A TRPM2 shRNA or control plasmid was injected and electroporated into E13.5 mouse brains. BrdU was gently injected 24 hours after electroporation at E14.5, and the electroporated brains of the embryos were collected for analysis at E18.5. Immunohistochemical analysis was performed using anti-BrdU and anti-CUX1 antibodies. During the process, the mice were exposed to 38C for 2 hours per day from E14.5 to E18.5. The arrowheads represent BrdU+/GFP+ cells, and the arrows represent GFP+BrdU+CUX1+ cells. Scale bar, 20 m. (J) Bar graph displaying the population of BrdU+GFP+ cells relative to the total number of GFP-positive cells in the CP (n = 6 embryos from four different mothers). (K) Quantification of the population of GFP+BrdU+CUX1+ cells relative to the population of GFP+BrdU+ cells (n = 6 embryos from four different mothers). The data are shown as means SEM; two-tailed Students t tests; *P < 0.05, **P < 0.01, and ***P < 0.001 versus the indicated group.

On the basis of the reduction in the number of GFP-positive cells in the VZ/SVZ, which enriches NPCs, we considered the possibility that TRPM2 plays a vital role in modulating NSC proliferation in hyperthermia. To address this possibility, we injected BrdU into pregnant mice 2 hours before the collection of electroporated embryonic brains. In TRPM2 knockdown mice, heat stress at E13.5 to E16.5 led to a marked reduction in the percentage of GFP+BrdU+ cells (fig. S3, A to C), the percentage of GFP+BrdU+PAX6+ cells (fig. S3, D and E), the expression of mitotic marker PH3 (fig. S3, F and G), and the expression of TBR2 (fig. S3, H and I) in NPCs residing in the VZ/SVZ.

Together, these results indicate that TRPM2 is vital for maintaining the NSC pool. To further explore whether a decrease in NPC proliferation leads to precocious cortical neurogenesis, we analyzed cell cycle exit. After electroporating control or TRPM2-shRNA plasmids into embryonic brains at E13.5, BrdU was injected 24 hours before the collection of electroporated brains from embryos on E15.5 and from E14.5 to E16.5. During the process, the pregnant mice were kept at 38C for 2 hours per day. Next, we stained brain slices with antibodies against BrdU and the proliferative marker KI67 to evaluate cells that precociously exit the cell cycle. We observed a substantial augmentation of the indicator of cell cycle exit in the TRPM2-silenced group that was subjected to heat stress, confirming that the elimination of TRPM2 facilitated cell cycle exit in response to hyperthermia (fig. S4, A to C).

To verify the possibility that TRPM2 knockdown NPCs that exit the cell cycle during heat stress may differentiate prematurely into neurons, we stained brain sections with an antibody against TUJ1 (-III-tubulin, a neuronal marker) to label neurons. Analysis revealed an obvious change in the percentage of TUJ1+/GFP+ cells in brain slices from TRPM2 knockdown mice subjected to heat stress (Fig. 2, E and F). We also observed a remarkable increase in the number of cells expressing the neuronal or upper layer markers MAP2+/GFP+ (Fig. 2, G and H), SATB2+/GFP+ (fig. S4, D and E), and CUX1+/GFP+ (fig. S4, F and G) and a decrease in the number of cells expressing CTIP2 (a marker of deep layer neurons)+/GFP+ (fig. S4, I and J) compared to those in control brain slices, suggesting an increase in the differentiation of NSCs. We also birthdated neurons using BrdU to investigate whether TRPM2 knockdown accelerates the terminal mitosis of premature neural progenitors in mice challenged with heat. As previously described (28), BrdU was injected into the abdominal cavity of pregnant mice 24 hours after the electroporation of E14.5 fetuses, and the electroporated brains of the embryos were collected for analyses at E18.5 (fig. S4H). Because BrdU labels dividing cells in the S phase (29), the label becomes diluted and gradually disappeared upon the self-renewal of NPCs. Only cells that differentiate into neurons within the CP layer during their final mitotic division are permanently labeled. By staining with an antibody against BrdU, we observed a marked increase in the number of BrdU+/GFP+ (Fig. 2, I and J) cells in the TRPM2 shRNAtreated brains compared with control shRNAtreated brains. When colocalized with the outer cortical layer marker CUX1, a significant change in the percentage of CUX1+GFP+BrdU+ cells relative to that of GFP+BrdU+ cells in the TRPM2 shRNAtreated group was observed. These results indicate that more BrdU-labeled NPCs differentiated into CUX1-positive neurons in the CP in the TRPM2 shRNAtreated group (Fig. 2K). Collectively, these findings effectively demonstrate that during heat stress, TRPM2 loss of function results in augmented terminal mitosis and enhanced cortical neuronal differentiation.

To verify the role of TRPM2 in neuron development under conditions of heat, we conducted an in vitro experiment using cultured primary NSCs. NPCs obtained from the E12.5 cerebral cortex were infected with either a control or TRPM2 shRNA plasmidpackaged lentivirus. After 24 hours, the cells were then incubated at 38C for 3 days in proliferative medium and finally stained with antibodies against TUJ1 and KI67. We observed an obvious increase in the number of GFP+TUJ1+ cells (fig. S5, A and B) and a marked decrease in the number of GFP+KI67 + cells (fig. S5, C and D) in TRPM2-deficient cells compared with control cells, supporting our in vivo findings. However, when NPCs were incubated at 37C for 3 days, we observed no obvious change in the percentage of GFP+TUJ1+ cells in the TRPM2-deficient cells (fig. S6, H and I).

To further investigate the effects of TRPM2 on NPC morphology during heat stress, we kept NSCs acquired from E12.5 brains in differentiation medium at 38C for 3 days. Using confocal imaging, we observed that compared with control NSCs, TRPM2 knockdown NSCs exhibited longer neurite outgrowth and increased branching after hyperthermia (fig. S5, H to J).

In addition, IUE was performed at E13.5, and the GFP-positive region of the brains from the embryo was collected and digested 2 days after electroporation at E15.5. During E14.5 to E15.5, the pregnant mothers were held at 38C for 2 hours per day. Embryonic GFP-positive brain cells were acquired using fluorescence-activated cell sorting and then cultured for 2 days in proliferative medium at 38C. Notably, TRPM2-silenced cells obtained from embryos whose mothers were heat-challenged showed prominent branching and longer neurite outgrowth compared with empty vectortreated cells (fig. S5, E to G). Jointly, these results suggest that TRPM2 can inhibit neuronal development during heat stress and is required for maintaining stem cell self-renewal.

In E13.5 mice electroporated with a TRPM2 overexpression vector, we observed a prominent increase in the number of GFP-positive cells residing in the VZ/SVZ and a corresponding decrease in the number of GFP-positive cells in the CP at E16.5 when pregnant mothers were subjected to heat stress for 2 hours from E14.5 to E16.5 (fig. S6, A and B). Compared to the normal expression of TRPM2, TRPM2 overexpression during heat stress also led to more BrdU-positive cells in the VZ/SVZ (fig. S6, C to E), supporting a role for TRPM2 in promoting NSC proliferation. In addition, TRPM2 overexpression was found to rescue abnormal NPC distribution caused by the depletion of TRPM2 in vivo (fig. S6, F and G), demonstrating that TRPM2 is required for the proliferation of NPCs during heat stress.

To further explore the phenotype of TRPM2 knockout mice, we generated mice using the CRISPR-Cas9 system through zygote microinjection. The coding sequence (CDS) of TRPM2 is located in exon 3, but not exon 1. After CRISPR editing, a termination codon was introduced near the start codon in the CDS (Fig. 3A). Genotyping PCR (Fig. 3B), Western blotting (fig. S7A), and real-time PCR (fig. S7B) were all performed to identify the knockout efficiency at the genome, protein, and RNA levels, respectively. We verified the knockout of TRPM2 in pregnant TRPM2 knockout mice exposed to hyperthermia at E14.5 to E16.5 by immunostaining E16.5 brain slices with an antibody against TRPM2 (fig. S7C). In addition, by immunostaining with an antibody against cleaved caspase-3, we observed that, in hyperthermia, there was no significant difference in the number of cleaved caspase-3+ cells per field between E16.5 TRPM2+/+ and TRPM2/ brain slices, suggesting that TRPM2 knockout had no effect on cell apoptosis under conditions of heat (fig. S7, D and E).

(A) Schematic diagram of the generation of TRPM2 knockout mice. (B) Genotyping of TRPM2+/+ and TRPM2/ mice. The results show that the PCR products of TRPM2+/+ and TRPM2/ were 1291 and 511 base pairs (bp), respectively. WT, wild type. (C and G) E16.5 brain slices from TRPM2+/+ and TRPM2/ mice were stained with DAPI and an antibody against PH3. Heat stress was applied from E14.5 to E16.5. The graph shows the number of PH3-positive cells per 100 m2 in the VZ/SVZ (n = 6). Scale bar, 20 m. (D and H) TRPM2+/+ and TRPM2/ mice underwent 2 hours of BrdU pulse labeling and were sacrificed at E16.5. Brain slices were then stained with antibodies against BrdU and PAX6. The graph shows the number of BrdU+PAX6+ cells per 100 m2 in the VZ/SVZ (n = 6). Scale bar, 20 m. (E and I) Coronal brain slices of E16.5 TRPM2+/+ and TRPM2/ mice were immunostained with an anti-CUX1 antibody. The number of CUX1+ cells per 100 m2 of CP is shown (n = 6). Scale bar, 20 m. (F and J) Representative images of E16.5 cortices showing SATB2-labeled cells. The graph shows the thickness of SATB2+ cells in the upper layer of the CP (n = 6). Scale bar, 20 m. (K) Deletion of TRPM2 leads to abnormal cell distribution and neurogenesis defects during heat stress. Furthermore, these defects were rescued by the constitutive expression of TRPM2 in the developing brain. A GFP-expressing control vector or TRPM2 overexpression vector was microinjected and electroporated into E13.5 mouse brains. Heat stress was administered from E14.5 to E16.5 for 2 hours a day. The brains were collected on E16.5 and stained for TUJ1. (L) The population of GFP-positive cells in each region is displayed in the bar graph (n = 6 embryos from four different mothers). Scale bar, 50 m. (M) The population of TUJ1+ GFP+ cells among GFP+ cells is displayed in the bar graph (n = 6 embryos from four different mothers). Scale bar, 50 m. The data are shown as means SEM; two-tailed Students t tests; *P < 0.05, **P < 0.01, and ***P < 0.001 versus the indicated group.

Next, we obtained E16.5 TRPM2+/+ or TRPM2/ embryonic brains from mothers that had been housed at 38C for 2 hours per day from E14.5 to E16.5. By staining analysis, we observed fewer neural progenitors expressing PH3 (Fig. 3, C and G) and BrdU/PAX6 (Fig. 3, D and H) in the VZ/SVZ and more neurons expressing CUX1 (Fig. 3, E and I) and SATB2 (Fig. 3, F and J) in the CP in TRPM2 knockout brain slices. In addition, when immunostaining for TRPM2 together with NESTIN or TUJ1 was performed on E16.5, we found that the expression of NESTIN was decreased, while the level of TUJ1 was observably augmented after the deletion of TRPM2 in hyperthermia (fig. S7, F and G). Consistently, when mice were housed at 38C for 2 hours per day from E14.5 to E18.5, more neurons expressing CUX1 were observed in the CP in TRPM2 knockout brain slices both on postnatal day 0 (P0) and P6 (fig. S8, F to I), which suggests that the heat-mediated shift in the proliferation to differentiation ratio upon TRPM2 knockout has a consistent and longer-term effect in later stages of development. However, in brain slices obtained from embryos of mothers who had been housed at room temperature, we did not find an obvious difference in TUJ1 staining at P0 between the wild-type and TRPM2 knockout groups (fig. S8J). Consistently, progenitors isolated from hyperthermic E12.5 TRPM2/ embryos developed longer neurites and more branching after culture in differentiation medium for 3 days than those of hyperthermic E12.5 TRPM2+/+embryos, while room temperature embryos lacked these phenotypes (fig. S8, A to E). These observations suggest that TRPM2 knockout and hyperthermia accelerate neuron development. In addition, NSCs obtained from E12.5 TRPM2/ embryos formed smaller neurospheres than those of controls in hyperthermia, but not room temperature conditions, suggesting that the loss of TRPM2 inhibits NPC proliferation during hyperthermia (fig. S7, K to M). To validate the function of TRPM2 during cortical neurogenesis in times of hyperthermia, we electroporated the brains of fetal TRPM2+/+ and TRPM2 / mice with control plasmids and brains of fetal TRPM2 / mice with TRPM2 overexpression plasmids on E13.5. Then, on E16.5, we collected brain samples from mice that had been exposed to heat stress for 2 hours from E14.5 to E16.5. By staining with an anti-TUJ1 antibody, we found that TRPM2/ mice not only exhibited an aberrant distribution of GFP-positive cells in three cortical layers but also showed a prominent increase in the proportion of GFP and TUJ1double positive cells compared with that in TRPM2+/+ mice, which is reminiscent of TRPM2 knockdown mice subjected to heat stress. Moreover, forced expression of TRPM2 in TRPM2/ mice in hyperthermia could rescue the abnormalities evoked by the ablation of TRPM2, i.e., both the distribution and ratio of GFP+ TUJ1+ cells (Fig. 3, K to M). In addition, we also compared the distribution and ratio of GFP+ TUJ1+ cells between TRPM2/ mice at room temperature and TRPM2/ mice in hyperthermia groups. The results revealed that, upon exposure to hyperthermia, TRPM2/ mice displayed a significant increase in the number of GFP-positive cells in the CP and the percentage of TUJ1+GFP+ cells (fig. S7, H to J). These findings demonstrate the vital role of TRPM2 during embryonic neurogenesis. In addition, the consistent phenotype of TRPM2 knockout excludes the possibility of potential off-target effects of TRPM2 shRNA in knockdown experiments. To investigate the effect of TRPM2 deficiency on differentiating neurons in hyperthermia, we conducted an in vitro experiment using cultured primary neurons. The neurons were isolated from P0 hyperthermic TRPM2+/+ and TRPM2/ embryos and cultured in differentiation medium for 3 days. By staining with an antibody against TUJ1, we observed no obvious difference between the wild-type and TRPM2 knockout groups in terms of neurite length or number of branches (fig. S8, K to M), suggesting that TRPM2 deficiency induces no phenotype in neurons under heat stress. We also analyzed other stimuli, such as treatment with NaCl (fig. S8, N and Q), change in pH (fig. S8, O and R), and X radiation exposure (fig. S8, P and S), and subsequently found that TRPM2 was not activated by these stimuli. Overall, these findings indicate that well-regulated embryonic cortical development can be disturbed in hyperthermic conditions when TRPM2 is deleted.

To further detail how TRPM2 affects the developing brain in hyperthermia, we sequenced RNA (RNA-seq) to analyze transcriptome-wide changes that arise from the loss of TRPM2. Total RNA was acquired from the cortical tissue of E16 TRPM2 knockout and wild-type mice with mothers that were housed at 38C for 2 hours per day from E14.5 to E16.5. Sequencing was repeated twice for each sample to increase the reliability of the sequencing results. Gene Ontology (GO) analysis revealed that down-regulated genes were associated with cell proliferation and temperature stimuli, including the canonical Wnt signaling pathway, neuronal stem cell division, the detection of temperature stimuli involved in sensory perception, and the negative regulation of cell differentiation. The up-regulated genes were associated with neurogenesis, the regulation of neuronal development, and cell fate commitment (fig. S9A). These data jointly suggest a crucial role for the thermal sensor protein TRPM2 in cortical neurogenesis during hyperthermia. Next, we explored how the deletion of TRPM2 affects neurogenesis at the molecular level during heat stress. Among the differentially expressed genes identified by genome analyses, we selected genes that changed consistently in both sequencing results and finally selected SP5 as a downstream target (fig. S9B and Fig. 4A). To confirm the results of RNA-seq, we performed RT-PCR (fig. S9C) and Western blotting (fig. S9D) and observed that SP5 expression was significantly decreased in samples obtained from the cortex of TRPM2 knockout mice that had experienced heat stress. SP5 is a transcription factor that is downstream of Wnt signaling (17, 19), but the function of SP5 in cortical neurogenesis during hyperthermia has not yet been identified.

(A) The volcano plot indicates differentially expressed genes. The red dots represent up-regulated genes, while the green dots represent down-regulated genes. SP5 is one of the notably down-regulated genes. (B and C) SP5 knockdown results in an abnormal cellular distribution during heat stress. The bar graph shows the population of GFP+ cells in the CP, IZ, and VZ/SVZ (n = 6 embryos from four different mothers). Scale bar, 50 m. (D) Western blot results showing the change in the expression of TRPM2, total -catenin, phosphorylated -catenin, SP5, TUJ1, PH3, and PCNA during heat stress in TRPM2 knockout embryos. Heat stress was applied from E14.5 to E16.5 for 2 hours per day. -Actin was used as the control (n = 3). (E) TRPM2 knockout in vivo during hyperthermia increases GSK3 activity (n = 3). (F) The suppression of TRPM2 in NSCs during heat stress intensifies GSK3 activity (n = 3). (G) Calmodulin (CAM) interacts with GSK3 in hyperthermia (n = 3). (H) Western blot analysis showing changes in the expression levels of TRPM2, total -catenin, phosphorylated -catenin, and SP5 between the brains of room temperature and hyperthermia-exposed embryonic mice. -Actin was used as the loading control (n = 3). (I and J) The intracellular calcium ion concentration increases upon exposure to 38C. After neural stem cells were isolated from the E12.5 cortex cultured at 37C or 38C overnight, they were incubated for 30 min with Fluo-3, and the intracellular calcium fluorescence was quantified with a confocal LSM780 microscope. The graph shows the relative Fluo-3 intensity (n = 30). Scale bar, 15 m. (K) Calcium concentration reduction is caused by TRPM2 knockdown in hyperthermia. NSCs isolated from the E12.5 cortex were infected with a control or TRPM2-shRNA plasmid (red)packaged lentivirus. After 6 hours, the cells were cultured at 38C overnight; then, the calcium concentration was measured (n = 3). Scale bar, 5 m. (L) Western blots showing the expression levels of Flag, total -catenin, and phosphorylated -catenin in primary NSCs with constitutively expressing CAM in hyperthermia conditions. -Actin was used as a control (n = 3). The data are shown as means SEM; two-tailed Students t tests; ***P < 0.001 versus the indicated group.

To investigate the function of SP5 in embryonic brain development, we first stained brain slices with a specific fluorescent antibody against SP5. The in vitro results showed that SP5 was expressed in the nuclei of primary mouse NSCs and was colocalized with progenitor markers, such as NESTIN and SOX2 (fig. S9G). Consistently, SP5 was expressed in vivo in NESTIN-positive NSCs in the VZ/SVZ of the E13.5 cortex (fig. S9H). Furthermore, shRNAs targeting SP5 were constructed, and they effectively silenced the expression of SP5 (fig. S10A). In addition, samples from heat stressexposed mice in which the expression of SP5 was silenced showed an increased number of GFP-positive cells in the CP and a decreased number of GFP-positive cells located in the VZ/SVZ (Fig. 4, B and C). However, the redistribution of GFP-positive cells was not obvious in control mice from mothers that had been housed at room temperature (fig. S10, F and G). Immunostaining for KI67 also showed that fewer GFP+KI67+ cells were observed in the VZ/SVZ in SP5 knockdown mice that had been exposed to heat stress (fig. S10, B and C). In addition, we also found that the percentage of TUJ1-positive cells was obviously increased in neural progenitors that had been infected with an SP5 shRNApackaged lentivirus and had been exposed to hyperthermia (fig. S10, D and E). Overall, these data confirm that SP5 acts downstream of TRPM2 to modulate neurogenesis during heat stress.

To further confirm and elucidate the specific mechanisms by which TRPM2 exerts its effect on NPC proliferation in hyperthermia, we monitored the relative mRNA levels of SP5 and several molecular markers associated with proliferation. Transcription analysis revealed that -catenin mRNA levels were reduced by 40% in TRPM2 knockout NPCs from mice exposed to hyperthermia, while the levels of REST, Hes5, SOX2, CyclinD1, Foxg1, and Olig2 were unchanged (fig. S9C). These findings suggest that -catenin may work together with TRPM2 to regulate embryonic neurogenesis during heat stress. To compare the transcription results to translational outcome, we conducted Western blot analysis. Protein was obtained from E16 cortical tissue from TRPM2 knockout and wild-type mice that were housed at 38C for 2 hours per day from E14.5 to E16.5. Western blot analysis showed an obvious reduction in SP5 and -catenin expression levels. We also found that the phosphorylation levels of -catenin were augmented in TRPM2 knockout mice exposed to hyperthermia. In addition, decreases in expression of the proliferative markers PH3 and PCNA (proliferating cell nuclear antigen) and an increase in the expression of the neuronal marker TUJ1 in TRPM2 knockout mice clarified the role of TRPM2 in embryonic neurogenesis in hyperthermia (Fig. 4D). We obtained similar results in TRPM2 knockdown or TRPM2 overexpression primary NSCs exposed to 38C (fig. S9, E and F). In TRPM2 knockdown NPCs, immunostaining for total -catenin verified that its expression was reduced during heat stress (fig. S10, H and I). We did not observe such an obvious change under room temperature conditions (fig. S6J). Intrigued by the altered phosphorylation levels of -catenin in TRPM2 knockout mice exposed to hyperthermia, we tested the activity of glycogen synthase kinase 3 (GSK3), which is a serine/threonine kinase associated with -catenin phosphorylation. On the basis of the fact that GSK3 activity requires the autophosphorylation of Tyr216 (30), we evaluated protein levels and protein modifications. In TRPM2 knockout mice exposed to hyperthermia, we observed an obvious increase in Tyr216 phosphorylation, suggesting that TRPM2 may negatively regulate GSK3 activity (Fig. 4, E and F). The constitutive overexpression of TRPM2 during hyperthermia intensifies GSK3 activity (fig. S10K). In addition, Western blot analysis showed an increase in the expression of TRPM2, total -catenin, and SP5 and a decrease in the phosphorylation of -catenin (Fig. 4H). Together, these findings suggest that TRPM2 may modulate SP5 transcription by inhibiting the phosphorylation of -catenin and activating -catenin expression.

Intracellular calcium signaling plays key roles in neural development, including neuronal plasticity, neuronal survival, and neurogenesis (31). Studies have shown that intracellular calcium affects the -catenin pathway (32). To further investigate the mechanisms by which TRPM2 plays a role in activating -catenin expression, we measured the calcium ion concentration in NSCs using a confocal microscope and a calcium-sensitive dye. We observed that, when the cells were cultured at 38C overnight, the intracellular calcium levels were significantly increased (Fig. 4, I and J). However, when cells were transfected with the TRPM2-sh1 plasmid with red fluorescent protein (RFP), intracellular calcium decreased (Fig. 4K), suggesting that TRPM2 modulates intracellular calcium. Calmodulin (CAM) is a target of calcium ions within the cell, and once bound to calcium ions, CAM is activated and serves as part of the calcium signal transduction pathway by modulating interactions with various target proteins (33). In our study, we found that CAM interacted with GSK3 (Fig. 4G), and Western blotting showed that phosphorylated -catenin levels were reduced, while total -catenin expression was slightly increased when CAM was overexpressed during heat stress (Fig. 4L). Therefore, these findings suggest that thermal stimuli activate TRPM2, which increases intracellular calcium. Calcium ions can then bind to CAM, thus inhibiting the levels of phosphorylated -catenin and simultaneously activating the expression of -catenin.

On the basis of these results, we suggest that -catenin may enter the nucleus, bind to the SP5 promoter, and modulate the expression level of SP5 during heat stress. To test this hypothesis, we used a luciferase plasmid containing 2 kb of the SP5 promoter and measured luciferase activity (Fig. 5A). We also generated a vector that overexpressed -catenin with a hemagglutinin (HA) tag and characterized its efficiency by Western blotting (fig. S10J). At 39C, we observed more than twofold increase in luciferase activity in cells treated with the -catenin vector compared with cells treated with the empty vector, demonstrating that -catenin binds to the SP5 promoter to exert its function (Fig. 5A). To further determine the specific binding site, we used a chromatin immunoprecipitation (ChIP) assay (Fig. 5B). At 39C, in cells in which -catenin was constitutively expressed, the binding of -catenin 0.5 kb from the SP5 promoter increased, and binding decreased as the distance to the transcription start site increased (Fig. 5B). These differences were not observed at 37C (Fig. 5B). In addition, we analyzed the promoters of other -catenin target genes, such as Axin2 and CyclinD1, in hyperthermia and observed that there was almost no binding of -catenin (fig. S10, L and M), suggesting specificity for SP5.

(A) Flow chart of the luciferase assay in which the SP5 promoter was cloned into the psiCHECK-2 vector. (A) 293FT cells were transfected with an empty vector or a -cateninexpressing vector. Both groups were cotransfected with an SP5 promotercontaining psiCHECK-2 vector and cultured at 39C. After 36 hours of transfection, the relative luciferase activity was quantified and is shown in the bar graph (n = 4). (B) Four pairs of primers were designed for 0.5, 1, and 2 kb from the SP5 transcription start sites and SP5 CDS for ChIP analysis. (B) NPCs cultured in vitro at 39C were infected with a -cateninHAcontaining lentivirus and then pulled down using immunoglobulin G (IgG) or HA-incubated magnetic beads. The relative amount of SP5 promoter was detected via ChIP and real-time PCR and is shown in the bar graph (n = 3). (B) NPCs cultured in vitro at 37C were infected with a -cateninHAcontaining lentivirus and then pulled down with IgG- or HA-incubated magnetic beads. The relative amount of SP5 promoter was determined by ChIP and real-time PCR and is shown in the bar graph (n = 3). (C to F) SP5 overexpression rescues the cortical neurogenesis defects evoked by TRPM2 knockdown (C and D) or knockout (E and F) in hyperthermia. After electroporation (E13.5) and heat stress (E14.5 to E16.5), E16.5 brain slices were stained with anti-TUJ1 antibody. The bar graphs show the percentage of TUJ1+GFP+ cells relative to the total number of GFP+ cells (n = 6 embryos from four different mothers). Scale bars, 50 m. (G) Working model of TRPM2 function in modulating cortical neurogenesis during heat stress. TRPM2 during heat stress increases calcium influx, which inhibits the phosphorylation of -catenin and induces -catenin enrichment on the SP5 promoter, thereby promoting NPC proliferation. The data are shown as means SEM; two-tailed Students t tests; *P < 0.05, **P < 0.01, and ***P < 0.001 versus the indicated group.

To decipher the connection between TRPM2 and SP5 in neurogenesis during heat stress, we performed rescue experiments. We observed that the constitutive expression of SP5 increased the cell populations residing in the VZ/SVZ and ameliorated the irregularity of both the distribution and percentage of GFP+ TUJ1+ cells caused by TRPM2 knockdown (Fig. 5, C and D) and knockout (Fig. 5, E and F) during heat stress in vivo. Therefore, these data demonstrate that SP5 acts downstream of TRPM2 to modulate early cortical development in hyperthermia. Together, our data supported the notion that, during heat stress, TRPM2 increases SP5 levels via the stabilization of -catenin enrichment on the SP5 promoter, thus enhancing NPC proliferation (Fig. 5G).

Cortical neurogenesis is a very sophisticated process that is strictly controlled by a great deal of signaling molecules. If any step of this process goes wrong, abnormal brain functions, and thus neurodevelopmental disorders, result (34). Temperature homeostasis is essential for embryo survival, and heat stress disturbs numerous aspects of fetal development and brain function (35). TRPM2, which has been recently identified as a heat activation protein, plays an important role in the heat response. TRPM2 is also a calcium-permeable channel in the plasma membrane, and a growing body of evidence has shown that calcium signaling heavily affects neural progenitor proliferation during embryonic neurogenesis (10, 36). However, no details as to whether or how TRPM2 affects brain neural development under conditions of heat exist. Here, we used TRPM2 shRNA and knockout mice to investigate the specific functions of TRPM2 in NPC proliferation and differentiation, cortical neuronal morphology, and the mechanisms guiding embryonic neurogenesis under hyperthermic conditions.

In our study, we first confirmed the thermal sensitivity of TRPM2 and then observed that TRPM2 is expressed in NSCs. When expressed during heat stress, TRPM2 augments NPCs in the E15.5 cerebral cortex, providing clues regarding its effect on neurogenesis during hyperthermia. Furthermore, we found that heat stress changes cellular distribution and facilitates NSC proliferation. Previous studies have shown that at room temperature, TRPM2 loss of function leads to increased axonal growth to promote neuronal differentiation (37). Here, we demonstrated that TRPM2 can exert its function earlier, specifically at E13.5, and that during heat stress, the loss of TRPM2 has a more powerful effect on facilitating cortical neurogenesis. However, at room temperature, the phenotype is not obvious. Our data indicate that TRPM2 deficiency in hyperthermia results in a change in cell distribution and proliferation defects with a sharp drop in the NSC pool. We also found that the depletion of TRPM2 during heat stress increases cell cycle exit and premature cell terminal mitosis, ultimately promoting neurons to a more differentiated state. Both proliferation defects and abnormalities in neuronal morphogenesis lead to severe brain illness, such as autism and schizophrenia (38, 39). In addition, we were able to eliminate the influence of cell migration and apoptosis during hyperthermia by knocking out TRPM2. However, why the TRPM2 knockdown phenotype observed during heat stress is more obvious than the phenotype observed under room temperature conditions still needs to be explored.

To investigate the mechanisms underlying the unique phenotype caused by the loss of TRPM2 and hyperthermia, we searched for downstream targets using RNA-seq analysis and found that SP5 expression was decreased upon TRPM2 knockout and hyperthermia. SP5 is a member of the SP1 family of transcription factors, but its function in embryonic brain development is still unclear.

Our research shows that SP5 is abundant in NPCs and that, under conditions of heat, TRPM2 deficiency inhibits SP5 expression from E13.5 to E16.5. This leads to a decrease in the number of GFP-positive cells residing in the VZ/SVZ and results in the promotion of neuronal differentiation. To further decipher how TRPM2 enhances SP5 expression in hyperthermia, we analyzed some signaling molecules and found that total -catenin expression was significantly down-regulated, while the phosphorylation of -catenin was obviously increased upon TRPM2 deficiency and heat stress. -Catenin, which functions in canonical Wnt signaling, is abundant in NSCs and contributes to the modulation of NSC expansion (15). However, specific mechanisms of the protein are not entirely clear. Previous studies have indicated that Wnt/-catenin is associated with intracellular Ca+ (32). Given that TRPM2 is a calcium-permeable channel, we investigated calcium ions during heat stress, and our data showed a decrease in intracellular Ca+ levels upon TRPM2 knockout. Moreover, the overexpression of CAM inhibited the phosphorylation of -catenin and augmented the expression of -catenin. Using a luciferase and ChIP assay, we also confirmed that -catenin binds to the SP5 promoter during heat stress. Unexpectedly, our results indicated that the overexpression of SP5 ameliorates the defects evoked by TRPM2 loss of function in hyperthermia. However, in the future, the current hyperthermia model needs to be further improved because in human, such as fever response, immune system component may take part in this model.

In summary, our findings uncovered a novel mechanism by which TRPM2, a thermo-sensor protein, governs embryonic neural development during heat stress. Furthermore, the neuronal morphology abnormalities in TRPM2 knockout mice exposed to hyperthermia during embryonic development may provide novel insights into neurological disorders associated with heat stress, including maternal fever, and reveal new strategies for treatment. In terms of the mechanism, we found that when TRPM2 is activated by heat and intracellular calcium binds to CAM, the phosphorylation of -catenin is inhibited. Accumulating -catenin then binds to the SP5 promoter to ultimately enhance NPC proliferation.

Pregnant ICR mice were obtained from Vital River Laboratories. All animal-related experiments were conducted in line with the Animal Care and Use Committee of Institute of Zoology, Chinese Academy of Sciences. TRPM2 knockout mice used in our experiments were generated and kept in the Experiment Animal Center of Institute of Zoology, Chinese Academy of Sciences.

To construct shRNA-expressing plasmids, the oligonucleotides were inserted into the pSicoR-GFP (Addgene, 12093) or pSicoR-TOMATO lentiviral vector. The sequences of shRNAs targeting TRPM2 were as follows: TRPM2-sh1, AACCTTAGCTCATGGATTC (13); TRPM2-sh2, GACCTTCTCATTTGGGCCGTT (Sigma). The sequences of SP5 shRNAs were as follows: SP5-sh1, GGATTCAAAGGATTTGCTTTC (17); SP5-sh2, CCCGTCGGACTTTGCACAG (Sigma). The full-length complementary DNAs (cDNAs) of mouse TRPM2, SP5, and CAM were obtained via PCR and cloned into the Flag-tagged pCDH (System Biosciences, CD511B-1) vector for lentivirus packaging.

Human 293FT cells and mouse N2A cells were cultured in Dulbeccos modified Eagles medium (DMEM) that contained 1% penicillin-streptomycin (PS) and 10% fetal bovine serum (FBS). Mouse cortical NPCs from E12.5 mouse cortex were maintained in proliferation medium, which contained 50% DMEM/F12 (Invitrogen), 50% neural basal medium (Invitrogen), epidermal growth factor (EGF) (10 ng/ml), basic fibroblast growth factor (bFGF) (10 ng/ml) (Invitrogen), 1% PS, and 2% B27 (without vitamin A).

The production of lentivirus was obtained by transfecting the core and packaging plasmids into 293FT cells using GenEscort I (Nanjing Wisegen Biotechnology). The virus was gathered at 24, 48, and 72 hours after changing the medium 6 hours after transfection. The primary NSCs for Western blot and immunofluorescence were seeded in 6- or 24-well plates, which were coated with laminin (Invitrogen) and poly-d-lysine (Sigma) (both 10 g/ml) in advance. Twenty-four hours later, half of the medium was changed with proliferation medium without PS. Lentivirus was then added to each well and maintained for 8 hours. Meanwhile, to improve the infection efficiency, polybrene (2 g/ml) was mixed into the medium. Forty-eight hours later, to induce a differentiation state, the medium was displaced with low-glucose DMEM (Gibco) supplemented with 1% FBS (Invitrogen), 1% PS, and 2% B27 (with vitamin A).

IUE was performed as reported previously (40). In brief, pregnant ICR or C57 mice were deeply anesthetized with pentobarbital sodium (70 mg/kg). Subsequently, the recombinant knockdown or overexpression plasmids with a final concentration of 1500 ng/l were mixed with an enhanced GFP plasmid at a ratio of 3:1. In addition, 0.02% Fast Green was included as a tracer. Then, the mixture was microinjected into the lateral ventricle of the embryonic mouse brains using glass capillaries. Five electric pulses of 40 V (950-ms interval; 50-ms duration) were generated using an electroporator (Manual BTX ECM 830) and platinum electrodes. After IUE, the brains of the embryos were collected at E16.5, E17.5, or P1 for further phenotype analysis.

For neural progenitor proliferation analysis, BrdU (50 mg/kg) was injected 2 hours before brain harvesting at E16.5. For neuronal birth dating, BrdU (50 mg/kg) was administrated to pregnant mice at E14.5. For cell cycle exit analysis, BrdU (100 mg/kg) was administrated to pregnant mice 24 hours before brain collection at E15.5.

For heat stress experiments, mice were maintained in their cages, and the cages were put in a large temperature-controlled incubator set at 38 or 39C for 2 hours each day for 2 or 3 days.

Brain slices or cells cultured in vitro were washed with phosphate-buffered saline (PBS) for 5 min, fixed in 4% paraformaldehyde for 20 min, and blocked in 5% bovine serum albumin (Sangon)/PBS containing 1% Triton X-100 (1% PBST) for 1 hour. Subsequently, the primary antibody was diluted with 1% PBST, added, and then incubated at 4C overnight. The following day, the samples to be visualized were rinsed with PBS three times and incubated with secondary antibodies at room temperature for nearly 1.5 hours. The primary antibodies used for immunofluorescence are listed here: rabbit anti-TRPM2 (1:1000; Bethyl Laboratories), rabbit anti-TUJ1 (1:1000; Sigma), mouse anti-BrdU (1:1000; Millipore), rat anti-BrdU (1:1000; Abcam), rabbit anti-CUX1 (1:100; Santa Cruz Biotechnology), rabbit anticleaved caspase-3 (1:1000; Cell Signaling Technology), rabbit anti-PAX6 (1:1000; Millipore), mouse anti-MAP2 (1:1000; Millipore), mouse anti-NESTIN (1:1000; Millipore), rabbit anti-KI67 (1:1000; Abcam), mouse anti-SATB2 (1:300; Abcam), rabbit anti-SP5 (1:200; Bioss), rabbit anti-TBR2 (1:1000; Abcam), rat anti-CTIP2 (1:1000; Abcam), and mouse anti-SOX2 (1:1000; R&D Systems). Secondary antibodies applied were conjugates of Alexa Fluor Cy3, Cy5, or 488 (1:1000; Jackson ImmunoResearch). 4,6-Diamidino-2-phenylindole (DAPI) (2 mg/ml; Sigma) was used for nuclear staining.

Protein was extracted from brain cortical tissue of mouse or cultured cells by lysing with radioimmunoprecipitation assay buffer (Solarbio), with 10 mM phenylmethylsulfonyl fluoride and a protease inhibitor cocktail (Sigma, P8340). Samples were then ultrasonicated and centrifuged at approximately 12,000 rpm for 15 min at 4C. Subsequently, the supernatants were gathered, and protein concentrations were determined using a BCA kit (Thermo Scientific). Next, similar amounts of protein samples were size-separated by 6 to 12% SDSpolyacrylamide gel electrophoresis gels and shifted onto nitrocellulose membranes (Whatman) making use of a semidry transfer system (Bio-Rad). We run multiple gels and normalized to a control. The primary antibodies applied in the Western blots are listed here: rabbit anti-TRPM2 (1:1000; Bethyl Laboratories and Novus Biologicals), rabbit antitotal -catenin (1:1000; Cell Signaling Technology), rabbit antiP-catenin (S33/S37/T41) (1:1000; Cell Signaling Technology), rabbit antinonP-catenin (S33/S37/T41) (1:1000; Cell Signaling Technology), rabbit anti-PCNA (1:500; Santa Cruz Biotechnology), rabbit anti-TUJ1 (1:1000; Bioward), rabbit anti-SP5 (1:500; Bioss), rabbit anti-PH3 (1:1000; Cell Signaling Technology), rabbit anti-TBR2 (1:1000; Abcam), and rabbit anti-Flag (1:1000; Sigma). Secondary antibodies were 800CW Donkey Anti-Mouse IgG (immunoglobulin G), 800CW Donkey Anti-Rabbit, 680LT Donkey Anti-Mouse IgG, and 680LT Donkey Anti-Rabbit IgG (LI-COR Biosciences). Odyssey v3.0 software was used to scan and quantify Western blot bands.

Total RNA was obtained using TRIzol (Invitrogen, 15596) following the manufacturers directions. Reverse transcription of mRNA to first-strand cDNA was achieved using the FastQuant RT Kit (TIANGEN). Quantitative RT-PCR was conducted using the SYBR Green PCR Kit (Takara) with an ABI PRISM 7500 sequence detector system (Applied Biosystems). All reactions were repeated in triplicate for each sample. The primer sequences used for RT-PCR are listed here: TRPM2, AAGGAACACAGACAATGCCTG (forward) and AGGATGGTCTTGTGGTTCGC; TRPM3, TACACCAAAGTCAGCTCCCTG (forward) and GGCCTCTCGTGGAAAGTCAT (reverse); TRPM7, CCCAGCCAAGTTGCAAAAGT (forward) and CTACAGCTTTCTGCTTGCACC (reverse); TRPM8, GTCCTGTGACACCGACTCTG (forward) and CAGTGAGAATCCACGCACCT (reverse); TRPV1, CTCGGATGAATCTGAGCCCC (forward) and GACAACAGAGCTGACGGTGA (reverse); TRPV3, AGTGCTTATAGCAGCGGGTG (forward) and CGTGCAGGATGTTGTTTCCC (reverse); TRPV4, TCCTCTTCTCTTTCCCCGGT (forward) and GTGCCGTAGTCGAACAAGGA (reverse); ANO1, CGAGAAGTACTCGACGCTCC (forward) and TAGTCCACCTTCCGTTTGCC (reverse); TRPA1, TCTGCATATTGCCCTGCACA (forward) and ACTTTCATGCACTCGGGGAG (reverse); BDNF, TACCTGGATGCCGCAAACAT (forward) and GCCTTTGGATACCGGGACTT (reverse); PACAP, ATGACCATGTGTAGCGGAGC (forward) and CGCTGGATAGTAAAGGGCGT (reverse); -catenin, ATCACTGAGCCTGCCATCTG (forward) and GTTGCCACGCCTTCATTC (reverse) (39); SP5, GGCAAGGTGTACGGCAAAAC (forward) and CATAGGTCCCGCGGATTCTC (reverse); REST, GTGCGAACTCACACAGGAGA (forward) and AAGAGGTTTAGGCCCGTTGT (reverse) (41); Hes5, CGCATCAACAGCAGCATAGAG (forward) and TGGAAGTGGTAAAGCAGCTTC (reverse); CyclinD1, GCCTACAGCCCTGTTACCTG (forward) and ATTTCATCCCTACCGCTGTG (reverse) (42); SOX2, GCACATGAACGGCTGGAGCAACG (forward) and TGCTGCGAGTAGGACATGCTGTAGG (reverse); Foxg1, GGCAAGGGCAACTACTGGAT (forward) and CGTGGTCCCGTTGTAACTCA (reverse); Olig2, GGTGTCTAGTCGCCCATCG (forward) and AGATGACTTGAAGCCACCGC (reverse); -actin, GGTGGGAATGGGTCAGAAGG (forward) and AGGAAGAGGATGCGCCAGTG (reverse).

ChIP was performed as follows. To generate the cross-link, in vitro cultured cells were processed with 1% formaldehyde and maintained at room temperature for 10 min. Subsequently, 2.5 M glycine was then added to terminate the cross-link reaction. After washing three times with sterile PBS, the cells were gathered in lysis buffer. Next, the lysates were incubated with 15 l of Dynabeads Protein G (Invitrogen), which was incubated at least 12 hours with 1 g of specific antibody at 4C before incubation. After washing three times with low- and high-salt buffer, the DNA-protein-antibody complex was incubated overnight at 65C to open the covalent bond. Genomic DNA was then obtained using the TIANamp Genomic DNA Kit (TIANGEN Biotech) for subsequent real-time PCR analysis. The primer sequences applied for SP5 promoter are listed here: SP5-CDS, GGCAAGGTGTACGGCAAAAC (forward) and CATAGGTCCCGCGGATTCTC (reverse); SP5-0.5k, AGCTCGGTTGTGGGAGGAA (forward) and TCTTGACAAGCCGCTTGAAG (reverse); SP5-1k, ACCGCTGCCAGGTCGCT (forward) and AGGCAGGGTCAGTCGGC (reverse); SP5-2k, GCTGGGAACCGGTGGCT (forward) and TTGGGAGTATCCTCTTTGGC (reverse); CyclinD1-CDS, TCAAGACGGAGGAGACCTGT (forward) and TTCCGCATGGATGGCACAAT (reverse); CyclinD1-0.5k, CAGCCTCTTCCTCCACTTCC (forward) and AAGCCCTTCTGGAGTCAAGC (reverse); CyclinD1-1k, TCTACTTTAACAATGGTTTGCTGT (forward) and ACAGGGGAAGTCTTGAGAAGG (reverse); CyclinD1-2k, TCAGACATGGCCCTAAACCT (forward) and CATGACCAGTGTGACTCAAAGC (reverse); Axin2-CDS, CAAATGCAAAAGCCACCCGA (forward) and TGCATTCCGTTTTGGCAAGG (reverse); Axin2-0.5k, TACACACTCCCACCACCGA (forward) and ATCTCTGCTCACAGTTTCGGA (reverse); Axin2-1k, TGGAATGCAGTCTATCCCAGC (forward) and AGAAGCTGTGTGACCAGCCA (reverse); Axin2-2k, CCACCACAATCATCCTGGGT (forward) and TCAACTTTAAGGACTGAGGCCA (reverse).

Global transcriptome analysis was conducted by Annoroad Company. Total RNA samples were first tested for quality and quantity using an Agilent 2100 bioanalyzer. After building the library, high-throughput sequencing was used with the Illumina HiSeq 2500 platform. Our RNA-Seq data were deposited in the Gene Expression Omnibus database with the accession number of GSE113954.

The CRISPR-Cas9 system was used to construct TRPM2 knockout mice. During the process, two guide RNAs (gRNAs) (gRNA5, GCCAGTTCTTCTCCGGTCCAAGG; gRNA3, TATTGCTTCGTCGGAGATTGGGG) were used to cleave the whole genome sequence of TRPM2 to approximately 800 base pairs (bp). The genotyping primers designed for the TRPM2 knockout mice were TRPM2-2717F GAAGGGAAACGGGTGGATGT and TRPM2-4007R GCAGGTCTCCTCAACCAGTC. The length of PCR product was 511 or 1291 bp for TRPM2 knockout mice or wild-type mice, respectively.

Apoptotic cells were identified with immunostaining using an antibody targeting cleaved caspase-3.

293FT cells (4 104) were seeded into a 24-well plate and transfected with 0.5 g of luciferase plasmid containing an SP5 promoter and empty vector or with 0.5 g of luciferase plasmid containing an SP5 promoter and -catenin overexpression vector, using GenEscort I (Nanjing Wisegen Biotechnology). Thirty-six hours after transfection, luciferase activity was measured using the Dual-Luciferase Assay System (Promega) and GloMax 96 Microplate Luminometer (Promega).

All images were taken with a Zeiss LSM780 confocal microscope and analyzed with Photoshop CS6 (Adobe). ZEN 2010 was applied for image acquisition and processing. Brightness or expression quantity was measured using ImageJ when needed.

All statistical analyses in this study were performed and plots were generated using GraphPad Prism7.0 software. Results are represented as means SEM. Two-tailed Students t tests and one-way analysis of variance (ANOVA) were used for statistical comparisons. The differences were regarded as statistically significant with *P < 0.05, **P < 0.01, and ***P < 0.001. n.s. means not significant.

Acknowledgments: Funding: This work was supported by grants obtained from the National Science Fund for Distinguished Young Scholars (81825006), CAS Strategic Priority Research Program (XDA16010301), National Key R&D Program of China (2019YFA0110300 and 2018YFA0108402), National Science Foundation of China (31730033 and 31621004), and K. C. Wong Education Foundation. Author contributions: Y.L. performed the experiments, analyzed data, and wrote the manuscript. J.J. conceived and supervised this project. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. Additional data related to this paper may be requested from the authors.

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Deficiency of TRPM2 leads to embryonic neurogenesis defects in hyperthermia - Science Advances

Girl, 3, dies in her parents arms on New Years Day after leukaemia battle – The Sun

A LITTLE girl who won the backing of thousands of strangers online died of leukaemia on New Year's Day.

Esme Handley was just three years old when she passed away.

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The adorable tot was diagnosed with blood cancer at just 22 months, after developing a bruise while she was on a family holiday in Greece.

Her parents Rebecca and Will broke the heartbreaking news on their daughter's Facebook Page, named Esme Lionheart after her love of lions.

They said: If you look to the sky tonight you will see a star shining brighter than any other.

Our darling girl went onwards with her journey at midday today.

"She was peaceful and in our arms and knew how ridiculously adored she was.

Esme Grace Angela Handley 13.08.2016 - 01.01.2020.

Rebecca, 38, and Will, 43, faced a battle to try and save their only daughter following her diagnosis.

They discovered she had the high risk acute myeloid leukaemia during a family trip to Greece before which Esme fell.

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When a bruise that developed shortly afterwards failed to disappear, the couple Googled Esme's symptoms and became concerned.

She was taken to hospital in Greece where the diagnosis was confirmed.

Esme was given a stem cell transplant in September 2018 alongside three rounds of chemotherapy but after six months the leukaemia returned in the tots bone marrow.

If you look to the sky tonight you will see a star shining brighter than any other. Our darling girl went onwards with her journey at midday today.

The family were not eligible for a second transplant on the NHS and were faced with raising 500,000 privately for the urgent treatment.

In November, her parents admitted that Esme could no longer expect to be cured and said their baby had simply had enough.

They said: Since diagnosis we have often spoken about a metaphorical 'sealed envelope' that contains Esme's fate.

"Yesterday we got to open that envelope and it was not what we had hoped.

The leukaemia is out of control and there is nothing more which can be done.

We have spoken with every single, leading paediatric consultant globally, tried all available drugs (some of which arent even licensed in kids), explored a ridiculous amount of supplements and complementary medicines, had healing circles far and wide sending prayers.....

But its not been enough. We dont get to keep our baby.

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And to be perfectly honest, even if there was something else they could come up with, right now, Im not sure we would be able to pursue it.

"Its very clear to see that Esme has simply had enough....and who could blame her?

Esme thrives when shes outdoors but all she has known for 18 months is hospitals. The treatment she has had wouldnt be tolerated by most adults.

She has been continually pumped full of drugs; had hundreds of blood transfusions; successfully come through one stem cell transplant; had surgery for three Hickman lines into her heart; had numerous tubes shoved up her nose and drops in her eyes, suffered countless horrendous infections including a type of pneumonia three times; lost her hair; lost her fingernails; vomited daily, had her skin break down, crack, be burnt from chemo; nearly died from sepsis; almost died from anaphylaxis; been blue-lighted to PICU after having a seizure which temporarily left her in a vegetative state thanks to a fungal brain infection....and it goes on.

Whilst we would do absolutely anything for her, ANYTHING, Im also not sure how much more we can tolerate either.

A month later, they described the heartbreaking cocktail of pain management Esme had to bear to soften her ever-increasing suffering".

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At the time, her parents posted: It's now three weeks to the day that we learnt that Esme's story will not have the happy ending we've all prayed for, three long weeks in which we've had to contemplate the unthinkable and bear witness to Esme's ever-increasing suffering.

In the first couple of weeks one of the biggest difficulties was accepting that the team's goal was no longer to cure but just to manage pain.

This sounds obvious but you suddenly find yourself inexplicably sad that the nurses are no longer asking you for Esme's heart rate or temperature every few hours.

At one point I even found myself crying when I bumped into another child being wheeled to theatre and realised Esme will never have another general anaesthetic.

Instead, getting ahead of Esme's pain has become a full-time occupation for us and the team, and Ezzie is now on an ever-escalating daily mix of paracetamol, topical morphine, oxycodone, ketamine and, most recently, methadone.

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The psychology team here warn against reading adult meanings into our children's innocent words but it's difficult not to tear up when Esme tells us repeatedly I don't think my bottom's ever gonna get better, it's the hurtiest bottom in the whole world ....or My arm/leg/back/headache is killing me.

They also described how Esme had been bedridden for three months and would never walk again.

But the tot had her own Christmas tree and was even taken out of the Royal Marsden Hospital over the festive period to see Christmas lights in Morden before a screening of Frozen 2 at Everyman Esher.

SIGNS OF LEUKAEMIA EVERY PARENT NEEDS TO KNOW

LEUKAEMIA is a type of blood cancer, some forms of which are more common in children.

There are no specific signs or symptoms which would allow for a doctor to make a diagnosis without lab tests.

In all types of leukaemia symptoms are more commonly caused by a lack of normal blood cells than by the presence of abnormal white cells.

As the bone marrow becomes full of leukaemia cells, it is unable to produce the large numbers of normal blood cells which the body needs.

Thiscan lead to:

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Now Will and Rebecca, of West Norwood, south London, hope to donate money in Esmes name.

They have already raised 425,000 on GoFundMe.

Rebecca said in November: When we began fundraising we were punchy with our target to ensure we had enough for a self-funded transplant and said that whatever remained would go to the CCLG, the UK's leading kids cancer charity.

Given how desperately poor the funding is into paediatric AML research, we feel even more strongly about this now.

So a large chunk of the cash we have remaining (after spending some on novel drugs and supportive care) will be donated to AML research to try and spare future families the pain and anguish we have experienced.

To donate in memory of Esme, visit her GoFundMe page here.

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Girl, 3, dies in her parents arms on New Years Day after leukaemia battle - The Sun

Red Shamrock: Fight never over, even when kids beat cancer – Iowa City Press-Citizen

Dick Hakes, Taking Liberties Published 10:13 a.m. CT Jan. 2, 2020 | Updated 11:21 a.m. CT Jan. 2, 2020

Finn is shown with his father, John Hall, during the nearly 18-month period about ten years ago in which the boy battled cancer through chemotherapy, radiation and immunotherapy.(Photo: Special to the Press-Citizen)

John Hall of Iowa City recalls how it all started in early 2009.

Before his son Finns third birthday, the boy started spiking fevers. Then he complained of stiff legs. Then a black eye showed up that would not go away.

A CT scan eventually produced what John said was the worst call I ever received.

A tumor on Finns cheek was traced to another on his adrenal gland. It was stage four neuroblastoma. He had about a 35% to 40% chance to survive it.

What followed was almost 18 months of aggressive treatment at University of Iowa Hospitals and Clinics (UIHC) chemotherapy sessions, two surgeries, two stem cell transplants, radiation and finally immunotherapy, which had just been green-lighted for broader use nationwide.

Those months became a heartbreakingly painful, sleepless, worrisome and all-encompassing ordeal for the entire family especially for Finn.

A recent photo of Finn Hall shows a smiling, cancer-free kid wearing a T-shirt promoting the Red Shamrock Foundation started by his father, John Hall.(Photo: Special to the Press-Citizen)

It worked, however, and the cancer disappeared.

We threw the cancer playbook at him, John said. I give the immunotherapy regiment credit for saving his life. It took care of the remaining cancer cells in the end. He was the first patient to complete that regiment at the U.

But it wasnt long after Finn came home and the family worked to return to a normal life that a new troubling reality emerged that led John to form the Red Shamrock Foundation.

Our only focus was getting past the cancer, he said. But now, because he had received so many harsh treatments at such a young age, we realized Finn would need some type of specialized care for the rest of his life.

Finn is 13 now and leading a pretty normal life, but because chemotherapy killed the seeds of his adult teeth, he still has all of his baby teeth, which will have to be replaced when he becomes an adult. He also has some minor hearing loss, kidney damage and must take growth hormones.

But it could have been a lot worse, John said. After cancer, kids sometimes have serious cognitive issues or chronic heart disease or secondary cancers due to the chemo and radiation. Some lose a limb or an organ.

He says he was amazed to learn that 95% of young cancer survivors can expect some type of serious chronic health condition by the time they reach age 45.

It hit me that people need to know about this, he said. I wanted to raise awareness that youre not done just because you have left the hospital.

John formed his nonprofit in 2011 with the help of friends who could handle obtaining legal status and help design a professional logo and web pages. A shamrock logo with a red heart seemed appropriate, given the familys Irish heritage.

The Red Shamrock Foundation mission is simple: Raise public awareness of the unique needs of kids who survive cancer, plus support survivorship programs and post-cancer research in Iowa.

As detailed on its website at http://www.redshamrock.org, the group sponsors three large fundraising events each year: A trail race at Regina High School in the spring, a golf outing in Mount Vernon in June and a Red Tie Gala during Childhood Cancer Awareness Month in September. Other money comes from donations and an online store operated through One Mission Fund Raising of Mount Vernon.

John Hall of Iowa City founded the Red Shamrock Foundation to raise public awareness that children who survive cancer will often face other medical challenges related to their treatment for the rest of their lives.(Photo: Dick Hakes/Special to the Press-Citizen)

As its director, John meets monthly with his board and often promotes the cause by speaking to civic groups. He says securing about $25,000 from the local 100 Men Who Careorganization a few years ago helped raise our profile in the community. All involved with Red Shamrock are unpaid volunteers.

In the past few years, the nonprofit has donated $110,000 for research projects at the university and through Passport for Care to assemble data on the health and needs of post-cancer patients.

Red Shamrock also provides educational materials for parents and teachers on how to explain cancer to kids and what to expect when a cancer survivor returns to class.

Finn was out of preschool for a year and a half, going through all he went through, then suddenly found himself back at preschool surrounded by 30 active, screaming kids, John said. The teachers were good, but Id drop him off and hed just sit in the middle of the room and cry. It took maybe six months for him to get comfortable again.

Dick Hakes(Photo: Special to the Press-Citizen)

The next step for Red Shamrock, John says, is to try to find a national partner and increase its scope beyond Iowa. A dedicated Team Red Shamrock group that participates in running events in other locations may be the catalyst for this, he said.

He has high praise for UIHC and points out that it now operates a survivorship clinic directed by Dr. Bill Terry, a pediatric oncologist.

The bottom line is to raise awareness of what pediatric cancer patients must face after theyve already fought the battle of their lives,John said. People need to understand that their fight is never over.

John is an Elkader native, a University of Iowa graduate in anthropology and a 30-year resident of Iowa City who works for Coldwell Banker in real estate. His wife Monica is a nurse at UIHC. Finn has an older brother, Sully.

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Red Shamrock: Fight never over, even when kids beat cancer - Iowa City Press-Citizen

International peace prize awarded to FNI executive director | Saginaw – Browncitybanner

By ohtadmin | on January 01, 2020

SAGINAW Gary L. Dunbar, PhD, executive director of the Field Neurosciences Institute (FNI), part of Ascension St. Marys, was recently presented with the Gusi Peace Prize International Award. Dr. Dunbar traveled to Manila, Philippines to accept this honor at the Gusi Peace Prize International 20th Annual Awards Night.

The Gusi Peace Prize award is given by the Gusi Peace Prize Foundation to recognize individuals and organizations who contribute to global peace and progress through a wide variety of fields. Dr. Dunbar was one of 18 international recipients selected for the award and chosen because of his global contributions in both the educational and the research domains of neuroscience. Similarly, his outstanding contributions in research, especially for developing new strategies for treating damage to the nervous system, including transplantation of genetically altered adult stem cells as a potential therapy for injury to the brain and spinal cord as well as neurological deficits in Huntingtons, Parkinsons and Alzheimers diseases, has earned international recognition and a prominent leadership role in the American Society for Neural Therapy and Repair.

I felt both honored and humbled to be selected for the Gusi Peace Prize, especially after meeting and hearing, first-hand, what the other 2019 Gusi Laureates have accomplished in the context of helping others, which was humbling to me, said Dr. Dunbar. The prize is given to those whose efforts have provided significant improvements to the lives of others through education, research, politics, and/or the arts, along with a strong commitment to humanitarian commitments, so I felt deeply honored to be included in this group of people.

Dr. Dunbar has been the executive director for FNI since 2008.

The Gusi Peace Prize was founded by the Honorable Ambassador Barry Gusi, to honor and continue the work of his late father, Captain Gemeniano Javier Gusi, who fought against Japanese oppression during World War II and later championed human rights in the Philippines. For 20 years, the Gusi Peace Prize Award has been awarded to prominent individuals from all over the world who have made significant contributions to the betterment of humankind.

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International peace prize awarded to FNI executive director | Saginaw - Browncitybanner

Conway supports man fighting rare double diagnosis of MS, ALS – THV11.com KTHV

CONWAY, Ark. A Conway man has spent many years living with Multiple Sclerosis, but this year he was also diagnosed with ALS, or Lou Gherigs Disease.

For the Nobles family, every day with their father, Greg, is a treasured moment.

"I was first diagnosed 16 years ago with MS," said Greg Nobles.

Life has been a challenge since, but it was this January when his health began to decline severely.

Greg lost all mobility. After getting treated for his symptoms and not seeing a difference is when neurologists confirmed Greg also suffers from ALS, a nervous system disease weakening muscles with no cure.

"Doctors have never seen a patient with both before, said Bailey Smith, Gregs daughter. Being diagnosed MS first, we got 15 good years with him versus the ALS now.

RELATED: A final fundraiser for the man who boosted the ice bucket challenge

Once active and known as one of the best hairstylist in town, Gregs now homebound hoping for relief from the pain he endures.

"My husband passed away from ALS in 2004, so I know the journey they are going on, said Diana Kirkland, a hair client of Gregs.

Kirkland knew she needed to do something for the Nobles.

She owns Legacy Acres in Conway.

This week shes preparing her space for a fundraising event Friday night to raise money so Greg can receive stem cell therapy, an expensive procedure done in Mexico, but one that will reduce his discomfort.

"If I could just get some mobility back, it's worth it, said Greg.

Greg has already received two rounds of stem cell therapy.

RELATED: Arkansas man raises money for charity by streaming 24-hour gaming session

Fortunately, hes starting to notice relief in his left leg.

But with ALS, hes given 3 to 5 years to live, but with a community coming together to help, his family hopes that love and support will give them more time with him.

"It means everything to us, said Smith. To continue to get stem cells for us, my babies to see my dad keep fighting.

Greg Nobles Fundraising Dinner is at Legacy Acres, 100 Legacy Acres Drive, in Conway on Friday night beginning at 6 p.m.

Everyone is invited. The event will have live music, a silent auction, catered food provided by Catering By S and I.

There will also be a donation table set up for a stem cell therapy fund.

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Conway supports man fighting rare double diagnosis of MS, ALS - THV11.com KTHV

Predicting shifts in technology and science can be tricky, but here’s what could happen in 2020 – inews

NewsScienceIt's likely to be an eventful year for gene editing and stem cell research

Tuesday, 31st December 2019, 7:03 am

Gene editing

It was suggested that prime editing has the potential to mend about 89 per cent of the 75,000 harmful genetic mutations that lie behind hereditary diseases, such as cystic fibrosis and the blood disorder sickle cell disease.

3D rockets

Major strides were made in rocket science last year, with a number of 3D-printed engine prototypes being successfully tested.

This year, Relativity Space, a California startup, hopes to go one better. It plans to become the first company in the world to print almost an entire rocket 95 per cent of it which it hopes will be ready for launching at the end of the year.

Only a handful of components, such as electronics and circuit boards, will have to be made by hand for the craft, named Teran 1.

If successful, the launch will pave the way for numerous 3D-printed rockets to be sent into space much more quickly and cheaply than they are at the moment.

Stem cells

Scientists are working around the world on trials of promising stem-cell treatments for blindness, spinal cord injury, heart failure, diabetes, Parkinsons disease and lung cancer, and some of the first results should become available later in the year.

Embryonic, or pluripotent, stem cells have extraordinary medical potential because they can develop into any of the 220 or so mature, specialised cells of the body, from insulin-making pancreatic cells to the nerve cells of the brain.

Mars

The 2020 mission of the ExoMars programme, if all goes to plan, will deliver a European rover and a Russian platform to the surface of Mars.

ExoMars will be the first mission to combine the capability to move across the surface of the planet and to the ability study Mars at depth. Meanwhile, Nasa will launch a separate mission to study the habitability of Mars and prepare for future human missions.

Smart needle

They have demonstrated that the technique works in the laboratory, and are in the early stages of a three-year clinical trial to test it in living people.

The researchers have focused on lymphoma so far, but said that they are hopeful the technique could also be used further down the line to diagnose other forms of the disease, such as breast and prostate cancer.

At the moment, diagnosing lymphoma can be an invasive process that involves a surgical biopsy followed by a nerve-racking wait for the result, which can often take two weeks or more.

The smart needle uses light to pinpoint cancerous tissues almost instantaneously.

Using a technique called Raman spectroscopy, the optical biopsy measures the light scattered by tissues when a laser contained in the needle is shone on it.

The light scatters differently from healthy tissues than it does from diseased tissues, meaning that doctors can make their diagnosis straight away.

Japan's robotic Olympics

Japan has pledged to make the 2020 Tokyo Olympics and Paralympics the most innovative in history by deploying robots to assist spectators and staff during the games.

The Human Support Robot (HSR) and Delivery Support Robot (DSR), developed by Toyota, will be used in tandem.

HSR, a one-armed robot about 3ft (1m) tall, can hold objects, pick things up off the ground and reach up high. It can move by itself, or can be controlled remotely as it attends to people in wheelchairs, guiding them to their seats and helping to carry items.

When people order food or drinks using a tablet computer, DSR will transport the items in a basket and HSR will then deliver them directly to guests.

Waste to Energy

The worlds largest waste-to-energy plant is set to open on the outskirts of Shenzhen, China. The new plant is made to handle 5000 tons of waste per day, burning the waste to generate electricity.

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Predicting shifts in technology and science can be tricky, but here's what could happen in 2020 - inews

None of these four beaming children would be alive today if a stranger had not given blood – The Sun

HERE are four beaming children none of whom would be alive today if a stranger had not given blood.

Each of their lives was saved by a transfusion, yet many of us never find the time to sign up to become a donor.

NHS Blood and Transplant is encouraging readers to make giving blood one of their New Year resolutions.

It is particularly calling on men to donate because their blood can be more suitable for treating patients. The families of these four survivors tell Lynsey Hope their stories.

'We worry every day he might suffer a serious bleed'

GEORGE CLAXTON lives with mum Faye, 36, a salon owner, dad Luke, 34, an electrical engineer, and sister Ella, six, in Huntingdon, Cambridgeshire. Faye says:

"When George was 14 months old he was diagnosed with a rare platelet disorder.

"The condition doesnt have a name but it means his blood cant clot properly.

"Tiny blood cells called platelets in his blood are the wrong shape and size and he has to take medication daily.

"We found out he had it after he suffered a virus and came out with a rash.

"Its called petechiae but can look similar to meningitis.

"We took George to A&E at Hinchingbrooke Hospital near Huntington. Blood tests came back negative and we were sent home.

"But two weeks later, we were back again.

"We were referred to specialists at Addenbrookes Hospital in Cambridge, who discovered George was bleeding under the skin.

"Its been hard to accept its a lifelong condition and not something that can be cured.

"There have been two occasions when George has needed a transfusion.

"The first was in June 2016.

"Doctors had to perform a transfusion before he had a tooth extracted to make sure he didnt bleed too much during the procedure.

"In May last year, he fell over in the school playground and hurt his elbow, causing a bleed in his joint.

"George has been brave from the start.

"He loves football but we worry every day he may have an accident that causes a serious bleed.

"He can also have spontaneous bleeds.

"His little sister was also diagnosed with the condition.

"She hasnt needed a transfusion yet but she may do and that is devastating for us as parents.

"Were so grateful to people who donate blood.

"It can enable people to live."

'Just an hour of your time could be the gift of a lifetime'

JESSICA FAY lives in Burnley with her mum Laura Bell, 32, dad Adam Fay, 39, who is a carer, and her brothers Kyle, 14, Denver, 13, Jayden, eight and Taylor, six. Laura, a full-time mum, says:

"Jessica was diagnosed with meningitis and septicaemia when she was 15 weeks old.

"I took her to the GP when she started feeling unwell.

"She wasnt feeding and had a high temperature.

"The doctor was concerned and said I must take her straight to hospital.

"Within hours of arriving at A&E, Jessica stopped breathing and was put on life-support.

"The disease had taken over her body and, one by one, her organs were shutting down.

"There was only one option. A blood transfusion might dilute the infection in her blood and give her a chance.

"There was a risk her body would reject the blood and we knew if that happened wed lose her.

"Incredibly though, that blood transfusion saved her life.

"She remained in intensive care for a week and, after three weeks, she came home.

"Jessica was being given so many treatments in those terrible few weeks that I didnt think too much about where the blood had come from.

"But when she recovered, I realised that without it she would not have made it. Unfortunately, Jessica suffered some brain damage because of what happened.

"She has social communication disorder and finds it hard to make friends.

"She is an incredible child and Im so grateful to whoever it was that took the time to donate blood for her.

"If someone hadnt donated that blood, Jessica would be dead.

"She has done all she can to give something back.

"Shes raised thousands of pounds for charity by organising events in the community.

"I would urge anyone who can to give blood it is just an hour of your time but it could be the gift of a lifetime to a child like Jessica.'

'Our baby can be in a lot of pain due to the disease'

EZRAH PINK was born with sickle cell disease. He lives with his mum Serena, 30, who looks after an office building, and her partner Courtney, 32, an estate agent, in Beckenham, Kent. Serena says:

"We knew before Ezrah was born that he might have sickle cell disease.

"When I was pregnant, doctors found out I carried a gene.

"About a week after he was born, they confirmed Ezrah had the disease.

"People with sickle cell produce unusual C-shaped red blood cells, meaning they sometimes get stuck or block blood vessels. At first, he didnt show any symptoms.

"He started having problems when he was around 11 months.

"Since then its been a whirlwind. We have been in and out of hospital.

"Id never known anyone with sickle cell so its been a tough learning curve and the condition will affect him for life.

"Ezrah has already had four blood transfusions.

"When one of his odd-shaped blood cells gets stuck, it causes what is called a sickle cell crisis and this can cause a great deal of pain.

"Ezrah is also prone to serious infections.

"He takes penicillin every day as well as folic acid to boost his immunity.

"Id never given blood before having Ezrah.

"It wasnt until the first time doctors told me that they were going to have to transfuse him that I realised how important it was.

"Im pregnant now so I cant do it myself just yet, but as soon as I can sign up, I will.

"You never know whats round the corner.

"Its not until it happens to someone close to you that you realise how important it is."

'While recovering he's had more than 50 transfusions'

JACOB JESSEL lives with mum Emma Riley, 47, an NHS project manager, dad Nick Jessel, 44, a sales manager, and brother Sam, eight, near Grimsby, Lincs. Emma says:

"Jacob was diagnosed with a rare blood disorder when he was seven.

"We went on a camping trip and he was bitten by a mosquito. A huge bruise came out, which covered most of his forearm.

"Our GP took blood and told us his blood count was dangerously low and that we had to take him straight to hospital.

"It was a huge shock and it was obvious to us that doctors feared he had leukaemia.

"Jacob was given an emergency bone marrow biopsy at Sheffield Childrens Hospital and we were told he probably had cancer.

"Waiting for the results of the biopsy was horrible.

"We were relieved when the tests came back negative, but more tests revealed he had an incurable bone marrow disorder.

"Doctors said hed need a transplant, which he had in 2017.

"There was only one match on the register at the time so we went ahead with it. But sadly that didnt work.

"About a month later, he had a transplant using his dads stem cells, which has been effective.

"While recovering, he had more than 50 blood transfusions.

"He now attends a follow-up clinic every four to six months to make sure his blood keeps working properly.

"Before Jacob was ill, I was one of these people who never got round to giving blood.

"I thought it was a good thing to do but I kept putting it off.

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"But every time a unit of blood was delivered to the ward for Jacob, I felt incredibly relieved that someone, somewhere, had taken the time to give blood.

"Now I give blood regularly. Its a good feeling to know you are helping someone else.

"I know how grateful the recipient will 7 be. Its the best gift anyone can give."

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None of these four beaming children would be alive today if a stranger had not given blood - The Sun

2019: the year gene therapy came of age – Breitbart

Washington (AFP) In the summer, a mother in Nashville with a seemingly incurable genetic disorder finally found an end to her suffering by editing her genome.

Victoria Grays recovery from sickle cell disease, which had caused her painful seizures, came in a year of breakthroughs in one of the hottest areas of medical research gene therapy.

I have hoped for a cure since I was about 11, the 34-year-old told AFP in an email.

Since I received the new cells, I have been able to enjoy more time with my family without worrying about pain or an out-of-the-blue emergency.

Over several weeks, Grays blood was drawn so doctors could get to the cause of her illness stem cells from her bone marrow that were making deformed red blood cells.

The stem cells were sent to a Scottish laboratory, where their DNA was modified using Crispr/Cas9 pronounced Crisper a new tool informally known as molecular scissors.

The genetically edited cells were transfused back into Grays veins and bone marrow. A month later, she was producing normal blood cells.

Medics warn that caution is necessary but, theoretically, she has been cured.

This is one patient. This is early results. We need to see how it works out in other patients, said her doctor, Haydar Frangoul, at the Sarah Cannon Research Institute in Nashville.

But these results are really exciting.

In Germany, a 19-year-old woman was treated with a similar method for a different blood disease, beta thalassemia. She had previously needed 16 blood transfusions per year.

Nine months later, she is completely free of that burden.

For decades, the DNA of living organisms such as corn and salmon has been modified.

But Crispr, invented in 2012, made gene editing more widely accessible. It is much simpler than preceding technology, cheaper and easy to use in small labs.

The technique has given new impetus to the perennial debate over the wisdom of humanity manipulating life itself.

Its all developing very quickly, said French geneticist Emmanuelle Charpentier, one of Crisprs inventors and the cofounder of Crispr Therapeutics, the biotech company conducting the clinical trials involving Gray and the German patient.

Cures

Crispr is the latest breakthrough in a year of great strides in gene therapy, a medical adventure started three decades ago, when the first TV telethons were raising money for children with muscular dystrophy.

Scientists practising the technique insert a normal gene into cells containing a defective gene.

It does the work the original could not such as making normal red blood cells, in Victorias case, or making tumor-killing super white blood cells for a cancer patient.

Crispr goes even further: instead of adding a gene, the tool edits the genome itself.

After decades of research and clinical trials on a genetic fix to genetic disorders, 2019 saw a historic milestone: approval to bring to market the first gene therapies for a neuromuscular disease in the US and a blood disease in the European Union.

They join several other gene therapies bringing the total to eight approved in recent years to treat certain cancers and an inherited blindness.

Serge Braun, the scientific director of the French Muscular Dystrophy Association, sees 2019 as a turning point that will lead to a medical revolution.

Twenty-five, 30 years, thats the time it had to take, he told AFP from Paris.

It took a generation for gene therapy to become a reality. Now, its only going to go faster.

Just outside Washington, at the National Institutes of Health (NIH), researchers are also celebrating a breakthrough period.

We have hit an inflection point, said Carrie Wolinetz, NIHs associate director for science policy.

These therapies are exorbitantly expensive, however, costing up to $2 million meaning patients face grueling negotiations with their insurance companies.

They also involve a complex regimen of procedures that are only available in wealthy countries.

Gray spent months in hospital getting blood drawn, undergoing chemotherapy, having edited stem cells reintroduced via transfusion and fighting a general infection.

You cannot do this in a community hospital close to home, said her doctor.

However, the number of approved gene therapies will increase to about 40 by 2022, according to MIT researchers.

They will mostly target cancers and diseases that affect muscles, the eyes and the nervous system.

Bioterrorism

Another problem with Crispr is that its relative simplicity has triggered the imaginations of rogue practitioners who dont necessarily share the medical ethics of Western medicine.

Last year in China, scientist He Jiankui triggered an international scandal and his excommunication from the scientific community when he used Crispr to createwhat he called thefirst gene-edited humans.

The biophysicist said he had altered the DNA of human embryos that became twin girls Lulu and Nana.

His goal was to create a mutation that would prevent the girls from contracting HIV, even though there was no specific reason to put them through the process.

That technology is not safe, said Kiran Musunuru, a genetics professor at the University of Pennsylvania, explaining that the Crispr scissors often cut next to the targeted gene, causing unexpected mutations.

Its very easy to do if you dont care about the consequences, Musunuru added.

Despite the ethical pitfalls, restraint seems mainly to have prevailed so far.

The community is keeping a close eye on Russia, where biologist Denis Rebrikov has said he wants to use Crispr to help deaf parents have children without the disability.

There is also the temptation to genetically edit entire animal species malaria-causing mosquitoes in Burkina Faso or mice hosting ticks that carry Lyme disease in the US.

The researchers in charge of those projects are advancing carefully, however, fully aware of the unpredictability of chain reactions on the ecosystem.

Charpentier doesnt believe in the more dystopian scenarios predicted for gene therapy, including American biohackers injecting themselves with Crispr technology bought online.

Not everyone is a biologist or scientist, she said.

And the possibility of military hijacking to create soldier-killing viruses or bacteria that would ravage enemies crops?

Charpentier thinks that technology generally tends to be used for the better.

Im a bacteriologist weve been talking about bioterrorism for years, she said.Nothing has ever happened.

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2019: the year gene therapy came of age - Breitbart

On the Road: A year to remember – WCBI

On the Road with Steve Hartman: A Year to Remember will air on CBSN on January 1 at 8 p.m., 11 p.m. and 2 a.m. ET. Its also available on the free CBS News app. And dont missOn the Road for the holidays with Steve Hartman.

Every week, Steve Hartman travels America, talking to regular people and looking for the extraordinary in the ordinary. Theyre from all walks of life, but all are inspiring. Its amazing the impact kids have, especially.

11-year-old expands her charity granting wishes

At a nursing home in northwest, Arkansas, theres a gem named Ruby. As CBS News first reported in March, 11-year-old Ruby Chitsey likes to go to work with her mom, Amanda, a nurse who travels to several nursing homes in the area. It was on one of those visits that Ruby started going up to residents with her notepad and asking, If you could have any three things, what would they be?

Ruby said she was mostly curious about what theyd say. Instead of asking for money or a fancy car, they asked for electric razors, new shoes, Vienna sausage and other basic items. So she started a charity calledThree Wishes for Rubys Residents. Now, while her mom is caring for patients, Ruby goes room to room, jots down wishes and sets out to grant them.

Since first sharing her story, Ruby has helped start chapters of her charity in other states. She speaks to advocates for the aging, and of course, she is still very much hands-on.

Texas school bus driver gives more than just a ride

Bus driver Curtis Jenkins loves delivering little ones to Lake Highlands Elementary in Dallas, Texas. To show his love and understanding, Curtis gives presents throughout the year and each one is personally selected with that child in mind.

Over the year he has bought these kids bikes, backpacks, handed out cards on birthdays and even turkeys at Thanksgiving. He has spent thousands out of his own pocket. And yet, if you ask the kids what they like most about Curtis, the gifts dont even come up.

He really cares about us, one child said.

Since that story first aired in May, Curtis has gotten a big promotion. He still sees the kids all the time, but hes no longer a bus driver. Instead, hes been granted the title of Relationship Consultant, teaching staff all across the district how they can form bonds with students like he did.

Toddler contributes to making a sign language town

At the far end of Islington Road in Newton, Massachusetts, lives a little girl near and dear to the neighborhood. Samantha Savitz, 2, is deaf, but boy does she love to talk to anyone who knows sign language. If someone cant, that makes her just a little sad.

Her desire for engagement has been painfully obvious to everyone in the neighborhood. Whenever they see her on a walk or in her yard, they find themselves at a frustrating loss for words. So on their own, Sams neighbors got together, hired an instructor and are now fully immersed in an American Sign Language class.

Sometimes it feels like America is losing its sense of community. But then you hear about a place like this, where the village it takes to raise a child is alive and well and here to remind us that what makes a good neighborhood is nothing more than good neighbors. Since Steve visited Newton in February, Sam celebrated her 3rd birthday, and the class size has doubled to 40 students.

Middle school teacher takes in student battling kidney disease

Good educators can make all the difference. At AXL Academy in Aurora, Colorado, middle school math teacher Finn Lanning has gone above and beyond for one student, 13-year-old Damien.

One day, Damien told Finn he wasnt coming back to school. He learned Damien was in foster care, had kidney disease and because social services couldnt find a foster family willing and able to meet his medical needs, Damien had to leave school and move into a hospital. He also needed a transplant, desperately. A lot of times, you cant get a transplant if you dont have a stable home to return to after surgery.

Thats how Finn became a foster parent. He took in Damien, dialysis needs and all, even though prior to that, hed been a confirmed bachelor who delighted in his childlessness. But he decided to adopt Damien.

Because of Finn, Damien got back on the transplant list and got his new kidney. Today, his kidney is doing well and the adoption is almost complete.

97-year-old veteran still hard at work bagging groceries

When you reach a certain age, just getting down to the driveway can feel like a full days work. But for 97-year-old Benny Ficeto of Perth Amboy, New Jersey, overcoming those stairs is just the beginning of his workday. Two days a week, he clocks in for a 4-hour shift as a bag boy at the local Stop & Shop.

Benny used to be warehouse supervisor for a cosmetics company. He supposedly retired back in the 80s, but hes been doing odd jobs ever since because he said he loves a hard days work and always has.

Benny served in the Army Air Force during World War II. He was a gunner on a B-25 Mitchell bomber, flying mostly over northern Africa and Italy. He still approaches his job with that same tireless, warrior-like determination. For example, Benny said hed sooner stack a honeydew on white bread than loaf around on the job.

For Benny, his reason to continue working is to go out and earn, not just a paycheck, but a purpose. And avoid breaks, at all costs.

Cleveland auto mechanic fulfills lifelong dream to become a doctor

If youre having trouble motivating to go back to work or school after the holidays, 48-year-old Carl Allamby might help you with that. He dreamed about becoming a doctor but said growing up, that wasnt always realistic.

We were on welfare. I remember the powdered milk, the government powdered milk, he said.

Because they were so poor, young Carl quickly set aside his professional aspirations and focused instead on becoming the best auto mechanic he could be. Eventually he got his own shop and for 15 years, he did OK. Until one day, he decided to step it up a notch.

In 2006, Carl enrolled at Ursuline College. His intention was to get a business degree to help him manage his repair shop. But there was one hurdle: a biology class. He couldnt understand why he had to take it and he put it off as long as possible.

Im a business major, what do I care about biology. And in the first hour of being there, I knew what I wanted to do with the rest of my life. All those ideas of wanting to be a doctor just came rushing back, Carl said.

Now the car doctor is now a doctor-doctor. Last spring, he graduated from Northeast Ohio Medical University and today hes an emergency medical resident at Cleveland Clinic Akron General.

Once housebound, young boy gets his chance to see the world

Aside from immediate family, no one was allowed in the house to see 3-year-old Quinn Waters of Weymouth, Massachusetts. More importantly, Quinn wasnt allowed out. Parents Jarlath and Tara Waters say Quinns natural immunity was temporarily wiped out after he got a stem cell transplant to treat his brain cancer.

Fortunately, the kid is a fighter, and as we first reported a few months ago, he kept a mostly positive attitude. But it still stunk. There would be days when Quinn was literally pounding to get out.

Unfortunately, staring out a window is a poor substitute for walking out the door. Quinns connection to the outside world has been limited to whoever passes by, which hasnt been all that limiting, actually. The neighbors started showing up to entertain Quinn, the police caught wind of it and pretty soon topnotch performers were just showing up on Quinns front lawn.

One minute it could be a dog parade, the next, a team of Irish step dancers. Everyone brought together by word of mouth and a will to help Quinn get better. Which his parents said, did start happening.

Its the positive energy from all these people that we believe has gotten him through his sickness, you know. You can never repay, you know, just maybe pay it forward, Jarlath said.

After this story first aired in August, things got even better for Quinn. By Halloween, doctors had released him from home confinement and free to be a kid again, he rushed outdoors at warp speed. He also got to drop the puck at a Boston Bruins game, feel the sand between his toes at the Massachusetts shore, and even watch the Macys Thanksgiving Day Parade pass by.

To contact On the Road, or to send us a story idea, email us: OnTheRoad@cbsnews.com.

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On the Road: A year to remember - WCBI

The health stories we won’t forget and what 2020 holds – nation.co.ke

Which stories made the headlines and why?By EUNICE OMOLLOMore by this AuthorBy NASIBO KABALE More by this Author2daysago

It has been a year marked by milestones from new vaccines for deadly diseases to a law that meant life for recipients of organs. But, along the way there were hitches that threatened crucial programmes.

In September, Kenya became the third African country to start the routine immunisation of children against malaria using the worlds first vaccine. Kenya was picked by the World Health Organisation (WHO) for the malaria drive to vaccinate 360,000 children per year. The drive has already taken place in eight counties in Western Kenya and all endemic counties in a pilot that will end in 2021.

Mosquirix, the brand name for RTS, S vaccine, triggers the immune system to defend itself against the first stages of the disease shortly after a malaria parasite enters the bloodstream through a mosquito bite.

Children in the eight counties will receive four doses of RTS, S at six, seven, nine and 24 months in addition to standard vaccines.

Kenya also became the 16th African country to introduce the cervical cancer vaccine. The Human Papillomavirus (HPV) vaccine works by preparing the body to fight the germs that cause the infections.

The vaccination rollout in Kenya targets 766,207 girls aged 10 and will cost the government Sh467 per dose for the same vaccine that costs more than Sh10,000 in high-income countries.

The vaccine is most effective when given to girls before they are sexually active and could be exposed to the virus.

Two doses of the vaccine are given to the girls six months apart at about 9,000 public, private and faith-based centres countrywide.

Signed into law in June and published in July, the 2017 Health Act operationalises and ensures important constitutional provisions for health services. Before its enactment, organ transplant donation procedures were not clear. With the law in place, patients have hope as it now allows people to donate their organs to others or for research when they die.

The law also gives weight to some of the more aspirational health language in the Constitution. It seeks to safeguard access to healthcare services for vulnerable groups by making clear the governments obligation to provide these for women, the elderly, the disabled, children, youth and members of minority or marginalised communities.

The Act also instructs the national government to expand free maternity care and childhood immunisation by mandating funding for these services through ring-fenced, conditional grants grants earmarked for a specific activity and must meet certain conditions. Employers and all formal workplaces will also be required to provide breastfeeding facilities to promote the well-being of infants, and health facilities must provide emergency care or face punitive measures.

For the second time since 1994, renowned population and development scholars, scientists and researchers met in Nairobi in November for the International Conference on Population and Development (ICPD). The 179 governments present at the Nairobi meet reaffirmed their commitment to the goals they set in Cairo 25 years ago to end the unmet need of child spacing, to end preventable maternal deaths, to end sexual and gender-based violence and to end early marriages and other harmful practices against women and girls.

Countries agreed to bring down to zero cases of maternal and infant deaths, and gender-based violence by 2030.

For instance, as a way of reducing unsafe abortions, Kenya is expected to reinstate post-abortion care guidelines which had been revoked.

The aims of the ICPD are rooted in the sacred value and dignity of every human life.

President Uhuru Kenyatta directed the Health ministry to establish a task force to assess the status of mental health in the country.

The team is expected to come up with new policies to address growing concerns about mental health among Kenyans.

The teams findings will help the government in allocation of resources to mental health.

The task force is expected to assess the mental health systems including the legal, policy and administrative environment to identify areas that may benefit from reform for optimal delivery.

In addition, the team will consider the changing societal dynamics and associated threats to mental well-being such as substance abuse, gambling, sexual and gender-based violence, cyber bullying, child abuse and neglect.

Health Cabinet Secretary Sicily Kariuki said the implementation of the national mental health policy will create a sustainable response mechanism, including resource mobilisation, training and creation of awareness.

Four counties have this year taken part in the Universal Health Coverage (UHC) pilot which kicked off in December last year.

Residents of Isiolo, Machakos, Kisumu and Nyeri have been receiving next to free medical services as part of the programme ahead of the nationwide roll-out.

About 80 per cent of the money for the pilot has gone into the purchase of drugs and basic medical equipment, the Health ministry said, with additional Sh800 million allocated to each of the regions for complicated cases that would be referred outside the participating counties.

The pilot has had its fair share of troubles especially in Kisumu where doctors have been on strike for the three months. Counties have also had to grapple with drug shortage.

The ministrys approach to achieving UHC has been through removal of user fees at all public hospitals, including level four and five facilities and ensuring commodity security through the Kenya Medical Supplies Authority (Kemsa). Kemsa, however, has been unable to deliver 100 per cent of the required drugs.

The hospitals have also experienced a surge in numbers where the county data shows a 300 per cent increase, which could mean trust in the facilities or easier access to healthcare given the low costs.

A deal that would see 100 Cuban doctors come to Kenya was sealed in 2018. Under the agreement, 47 would work as specialists and 53 family physicians would be deployed to the counties.

At the same time, Kenya secured space for its 50 doctors to study in Cuba, famed for its world-class healthcare system.

The programme was meant to instill much-needed skills in the ailing sector.

However, this year, the suicide of a Kenyan doctor who was sponsored by the government to study family medicine in Cuba exposed the programmes soft underbelly. Kenya Medical Practitioners, Pharmacists and Dentists Union Nairobi Secretary-General, Dr Thuranira Kaugiria, said the doctors who travelled to Cuba were given a raw deal and had on several occasions unsuccessfully sought to air their grievances with the ministry.

Here in the country, two Cuban doctors were kidnapped in Mandera County which led the ministry to reassign 10 medics stationed in border counties to Kenyatta National Hospital, National Spinal Injury Hospital, Mathare Mental Hospital and Kiambu County hospitals.

For the 37 million people who have HIV around the world, the news of a possible cure for the disease was more than welcome.

A London patient with HIV became the second person ever to be free of the virus after a bone marrow transplant, raising hopes of a cure. In 2007, another patient identified as the Berlin patient received a bone-marrow transplant from a donor with natural immunity to the virus.

Timothy Brown, the so-called Berlin patient, who later went public, and the London patient, who does not want to disclose his identity, received stem cells from a donor with a rare genetic mutation of the CCR5 gene, making them HIV-resistant. Brown has been virus-free ever since. The London patient stopped taking the medication 18 months ago and there is no sign of a return of HIV.

The procedure in itself can never be offered as a cure for HIV infection because stem cell transplants carry risks.

An expos by NTV investigative team revealed how supermarkets are using toxic chemicals to make their meat look fresher for longer.

The expos, which involved laboratory tests on meat samples which revealed that supermarkets use chemical as a food preservative to keep the food fresh for longer.

The documentary highlighted how rotten the system is. The fact that more than one supermarket was doing it means that it is an open secret which led the Ministry of Health to conduct a random survey on the safety of meat sold in the capital city.

The survey exposed just rotten the system is the results showing that six out of 40 samples collected tested positive to the preservative Sodium Metabisulfite which is harmful in large doses.

All the meat in the affected outlets were destroyed and some outlets were closed.

The year was characterised by adverse weather conditions, with drought being experienced at the start of the year and heavy rainfall at the end.

Just before the start of the short rain in October, between August and October, at least 3.1 million people were projected to be facing acute food insecurity.

The most hit areas were Turkana, Marsabit, Mandera, Wajir, Garissa, Tana River and Baringo counties, according to the Integrated Food Security Phase Classification report.Then came the floods caused by the October-November-December rainfall.

As of December 2019, at least 130 people had been reported dead from the flooding and landslides and more than 17,000 displaced.

Earlier in December, the government announced it had set aside Sh6.1 billion to restore infrastructure damaged by floods.

Blood test for breast cancer

Recent findings by scientists from University of Nottingham in England that a blood test could potentially detect breast cancer at least five years before other symptoms and lumps appear, could just be the answer to the killer disease that claims lives in millions globally.

A more elaborate research on the blood test is set to kick off in 2020. According to the scientists, if all goes well, the test could be in the market within the next five years.

According to the Kenya Medical Research Institute cancer registry, eight out of 10 cancers in the country are detected late due to low awareness of symptoms.

Breast cancer is the second most common type of cancer in the country, with women under 50 accounting for 50 per cent of cases.

The test, which would be much cheaper and easier to conduct than a mammogram, looks for autoantibodies which are produced by the body in reaction to the presence of cancer bodies in the blood. According to WHOs International Agency for Research on Cancer, the global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. One in five men and one in six women worldwide develop cancer during their lifetime, and one in eight men and one in 11 women die from the disease.

These new figures highlight that much remains to be done to address the alarming rise in the cancer burden globally and that prevention has a key role to play, said International Agency for Research on Cancer Director Christopher Wild.

Kenyans countrywide will experience UHC in 2020. This is after a 12-month pilot programme that has been running in the four counties of Nyeri, Machakos, Isiolo and Kisumu. Speaking during the last meeting of the Council of Governors held early this month in Nairobi, chairman Wycliffe Oparanya hinted that counties are ready for the roll out.

But, the national government should find ways to solve the challenges that have been experienced in the four counties, he said.

Speaking to HealthyNation, Cabinet Secretary Sicily Kariuki had said her ministry was ready for the scale up and had outlined the challenges experienced. The lessons we have picked is that once we invest right, once we are consistent and speak to the population, the issue of confidence comes back within the shortest time possible, she said.

The Kenya-Cuba relationship is set to bring in an additional tactical move in the fight against malaria in 2020. The ministry is setting sights on the introduction of malaria bio larvicide method to combat transmission in endemic areas.

Larviciding refers to the regular application of chemical or microbial insecticides to water bodies or water containers to kill the aquatic immature forms of the mosquito (the larvae and pupae).

According to Ms Kariuki, the collaboration with the Cuban government would help Kenya learn how the country eradicated the disease.

In the first quarter of the coming year, we have identified the experts that we will require to bring in and train our own people in collaboration with the experts coming from Cuba.

It is good to note that there is no malaria in Cuba. They got to that stage by applying the technology, which we believe will play a big role in Kenya in the fight against Malaria, she said.

The aim of larviciding is to reduce the adult population of mosquitoes by killing the aquatic immature forms, so that fewer will develop into adults. This should reduce the number of mosquitoes that bite and infect humans with malaria.

Additional reporting by Bernadine Mutanu

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The health stories we won't forget and what 2020 holds - nation.co.ke