BACKGROUND Heightened surveillance of acute febrile illness in China since 2009 has led to the identification of a severe fever with thrombocytopenia syndrome (SFTS) with an unknown cause. Infection with Anaplasma phagocytophilum has been suggested as a cause, but the pathogen has not been detected in most patients on laboratory testing. METHODS We obtained blood samples from patients with the case definition of SFTS in six provinces in China. The blood samples were used to isolate the causal pathogen by inoculation of cell culture and for detection of viral RNA on polymerase-chain-reaction assay. The pathogen was characterized on electron microscopy and nucleic acid sequencing. We used enzyme-linked immunosorbent assay, indirect immunofluorescence assay, and neutralization testing to analyze the level of virus-specific antibody in patients’ serum samples. RESULTS We isolated a novel virus, designated SFTS bunyavirus, from patients who presented with fever, thrombocytopenia, leukocytopenia, and multiorgan dysfunction. RNA sequence analysis revealed that the virus was a newly identified member of the genus phlebovirus in the Bunyaviridae family. Electron-microscopical examination revealed virions with the morphologic characteristics of a bunyavirus. The presence of the virus was confirmed in 171 patients with SFTS from six provinces by detection of viral RNA, specific antibodies to the virus in blood, or both. Serologic assays showed a virus-specific immune response in all 35 pairs of serum samples collected from patients during the acute and convalescent phases of the illness. CONCLUSIONS A novel phlebovirus was identified in patients with a life-threatening illness associated with fever and thrombocytopenia in China. (Funded by the China Mega-Project for Infectious Diseases and others.)

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Cystic fibrosis (CF) is an autosomal recessive disorder, the most common lethal genetic disease in Caucasians. Respiratory disease is the major cause of morbidity and mortality. Indeed, 95% of CF patients die of respiratory failure. Pseudomonas aeruginosa, an opportunistic pathogen, chronically infects the lungs of over 85% of CF patients. It is ineradicable by antibiotics and responsible for airway mucus overproduction that contributes to airway obstruction and death. The molecular mechanisms underlying this pathology are unknown. Here we show that P. aeruginosa activates a c-Src-Ras-MEK1͞2-MAPK-pp90rsk signaling pathway that leads to activation of nuclear factor NF-B (p65͞p50). Activated NF-B binds to a B site in the 5-f lanking region of the MUC2 gene and activates MUC2 mucin transcription. These studies bring new insight into bacterialepithelial interactions and more specifically into the molecular pathogenesis of cystic fibrosis. Understanding these signaling and gene regulatory mechanisms opens up new therapeutic targets for cystic fibrosis.Cystic fibrosis (CF) is the most common lethal genetic disease in the Caucasian population (1). The mutation responsible for the disease is in the gene encoding the cystic fibrosis transmembrane regulator (CFTR), a chloride channel. This mutation gives rise to a chain of events involving chronic bacterial lung infection and mucus overproduction. Although there have been significant clues regarding the link between the mutation and chronic infection (2-4), the nature of the link between the mutation and mucus overproduction is completely unknown.We recently showed that bacterial exoproducts up-regulate epithelial MUC2 mucin transcription (5). This suggests that CF-associated mucin overproduction occurs secondary to lung infection, a sine qua non of advanced disease. The molecular mechanisms underlying mucin induction are unknown. In the present study, we performed experiments to examine these mechanisms. Results showed that Pseudomonas aeruginosa, a common CF pathogen, activates the MUC2 mucin gene transcription by activation of a Src-dependent Ras-MEK1͞2-ERK1͞2-pp90rsk-NF-B pathway. These studies provide insight into bacterial-host epithelial interactions and open up new therapeutic targets for CF. MATERIALS AND METHODSReagents. P. aeruginosa lipopolysaccharide (LPS) from serotype 10 was purchased from Sigma. PP1, PD98059, and caffeic acid phenethyl ester (CAPE) were purchased from Calbiochem.Bacterial Strains and Culture Conditions. The P. aeruginosa strains used in these studies were grown in M9 medium with aeration at 37°C to late logarithmic phase. The broth cultures were then centrifuged at 10,000 rpm in a Sorvall RC5C for 50 min. The supernatants containing bacterial exoproducts were sterilized by passage through a 0.22-m polymer filter (Corning) and were then kept at Ϫ80°C until use. Bacterial culture supernatants were added to epithelial cell culture medium at a 1:4 dilution ratio.Cell Culture. Two MUC2-expressing epithelial cell lines were used in these...

Vitamin D receptor (VDR) plays an essential role in gastrointestinal inflammation. Most investigations have focused on the immune response; however, how bacteria regulate VDR and how VDR modulates the nuclear factor (NF)-B pathway in intestinal epithelial cells remain unexplored. This study investigated the effects of VDR ablation on NF-B activation in intestinal epithelia and the role of enteric bacteria on VDR expression. We found that VDR ؊/؊ mice exhibited a pro-inflammatory bias. After Salmonella infection, VDR ؊/؊ mice had increased bacterial burden and mortality. Serum interleukin-6 in noninfected VDR ؉/؉ mice was undetectable, but was easily detectable in VDR ؊/؊ mice. NF-B p65 formed a complex with VDR in noninfected wild-type mouse intestine. In contrast, deletion of VDR abolished VDR/P65 binding. P65 nuclear translocation occurred in colonic epithelial cells of untreated VDR ؊/؊ mice. VDR deletion also elevated NF-B activity in intestinal epithelia. VDR was localized to the surface epithelia of germ-free mice, but to crypt epithelial cells in conventionalized mice. VDR expression, distribution, transcriptional activity, and target genes were regulated by Salmonella stimulation, independent of 1,25-dihydroxyvitamin D3. Our study demonstrates that commensal and pathogenic bacteria directly regulate colonic epithelial VDR expression and location in vivo. VDR negatively regulates bacterial-induced intestinal NF-B activation and attenuates response to infection. Therefore, VDR is an important contributor to intestinal homeostasis and host protection from bacterial invasion and infection.

An unresolved question in cystic fibrosis (CF) research is how mutations of the CF transmembrane conductance regulator, a Cl ion channel, cause airway mucus obstruction leading to fatal lung disease. Recent evidence has linked the CF transmembrane conductance regulator mutation to the onset and persistence of Pseudomonas aeruginosa infection in the airways, and here we provide evidence directly linking P. aeruginosa infection to mucus overproduction. We show that P. aeruginosa lipopolysaccharide profoundly upregulates transcription of the mucin gene MUC 2 in epithelial cells via inducible enhancer elements and that this effect is blocked by the tyrosine kinase inhibitors genistein and tyrphostin AG 126. These findings improve our understanding of CF pathogenesis and suggest that the attenuation of mucin production by lipopolysaccharide antagonists and tyrosine kinase inhibitors could reduce morbidity and mortality in this disease.

Rationale: Cyclic nucleotide phosphodiesterases (PDEs) through the degradation of cGMP play critical roles in maintaining cardiomyocyte homeostasis. Ca 2؉ /calmodulin (CaM)-activated cGMP-hydrolyzing PDE1 family may play a pivotal role in balancing intracellular Ca 2؉ /CaM and cGMP signaling; however, its function in cardiomyocytes is unknown. Objective: Herein, we investigate the role of Ca 2؉ /CaM-stimulated PDE1 in regulating pathological cardiomyocyte hypertrophy in neonatal and adult rat ventricular myocytes and in the heart in vivo. Methods and Results: Inhibition of PDE1 activity using a PDE1-selective inhibitor, IC86340, or downregulation of PDE1A using siRNA prevented phenylephrine induced pathological myocyte hypertrophy and hypertrophic marker expression in neonatal and adult rat ventricular myocytes. Importantly, administration of the PDE1 inhibitor IC86340 attenuated cardiac hypertrophy induced by chronic isoproterenol infusion in vivo. Both PDE1A and PDE1C mRNA and protein were detected in human hearts; however, PDE1A expression was conserved in rodent hearts. Moreover, PDE1A expression was significantly upregulated in vivo in the heart and myocytes from various pathological hypertrophy animal models and in vitro in isolated neonatal and adult rat ventricular myocytes treated with neurohumoral stimuli such as angiotensin II (Ang II) and isoproterenol. Key Words: phosphodiesterase Ⅲ cGMP Ⅲ cardiomyocyte Ⅲ cardiac hypertrophy C a 2ϩ /calmodulin (CaM)-dependent signaling has been implicated in promoting pathological gene expression involved in hypertrophy and heart failure through the activation of Ca 2ϩ /CaM-dependent kinases, phosphatases, and ion channels. 1 Recently, a number of intrinsic negative regulators of cardiac growth have been identified which activate cGMPdependent signaling. 2 Stimulation of cGMP synthesis through genetic upregulation of natriuretic peptide receptor (guanylyl cyclase-A) prevents neurohumoral or pressure overload induced hypertrophy, 3 whereas disruption of cGMP synthesis results in enhanced hypertrophy and deteriorated cardiac function. 4 Likewise, chronic inhibition of cGMP metabolism by a cyclic nucleotide phosphodiesterase (PDE)5 inhibitor prevents and reverses pressure overload induced cardiac hypertrophy. 5 PDEs, by degrading cAMP and/or cGMP, regulate the amplitude, duration, and compartmentation of intracellular cyclic nucleotide signaling. PDEs constitute a superfamily of enzymes grouped into 11 broad families based on their distinct kinetic, regulatory, and inhibitory properties. PDE family members are also differentially expressed in various tissues and present within distinct subcellular domains. Together, these properties enable PDE enzymes to regulate the spatiotemporal, intracellular cAMP and cGMP gradients in response to various external stimuli. At least 5 PDE families, PDE1 to -5, have been reported in the heart, of which PDE1 and PDE5 are most likely responsible for cGMP hydrolysis. Logically, alteration of cGMP-hydrolyzing PDE expression/ activity...

Inflammation is a hallmark of many diseases, such as atherosclerosis, chronic obstructive pulmonary disease, arthritis, infectious diseases, and cancer. Although steroids and cyclooxygenase inhibitors are effective antiinflammatory therapeutical agents, they may cause serious side effects. Therefore, developing unique antiinflammatory agents without significant adverse effects is urgently needed. Vinpocetine, a derivative of the alkaloid vincamine, has long been used for cerebrovascular disorders and cognitive impairment. Its role in inhibiting inflammation, however, remains unexplored. Here, we show that vinpocetine acts as an antiinflammatory agent in vitro and in vivo. In particular, vinpocetine inhibits TNF-α-induced NF-κB activation and the subsequent induction of proinflammatory mediators in multiple cell types, including vascular smooth muscle cells, endothelial cells, macrophages, and epithelial cells. We also show that vinpocetine inhibits monocyte adhesion and chemotaxis, which are critical processes during inflammation. Moreover, vinpocetine potently inhibits TNF-α-or LPS-induced up-regulation of proinflammatory mediators, including TNF-α, IL-1β, and macrophage inflammatory protein-2, and decreases interstitial infiltration of polymorphonuclear leukocytes in a mouse model of TNF-α-or LPSinduced lung inflammation. Interestingly, vinpocetine inhibits NF-κB-dependent inflammatory responses by directly targeting IKK, independent of its well-known inhibitory effects on phosphodiesterase and Ca 2+ regulation. These studies thus identify vinpocetine as a unique antiinflammatory agent that may be repositioned for the treatment of many inflammatory diseases.vinpocetine | inflammation | NF-κB | IKK

Toll-like receptor 2 (TLR2) plays an important role in host defense against bacterial pathogens. Activation of TLR2 signaling not only induces the activation of innate immunity and instructs the development of the acquired immunity but also leads to the detrimental inflammatory responses in inflammatory and infectious diseases. To avoid detrimental inflammatory responses, TLR2 signaling must be tightly regulated. In contrast to the relative known positive regulation of TLR2 signaling, its negative regulation, however, is largely unknown. In addition the distal signaling components that link TLR2 to its downstream signaling pathways have yet to be further defined. In the present study we have provided direct evidence for the negative regulation of TLR2 signaling by the tumor suppressor cylindromatosis (CYLD). We showed that activation of TLR2 signaling by TLR2 ligands including peptidoglycan (PGN), MALP-2, and Pam3CSK4 induces activation of IKKs-IB␣ and MKK3/6-p38 pathways not only by TRAF6 but also by TRAF7, a recently identified TRAF family member. The activation of both pathways leads to the transcription of TNF-␣, IL-1␤, and IL-8 as well as CYLD. CYLD in turn leads to the inhibition of TRAF6 and TRAF7 likely via a deubiquitination-dependent mechanism. The present studies thus unveil a novel autoregulatory feedback mechanism that negatively controls TLR2-IKKs-IB␣/MKK3/6-p38-NF-B-dependent induction of immune and inflammatory responses via negatively cross-talking with both TRAF6 and TRAF7. These findings provide novel insights into autoregulation and negative regulation of TLR signaling.