Bardet-Biedl syndrome (BBS) is a heterogeneous, pleiotropic human disorder characterized by obesity, retinopathy, polydactyly, renal and cardiac malformations, learning disabilities, hypogenitalism, and an increased incidence of diabetes and hypertension. No information is available regarding the specific function of BBS2. We show that mice lacking Bbs2 gene expression have major components of the human phenotype, including obesity and retinopathy. In addition, these mice have phenotypes associated with cilia dysfunction, including retinopathy, renal cysts, male infertility, and a deficit in olfaction. With the exception of male infertility, these phenotypes are not caused by a complete absence of cilia. We demonstrate that BBS2 retinopathy involves normal retina development followed by apoptotic death of photoreceptors, the primary ciliated cells of the retina. Photoreceptor cell death is preceded by mislocalization of rhodopsin, indicating a defect in transport. We also demonstrate that Bbs2 ؊/؊ mice and a second BBS mouse model, Bbs4 ؊/؊ , have a defect in social function. The evaluation of Bbs2 ؊/؊ mice indicates additional phenotypes that should be evaluated in human patients, including deficits in social interaction and infertility.Bardet-Biedl syndrome ͉ mouse model ͉ obesity

Although breast cancer stem cells (BCSCs) display plasticity transitioning between quiescent mesenchymal-like (M) and proliferative epithelial-like (E) states, how this plasticity is regulated by metabolic or oxidative stress remains poorly understood. Here, we show that M- and E-BCSCs rely on distinct metabolic pathways and display markedly different sensitivities to inhibitors of glycolysis and redox metabolism. Metabolic or oxidative stress generated by 2DG, HO, or hypoxia promotes the transition of ROS M-BCSCs to a ROS E-state. This transition is reversed by N-acetylcysteine and mediated by activation of the AMPK-HIF1α axis. Moreover, E-BCSCs exhibit robust NRF2-mediated antioxidant responses, rendering them vulnerable to ROS-induced differentiation and cytotoxicity following suppression of NRF2 or downstream thioredoxin (TXN) and glutathione (GSH) antioxidant pathways. Co-inhibition of glycolysis and TXN and GSH pathways suppresses tumor growth, tumor-initiating potential, and metastasis by eliminating both M- and E-BCSCs. Exploiting metabolic vulnerabilities of distinct BCSC states provides a novel therapeutic approach targeting this critical tumor cell population.

Bardet-Biedl syndrome (BBS) is a heterogeneous genetic disorder characterized by many features, including obesity and cardiovascular disease. We previously developed knockout mouse models of 3 BBS genes: BBS2, BBS4, and BBS6. To dissect the mechanisms involved in the metabolic disorders associated with BBS, we assessed the development of obesity in these mouse models and found that BBS-null mice were hyperphagic, had low locomotor activity, and had elevated circulating levels of the hormone leptin. The effect of exogenous leptin on body weight and food intake was attenuated in BBS mice, which suggests that leptin resistance may contribute to hyperleptinemia. In other mouse models of obesity, leptin resistance may be selective rather than systemic; although mice became resistant to leptin's anorectic effects, the ability to increase renal sympathetic nerve activity (SNA) was preserved. Although all 3 of the BBS mouse models were similarly resistant to leptin, the sensitivity of renal SNA to leptin was maintained in Bbs4 -/-and Bbs6 -/-mice, but not in Bbs2 -/-mice. Consequently, Bbs4 -/-and Bbs6 -/-mice had higher baseline renal SNA and arterial pressure and a greater reduction in arterial pressure in response to ganglionic blockade. Furthermore, we found that BBS mice had a decreased hypothalamic expression of proopiomelanocortin, which suggests that BBS genes play an important role in maintaining leptin sensitivity in proopiomelanocortin neurons.

Cancer cells, relative to normal cells, demonstrate significant alterations in metabolism that are proposed to result in increased steady-state levels of mitochondrial-derived reactive oxygen species (ROS) such as O2•−and H2O2. It has also been proposed that cancer cells increase glucose and hydroperoxide metabolism to compensate for increased levels of ROS. Given this theoretical construct, it is reasonable to propose that forcing cancer cells to use mitochondrial oxidative metabolism by feeding ketogenic diets that are high in fats and low in glucose and other carbohydrates, would selectively cause metabolic oxidative stress in cancer versus normal cells. Increased metabolic oxidative stress in cancer cells would in turn be predicted to selectively sensitize cancer cells to conventional radiation and chemotherapies. This review summarizes the evidence supporting the hypothesis that ketogenic diets may be safely used as an adjuvant therapy to conventional radiation and chemotherapies and discusses the proposed mechanisms by which ketogenic diets may enhance cancer cell therapeutic responses.

McKusick-Kaufman syndrome (MKS) is an autosomal recessive disorder characterized by post-axial polydactyly, congenital heart defects and hydrometrocolpos, a congenital structural abnormality of female genitalia. Mutations in the MKKS gene have also been shown to cause some cases of Bardet-Biedl syndrome (BBS) which is characterized by obesity, pigmentary retinopathy, polydactyly, renal abnormalities and hypogenitalism with secondary features of hypertension and diabetes. Although there is overlap in clinical features between MKS and BBS, MKS patients are not obese and do not develop retinopathy or have learning disabilities. To further explore the pathophysiology of BBS and the related disorder MKS, we have developed an Mkks(-/-) mouse model. This model shows that the absence of Mkks leads to retinal degeneration through apoptosis, failure of spermatozoa flagella formation, elevated blood pressure and obesity. The obesity is associated with hyperphagia and decreased activity. In addition, neurological screening reveals deficits in olfaction and social dominance. The mice do not have polydactyly or vaginal abnormalities. The phenotype of the Mkks(-/-) mice closely resembles the phenotype of other mouse models of BBS (Bbs2(-/-) and Bbs4(-/-)). These observations suggest that the complete absence of MKKS leads to BBS while the MKS phenotype is likely to be due to specific mutations.

Heparin-binding growth-associated molecule (HB-GAM) is an extracellular matrix-associated protein implicated in the development and plasticity of neuronal connections of brain. Binding to cell surface heparan sulfate is indispensable for the biological activity of HB-GAM. In the present paper we have studied the structure of recombinant HB-GAM using heteronuclear NMR. These studies show that HB-GAM contains two ␤-sheet domains connected by a flexible linker. Both of these domains contain three antiparallel ␤-strands. In addition to this domain structure, HB-GAM contains the Nand C-terminal lysine-rich sequences that lack a detectable structure and appear to form random coils. Studies using CD and NMR spectroscopy suggest that HB-GAM undergoes a conformational change upon binding to heparin, and that the binding occurs primarily to the ␤-sheet domains of the protein. Search of sequence data bases shows that the ␤-sheet domains of HB-GAM are homologous to the thrombospondin type I repeat (TSR). Sequence comparisions show that the ␤-sheet structures found previously in midkine, a protein homologous with HB-GAM, also correspond to the TSR motif. We suggest that the TSR sequence motif found in various extracellular proteins defines a ␤-sheet structure similar to that found in HB-GAM and midkine. In addition to the apparent structural similarity, a similarity in biological functions is suggested by the occurrence of the TSR sequence motif in a wide variety of proteins that mediate cell-to-extracellular matrix and cell-to-cell interactions, in which the TSR domain mediates specific cell surface binding.Heparin-binding growth-associated molecule (HB-GAM) 1 (p18) was originally isolated from rat brain as an 18-kDa neurite outgrowth-promoting protein, the expression of which in brain tissue peaks during the perinatal stage of rapid axon growth and synapse formation (1). HB-GAM is highly homologous with the midkine (MK) sequence (2-4), and these proteins thus form a two-member family of small extracellular proteins that are conserved in vertebrates.In developing tissues HB-GAM associates with extracellular matrix of axonal tracts and of synapses (5, 6). It is also clearly expressed in developing basement membranes outside of brain (7) and in the cartilage matrix (8). N-syndecan (syndecan-3) acts as a receptor of HB-GAM in brain neurons in vitro (9) and localizes in many anatomical areas to the same developing fiber tracts as HB-GAM (10, 11). The heparan sulfate structure of brain N-syndecan is exceptionally heparin-like, especially in its high content of 2-0-sulfo-iduronic acid residues, which is of importance in the HB-GAM binding carbohydrate epitope, the minimal size of which appears to be 10 monosaccharide residues (12). The neurite outgrowth-promoting effect, based on HB-GAM/N-syndecan interaction, was very recently shown to be mediated by the cortactin/src-kinase signaling pathway to the cytoskeleton of neurites (13). These findings have led to the concept that N-syndecan mediates HB-GAM-induced neurite growth (for r...

Purpose Ketogenic diets (KDs) are high in fat and low in carbohydrates as well as protein which forces cells to rely on lipid oxidation and mitochondrial respiration rather than glycolysis for energy metabolism. Cancer cells (relative to normal cells) are believed to exist in a state of chronic oxidative stress mediated by mitochondrial metabolism. The current study tests the hypothesis that KDs enhance radio-chemo-therapy responses in lung cancer xenografts by enhancing oxidative stress. Experimental Design Mice bearing NCI-H292 and A549 lung cancer xenografts were fed a KD (KetoCal® 4:1 fats: proteins+carbohydrates) and treated with either conventionally fractionated (1.8-2 Gy) or hypofractionated (6 Gy) radiation as well as conventionally fractionated radiation combined with carboplatin. Mice weights and tumor size were monitored. Tumors were assessed for immuno-reactive 4-hydroxy-2-nonenal-(4HNE) modified proteins as a marker of oxidative stress as well as PCNA and γH2AX as indices of proliferation and DNA damage, respectively. Results The KD combined with radiation resulted in slower tumor growth in both NCI-H292 and A549 xenografts (p<0.05), relative to radiation alone. The KD also slowed tumor growth when combined with carboplatin and radiation, relative to control. Tumors from animals fed a KD in combination with radiation demonstrated increases in oxidative damage mediated by lipid peroxidation as determined by 4HNE-modified proteins as well as decreased proliferation as assessed by decreased immunoreactive PCNA. Conclusions These results show that a KD enhances radio-chemo-therapy responses in lung cancer xenografts by a mechanism that may involve increased oxidative stress.

Purpose Cancer cells (relative to normal cells) demonstrate increased steady-state levels of hydroperoxides that are compensated for by increased glucose and hydroperoxide metabolism. The current study determined if inhibitors of glucose and hydroperoxide metabolism could induce chemo-radio-sensitization by enhancing oxidative stress in lung cancer cells. Experimental Design A549 and NCI-H292 human lung carcinoma cells were treated with 2-Deoxy-D-glucose (2DG) combined with carboplatin (carbo) + ionizing radiation (IR). Lung cancer cells were further sensitized with inhibitors of glutathione- and thioredoxin-dependent metabolism [buthionine sulfoximine (BSO) and auranofin (Au), respectively] in vitro and in vivo. Results When 2DG was combined with carbo+IR, clonogenic cell killing was enhanced in A549 and NCI-H292 cells and this combination was more effective than paclitaxel+carbo+IR. The thiol antioxidant (N-acetylcysteine, NAC) was capable of protecting cancer cells from 2DG+carbo-induced cell killing. Simultaneous treatment of cancer cells with BSO and Au, at doses that were not toxic as single agents also enhanced lung cancer cell killing and sensitivity to 2DG+carbo. This treatment combination also increased both glutathione and thioredoxin oxidation which were inhibited by NAC. Mice treated with Au+BSO showed no alterations in circulating leukocytes or red blood cells. Xenograft lung tumor growth in mice was more effectively inhibited by treatment with Au+BSO+carbo when compared to animals treated with carbo or Au+BSO alone. Conclusions These results show in vitro and in vivo that simultaneous inhibition of glutathione and thioredoxin metabolism can effectively inhibit lung cancer cell growth and induce chemo-sensitization by a mechanism that involves thiol mediated oxidative stress.