Anesthesia doesn't simply turn off the brain, it changes its rhythms

In a uniquely deep and detailed look at how the commonly used anesthetic propofol causes unconsciousness, a collaboration of labs at The Picower Institute for Learning and Memory at MIT shows that as the drug takes hold in the brain, a wide swath of regions become coordinated by very slow rhythms that maintain a commensurately languid pace of neural activity. Electrically stimulating a deeper region, the thalamus, restores synchrony of the brain’s normal higher frequency rhythms and activity levels, waking the brain back up and restoring arousal.
“There’s a folk psychology or tacit assumption that what anesthesia does is simply ‘turn off’ the brain,” said Earl Miller, Picower Professor of Neuroscience and co-senior author of the study in eLife. “What we show is that propofol dramatically changes and controls the dynamics of the brain’s rhythms.”
Conscious functions, such as perception and cognition, depend on coordinated brain communication, in particular between the thalamus and the brain’s surface regions, or cortex, in a variety of frequency bands ranging from 4 to 100 Hz. Propofol, the study shows, seems to bring coordination among the thalamus and cortical regions down to frequencies around just 1 Hz.
Miller’s lab, led by postdoc Andre Bastos and former graduate student Jacob Donoghue, collaborated with that of co-senior author Emery N. Brown, who is Edward Hood Taplin Professor of Medical Engineering and Computational Neuroscience and an anesthesiologist at Massachusetts General Hospital. The collaboration therefore powerfully unified the Miller lab’s expertise on how neural rhythms coordinate the cortex to produce conscious brain function with the Brown lab’s expertise in the neuroscience of anesthesia and statistical analysis of neural signals.
Brown said studies that show how anesthetics change brain rhythms can directly improve patient safety because these rhythms are readily visible on the EEG in the operating room. The study’s main finding of a signature of very slow rhythms across the cortex offers a model for directly measuring when subjects have entered unconsciousness after propofol administration, how deeply they are being maintained in that state, and how quickly they may wake up once propofol dosing ends.
“Anesthesiologists can use this as a way to better take care of patients,” Brown said.

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A new treatment that might keep COVID-19 patients off the ventilator

A new treatment is among the first known to reduce the severity of acute respiratory distress syndrome caused by the flu in animals, according to a new study.
Tests in mice infected with high doses of influenza showed that the treatment could improve lung function in very sick mice and prevent progression of disease in mice that were pre-emptively treated after being exposed to the flu.
The hope is that it may also help humans infected with the flu, and potentially other causes of acute respiratory distress syndrome (ARDS) such as SARS-CoV-2 infection.
Specific cells in mice are less able to make key molecules after influenza invades the lungs, reducing their ability to produce a substance called surfactant that enables lungs to expand and contract. The shortage of surfactant is linked to ARDS, an illness so serious that it typically requires mechanical ventilation in an ICU.
Researchers bypassed the blocked process in mice by re-introducing the missing molecules alone or in combination as an injected or oral treatment. The results: normalized blood oxygen levels and reduced inflammation in mouse lungs — effects that could make a person well enough for hospital discharge.
“The most important and impressive thing in this study is the fact that we have benefits even when we treat late in the disease process. If we could develop a drug based on these findings, you could take somebody who’s going to have to go on a ventilator and stop that completely,” said Ian Davis, professor of veterinary biosciences at The Ohio State University and senior author of the study. “There’s nothing out there now that can do this for ARDS that will bring them back to that degree, and certainly not for flu.”
ARDS can also result from infections, cancer, trauma and many other ailments. Though this therapy has been tested in the context of the flu, Davis said its reliance on fixing a broken cell function in the host rather than killing the virus suggests it has potential to treat virtually any lung injury.

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Treating severe COVID-19 cases

Scientific studies rarely focus on long non-coding RNA molecules (lncRNAs), even though they potentially regulate several diseases. The role of several lncRNAs in anti-viral inflammatory response regulation has recently been reported. Considering their significant regulatory function in immune response, researchers from the Azrieli Faculty of Medicine of Bar-Ilan University sought to identify lncRNAs co-expressed with human genes involved in immune-related processes during severe SARS-CoV-2 infection in the lungs.
Recent studies demonstrated that patients afflicted with severe SARS-CoV-2 infections present increased levels of pro-inflammatory plasma cytokines, as opposed to milder cases, highlighting the release of inflammatory cytokines as being central to COVID-19 severity. However, the underlying molecular mechanisms responsible for dysfunctional immune responses during COVID-19 infection remain elusive.
In a paper recently published in the journal Viruses, the researchers demonstrated that lncRNAs are indeed potential regulators of anti-viral response during severe SARS-CoV-2 infection. Using the available transcriptome data from the lung cells of severely affected COVID-19 patients and SARS-CoV-2 infected lung-cell-lines, they constructed a gene co-expression network that can measure the relationship of gene expression patterns across a group of samples. This analysis enables them to identify four differentially expressed lncRNAs that are found to be strongly correlated to the protein-coding genes in a novel network enriched for different immune-related processes associated with dysregulated cytokine production. These four lncRNAs were also identified as “hubs” — important nodes in this co-expression network, signifying their association with cytokine over-production due to fierce immune response.
The finding suggests that the aberrant expression of lncRNAs can be associated with cytokine storms and anti-viral responses during severe SARS-CoV-2 infection. Thus, the present study uncovers the potential associations of lncRNAs in cytokine and interferon signaling during the response to severe SARS-CoV-2 infection in the lungs. This could provide valuable insight into pro-inflammatory cytokine production and how to mitigate it. It could also potentially be utilized as a future drug target to combat the hyper-inflammation caused by SARS-CoV-2 infection.
“It is remarkable that a major part of the human genome is filled in by non-coding regulatory elements, formerly known as “junk DNA.” Among these are the long non-coding RNAs (lncRNAs). These lncRNAs are receiving more and more recognition as the potential regulators of several diseases,” says Dr. Milana Frenkel-Morgenstern, of Bar-Ilan University’s Azrieli Faculty of Medicine, who led the study with Prof. David Karasik.
This study sheds light on the mechanisms behind COVID-19 severity and dysfunctional immune responses. Understanding the molecular interactions behind the immune dysfunction during severe COVID-19 infection in the lungs should help inform the design and development of novel approaches for treating severe COVID-19 patients.
The researchers plan to validate their findings on human samples in collaboration with several of Israel’s health care centers. Further, they will aim to determine which drugs from their COVID-19 drug database may inhibit the cytokine storm generation in COVID-19, and will design experiments to test the efficacy of those drugs.
This study was supported by a grant from the COVID-19 Data Science Institute (DSI) at Bar-Ilan University and a PBC fellowship for outstanding postdoctoral researchers from China and India (to Dr. Sumit Mukherjee, who participated in the research) from the Israel Council for Higher Education.
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New method preserves viable fruit fly embryos in liquid nitrogen

Cryopreservation, or the long-term storage of biomaterials at ultralow temperatures, has been used across cell types and species. However, until now, the practical cryopreservation of the fruit fly (Drosophila melanogaster) — which is crucial to genetics research and critical to scientific breakthroughs benefiting human health — has not been available.
“To keep alive the ever-increasing number of fruit flies with unique genotypes that aid in these breakthroughs, some 160,000 different flies, laboratories and stock centers engage in the costly and frequent transfer of adults to fresh food, risking contamination and genetic drift,” said Li Zhan, a postdoctoral associate with the University of Minnesota College of Science and Engineering and the Center for Advanced Technologies for the Preservation of Biological Systems (ATP-Bio).
In new research published in Nature Communications, a University of Minnesota team has developed a first-of-its-kind method that cryopreserves fruit fly embryos so they can be successfully recovered and developed into adult insects. This method optimizes embryo permeabilization and age, cryoprotectant agent composition, different phases of nitrogen (liquid vs. slush), and post-cryopreservation embryo culture methods.
Researchers were able to: show that the method is broadly applicable and easily adopted by non-specialists, with it being successfully implemented in 25 distinct strains for fruit flies from different sources (e.g., laboratories); demonstrate that for most strains, more than 50% of embryos hatch and more than 25% of the resulting larvae develop into adults after cryopreservation; and show that flies retain normal sex ratio, fertility and original mutation after successive crypropreservation through generations and long-time storage in liquid nitrogen.

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Comprehensive single-cell atlas of human teeth

During the last 30 years, medical and dental research has attracted a large number of scientists and practitioners working on aspects of high medical relevance that involve a combination of genetic and tissue regeneration approaches. These developments in stem cell and tissue engineering have provided medical and dental researchers with new insights and given rise to new ideas as to how everyday clinical practice can be improved. Many research groups are dealing with questions like: How can we help injured tissues and organs heal? Can lost tissue be regenerated? How can we create solid protocols that apply across all stem cell therapies?
Advanced single-cell sequencing technology used
A team of researchers led by Thimios Mitsiadis, professor at the Institute of Oral Biology at the University of Zurich, and Dr. Andreas Moor, professor at the Department of Biosystems Science and Engineering at ETH Zurich, has now created the first-ever single cells atlas of the human teeth. By using advanced single-cell sequencing technology, they were able to distinguish every single cell that is part of the dental pulp and the periodontium. “Our study provides an unprecedented understanding of the composition of these two tissues, which are subject to tooth-specific and bacterially-linked pathologies such as caries and periodontitis. Both the dental pulp and the periodontium contain stem cells that possess a great regenerative potential,” states first co-author Pierfrancesco Pagella, senior researcher in Mitsiadis’ team.
The study identified great cellular heterogeneity in the dental pulp and the periodontium. Unexpectedly, the team found that the molecular signatures of the stem cell populations were very similar. “We think their different behavior is possibly brought about by their distinctive microenvironment,” says Pagella. The findings suggest that the microenvironmental specificity is the potential source of the major functional differences of the stem cells located in the various tooth compartments.
New cell-based dental therapies possible
The study demonstrates the complexity of dental tissues and represents a major contribution to a better understanding of the cellular and molecular identity of human dental tissues. “Single-cell approaches can help us understand the interactions of dental pulp and periodontal cells involved in immune responses upon bacterial insults. Therefore, single-cell analysis could be useful for diagnostic purposes to support the early detection of dental diseases,” last author Thimios Mitsiadis explains. The findings thus open up new avenues for cell-based dental therapeutic approaches.
According to Mitsiadis, these advances in dental research can lead to more appropriate therapies, successful regeneration of damaged parts of the teeth, and even more precise diagnostic tools in case of dental pathologies. “These innovations are the consequence of the fusion between bioinformatics and modern dentistry,” he concludes.
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Materials provided by University of Zurich. Note: Content may be edited for style and length.

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How oxygen radicals protect against cancer

Originally, oxygen radicals — reactive oxygen species, or ROS for short — were considered to be exclusively harmful in the body. They are produced, for example, by smoking or UV radiation. Because of their high reactivity, they can damage many important molecules in cells, including the hereditary molecule DNA. As a result, there is a risk of inflammatory reactions and the degeneration of affected cells into cancer cells.
Because of their damaging effect, however, ROS are also deliberately produced by the body, for example by immune or lung epithelial cells, which destroy invading bacteria and viruses with ROS. This requires relatively high ROS concentrations. In low concentrations, on the other hand, ROS play an important role as signalling molecules. For these tasks, ROS are specifically produced by a whole group of enzymes. One representative of this group of enzymes is Nox4, which continuously produces small amounts of H2O2. Nox4 is found in almost all body cells, where its product H2O2 maintains a large number of specialised signaling functions, contributing, for example, to the inhibition of inflammatory reactions.
Researchers at Goethe University Frankfurt, led by Professor Katrin Schröder, have now discovered that by producing H2O2, Nox4 can even prevent the development of cancer. They examined mice that were unable to produce Nox4 due to a genetic modification. When these mice were exposed to a carcinogenic environmental toxin (cancerogen), the probability that they would develop a tumour doubled. Since the mice suffered from very different types of tumours such as skin sarcomas and colon carcinomas, the researchers suspected that Nox4 has a fundamental influence on cellular health.
Molecular investigations showed that the H2O2 formed by Nox4 keeps a cascade going that prevents certain important signalling proteins (phosphatases) from entering the cell nucleus. If Nox4 and consequently H2O2 are absent, those signalling proteins migrate into the cell nucleus and as a consequence, severe DNA damage is hardly recognised.
Severe DNA damage — e.g. double strand breaks — occurs somewhere in the body every day. Cells react very sensitively to such DNA damage, setting a whole repertoire of repair enzymes in motion. If this does not help, the cell activates its cell death programme — a precautionary measure of the body against cancer. When such damage goes unrecognised, as occurs in the absence of Nox4, it spurs cancer formation.
Prof. Katrin Schröder explains the research results: “If Nox4 is missing and there is therefore no H2O2, the cells no longer recognise DNA damage. Mutations accumulate and damaged cells continue to multiply. If an environmental toxin is added that massively damages the DNA, the damage is no longer recognised and repaired. The affected cells are not eliminated either, but multiply, sometimes very quickly and uncontrollably, which eventually leads to the development of tumours. A small amount of H2O2 thus maintains an internal balance in the cell that protects the cells from degeneration.”
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Materials provided by Goethe University Frankfurt. Note: Content may be edited for style and length.

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Men's loneliness linked to an increased risk of cancer

A recent study by the University of Eastern Finland shows that loneliness among middle-aged men is associated with an increased risk of cancer. According to the researchers, taking account of loneliness and social relationships should thus be an important part of comprehensive health care and disease prevention. The findings were published in Psychiatry Research.
“It has been estimated, on the basis of studies carried out in recent years, that loneliness could be as significant a health risk as smoking or overweight. Our findings support the idea that attention should be paid to this issue,” Project Researcher Siiri-Liisi Kraav from the University of Eastern Finland says.
The study was launched in the 1980s with 2,570 middle-aged men from eastern Finland participating. Their health and mortality have been monitored on the basis of register data up until present days. During the follow-up, 649 men, i.e. 25% of the participants, developed cancer, and 283 men (11%) died of cancer. Loneliness increased the risk of cancer by about ten per cent. This association with the risk of cancer was observed regardless of age, socio-economic status, lifestyle, sleep quality, depression symptoms, body mass index, heart disease and their risk factors. In addition, cancer mortality was higher in cancer patients who were unmarried, widowed or divorced at baseline.
“Awareness of the health effects of loneliness is constantly increasing. Therefore, it is important to examine, in more detail, the mechanisms by which loneliness causes adverse health effects. This information would enable us to better alleviate loneliness and the harm caused by it, as well as to find optimal ways to target preventive measures.”
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Ship traffic dropped during first months of COVID pandemic

Ship movements on the world’s oceans dropped in the first half of 2020 as Covid-19 restrictions came into force, a new study shows.
Researchers used a satellite vessel-tracking system to compare ship and boat traffic in January to June 2020 with the same period in 2019.
The study, led by the University of Exeter (UK) and involving the Balearic Islands Coastal Observing and Forecasting System and the Mediterranean Institute for Advanced Studies (both in Spain), found decreased movements in the waters off more than 70 per cent of countries.
Global declines peaked in April 2020, but by June — as Covid restrictions were eased in many countries — ship movements began to increase.
“As lockdowns came into force, we heard stories and began to see early research findings that suggested reduced boat movements had allowed some marine ecosystems to recover,” said lead-author Dr David March of the Centre for Ecology and Conservation on Exeter’s Penryn Campus in Cornwall.
“There were reports of clearer water in Venice’s canals, and a study showed a reduction in underwater noise at Vancouver.”
Professor Brendan Godley, who leads the Exeter Marine research group, added: “The effects of ships and boats — from noise and pollution to fishing and collisions with animals — have a major impact on marine ecosystems across the world.

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Tracking the Evolution of a ‘Variant of Concern’ in Brazil

By last October, about three out of every four residents of Manaus, Brazil already had been infected with SARS-CoV-2, the virus that causes COVID-19 [1]. And yet, despite hopes of achieving “herd immunity” in this city of 2.2 million in the Amazon region, the virus came roaring back in late 2020 and early 2021 to cause a second wave of illness and death [2]. How is this possible?

The answer offers a lesson in viral evolution, especially when an infectious virus such as SARS-CoV-2 replicates and spreads through a population largely unchecked. In a recent study in the journal Science, researchers tied the city’s resurgence of SARS-CoV-2 to the emergence and rapid spread of a new SARS-CoV-2 “variant of concern” known as P.1 [3]. This variant carries a unique constellation of mutations that allow it not only to sneak past the human immune system and re-infect people, but also to be about twice as transmissible as earlier variants.

To understand how this is possible, consider that each time the coronavirus SARS-CoV-2 makes copies of itself in an infected person, there’s a chance a mistake will be made. Each mistake can produce a new variant that may go on to make more copies of itself. In most cases, those random errors are of little to no consequence. This is evolution in action.

But sometimes a spelling change can occur that benefits the virus. In the special case of patients with suppressed immune systems, the virus can have ample opportunity to accrue an unusually high number of mutations. Variants carrying beneficial mutations can make more copies of themselves than other variants, allowing them to build their numbers and spread to cause more infection.

At this advanced stage of the COVID-19 pandemic, such rapidly spreading new variants remain cause for serious concern. That includes variants such as B.1.351, which originated in South Africa; B.1.1.7 which emerged in the United Kingdom; and now P.1 from Manaus, Brazil.

In the new study, Nuno Faria and Samir Bhatt, Imperial College London, U.K., and Ester Cerdeira Sabino, Universidade de Sao Paulo, Brazil, and their colleagues sequenced SARS-CoV-2 genomes from 184 patient samples collected in Manaus in November and December 2020. The research was conducted under the auspices of the Brazil-UK Centre for Arbovirus Discovery, Diagnosis, Genomics and Epidemiology (CADDE), a project focused on viral genomics and epidemiology for public health.

Those genomic data revealed the P.1 variant had acquired 17 new mutations. Ten were in the spike protein, which is the segment of the virus that binds onto human cells and the target of current COVID-19 vaccines. In fact, the new work reveals that three of these spike protein mutations make it easier for the P.1 spike to bind the human ACE2 receptor, which is SARS-CoV-2’s preferred entry point.

The first P.1 variant case was detected by genomic surveillance on December 6, 2020, after which it spread rapidly. Through further evolutionary analysis, the team estimates that P.1 must have emerged, undetected for a brief time, in mid-November 2020.

To understand better how the P.1 variant led to such an explosion of new COVID-19 cases, the researchers developed a mathematical model that integrated the genomic data with mortality data. The model suggests that P.1 may be 1.7 to 2.4 times more transmissible than earlier variants. They also estimate that a person previously infected with a variant other than P.1 will have only 54 percent to 79 percent protection against a subsequent infection with P.1.

The researchers also observed an increase in mortality following the emergence of the P.1 variant. However, it’s not yet clear if that’s an indication P.1 is inherently more deadly than earlier variants. It’s possible the increased mortality is related primarily to the extra stress on the healthcare system in Manaus from treating so many people with COVID-19.

These findings are yet another reminder of the importance of genomic surveillance and international data sharing for detecting and characterizing emerging SARS-CoV-2 variants quickly. It’s worth noting that at about the same time this variant was detected in Brazil, it also was reported in four individuals who had traveled to Brazil from Japan. The P.1 variant continues to spread rapidly across Brazil. It has also been detected in more than 37 countries [4], including the United States, where it now accounts for more than 1 percent of new cases [5].

No doubt you are wondering what this means for vaccines, such as the Pfizer and Moderna mRNA vaccines, that have been used to immunize (at least one dose) over 140 million people in the United States. Here the news is encouraging. Serum from individuals who received the Pfizer vaccine had titers of neutralizing antibodies that were only slightly reduced for P.1 compared to the original SARS-CoV-2 virus [6]. Therefore, the vaccine is predicted to be highly protective. This is another example of a vaccine providing more protection than a natural infection.

The United States has made truly remarkable progress in combating COVID-19, but we must heed this lesson from Manaus: this terrible pandemic isn’t over just yet. While the P.1 variant remains at low levels here for now, the “U.K. variant” B.1.1.7 continues to spread rapidly and now is the most prevalent variant circulating in the U.S., accounting for 44 percent of new cases [6]. Fortunately, the mRNA vaccines also work well against B.1.1.7.

We must continue to do absolutely everything possible, individually and collectively, to prevent these new SARS-CoV-2 variants from slowing or even canceling the progress made over the last year. We need to remain vigilant for a just a while longer, while encouraging our friends, neighbors, and loved ones to get vaccinated.

References:

[1] Three-quarters attack rate of SARS-CoV-2 in the Brazilian Amazon during a largely unmitigated epidemic. Buss, L. F., C. A. Prete, Jr., C. M. M. Abrahim, A. C. Dye, V. H. Nascimento, N. R. Faria and E. C. Sabino et al. (2021). Science 371(6526): 288-292.

[2] Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence. Sabino EC, Buss LF, Carvalho MPS, Prete Jr CCA, Crispim MAE, Fraiji NA, Pereira RHM, Paraga KV, Peixoto PS, Kraemer MUG, Oikawa MJ, Salomon T, Cucunuba ZM, Castro MC, Santos AAAS, Nascimento VH, Pereira HS, Ferguson NM, Pybus OG, Kucharski A, Busch MP, Dye C, Faria NR Lancet. 2021 Feb 6;397(10273):452-455.

[3] Genomics and epidemiology of the P.1 SARS-CoV-2 lineage in Manaus, Brazil. Faria NR, Mellan TA, Whittaker C, Claro IM, Fraiji NA, Carvalho MDPSS, Pybus OG, Flaxman S, Bhatt S, Sabino EC et al. Science. 2021 Apr 14:eabh2644.

[4] GRINCH Global Report Investigating novel coronavirus haplotypes. PANGO Lineages.

[5] COVID Data Tracker. Variant Proportions. Centers for Disease Control and Prevention.

[6] Antibody evasion by the P.1 strain of SARS-CoV-2. Dejnirattisai W, Zhou D, Supasa P, Liu C, Mongkolsapaya J, Ren J, Stuart DI, Screaton GR, et al. Cell. 2021 Mar 30:S0092-8674(21)00428-1.

Links:

COVID-19 Research (NIH)

Brazil-UK Centre for Arbovirus Discovery, Diagnosis, Genomics and Epidemiology (CADDE)

Nuno Faria (Imperial College, London, U.K.)

Samir Bhatt (Imperial College)

Ester Cerdeira Sabino (Universidade de Sao Paulo, Brazil)

NIH Support: National Institute of Allergy and Infectious Diseases

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