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van der Vaart, M.

Publications and source records attributed to van der Vaart, M..

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Sensory event-related potential morphology predicts age in premature infants

Preterm infants undergo substantial neurosensory development in the first weeks after birth. Infants born prematurely are more likely to have long-term adverse neurological outcomes and early detection of abnormal brain development is essential for timely interventions. We investigated whether sensory-evoked cortical potentials could be used to accurately estimate the age of an infant. Such a model could be used to identify infants who deviate from normal neurodevelopment by comparing the brain age to the infants postmenstrual age (PMA). Infants aged between 28- and 40-weeks PMA from a training and test sample (consisting of 101 and 65 recording sessions in 82 and 14 infants, respectively) received trains of approximately 10 visual and 10 tactile stimuli (interstimulus interval approximately 10 seconds). PMA could be predicted accurately from the magnitude of the evoked responses (training set mean absolute error (MAE and 95% confidence intervals): 1.41 [1.14; 1.74] weeks, p = 0.0001; test set MAE: 1.55 [1.21; 1.95] weeks, p = 0.0002. Moreover, we show with two examples that brain age, and the deviations between brain age and PMA, may be biologically and clinically meaningful. By firstly demonstrating that brain age is correlated with a measure known to relate to maturity of the nervous system (based on animal and human literature, the magnitude of reflex withdrawal is used) and secondly by linking brain age to long-term neurological outcomes, we show that brain age deviations are related to biologically meaningful individual differences in the rate of functional nervous system maturation rather than noise generated by the model. In summary, we demonstrate that sensory-evoked potentials are predictive of age in premature infants. It takes less than 5 minutes to collect the stimulus electroencephalographic data required for our model, hence, increasing its potential utility in the busy neonatal care unit. This model could be used to detect abnormal development of infants response to sensory stimuli in their environment and may be predictive of later life abnormal neurodevelopmental outcome.

neuroscience↗

DRAM1 promotes antibacterial autophagy and lysosomal delivery of Mycobacterium marinum in macrophages

Damage-Regulated Autophagy Modulator 1 (DRAM1) is an infection-inducible membrane protein, whose function in the immune response is incompletely understood. Based on previous results in a zebrafish infection model, we have proposed that DRAM1 is a host resistance factor against intracellular mycobacterial infection. To gain insight into the cellular processes underlying DRAM1-mediated host defence, here we studied the interaction of DRAM1 with Mycobacterium marinum in murine RAW264.7 macrophages. We found that shortly after phagocytosis, DRAM1 localised in a punctate pattern to mycobacteria, which gradually progressed to full DRAM1 envelopment of the bacteria. Within the same time frame, DRAM1-positive mycobacteria colocalised with the LC3 marker for autophagosomes and LysoTracker and LAMP1 markers for (endo)lysosomes. Knockdown analysis revealed that DRAM1 is required for recruitment of LC3 and for acidification of mycobacteria-containing vesicles. A reduction in the presence of LAMP1 further suggested reduced fusion of lysosomes with mycobacteria-containing vesicles. Finally, we show that DRAM1 knockdown impairs the ability of macrophages to control mycobacterial infection. Together, these results support that DRAM1 promotes the trafficking of mycobacteria through the degradative (auto)phagolysosomal pathway. Considering its prominent effect on host resistance to intracellular infection, DRAM1 is a promising target for therapeutic modulation of the microbicidal capacity of macrophages.

immunology↗

DRAM1 requires PI(3,5)P2 generation by PIKfyve to deliver vesicles and their cargo to endolysosomes

Endolysosomal vesicle trafficking and autophagy are crucial degradative pathways in maintenance of cellular homeostasis. The transmembrane protein DRAM1 is a potential therapeutic target that primarily localises to endolysosomal vesicles and promotes autophagy and vesicle fusion with lysosomes. However, the molecular mechanisms underlying DRAM1-mediated vesicle fusion events remain unclear. Using high-resolution confocal microscopy in the zebrafish model, we show that mCherry-Dram1 labelled vesicles interact and fuse with early endosomes marked by PI(3)P. Following these fusion events, early endosomes mature into late endosomes in a process dependent on the conversion of PI(3)P into PI(3,5)P2 by the lipid kinase PIKfyve. Chemical inhibition of PIKfyve reduces the targeting of Dram1 to acidic endolysosomal vesicles, arresting Dram1 in multivesicular bodies, early endosomes, or non-acidified vesicles halted in their fusion with early endosomes. In conclusion, Dram1-mediated vesicle fusion requires the formation of PI(3,5)P2 to deliver vesicles and their cargo to the degradative environment of the lysosome.

molecular biology↗

Inferring the infant pain experience: a translational fMRI-based signature approach

BackgroundIn the absence of verbal communication it is challenging to infer an individuals sensory and emotional experience. In adults, fMRI has been used to develop multivariate brain activity signatures, which reliably capture elements of human pain experience. We translate whole-brain fMRI signatures that encode pain perception in adults to the newborn infant brain, to advance understanding of functional brain development and pain perception in early life. MethodsA cohort of adults (n=10; mean age=28.3 years) and 2 cohorts of healthy infants (Cohort A: n=15; Cohort B: n=22; mean postnatal age=3 days) were stimulated with low intensity nociceptive stimuli (64-512mN) during acquisition of functional MRI data. fMRI pain signatures were applied directly to the adult data and transformed such that they could be applied to the infant brain. In each cohort, we assessed the concordance of the signatures with the brain responses using cosine-similarity scores, and we assessed stimulus intensity encoding of the signature responses using Spearman rank correlation. Brain activity in pro-pain and anti-pain brain regions were also examined. FindingsThe Neurologic Pain Signature (NPS), which reflects aspects of nociceptive pain experience, was activated in both the adults and infants, and reliably encoded stimulus intensity. However, the Stimulus Intensity Independent Pain Signature (SIIPS1), which reflects higher-level cognitive modulation of nociceptive input, was only expressed in adults. Pro-pain brain regions showed similar activation patterns in adults and infants, whereas, anti-pain brain regions exhibited divergent responses. InterpretationBasic intensity encoding of nociceptive information is similar in adults and infants. However, translation of adult brain signatures into infants reveals significant differences in infant cerebral processing of nociceptive information, which may reflect their lack of expectation, motivation and contextualisation. This study expands the use of brain activity pain signatures to non-verbal patients and provides a potential approach to assess analgesic interventions in infancy. FundingThis work was funded by Wellcome (Senior Research Fellowship awarded to Prof. Rebeccah Slater) and SSNAP "Support for Sick and Newborn Infants and their Parents" Medical Research Fund (University of Oxford Excellence Fellowship awarded to Dr Eugene Duff). Research in contextO_ST_ABSEvidence before this studyC_ST_ABSWe searched PubMed for research articles published prior to March 2020 using terms including fMRI, infant or neonate, and pain or nociception in the title or abstract. Due to the relatively new emergence of this field, and the experimental and analytical challenges involved in studying cerebral processing of pain in the MRI environment in healthy newborn infants, only five fMRI studies have examined infant brain responses to nociceptive input. In a foundational pilot study, Williams et al., applied an experimental noxious stimulus to a single infant, evoking widespread brain activity that included several brain regions involved in pain processing in adults. Goksan et al., subsequently performed an observational cohort study and used regional analyses to compare active brain regions in infants (n=10) and adults (n=10), concluding that the evoked patterns of brain activity were broadly similar in infants and adults. Further follow-up analysis in the infant cohort revealed that the functional connectivity of brain regions involved in descending pain modulation influences the magnitude of pain-related brain activity. Two further studies focused on methodological advances, providing evidence-based recommendations for fMRI acquisition parameters and image processing in order to maximise the quality of infant data, and these methods have been implemented in this study. Added value of this studyThis study translates validated adult pain fMRI brain signatures to a nonverbal patient population in which the assessment and management of pain presents a significant clinical challenge. Application of fMRI brain signatures to newborn infants expands on previous fMRI studies that provided only qualitative evidence that noxious stimulation commonly activates brain regions in the adult and infant brain. Here we demonstrate that the basic encoding of the sensory discriminative aspects of pain, as represented by the Neurologic Pain Signature (NPS), occurs in both adults and infants, whereas higher-level cognitive modulation of pain, represented by the Stimulus Intensity Independent Pain Signature (SIIPS1) is only present in adults and not observed in infants. The differences in how the immature infant brain processes pain, relative to the mature adult brain, are likely to reflect differences in their expectation, motivation and contextualisation of external events rather than differences in their core nociceptive cerebral processing of pain. This work allows us to use quantitative fMRI observations to make stronger inferences related to pain experience in nonverbal infants. Implications of all the available evidenceBehavioural pain scores used in neonatal clinical care offer limited sensitivity and specificity to pain. Neonatal clinical trials that use these scores as outcome measures frequently report a lack of efficacy of common analgesic interventions, resulting in few evidence-based drugs for treating pain. The value of using brain-based neuroimaging markers of pain as a means of providing objective evidence of analgesic efficacy in early proof of concept studies is well recognised in adults, even in the absence of behavioural pain modulation. Similarly, in infants EEG-based measures of noxious-evoked brain activity have been used as outcome measures in clinical trials of analgesics to overcome some of the inherent limitations of using behavioural observations to quantify analgesic efficacy. Considering the successful translation of the Neurologic Pain Signature (NPS) and its sensitivity to analgesic modulation in adults, this novel methodology represents an objective brain-based fMRI approach that could be used to advance the discovery and assessment of analgesic interventions in infancy.

neuroscience↗

Deficiency in the autophagy modulator Dram1 exacerbates pyroptotic cell death of Mycobacteria-infected macrophages

DNA Damage Regulated Autophagy Modulator 1 (DRAM1) is a stress-inducible regulator of autophagy and cell death. DRAM1 has been implicated in cancer, myocardial infarction, and infectious diseases, but the molecular and cellular functions of this transmembrane protein remain poorly understood. Previously, we have proposed DRAM1 as a host resistance factor for tuberculosis (TB) and a potential target for host-directed anti-infective therapies. In this study, we generated a zebrafish dram1 mutant and investigated its loss-of-function effects during Mycobacterium marinum (Mm) infection, a widely used model in TB research. In agreement with previous knockdown analysis, dram1 mutation increased the susceptibility of zebrafish larvae to Mm infection. RNA sequencing revealed major effects of Dram1 deficiency on metabolic, immune response, and cell death pathways during Mm infection, whereas only minor effects on proteinase and metabolic pathways were found under uninfected conditions. Furthermore, unchallenged dram1 mutants did not display overt autophagic defects, but autophagic targeting of Mm was reduced in absence of Dram1. The phagocytic ability of macrophages in dram1 mutants was unaffected, but acidification of Mm-containing vesicles was strongly reduced, indicating that Dram1 is required for phagosome maturation. By in vivo imaging we observed that Dram1-deficient macrophages fail to restrict Mm during early stages of infection. The resulting increase in bacterial burden could be reverted by knockdown of inflammatory caspase a (caspa) and gasdermin Eb (gsdmeb), demonstrating pyroptosis as the mechanism underlying premature cell death of Mm-infected macrophages in dram1 mutants. Collectively, these data demonstrate that dissemination of mycobacterial infection in zebrafish larvae is promoted in absence of Dram1 due to reduced maturation of mycobacteria-containing vesicles, failed intracellular containment, and consequent pyroptotic cell death of infected macrophages. These results provide new evidence that Dram1 plays a central role in host resistance to intracellular infection, acting at the crossroad of autophagy and cell death.

immunology↗

Extracellular mycobacterial DNA triggers Caspase-11-dependent pyroptosis of infected macrophages and drives disease progression

Deregulated inflammation seriously complicates life-threatening microbial infections, including tuberculosis (TB). Assembly of multiprotein inflammasome complexes is an important trigger of inflammation, but how this impacts TB progression remains unknown. Here, in vivo imaging in the zebrafish TB model revealed that mycobacterial expansion in TB granulomas is driven by inflammasomes and ensuing pyroptotic cell death of infected macrophages. We show that an Asc-independent pathway induces macrophage pyroptosis and impairs host resistance, in contrast to host-protective roles of Asc-dependent inflammasome activation and Il1b secretion. Using ASC-deficient murine macrophages, we demonstrate extracellular bacterial DNA to induce CASP11-dependent pyroptosis in a manner dependent on phagosome permeabilization. Finally, we propose that mycobacteria induce pyroptosis to escape cell-in-cell structures, formed within granulomas when living infected cells are engulfed by neighbor cells. This study provides new insight into the role of pyroptosis in TB pathogenesis and reveals a novel link between nucleic acid sensing and CASP11-dependent pyroptosis.

immunology↗

The selective autophagy receptors Optineurin and p62 are both required for innate host defense against mycobacterial infection

Mycobacterial pathogens are the causative agents of chronic infectious diseases like tuberculosis and leprosy. Autophagy has recently emerged as an innate mechanism for defense against these intracellular pathogens. In vitro studies have shown that mycobacteria escaping from phagosomes into the cytosol are ubiquitinated and targeted by selective autophagy receptors. However, there is currently no in vivo evidence for the role of selective autophagy receptors in defense against mycobacteria, and the importance of autophagy in control of mycobacterial diseases remains controversial. Here we have used Mycobacterium marinum (Mm), which causes a tuberculosis-like disease in zebrafish, to investigate the function of two selective autophagy receptors, Optineurin (Optn) and SQSTM1 (p62), in host defense against a mycobacterial pathogen. To visualize the autophagy response to Mm in vivo, optn and p62 zebrafish mutant lines were generated in the background of a GFP-Lc3 autophagy reporter line. We found that loss-of-function mutation of optn or p62 reduces autophagic targeting of Mm, and increases susceptibility of the zebrafish host to Mm infection. Transient knockdown studies confirmed the requirement of both selective autophagy receptors for host resistance against Mm infection. For gain-of-function analysis, we overexpressed optn or p62 by mRNA injection and found this to increase the levels of GFP-Lc3 puncta in association with Mm and to reduce the Mm infection burden. Taken together, our results demonstrate that both Optineurin and p62 are required for autophagic host defense against mycobacterial infection and support that protection against tuberculosis disease may be achieved by therapeutic strategies that enhance selective autophagy.\n\nAuthor summaryTuberculosis is a serious infectious disease that claims over a million lives annually. Vaccination provides insufficient protection and the causative bacterial pathogen, Mycobacterium tuberculosis, is becoming increasingly resistant to antibiotic therapy. Therefore, there is an urgent need for novel therapeutic strategies. Besides searches for new antibiotics, considerable efforts are being made to identify drugs that improve the immune defenses of the infected host. One host defense pathway under investigation for therapeutic targeting is autophagy, a cellular housekeeping mechanism that can direct intracellular bacteria to degradation. However, evidence for the anti-mycobacterial function of autophagy is largely based on studies in cultured cells. Therefore, we set out to investigate anti-mycobacterial autophagy using zebrafish embryos, which develop hallmarks of tuberculosis following infection with Mycobacterium marinum. Using red-fluorescent mycobacteria and a green-fluorescent zebrafish autophagy reporter we could visualize the anti-mycobacterial autophagy response in a living host. We generated mutant and knockdown zebrafish for two selective autophagy receptors, Optineurin and p62, and found that these have reduced anti-bacterial autophagy and are more susceptible to tuberculosis. Moreover, we found that increased expression of these receptors enhances anti-bacterial autophagy and protects against tuberculosis. These results provide new evidence for the host-protective function of selective autophagy in tuberculosis.

immunology↗