Stopping a pervasive bacterium that makes millions sick each year
Stopping a pervasive bacterium that makes millions sick each year
As we head outdoors this summer, scientists are working to clip the long, flexible appendages that enable the common bacterium Campylobacter jejuni to make its way from undercooked poultry and natural waterways into our intestinal tract where it makes millions of us sick each year.
Campylobacter jejuni is the most common cause of diarrhea, vomiting and stomach pain in the United States and the world, with about 140 million cases worldwide and more than 30,000 deaths each year, primarily in children under age 5.
Motility is the "magic bullet" for this bacterium which uses its long, thin, flexible arm-like flagella to maneuver the thick mucus in our gastrointestinal tract, power its way inside our intestinal cells, then wrap itself in a protective biofilm when threatened, says Dr. Stuart A. Thompson, microbiologist in the Division of Infectious Diseases at the Medical College of Georgia at Augusta University.
"It's actually very good at moving, not only because of the flagellum, but because of the spiral shape of the cell itself, so it just travels through mucus," says Dr. Claudia Cox, postdoctoral fellow, making a whooshing sound that mimics the whirling appendages.
The nimble flagella, each longer than the bacterium's corkscrew-shape central body, don't just propel, they help grab and hold onto the cell the bacterium is working to infect and push inside, she says. These essential arms, sticky because of their natural sugar coating, also play a role in building biofilm that will protect it from harsh times like too little food or too much oxygen.
Cox and Thompson want to stop the pervasive bacterium, potentially with a safe molecule that could be given as soon as signs of infection appear, like diarrhea and fever, by targeting elements key to its amazing mobility. But first they have to identify the best points of intervention.
They are looking at the enzyme CbrR, a so-called response regulator of the bacterium that enables it to assess its dynamic environment and make the adjustments it needs to survive. They also are taking the first looks in this bacterium at the "second messenger" cyclic-di-GMP, which the enzyme produces and uses to make those adjustments; and most recently the amino acids that function as building blocks for the bacterium's long arms.
Thompson is principal investigator on a new two-year $423,500 grant (R21AI164078-01) from the National Institute of Allergy and Infectious Diseases that is helping them better understand those building blocks.
He's also PI on a two-year, $410,000 grant (1R21AI154078-02) from the NIAID that ends this summer and has helped the scientists better understand how the bacterium uses cyclic-di-GMP to foster bile resistance -; bile salt is a powerful antimicrobial -; as well as motility/movement and the formation of the slick biofilm the bacterium shelters under when conditions get tough.
Cox and Thompson have shown that cyclic-di-GMP is produced by CbrR, which in this case is a negative regulator. They reported last year in the journal Microorganisms that when CbrR was present, both the mobility and the ability to produce biofilm were hampered. For example, the bacterium's general corkscrew form was the same but the long, thin, constantly moving flagella were MIA, Thompson says.
t turns out, CbrR is a regulator of motility, of flagella. Motility is the number one most important virulence factor of Campylobacter. It's required for colonization, it's required for host-cell adherence and invasion, and it's required for biofilm formation."
Dr. Stuart A. Thompson, microbiologist in the Division of Infectious Diseases at the Medical College of Georgia at Augusta University
Bottom lines: CbrR is a good thing for Campylobacter jejuni because it makes cyclic-di-GMP and because it can downshift motility to help enable the bacterium to survive in a harsh environment, Cox says. That means it's time to stop moving around so much, to conserve and look for something nearby -; they have seen the bacterium pull starch out of a culture medium it was sitting in -; to weave into biofilm or take shelter under some other bacterium's biofilm, she says.
No doubt the super-oxygen sensitive bacterium often needs a port in the storm. Sit a dish of them on a desk for a few days and they are dead, Thompson says, just from the oxygen content in room air, he says. But unlike e coli, Campylobacter jejuni does need some oxygen. Water too, he says, which are some of the reasons why it's happy in our gut and in the gut of poultry and migratory birds, he says, but notes that in birds, it's part of their normal flora.
Key to making all these adjustments and the critical function of movement are amino acids, which combine to form proteins, and changes in amino acids can result in changes in a protein's structure and function. It's well known that bacteria use a process called phosphorylation, which is key to regulating many cell processes, to make the alterations needed to build out the flagella, a construction process that works kind of like adding Lego pieces from the ground up until it's complete. Like with an actual building, there are a lot of regulators involved working to control growth, including stopping it when the time is right, which is where things like a negative regulator become important.
They have evidence that the amino acids serine and threonine, which they found are present in about half of flagella proteins, phosphorylate, or modify, proteins important to motility in that essential, dynamic building process. The new grant is enabling them to learn more about how phosphorylation of serine and threonine modify the bacterium's proteins and what that does to the bug's motility proteins with the goal again of finding the most direct target(s) for intervention. That might in this scenario include blocking phosphorylation instead of the resulting actions.
They already have identified two still unnamed proteins, 0215 and 0862, known to remove phosphates from serine and threonine, and have some evidence that 0215 may be involved in both adding and removing a phosphate group. They are looking for others that just add phosphates in this scenario.
This kind of addition and subtraction is important because when a protein has something added to it or taken away, it can change what the protein does, they say. "Sometimes it's like an on/off switch and sometimes phosphorylation morphs the protein into doing something else," Cox says.
Clever bacteria can slow down or resume the building of flagella depending on what's happening in their environment, the scientists say. If they can identify a protein whose loss stops flagella construction, a small molecule that inactivates that protein could mean the important arms don't get built, Thompson says.
While blocking key survival action of Campylobacter won't work like a vaccine to try to block initial infection, the idea is that if they can block the growth of flagella needed for the bacterium's movement, they can stop its progression in its tracks and early in the process, Thompson says.
The initial bacterial invaders would become more vulnerable to the natural immune response and/or simply die off, so the infection would be minor and unable to cause serious disease.
"It's more of a targeted therapeutic," Thompson says. "It's dead in the water," Cox adds.
The two also have studied both the primary sugar Campylobacter uses to make slimy, protective biofilm and how the regulatory protein CsrA helps. They showed long ago that when CsrA is missing, Campylobacter can't move well, stick to each other or the gastrointestinal tract or make biofilm.
While the jury remains out on exactly where the biofilm comes from, they have some evidence it can be made by other bacteria and potentially elsewhere.
But Thompson adds there is also good evidence that the bacterium's DNA is present in the biofilm but where the sugar, or polysaccharide, a major component, comes from remains unknown. He notes that the bacterium isn't always covered in biofilm, like when it's actively infecting a host and so rapidly replicating. "When our immune cells are spitting all kinds of nasty stuff" at the bacterium would likely be another good time to build biofilm and shelter, particularly when it's a persistent infection, or when campylobacter runs across bile salt in our gut.
Undercooked poultry is a major source
Undercooked poultry is a major source of Campylobacter jejuni, and so is animal poop, including from birds and cows, that ends up contaminating waters in lakes and ponds, Thompson says. While just how it causes disease remains unclear, most people recover in a week, often without antibiotic treatment.
Others develop irritable bowel syndrome, arthritis and the bacterium is the most common cause of Guillan-Barrè Syndrome, in which the immune system harms the nerves causing muscle weakness and potentially paralysis.
Antibiotic resistance by the bacterium can be a problem because of recent practices of feeding antibiotics to poultry as well as livestock to prevent illness, the scientists say.
Awareness may also be a problem. Despite the fact that it's far more common than Salmonella, even when Thompson asks a roomful of scientists about Campylobacter jejuni, typically only a handful of hands go up.
Reference: Medical Live Science: Reviewed by Emily Henderson, B.Sc.
Brain function of event trauma-exposed individuals restores over time: Study
Brain function of event trauma-exposed individuals restores over time: Study
Washington [US], July 2 (ANI): The brain function of otherwise-healthy individuals exposed to event trauma has the ability to 'bounce back' over time once the threat resolves, suggests new research by the University of Otago.
Researchers conducted a follow-up study on a group of Cantabrians, who had been exposed to trauma during the region's earthquakes over a decade ago.
Researchers led by Dr Katie Douglas at the University of Otago, Christchurch's Department of Psychological Medicine, conducted a follow-up study on a group of Cantabrians, who had been exposed to trauma during the region's earthquakes over a decade ago.
The original study conducted two to three years after the earthquakes, showed participants who were exposed to trauma but didn't develop psychological difficulties, still suffered from problems with aspects of cognitive function compared with non-exposed participants.
Dr Douglas says the new follow-up study, conducted 8 years post-quakes, shows the cognitive function of those trial participants is now normal compared with a group of people tested in Dunedin.
"This is good news as it offers preliminary evidence that there are no long-lasting effects on cognitive impairment after exposure to a traumatic event, at least in people who don't develop a mental health condition. It suggests changes in their cognitive functioning and emotion processing may be related to exposure to continued threat in the environment, which improves when the threat resolves."The original 89 trial participants were recruited in response to articles, opinion pieces and community notices in newspapers and via word of mouth over the course of 13 months, from January 2013 to February 2014. All received a face-to-face assessment and completed diagnostic questionnaires to confirm they had received no earthquake-related psychiatric diagnoses or counseling.
The results from this initial trial showed that similar to those with PTSD, resilient individuals exhibited a clinically significant impairment in visuospatial learning, memory and facial emotion processing compared to a non-exposed group who had completed cognitive testing in other studies prior to the earthquakes.
The new 2019 follow-up study, published in the British Journal of Psychiatry Open, tested 57 earthquake-exposed, resilient Canterbury residents from the original trial with 60 non-exposed participants from Dunedin, between July 2018 and
"The hypothesis was that participants in the earthquake-exposed resilient group, compared with the non-exposed, would perform less well on tests of spatial memory, would have increased accuracy for the identification of all facial emotions and also exhibit a bias in the misclassification of neutral facial expressions to threat-related emotions," Dr Douglas says.
"However, no significant differences were found in performance between the groups in the cognitive tasks. What's more, the original earthquake-exposed resilient group showed an improvement in their visuospatial performance from the first trial and their reaction times to negative emotions was also slowed."Dr Douglas says these findings back up similar international studies which show the brain's ability to recover once distanced in time from the original trauma.
March 2020. This time they were tested on a wider variety of cognitive tests -- including verbal and visuospatial learning and memory, executive functioning, psychomotor speed, sustained attention and social cognition.
"When the original studies were conducted, people were living in an environment of ongoing seismic activity where, over a two-year period, Canterbury experienced over ten thousand aftershocks. The fact that residents were in a chronically hyper-aroused state may have resulted in biological changes in the brain, such as in the amygdala, which is responsible for processing strong emotions. By the time of the current study, however, there was no seismic activity and the sense of threat had abated."Study co-author, Associate Professor Caroline Bell, also from the University of Otago, Christchurch's Department of Psychological Medicine, says this study adds to the growing body of international research relating to how large groups in society react and respond following traumatic situations.
"These findings give us a sense of the effects of exposure to major threats from disasters such as earthquakes on wider populations. They are reassuring in showing that a resilient response is the most prevalent. They also suggest, conversely, that persisting impairments in threat sensitivity and cognitive functioning may affect people's productivity and could potentially be a target for intervention." (ANI)
Reference: ANI: Big News Network:
Life-Extending Effects: How Serotonin, Dopamine, and the Smell of Food Affect Aging
Life-Extending Effects: How Serotonin, Dopamine, and the Smell of Food Affect Aging
Attractive food smells are enough to blunt the life-extending effect of a restricted diet. A research team figured out why this is the case and whether the phenomenon could be blocked with a drug.
The smell of food blocks the life-extending effect of a restricted diet. These drugs may unblock it.
A research study using worms provides new clues about the role of serotonin and dopamine in aging
Attractive food smells are enough to blunt the life-extending effect of a restricted diet. A research team figured out why this is the case and whether the phenomenon could be blocked with a drug.
The smell of food blocks the life-extending effect of a restricted diet. These drugs may unblock it.
A research study using worms provides new clues about the role of serotonin and dopamine in aging.
It’s common knowledge that a healthy diet is essential to a healthy life. And while many people follow specialized diets to trim down or improve their overall health, scientists interested in aging have been actively studying the life-extending effects of dietary restriction and fasting.
“There’s a concept called hormesis in biology, the idea of which is what doesn’t kill you makes you stronger,” said Scott Leiser, Ph.D., an assistant professor in Molecular & Integrative Physiology, and Internal Medicine at University of Michigan Medical School.
“One of the stresses that’s been most studied is dietary restriction, shown in many different organisms to extend lifespan and in people to improve health.”
However, as anyone on a strict weight loss regimen can attest, the mere smell of delicious food can be enough to break one’s willpower. What’s more, previous research actually found that in fruit flies, attractive food smells are enough to blunt the life-extending effect of a restricted diet. That study was from Leiser’s colleague Scott Pletcher, Ph.D., also of the Department of Molecular & Integrative Physiology.
In a new study published on June 7, 2022, in Nature Communications, Leiser, first authors Hillary Miller, Ph.D., and Shijiao Huang, Ph.D., and their team build on that research to figure out why this is the case and whether a drug could block the phenomenon.
In the roundworm C. elegans, lifespan extension in response to environmental stressors such as dietary restriction involves the activation of the fmo-2 gene. The researchers used the transparent nature of C. elegans to be able to see, in real time, the levels of FMO proteins.
When worms were limited in the amount of food they could eat, the FMO protein, which was highlighted using a fluorescent marker, lit up “like a Christmas tree…it was bright red,” noted Leiser. However, when the worms were exposed to food smells, there was considerably less activation of FMO, leading to a loss of life extension.
One of the main issues of dietary restriction as a potential approach for life extension in people is how difficult it is. But, said Leiser, “what if you could give yourself a drug that confused your body into thinking you were restricting your diet?”
Building on earlier research showing that neurotransmitters regulate longevity resulting from dietary restriction, the team screened compounds known to act on neurons.
They found three compounds that could prevent the reversal of fmo-2 induction in the presence of food: an antidepressant that blocks the neurotransmitter serotonin, and two antipsychotic drugs used to treat schizophrenia, both of which block the neurotransmitter dopamine.
“We know serotonin and dopamine are major players in the reward portion of the brain and tend to be involved in satiety and food response signals,” said Leiser. “The fact that the drugs we found were antagonizing this suggests you are blocking aspects of these pathways.” Ultimately, the drugs enabled the life extension effect of FMO, even in the presence of the smell of food.
Inability to Urinate With Others Nearby: Debilitating But Treatable
Inability to Urinate With Others Nearby: Debilitating But Treatable
KEY POINTS
- Paruresis is considered a form of performance anxiety and, thus, is on the social anxiety spectrum.
- Some sufferers are unable to leave their home for fear of using a public restroom and are as limited as people with agoraphobia.
- Paruresis is treated mostly with exposure therapy, though some evidence exists that medications enhance the cognitive-behavioral work.
Felix (name disguised) was a well-mannered inmate who made it to minimum security to get on a work crew. I was asked to check in with him because he was getting unusually agitated toward staff who demanded he take a pop urine test, part of making sure Felix wasn't accessing drugs while out working. This is what he told me:
They're sending me back to higher security because I can't pee for the urine test with them waiting for me at the bathroom door. It's like when you're in a public bathroom and someone else is in there, you know? You just get uptight, and it won't come out until you're alone. When I had to share a cell, I'd hold it 'til my cellmate left. It was kind of embarrassing to ask him to step out so I could take a leak. Even though the officer here isn't looking at me going, it's like a demand to pee for an audience. I just can't do it.
I was still young in my career, and this was the first I'd heard of this uncomfortable phenomenon, called paruresis, sometimes called a "shy bladder," being a pervasive issue. It never crossed my mind that this "slow to go" experience that I had heard joked about, and even experienced myself a few times, was associated with anxiety and could be debilitating for some people.
As readers will see, paruresis is simple in definition—an anxiety-driven inability to urinate in the presence of others—but may be complicated in terms of differential diagnosis, and certainly the havoc it wreaks upon those pervasively afflicted.
Paruresis, Unveiled
Etymologically, paruresis means an abnormal, or defective, urination process. It affects males and females, but the former accounts for the vast majority of cases, possibly partly due to genitourinary anatomy differences (Kuoch et al., 2019). While surely a condition that has existed for as long as humans, this mysterious inability to void was historically chalked up to, for example, in the Middle Ages, spells cast by enemies (Williams and Degenhardt, 1954).
References to it as a research topic, or at least investigation into psychological roots, following the timeline of the references listed on the International Paruresis Association's Web site, do not seem to have been broached until R.E. Wobus, in 1922, penned Notes on the Psychic Influence on Bladder Disturbances in Women. A few other scattered papers followed, and then, in 1954, researchers Williams and Degenhardt published Paruresis: Survey of a Disorder of Micturition. It was here we first see the term paruresis instead of some derivative of psychogenic urinary retention. These authors opined that paruresis was a preferable term because it can not get mistaken for enuresis or anuresis, the loss of urinary control, or a more general term for lack of urine production, respectively.
Kuoch (2017) explained the terminology nuance between psychogenic retention and paruresis as the former relates to cases like Felix, a "pee performance" matter, where voiding can occur once there is no audience. The latter is a more dangerous condition, a general retentiveness, audience or none, sans a contributing medical complication, that can require catheterization. While not described as such by Kuoch, this sort of psychogenic genitourinary complication would likely be significant in somatoform disorder. This diagnosis is marked by pain or bodily systems impairments, usually in the absence of any contributing medical condition, believed to serve as an expression of internalized conflict.
It has only been in the most recent decades that paruresis research, and an associated condition, parcopresis, the defecation equivalent, have gained momentum. In fact, outside of Kuoch and colleagues (e.g., 2017, 2019, 2021), little information exists on the prevalence of paruresis, which they have consistently reported ranges roughly between 3 and 16 percent of the population. Though they did not discuss the 13 percent spread, it might be surmised this represents the degree of pervasiveness, from debilitating to the very occasional experience, respectively.
Paruresis as Social Anxiety
What is clear is that this “shy bladder” problem is correlated to those with generalized social anxiety. Kuoch et al. (2017), for instance, noted that up to about 22 percent of those in their study exhibited social anxiety disorder. While mentioned as a symptom of social anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (p. 203), paruresis/parcopresis is not recognized as a subtype of social angst, though some researchers consider it to be (e.g., Kessler et al., 1997; Soifer and Ziprin, 2000; Knowles and Skues, 2016; Park et al., 2016). This makes sense, given, like general social anxiety, it is a performance anxiety associated within the social atmosphere. Here, the sufferer fears possible embarrassing scrutiny, a key feature of social anxiety disorder, regarding noise or visuals associated with voiding.
As to the development of the condition, like social anxiety disorder, some early, embarrassing, or otherwise unpleasant consequence of urination/defecation is likely at play. One patient I worked with, who was a socially anxious individual until their mid-20s, recalled that, in elementary school, another boy looked into the urinal he was using and said, “You’ve got a small one.” My patient recalled just wanting to escape, but being in “mid-stream” had to finish, and worried the peer would hear his continued urination and would come back to poke further fun. From then on, he feared that if someone nearby was of a bullying demeanor and heard his urination, given that would indicate he was in the process of peeing and thus exposed, they'd take that as an opportunity to look, and make a snide remark, embarrassing him again.
Pervasive Implications of Paruresis
On the most-pervasive end of the spectrum, an inability to void in a public restroom can lead to agoraphobic-like behavior. An agoraphobic person becomes reclusive for fear of not being able to escape to safety if need be while out in public. In contrast, but similar nonetheless, the paruretic person, knowing they may well have to void while out, but that it will be impossible and very uncomfortable, may do little more than leave the house to visit friends or family nearby if they know they have access to a private bathroom, or perhaps go to their job where there is a private bathroom.
From a correctional standpoint, inmates like Felix may be unfairly treated and returned to higher security because it is assumed they are trying to cover for drug use. Renowned forensic psychiatrist Kenneth Applebaum (2005) wrote that the absence of treatment for paruresis or the ability to sometimes void and not others does not rule out the issue. Unfortunately, in cases like Felix’s, staff were quick to assume it was “another manipulative inmate” and such consideration was not given.
Dr. Applebaum continued that such assumptions could lead to coercive interventions, like forcing fluids while the person was under observation, which can cause medical complications. He concluded that alternative methods like testing hair, saliva, or blood were better. Clearly, this is fairer to the inmates, and, nowadays, corrections staff are to place the inmate in a dry cell while conferring with a superintendent on what alternative test to use (Prisoner’s Legal Services of Massachusetts, 2022).
Differential Diagnosis
Agoraphobia: People with agoraphobia do not venture far because of their fear of being unable to escape to safety should it be required. People who are limited in movement by paruresis, on the other hand, are responding to anxiety related to voiding with others nearby.
Due to a general medical condition: Some people may have urological complications or be on medications that contribute to an inability to void. A man with, say, a prostate problem, might pee in spurts, which tends to be noticeable in a quiet bathroom, and he begins wondering if the others nearby are noticing the oddity, thus engendering fear of being scrutinized and leading to an inability to urinate in public places.Tags
Reference: Psychology Today:
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