Previous experience with stressors over which the subject has behavioral control blocks the typical behavioral consequences of subsequent exposure to stressors over which the organism has no behavioral control. The present experiments explored the involvement of the ventral medial prefrontal cortex (mPFCv) in mediating this “immunizing” or resilience producing effect of an initial experience with control. Behavioral immunization was blocked by inactivation of the mPFCv with muscimol at the time of the initial experience with control, as well as at the time of the later exposure to uncontrollable stress. Inhibition of protein synthesis within the mPFCv by anisomycin also blocked immunization when administered at the time of the initial controllable stress but had no effect when administered at the time of the later uncontrollable stress. Additional experiments found that the initial experience with control blocks the intense activation of serotonergic cells in the dorsal raphe nucleus that would normally be produced by uncontrollable stress, providing a mechanism for behavioral immunization. Furthermore, mPFCv activity during the initial controllable stressor was required for this effect to occur. These results suggest that the mPFCv is needed both to process information about the controllability of stressors and to utilize such information to regulate responses to subsequent stressors. Moreover, the mPFCv may be a site of storage or plasticity concerning controllability information. These results are consistent with recent research in other domains that explore the functions of the mPFCv.
Abstract For patients with hormone receptor-positive, early breast cancer without HER2 amplification, multigene expression assays including Oncotype DX ® recurrence score (RS) have been clinically validated to identify patients who stand to derive added benefit from adjuvant cytotoxic chemotherapy. However, cost and turnaround time have limited its global adoption despite recommendation by practice guidelines. We investigated if routinely available hematoxylin and eosin (H&E)-stained pathology slides could act as a surrogate triaging data substrate by predicting RS using machine learning methods. We trained and validated a multimodal transformer model, Orpheus, using 6,203 patients across three independent cohorts, taking both H&E images and their corresponding synoptic text reports as input. We showed accurate inference of recurrence score from whole-slide images (r = 0.63 (95% C.I. 0.58 - 0.68); n = 1,029), the raw text of their corresponding reports (r = 0.58 (95% C.I. 0.51 - 0.64); n = 972), and their combination (r = 0.68 (95% C.I. 0.64 - 0.73); n = 964) as measured by Pearson’s correlation. To predict high-risk disease (RS>25), our model achieved an area under the receiver operating characteristic curve (AUROC) of 0.89 (95% C.I. 0.83 - 0.94), and area under the precision recall curve (AUPRC) of 0.64 (95% C.I. 0.60 - 0.82), compared to 0.49 (95% C.I. 0.36 - 0.64) for an existing nomogram based on clinical and pathologic features. Moreover, our model generalizes well to external international cohorts, effectively identifying recurrence risk (r = 0.61, p < 10 -4 , n = 452; r = 0.60, p < 10 -4 , n = 575) and high-risk status (AUROC = 0.80, p < 10 -4 , AUPRC = 0.68, p < 10 -4 , n = 452; AUROC = 0.83, p < 10 -4 , AUPRC = 0.73, p < 10 -4 , n = 575) from whole-slide images. Probing the biologic underpinnings of the model decisions uncovered tumor cell size heterogeneity, immune cell infiltration, a proliferative transcription program, and stromal fraction as correlates of higher-risk predictions. We conclude that at an operating point of 94.4% precision and 33.3% recall, this model could help increase global adoption and shorten lag between resection and adjuvant therapy.
The degree of control that an organism has over a stressor potently modulates the impact of the stressor, with uncontrollable stressors producing a constellation of outcomes that do not occur if the stressor is behaviorally controllable. It has generally been assumed that this occurs because uncontrollability actively potentiates the effects of stressors. Here it will be suggested that in addition, or instead, the presence of control actively inhibits the impact of stressors. At least in part, this occurs because (i) the presence of control is detected by regions of the ventral medial prefrontal cortex (mPFCv); and (ii) detection of control activates mPFCv output to stress-responsive brain stem and limbic structures that actively inhibit stress-induced activation of these structures. Furthermore, an initial experience with control over stress alters the mPFCv response to subsequent stressors so that mPFCv output is activated even if the subsequent stressor is uncontrollable, thereby making the organism resilient. The general implications of these results for understanding resilience in the face of adversity are discussed.
Functionally heterogeneous populations of serotonergic neurons, located within the dorsal raphe nucleus (DR), play a role in stress-related behaviors and neuropsychiatric illnesses such as anxiety and depression. Abnormal development of these neurons may permanently alter their structure and connections, making the organism more susceptible to anxiety-related disorders. A factor that critically regulates the development of serotonergic neurons is fibroblast growth factor 8 (Fgf8). In this study, we used acute restraint stress followed by behavioral testing to examine whether Fgf8 signaling during development is important for establishing functional stress- and anxiety-related DR neurocircuits in adulthood. Wild-type and heterozygous male mice globally hypomorphic for Fgf8 were exposed to acute restraint stress and then tested for anxiety-like behavior on the elevated plus-maze. Further, we measured c-Fos immunostaining as a marker of serotonergic neuronal activation and tissue 5-hydroxyindoleacetic acid concentrations as a marker of serotonin functional output. Results showed that Fgf8 hypomorphs exhibited 1) an exaggerated response of DR anxiety-promoting circuits and 2) a blunted response of a DR panic-inhibiting circuit to stress, effects that together were associated with increased baseline anxiety-like behavior. Overall, our results provide a neural substrate upon which Fgf8 deficiency could affect stress response and support the hypothesis that developmental disruptions of serotonergic neurons affect their postnatal functional integrity.
Adenosine-to-inosine (A-to-I) RNA editing is a co-/posttranscriptional modification of double-stranded RNA, catalyzed by the adenosine deaminase acting on RNA (ADAR) family of enzymes, which results in recognition of inosine as guanosine by translational and splicing machinery causing potential recoding events in amino acid sequences. A-to-I editing is prominent within brain-specific transcripts, and dysregulation of editing at several well-studied loci (e.g., Gria2, Htr2c) has been implicated in acute and chronic stress in rodents as well as neurological (e.g., Alzheimer's) and psychopathological disorders such as schizophrenia and major depressive disorder. However, only a small fraction of recoding sites has been investigated within the brain following stress, and our understanding of the role of RNA editing in transcriptome regulation following environmental stimuli remains poorly understood. Thus, we aimed to investigate A-to-I editing at hundreds of loci following chronic social defeat stress (CSDS) in mice within corticolimbic regions responsive to chronic stress regulation. Adult male mice were subjected to CSDS or control conditions for 21 days and dynamic regulation of A-to-I editing was investigated 2 and 8 days following the final defeat within both the medial prefrontal cortex (mPFC) and basolateral amygdala (BLA). Employing a targeted resequencing approach, which utilizes microfluidics-based multiplex polymerase chain reaction (PCR) coupled with next-generation sequencing, we analyzed A-to-I editing at ∼100 high-confidence editing sites within the mouse brain. CSDS resulted in acute regulation of transcripts encoding several ADAR enzymes, which normalized 8 days following the final defeat and was specific for susceptible mice. In contrast, sequencing analysis revealed modest and dynamic regulation of A-to-I editing within numerous transcripts in both the mPFC and BLA of resilient and susceptible mice at both 2 and 8 days following CSDS with minimal overlap between regions and time points. Editing within the Htr2c transcript and relative abundance of Htr2c messenger RNA (mRNA)variants were also observed within the BLA of susceptible mice 2 days following CSDS. These results indicate dynamic RNA editing within discrete brain regions following CSDS in mice, further implicating A-to-I editing as a stress-sensitive molecular mechanism within the brain of potential relevance to resiliency and susceptibility to CSDS.
Multigene tests provide information that may guide the optimal treatment regimen for breast cancer (BCa) patients. However, assignment of an individual tumor to any subtype/prognostic risk group shows only moderate reproducibility depending on the assay, tumor composition, gene list and expression thresholds. This single-sample discordance impedes clinical use and raises important questions about which is the right test and whether multiple tests are better than one. We used multiplexed RNA fluorescent in situ hybridization of four BCa biomarkers, estrogen/progesterone/Her2/Ki67, to guide laser capture microdissection followed by RNAseq. This technique, called mFISHseq, ensures tumor purity, facilitates interrogation of tumor heterogeneity, permitting unbiased whole transcriptome analysis. To ascertain multigene test discordance, we applied mFISHseq on a cohort of 1,082 FFPE breast tumors with detailed clinicopathological data and derived molecular subtypes using research based PAM50, AIMS, and our own 293-gene subtyping classifier. We also assigned patients to prognostic risk groups using research based OncotypeDX, GENE70, risk of recurrence by subtype, and GGI. We observed considerable discordance with 24% and 61% of patients having at least one multigene test in disagreement for molecular subtyping and prognostic risk assignment, respectively. To improve single sample concordance, we implemented a simple voting scheme of the multigene classifiers to assign a consensus molecular subtype/risk group. Consensus subtyping reclassified 30% of patients into subtypes that better fit their transcriptomic risk and outcome, and further identified that 60% of these patients received suboptimal treatment. Likewise, our consensus prognostic risk approach mitigated discordance and provided prognostic insights for patients with high, low, and ultra-low risk. By leveraging spatially resolved, tumor enriched transcriptome profiling, mFISHseq alleviated sample-level discordance and assigned individuals to molecular subtypes/prognostic risk groups that better matched their outcome, thus resolving limitations to clinical adoption.
SARS-CoV-2 mutants carrying the ∆H69/∆V70 deletion in the amino-terminal domain of the Spike protein emerged independently in at least six lineages of the virus (namely, B.1.1.7, B.1.1.298, B.1.160, B.1.177, B.1.258, B.1.375). We analyzed SARS-CoV-2 samples collected from various regions of Slovakia between November and December 2020 that were presumed to contain B.1.1.7 variant due to drop-out of the Spike gene target in an RT-qPCR test caused by this deletion. Sequencing of these samples revealed that although in some cases the samples were indeed confirmed as B.1.1.7, a substantial fraction of samples contained another ∆H69/∆V70 carrying mutant belonging to the lineage B.1.258, which has been circulating in Central Europe since August 2020, long before the import of B.1.1.7. Phylogenetic analysis shows that the early sublineage of B.1.258 acquired the N439K substitution in the receptor-binding domain (RBD) of the Spike protein and, later on, also the deletion ∆H69/∆V70 in the Spike N-terminal domain (NTD). This variant was particularly common in several European countries including the Czech Republic and Slovakia but has been quickly replaced by B.1.1.7 early in 2021.
