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Commentary on SSO and other putative inhibitors of FA transport across membranes by CD36 disrupt intracellular metabolism, but do not affect fatty acid translocation

Henry J. Pownall
May 1, 2020; 61:595-597
Commentary




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Characterization of the small molecule ARC39, a direct and specific inhibitor of acid sphingomyelinase in vitro

Eyad Naser
Mar 10, 2020; 0:jlr.RA120000682v1-jlr.RA120000682
Research Articles




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Episode 13 - The Internet of Bitcoins (IoB) Vive VR, Bitcoin theories and Sky Q

On this week's UK Tech Weekly podcast host Matt Egan is joined by Macworld UK and PC Advisor Staff Writer Lewis Painter, who has spent the past week in virtual reality, and is beyond excited to tell us all about the amazing HTC Vive. Then regular podder David Price, acting editor of Macworld UK, brings us tales from the murky world of Bitcoin, and explains how the crypto-currency is bringing about new tech that may revolutionise the finance industry (16:30) Finally, producer Chris throws aside his mic stand to discuss Sky Q and the current options in media streaming and TV. (25:30).  


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Episode 77 - The Internet of Tulips (IoT) Bitcoin, the platform wars and Christmas tech gifts

We finally get the IoT acronym the pod has been waiting for as we discuss Bitcoin and 17th century Dutch finance. Charlotte Jee informs Henry Burrell, David Price and Scott Carey.


Scott then leads us down the winding road of the so-called platform wars, in a week when Google blocked the Amazon Echo Show from streaming YouTube. Is this a bump in the road or will services be cut from rival hardware?


And finally, led by David, the pod discusses its favourite tech of the year and what you might consider buying for friends and family for Christmas.

 

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Episode 82 - The Internet of Cars in Space (IoCiS) Falcon Heavy, Bitcoin bubble and Apple earnings

Back with a bang as Computerworld editor Scott Carey leads the squad into the cauldron of convo. Christina Mercer explains why her beau Elon Musk took a car into space, Sean Bradley on that bursting Bitcoin bubble, and David Price to tell us all how Apple can charge even more for its stuff and keep on making record profit.

 

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Episode 108 - The Internet of Silicon Valley Meal Drinks (IoSVMD) Soylent tasting, Black Friday and Bitcoin slump

David Price is in the host's chair this week, as the team talk about the latest hot tech topics. Tamlin Magee has got the drinks in - futuristic meal-replacement drinks called Soylent, which he forces everyone to try and which are apparently not people.


Then Dominic Preston talks us through the positive and extremely negative sides of Amazon's Black Friday activities, before Sean Bradley attempts to explain why Bitcoin is tanking and what the future holds for crypto currencies. Cheers!

 

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Characterization of the small molecule ARC39, a direct and specific inhibitor of acid sphingomyelinase in vitro [Research Articles]

Inhibition of acid sphingomyelinase (ASM), a lysosomal enzyme that catalyzes the hydrolysis of sphingomyelin into ceramide and phosphorylcholine, may serve as an investigational tool or a therapeutic intervention to control many diseases. Specific ASM inhibitors are currently not sufficiently characterized. Here, we found that 1-aminodecylidene bis-phosphonic acid (ARC39) specifically and efficiently (>90%) inhibits both lysosomal and secretory ASM in vitro. Results from investigating sphingomyelin phosphodiesterase 1 (SMPD1/Smpd1) mRNA and ASM protein levels suggested that ARC39 directly inhibits ASM’s catalytic activity in cultured cells, a mechanism which differs from that of functional inhibitors of ASM (FIASMAs). We further provide evidence that ARC39 dose- and time-dependently inhibits lysosomal ASM in intact cells, and we show that ARC39 also reduces platelet- and ASMpromoted adhesion of tumor cells. The observed toxicity of ARC39 is low at concentrations relevant for ASM inhibition in vitro, and it does not strongly alter the lysosomal compartment or induce phospholipidosis in vitro. When applied intraperitoneally in vivo, even subtoxic high doses administered short-term induced sphingomyelin accumulation only locally in the peritoneal lavage without significant accumulation in plasma, liver, spleen or brain. These findings require further investigation with other possible chemical modifications. In conclusion, our results indicate that ARC39 potently and selectively inhibits ASM in vitro and highlight the need for developing compounds that can reach tissue concentrations sufficient for ASM inhibition in vivo.




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Exon 9-deleted CETP inhibits full length-CETP synthesis and promotes cellular triglyceride storage [Research Articles]

Cholesteryl ester transfer protein (CETP) exists as full-length (FL) and exon 9 (E9)-deleted isoforms. The function of E9-deleted CETP is poorly understood. Here, we investigated the role of E9-deleted CETP in regulating the secretion of FL-CETP by cells and explored its possible role in intracellular lipid metabolism. CETP overexpression in cells that naturally express CETP confirmed that E9-deleted CETP is not secreted, and showed that cellular FL- and E9-deleted CETP form an isolatable complex. Coexpression of CETP isoforms lowered cellular levels of both proteins and impaired FL-CETP secretion. These effects were due to reduced synthesis of both isoforms; however, the predominate consequence of FL- and E9-deleted CETP coexpression is impaired FL-CETP synthesis. We reported previously that reducing both CETP isoforms or overexpressing FL-CETP impairs cellular triglyceride (TG) storage. To investigate this further, E9-deleted CETP was expressed in SW872 cells that naturally synthesize CETP and in mouse 3T3-L1 cells that do not. E9-deleted CETP overexpression stimulated SW872 triglyceride synthesis and increased stored TG 2-fold. Expression of E9-deleted CETP in mouse 3T3-L1 cells produced a similar lipid phenotype. In vitro, FL-CETP promotes the transfer of TG from ER-enriched membranes to lipid droplets. E9-deleted CETP also promoted this transfer, although less effectively, and it inhibited the transfer driven by FL-CETP. We conclude that FL- and E9-deleted CETP isoforms interact to mutually decrease their intracellular levels and impair FL-CETP secretion by reducing CETP biosynthesis. E9-deleted CETP, like FL-CETP, alters cellular TG metabolism and storage but in a contrary manner.




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A novel NanoBiT-based assay monitors the interaction between lipoprotein lipase and GPIHBP1 in real time [Methods]

The hydrolysis of triglycerides in triglyceride-rich lipoproteins by LPL is critical for the delivery of triglyceride-derived fatty acids to tissues, including heart, skeletal muscle, and adipose tissues. Physiologically active LPL is normally bound to the endothelial cell protein glycosylphosphatidylinositol-anchored high-density lipoprotein binding protein 1 (GPIHBP1), which transports LPL across endothelial cells, anchors LPL to the vascular wall, and stabilizes LPL activity. Disruption of LPL-GPIHBP1 binding significantly alters triglyceride metabolism and lipid partitioning. In this study, we modified the NanoLuc® Binary Technology split-luciferase system to develop a novel assay that monitors the binding of LPL to GPIHBP1 on endothelial cells in real time. We validated the specificity and sensitivity of the assay using endothelial lipase and a mutant version of LPL and found that this assay reliably and specifically detected the interaction between LPL and GPIHBP1. We then interrogated various endogenous and exogenous inhibitors of LPL-mediated lipolysis for their ability to disrupt the binding of LPL to GPIHBP1. We found that angiopoietin-like (ANGPTL)4 and ANGPTL3-ANGPTL8 complexes disrupted the interactions of LPL and GPIHBP1, whereas the exogenous LPL blockers we tested (tyloxapol, poloxamer-407, and tetrahydrolipstatin) did not. We also found that chylomicrons could dissociate LPL from GPIHBP1 and found evidence that this dissociation was mediated in part by the fatty acids produced by lipolysis. These results demonstrate the ability of this assay to monitor LPL-GPIHBP1 binding and to probe how various agents influence this important complex.




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HDL inhibits endoplasmic reticulum stress-induced apoptosis of pancreatic {beta}-cells in vitro by activation of Smoothened [Research Articles]

Loss of pancreatic β-cell mass and function as a result of sustained ER stress is a core step in the pathogenesis of diabetes mellitus type 2. The complex control of β-cells and insulin production involves hedgehog (Hh) signaling pathways as well as cholesterol-mediated effects. In fact, data from studies in humans and animal models suggest that HDL protects against the development of diabetes through inhibition of ER stress and β-cell apoptosis. We investigated the mechanism by which HDL inhibits ER stress and apoptosis induced by thapsigargin, a sarco/ER Ca2+-ATPase inhibitor, in β-cells of a rat insulinoma cell line, INS1e. We further explored effects on the Hh signaling receptor Smoothened (SMO) with pharmacologic agonists and inhibitors. Interference with sterol synthesis or efflux enhanced β-cell apoptosis and abrogated the anti-apoptotic activity of HDL. During ER stress, HDL facilitated the efflux of specific oxysterols, including 24-hydroxycholesterol (OHC). Supplementation of reconstituted HDL with 24-OHC enhanced and, in cells lacking ABCG1 or the 24-OHC synthesizing enzyme CYP46A1, restored the protective activity of HDL. Inhibition of SMO countered the beneficial effects of HDL and also LDL, and SMO agonists decreased β-cell apoptosis in the absence of ABCG1 or CYP46A1. The translocation of the SMO-activated transcription factor glioma-associated oncogene GLI-1 was inhibited by ER stress but restored by both HDL and 24-OHC. In conclusion, the protective effect of HDL to counter ER stress and β-cell death involves the transport, generation, and mobilization of oxysterols for activation of the Hh signaling receptor SMO




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SSO and other putative inhibitors of FA transport across membranes by CD36 disrupt intracellular metabolism, but do not affect FA translocation [Research Articles]

Membrane-bound proteins have been proposed to mediate the transport of long-chain FA (LCFA) transport through the plasma membrane (PM). These proposals are based largely on reports that PM transport of LCFAs can be blocked by a number of enzymes and purported inhibitors of LCFA transport. Here, using the ratiometric pH indicator (2',7'-bis-(2-carboxyethyl)-5-(and-6-)-carboxyfluorescein and acrylodated intestinal FA-binding protein-based dual fluorescence assays, we investigated the effects of nine inhibitors of the putative FA transporter protein CD36 on the binding and transmembrane movement of LCFAs. We particularly focused on sulfosuccinimidyl oleate (SSO), reported to be a competitive inhibitor of CD36-mediated LCFA transport. Using these assays in adipocytes and inhibitor-treated protein-free lipid vesicles, we demonstrate that rapid LCFA transport across model and biological membranes remains unchanged in the presence of these purported inhibitors. We have previously shown in live cells that CD36 does not accelerate the transport of unesterified LCFAs across the PM. Our present experiments indicated disruption of LCFA metabolism inside the cell within minutes upon treatment with many of the "inhibitors" previously assumed to inhibit LCFA transport across the PM. Furthermore, using confocal microscopy and a specific anti-SSO antibody, we found that numerous intracellular and PM-bound proteins are SSO-modified in addition to CD36. Our results support the hypothesis that LCFAs diffuse rapidly across biological membranes and do not require an active protein transporter for their transmembrane movement.




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Commentary on SSO and other putative inhibitors of FA transport across membranes by CD36 disrupt intracellular metabolism, but do not affect fatty acid translocation [Commentaries]




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Inhibition of the erythropoietin-producing receptor EPHB4 antagonizes androgen receptor overexpression and reduces enzalutamide resistance [Molecular Bases of Disease]

Prostate cancer (PCa) cells heavily rely on an active androgen receptor (AR) pathway for their survival. Enzalutamide (MDV3100) is a second-generation antiandrogenic drug that was approved by the Food and Drug Administration in 2012 to treat patients with castration-resistant prostate cancer (CRPC). However, emergence of resistance against this drug is inevitable, and it has been a major challenge to develop interventions that help manage enzalutamide-resistant CRPC. Erythropoietin-producing human hepatocellular (Eph) receptors are targeted by ephrin protein ligands and have a broad range of functions. Increasing evidence indicates that this signaling pathway plays an important role in tumorigenesis. Overexpression of EPH receptor B4 (EPHB4) has been observed in multiple types of cancer, being closely associated with proliferation, invasion, and metastasis of tumors. Here, using RNA-Seq analyses of clinical and preclinical samples, along with several biochemical and molecular methods, we report that enzalutamide-resistant PCa requires an active EPHB4 pathway that supports drug resistance of this tumor type. Using a small kinase inhibitor and RNAi-based gene silencing to disrupt EPHB4 activity, we found that these disruptions re-sensitize enzalutamide-resistant PCa to the drug both in vitro and in vivo. Mechanistically, we found that EPHB4 stimulates the AR by inducing proto-oncogene c-Myc (c-Myc) expression. Taken together, these results provide critical insight into the mechanism of enzalutamide resistance in PCa, potentially offering a therapeutic avenue for enhancing the efficacy of enzalutamide to better manage this common malignancy.




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Certain ortho-hydroxylated brominated ethers are promiscuous kinase inhibitors that impair neuronal signaling and neurodevelopmental processes [Cell Biology]

The developing nervous system is remarkably sensitive to environmental signals, including disruptive toxins, such as polybrominated diphenyl ethers (PBDEs). PBDEs are an environmentally pervasive class of brominated flame retardants whose neurodevelopmental toxicity mechanisms remain largely unclear. Using dissociated cortical neurons from embryonic Rattus norvegicus, we found here that chronic exposure to 6-OH–BDE-47, one of the most prevalent hydroxylated PBDE metabolites, suppresses both spontaneous and evoked neuronal electrical activity. On the basis of our previous work on mitogen-activated protein kinase (MAPK)/extracellular signal-related kinase (ERK) (MEK) biology and our observation that 6-OH–BDE-47 is structurally similar to kinase inhibitors, we hypothesized that certain hydroxylated PBDEs mediate neurotoxicity, at least in part, by impairing the MEK–ERK axis of MAPK signal transduction. We tested this hypothesis on three experimental platforms: 1) in silico, where modeling ligand–protein docking suggested that 6-OH–BDE-47 is a promiscuous ATP-competitive kinase inhibitor; 2) in vitro in dissociated neurons, where 6-OH–BDE-47 and another specific hydroxylated BDE metabolite similarly impaired phosphorylation of MEK/ERK1/2 and activity-induced transcription of a neuronal immediate early gene; and 3) in vivo in Drosophila melanogaster, where developmental exposures to 6-OH–BDE-47 and a MAPK inhibitor resulted in offspring displaying similarly increased frequency of mushroom-body β–lobe midline crossing, a metric of axonal guidance. Taken together, our results support that certain ortho-hydroxylated PBDE metabolites are promiscuous kinase inhibitors and can cause disruptions of critical neurodevelopmental processes, including neuronal electrical activity, pre-synaptic functions, MEK–ERK signaling, and axonal guidance.




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The focal adhesion protein kindlin-2 controls mitotic spindle assembly by inhibiting histone deacetylase 6 and maintaining {alpha}-tubulin acetylation [Signal Transduction]

Kindlins are focal adhesion proteins that regulate integrin activation and outside-in signaling. The kindlin family consists of three members, kindlin-1, -2, and -3. Kindlin-2 is widely expressed in multiple cell types, except those from the hematopoietic lineage. A previous study has reported that the Drosophila Fit1 protein (an ortholog of kindlin-2) prevents abnormal spindle assembly; however, the mechanism remains unknown. Here, we show that kindlin-2 maintains spindle integrity in mitotic human cells. The human neuroblastoma SH-SY5Y cell line expresses only kindlin-2, and we found that when SH-SY5Y cells are depleted of kindlin-2, they exhibit pronounced spindle abnormalities and delayed mitosis. Of note, acetylation of α-tubulin, which maintains microtubule flexibility and stability, was diminished in the kindlin-2–depleted cells. Mechanistically, we found that kindlin-2 maintains α-tubulin acetylation by inhibiting the microtubule-associated deacetylase histone deacetylase 6 (HDAC6) via a signaling pathway involving AKT Ser/Thr kinase (AKT)/glycogen synthase kinase 3β (GSK3β) or paxillin. We also provide evidence that prolonged hypoxia down-regulates kindlin-2 expression, leading to spindle abnormalities not only in the SH-SY5Y cell line, but also cell lines derived from colon and breast tissues. The findings of our study highlight that kindlin-2 regulates mitotic spindle assembly and that this process is perturbed in cancer cells in a hypoxic environment.




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Inhibition of glycosphingolipid biosynthesis reverts multidrug resistance by differentially modulating ABC transporters in chronic myeloid leukemias [Cell Biology]

Multidrug resistance (MDR) in cancer arises from cross-resistance to structurally- and functionally-divergent chemotherapeutic drugs. In particular, MDR is characterized by increased expression and activity of ATP-binding cassette (ABC) superfamily transporters. Sphingolipids are substrates of ABC proteins in cell signaling, membrane biosynthesis, and inflammation, for example, and their products can favor cancer progression. Glucosylceramide (GlcCer) is a ubiquitous glycosphingolipid (GSL) generated by glucosylceramide synthase, a key regulatory enzyme encoded by the UDP-glucose ceramide glucosyltransferase (UGCG) gene. Stressed cells increase de novo biosynthesis of ceramides, which return to sub-toxic levels after UGCG mediates incorporation into GlcCer. Given that cancer cells seem to mobilize UGCG and have increased GSL content for ceramide clearance, which ultimately contributes to chemotherapy failure, here we investigated how inhibition of GSL biosynthesis affects the MDR phenotype of chronic myeloid leukemias. We found that MDR is associated with higher UGCG expression and with a complex GSL profile. UGCG inhibition with the ceramide analog d-threo-1-(3,4,-ethylenedioxy)phenyl-2-palmitoylamino-3-pyrrolidino-1-propanol (EtDO-P4) greatly reduced GSL and monosialotetrahexosylganglioside levels, and co-treatment with standard chemotherapeutics sensitized cells to mitochondrial membrane potential loss and apoptosis. ABC subfamily B member 1 (ABCB1) expression was reduced, and ABCC-mediated efflux activity was modulated by competition with nonglycosylated ceramides. Consistently, inhibition of ABCC-mediated transport reduced the efflux of exogenous C6-ceramide. Overall, UGCG inhibition impaired the malignant glycophenotype of MDR leukemias, which typically overcomes drug resistance through distinct mechanisms. This work sheds light on the involvement of GSL in chemotherapy failure, and its findings suggest that targeted GSL modulation could help manage MDR leukemias.




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Structural basis of specific inhibition of extracellular activation of pro- or latent myostatin by the monoclonal antibody SRK-015 [Molecular Biophysics]

Myostatin (or growth/differentiation factor 8 (GDF8)) is a member of the transforming growth factor β superfamily of growth factors and negatively regulates skeletal muscle growth. Its dysregulation is implicated in muscle wasting diseases. SRK-015 is a clinical-stage mAb that prevents extracellular proteolytic activation of pro- and latent myostatin. Here we used integrated structural and biochemical approaches to elucidate the molecular mechanism of antibody-mediated neutralization of pro-myostatin activation. The crystal structure of pro-myostatin in complex with 29H4-16 Fab, a high-affinity variant of SRK-015, at 2.79 Å resolution revealed that the antibody binds to a conformational epitope in the arm region of the prodomain distant from the proteolytic cleavage sites. This epitope is highly sequence-divergent, having only limited similarity to other closely related members of the transforming growth factor β superfamily. Hydrogen/deuterium exchange MS experiments indicated that antibody binding induces conformational changes in pro- and latent myostatin that span the arm region, the loops contiguous to the protease cleavage sites, and the latency-associated structural elements. Moreover, negative-stain EM with full-length antibodies disclosed a stable, ring-like antigen–antibody structure in which the two Fab arms of a single antibody occupy the two arm regions of the prodomain in the pro- and latent myostatin homodimers, suggesting a 1:1 (antibody:myostatin homodimer) binding stoichiometry. These results suggest that SRK-015 binding stabilizes the latent conformation and limits the accessibility of protease cleavage sites within the prodomain. These findings shed light on approaches that specifically block the extracellular activation of growth factors by targeting their precursor forms.




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Affinity maturation, humanization, and co-crystallization of a rabbit anti-human ROR2 monoclonal antibody for therapeutic applications [Immunology]

Antibodies are widely used as cancer therapeutics, but their current use is limited by the low number of antigens restricted to cancer cells. A receptor tyrosine kinase, receptor tyrosine kinase-like orphan receptor 2 (ROR2), is normally expressed only during embryogenesis and is tightly down-regulated in postnatal healthy tissues. However, it is up-regulated in a diverse set of hematologic and solid malignancies, thus ROR2 represents a candidate antigen for antibody-based cancer therapy. Here we describe the affinity maturation and humanization of a rabbit mAb that binds human and mouse ROR2 but not human ROR1 or other human cell-surface antigens. Co-crystallization of the parental rabbit mAb in complex with the human ROR2 kringle domain (hROR2-Kr) guided affinity maturation by heavy-chain complementarity-determining region 3 (HCDR3)-focused mutagenesis and selection. The affinity-matured rabbit mAb was then humanized by complementarity-determining region (CDR) grafting and framework fine tuning and again co-crystallized with hROR2-Kr. We show that the affinity-matured and humanized mAb retains strong affinity and specificity to ROR2 and, following conversion to a T cell–engaging bispecific antibody, has potent cytotoxicity toward ROR2-expressing cells. We anticipate that this humanized affinity-matured mAb will find application for antibody-based cancer therapy of ROR2-expressing neoplasms.




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The major subunit of widespread competence pili exhibits a novel and conserved type IV pilin fold [Protein Structure and Folding]

Type IV filaments (T4F), which are helical assemblies of type IV pilins, constitute a superfamily of filamentous nanomachines virtually ubiquitous in prokaryotes that mediate a wide variety of functions. The competence (Com) pilus is a widespread T4F, mediating DNA uptake (the first step in natural transformation) in bacteria with one membrane (monoderms), an important mechanism of horizontal gene transfer. Here, we report the results of genomic, phylogenetic, and structural analyses of ComGC, the major pilin subunit of Com pili. By performing a global comparative analysis, we show that Com pili genes are virtually ubiquitous in Bacilli, a major monoderm class of Firmicutes. This also revealed that ComGC displays extensive sequence conservation, defining a monophyletic group among type IV pilins. We further report ComGC solution structures from two naturally competent human pathogens, Streptococcus sanguinis (ComGCSS) and Streptococcus pneumoniae (ComGCSP), revealing that this pilin displays extensive structural conservation. Strikingly, ComGCSS and ComGCSP exhibit a novel type IV pilin fold that is purely helical. Results from homology modeling analyses suggest that the unusual structure of ComGC is compatible with helical filament assembly. Because ComGC displays such a widespread distribution, these results have implications for hundreds of monoderm species.




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A Variation on the Theme: SGLT2 Inhibition and Glucagon Secretion in Human Islets

David J. Hodson
May 1, 2020; 69:864-866
Commentaries




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Evidence Against an Important Role of Plasma Insulin and Glucagon Concentrations in the Increase in EGP Caused by SGLT2 Inhibitors

Mariam Alatrach
Apr 1, 2020; 69:681-688
Pathophysiology




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Correction: Rational design, synthesis, and evaluation of uncharged, “smart” bis-oxime antidotes of organophosphate-inhibited human acetylcholinesterase. [Additions and Corrections]

VOLUME 295 (2020) PAGES 4079–4092There was an error in the abstract. “The pyridinium cation hampers uptake of OPs into the central nervous system (CNS)” should read as “The pyridinium cation hampers uptake into the central nervous system (CNS).”




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How changes to drug prohibition could be good for the UK—an essay by Molly Meacher and Nick Clegg




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Climate Change: Raising Ambition, Delivering Results

Conference

3 November 2014 - 9:30am to 4 November 2014 - 1:15pm

Chatham House, London

Overview

Agenda

Speakers

Pricing

Media partners

Sponsors

Audience profile

Venue and accommodation

Press registration

Climate change is climbing the political agenda. Extreme weather has raised questions in public discourse about the role of anthropogenic warming and concerns about its future impacts; slowdowns in emerging economies and sluggish recoveries in the developed world mean debates about the impact of climate policies on energy bills and competitiveness have assumed particular significance. Against this background, governments are gearing up for a crucial series of agreements in 2015 with climate change at their core. The international community must agree new global sustainable development goals, a new framework on disaster risk reduction and, at the 21st UN Framework Convention on Climate Change (UNFCCC) meeting of the Conference of Parties (COP 21) in Paris, a new global deal on climate change. 

The 18th Annual Chatham House Conference on Climate Change will take stock of developments in 2014, including the latest science, the findings of high-level commissions, initiatives from the business community and the UN Secretary-General’s High Level Summit at the end of September. Looking forward to COP 20 in Lima and beyond, this conference will examine opportunities to raise ambition and convert this into results.

In particular, it will:

  • Review the latest science on climate risk and the implications for business, society and politics 
     
  • Examine the benefits of a low carbon economy, and assess the costs of climate action and where they fall 
     
  • Discuss concrete measures to decarbonize key sectors and the barriers to action
     
  • Identify the critical path to the UNFCCC’s Conference of the Parties (COP 21) in 2015, and look at whether, and how, support for ambitious action can be built among publics, business and politicians


The Chatham House Rule
To enable as open a debate as possible, this conference will be held under the Chatham House Rule.

Twitter
Suggested hashtag: #CHclimate

DAY ONE
Monday 3 November

Session One
Taking Stock and Mapping the Road Ahead
09:30-11:15

  • What was achieved at the UN Secretary General’s High Level Summit in September? 
  • What is the outlook for COP 20 in Lima, and how can ambition be increased?
  • How will success at COP 21 in Paris be defined?

Chair
Rob Bailey, Acting Research Director, Energy, Environment and Resources, Chatham House

Keynote Address
Manuel Pulgar-Vidal, Minister of State for the Environment, Peru; President, COP 20, UN Framework for the Convention on Climate Change (UNFCCC) (on the record)

Amber Rudd MP, Parliamentary Under Secretary of State, Department of Energy and Climate Change, United Kingdom (on the record)

Questions and Discussion

Chair
Jennifer Morgan, Director, Climate and Energy Programme, World Resources Institute (WRI) 

Speakers

Selwin Hart, Director, Secretary-General's Climate Change Support Team, United Nations

Dr Halldór Thorgeirsson, Director for Strategy, UN Framework for the Convention on Climate Change (UNFCCC)

Leena Srivastava, Executive Director, The Energy and Resource Institute (TERI) 

Paul Watkinson, Head of Climate Negotiation Team, Ministry of Ecology, Sustainable Development and Energy, France

Questions and Discussion

11:15-11:45 Refreshments

Session Two
Low Carbon Economy: Costs and Benefits
11:45-13:00 

  • What are the economic and social opportunities and benefits of a low carbon economy? Where do these occur? How much are they worth?
  • What are examples of leadership among governments and business? What is needed to accelerate the transition and translate ambition into results?
  • What has been the impact of climate policies on economic competitiveness? Which economies and sectors have been most affected? How has this influenced national and international climate politics?
Chair's Opening Remarks
Marianne Fay, Chief Economist, Climate Change Group, The World Bank
Keynote Panel Discussion

Jeremy Oppenheim, Programme Director, New Climate Economy, Global Commission on the Economy and Climate 

Jos Delbeke, Director General for Climate Action, European Commission 

Dr Qi Ye, Director, Brookings-Tsinghua Center for Public Policy; Professor of Environmental Policy and Management at Tsinghua University’s School of Public Policy and Management

Jeremy Bentham, Vice President, Global Business Environment, Shell

Questions and Discussion

13:00-14:00 Lunch

Session Three
Concrete Steps to Action: Finance and Achieving Net Zero 

There is growing interest in the concept of net zero carbon emissions, for businesses, sectors and even countries. This session will examine the feasibility of net zero for the power and transport sectors, and for buildings and cities.

Chair
Shane Tomlinson, Senior Research Fellow, Energy, Environment and Resources, Chatham House

Opening Discussion
Manfred Konukiewitz, Co-Chair, the Green Climate Fund 

Matthew Kotchen, Professor of Economics, Yale University 

Farhana Yamin, Associate Fellow, Chatham House

Power and Transport
14:45-15:45

  • What do decarbonization roadmaps for the power and transport sectors look like? Is net zero feasible? If so, by when and how? What are the challenges posed by increasing renewable penetration, and how can they be managed? What are the implications of vehicle electrification for the power sector?
  • What are the implications for infrastructure and investment?

Chair
Shane Tomlinson, Senior Research Fellow, Energy, Environment and Resources, Chatham House

Speakers
Abyd Karmali, Managing Director, Climate Finance, Bank of America Merrill Lynch

Dries Acke, Policy Manager, European Climate Foundation (Belgium) 

Olivier Paturet, General Manager,  Zero Emissions Strategy, Nissan Europe

Stefan Raubenheimer, Co-Founder and Director, South South North;  Co-Director, MAPS Programme 

Questions and Discussion

15:45-16:15 Refreshments

Buildings and Cities
16:15-17:15

  • What is the state of the art for low carbon building; how can this be rolled out at scale? 
  • How can decarbonization objectives be incorporated into urban planning and regulation?
  • How are the challenges and needs different for developed and developing countries? 

Chair
Farhana Yamin, Associate Fellow, Energy, Environment and Resources, Chatham House

Speakers
Ed Mazria, Founder and CEO, Architecture 2030

Tony Mallows, Director, Masdar City 

Questions and Discussion

17:15 Close of day and drinks reception

DAY TWO
Tuesday 4 November

Session Four 
Climate Impacts
9:30-11:15 

Chair
Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Keynote Addresses
HE Belete Tafere, Minister, Ministry of Environment Protection and Forestry, Ethiopia (on the record)

Professor Hans Joachim Schellnhuber, Founding Director, Potsdam Institute for Climate Impact Research (on the record)

  • What climate impacts are already being witnessed? Are these in line with expectations? What is the current state of attribution analysis?
  • What are the implications for climate politics?
  • What are the expected social, economic and environmental impacts under different climate scenarios? What is the most recent science since the deadline for Working Group II of the Intergovernmental Panel on Climate Change’s Fifth Assessment Report?  
  • Which countries and sectors are most vulnerable? What are governments and businesses doing to adapt?


Chair
Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Speakers
Chris Field, Founding Director, Department of Global Ecology, Carnegie Institution of Science, Co-Chair of Working Group II of the IPCC’s Fifth Assessment Report 

Professor Myles Allen, Leader of ECI Climate Research Programme and Professor of Geosystem Science, University of Oxford 

Nick Mabey, Director, E3G 

Oilver Bettis, Chair, Resource and Environment Board, Institute and Faculty of Actuaries

Questions and Discussion

11:15 - 11.45 Refreshments

Session Five
The Conditions for Action
11:45 - 13:00

  • What is the current state of public support for climate action? What shapes attitudes and beliefs? How does this vary by country? 
  • What can create political ambition, nationally and internationally?
  • What role can different stakeholders play in catalysing climate action?
  • What immediate obstacles need to be overcome and what lessons can be learned from recent success? 
Chair
Simon Maxwell, Executive Chair, Climate Development Knowledge Network
Keynote Address
Bill McKibben, President and Co-Founder, 350.org (on the record)

Panel Discussion
Antonio Hill, Executive Director, Global Campaign for Climate Action

Michael Jacobs, Senior Adviser on International Climate Policy, The Institute for Sustainable Development and International Relations  

Jennifer Morgan, Director, Climate and Energy Programme, World Resources Institute (WRI) 

Sergio Margulis, National Secretary of Sustainable Development, Secretariat of Strategic Affairs of the Presidency of Brazil 

Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Questions and Discussion

Closing remarks
Rob Bailey, Acting Research Director, Energy, Environment and Resources, Chatham House

1
3:10 End of conference and lunch

 © The Royal Institute of International Affairs 2014

Keynote Speakers

Speakers

Dries Acke

Policy Manager, European Climate Foundation (Belgium)

Myles Allen

Coordinating Lead Author, Intergovernmental Panel on Climate Change Special Report on Global Warming of 1.5 °C; Professor of Geosystem Science, University of Oxford

Oliver Bettis

Chair, Institute and Faculty of Actuaries' Resource and Environment Board

Marianne Fay

Chief Economist, Climate Change Group, The World Bank

Chris Field

Founding Director, Department of Global Ecology, Carnegie Institution of Science

Selwin Hart

Director, Secretary-General's Climate Change Support Team, United Nations

Antonio Hill

Executive Director, Global Campaign for Climate Action

Michael Hogan

Senior Adviser, Regulatory Assistance Project

Professor Michael Jacobs

Senior Adviser on International Climate Policy, The Institute for Sustainable Development and International Relations

Abyd Karmali

Managing Director, Climate Finance, Bank of America Merrill Lynch

Sir David King

Foreign Secretary’s Special Representative for Climate Change

Manfred Konukiewitz

Co-Chair, The Green Climate Fund

Matthew Kotchen

Professor of Economics, Yale University

Nick Mabey

Co-Founding Director and Chief Executive, E3G

Antony Mallows

Director, Masdar City

Sergio Margulis

National Secretary of Sustainable Development, Secretariat of Strategic Affairs of the Presidency, Brazil

Simon Maxwell

Executive Chairman, Climate and Development Knowledge Network

Edward Mazria

Founder and CEO, Architecture 2030

Jennifer Morgan

Executive Director, Greenpeace International

Olivier Paturet

General Manager, Zero Emissions Strategy, Nissan Europe

Stefan Raubenheimer

Co-Founder and Director, South South North; Co-Director, MAPS Programme

Jose-Manuel Sanoval

Coordinator, Colombian Low Carbon Development Strategy (CLCDS) and Mitigation Action Plans and Scenarios (MAPS)

Leena Srivastava

Hony. Executive Director (Operations), The Energy and Resources Institute (TERI)

Halldór Thorgeirsson

Director for Strategy, UN Framework for the Convention on Climate Change

Paul Watkinson

Head of Climate Negotiation Team, Ministry of Ecology, Sustainable Development and Energy, France

Farhana Yamin

Associate Fellow, Energy, Environment and Resources Programme

[node:event_chair]

Pricing

For any questions about rates, please call +44 (0)20 7314 2782.

                      FULL RATE
EXCL. VATINCL. VAT
Major corporate member rates
All organizations£595£714 
Corporate member rates
Commercial organizations£1,295£1,554
Government departments£775£930
NGOs and academics£495£594
Standard rates
Commercial organizations£1,445£1,734 
Government departments£845£1,014
NGOs and academics£550£660

This conference will offer a unique opportunity to network with senior officials from businesses, government, NGO's and academic institutions.

Our previous Climate Change conferences saw delegates from companies and institutions such as:

Accenture
AEA Energy & Environment
Agulhas
ArcelorMittal
Association of Asia Pacific Airlines (AAPA)
Atkins Ltd
Bank of America Merrill Lynch
BASF plc
Bayerngas Norge AS
Beetle Capital
BG Group plc
BHP Billiton
BIRA-IASB
BirdLife
Booz & Co
BP plc
British Council
BT Group plc
CAFOD
Cairn Energy plc
Cambridge Centre for Energy Studies
Cambridge Programme for Sustainable Leadership
Carbon Capture and Storage Association
Carbon Leapfrog
Carbon Trust
Caritas Internationalis
Catholic Fund for Overseas Development (CAFOD)
CH2M Hill
Chevron Ltd
Chubu Electric Power Co Inc
City of London
ClientEarth
Clifford Chance LLP
Climate & Development Knowledge Network (CDKN)
Climate Action Network (CAN)
Climate and Health Council
Climate Secure
Coalition for an International Court for the Environment (ICE Coalition)
Compassion in World Farming (CIWF)
Conocophillips (UK) Ltd
Control Risks
Co-operative Group
Cranfield University
Deloitte Consulting LLP
Department for Business, Innovation & Skills (BIS)
Department for International Development (DFID)
Department of Energy and Climate Change (DECC)
Ecofys UK Ltd
Ecologic Institute
EDF Energy
Energy Charter Secretariat
Energy Technologies Institute
Eni S.p.A
Environment Agency
Environmental Law Foundation (ELF)
Environmental Protection Agency (EPA)
Environmental Resources Management (ERM)
ENWORKS
Ernst & Young
Ethical Investment Research Services Ltd (EIRIS)
European Bank For Reconstruction & Development
European Commission (Directorate General for Enterprise and Industry)
European Parliament
ExxonMobil International Ltd
Fauna & Flora International
FIA Foundation for the Automobile and Society
Finnish Forest Association
Foreign and Commonwealth Office (FCO)
Forestry Commission
Friends of the Earth
Genesis Investment Management LLP
GLG Partners LP
Global CCS Institute
Global Humanitarian Forum
Global Sustainability Institute
Global Witness
Globeleq Ltd
Grantham Research Institute on Climate Change and the Environment, LSE
Greater Manchester Chamber of Commerce
Greenpeace International
Herbert Smith Freehills LLP
HM Treasury
Imperial College London
INPEX Corporation
Institute for Public Policy Research (IPPR)
Institutional Investors Group on Climate Change (IIGCC)
International Association of Oil & Gas Producers
International Council on Mining and Metals
International Finance Corporation (IFC)
International Institute for Environment and Development (IIED)
International Organization for Standardization (ISO)
Japan External Trade Organization (JETRO)
Joseph Rowntree Foundation
JPMorgan
King's College London
KPMG
Kuwait Petroleum Corporation
London Assembly
London Metropolitan University
London School of Economics and Political Science (LSE)
Maersk Group
Massey University
McKinsey & Company
Met Office
METREX
Ministere des Affaires Etrangeres, France
Ministry of Defence (Development, Concepts and Doctrine Centre)
Ministry of Foreign Affairs, Netherlands
Ministry of Foreign Affairs, Finland
Ministry of Foreign Affairs, Poland
Ministry of Infrastructure and the Environment
Mitsubishi Corporation
National Farmers' Union
National Round Table on the Environment and the Economy
Netherlands Development Finance Company (FMO)
NEXUS Singapore
Nordic Council
Office of National Assessments
Ogilvy
Open Society Foundation
Overseas Development Institute (ODI)
Oxford University
Plan UK
PricewaterhouseCoopers LLP
Privy Council Office
Progressio
Quaker Peace and Social Witness
Québec Government Office
Renewable Energy and Energy Efficiency Partnership (REEEP)
Renewable Energy Systems Ltd (RES)
Rolls-Royce International Ltd
RWE Power AG
Save the Children UK
SCA, Svenska Cellulosa Aktiebolaget
School of Oriental and African Studies (SOAS)
Shell
Standard Chartered Bank plc
Statoil (UK) Ltd
SustainAbility Ltd
Swedish Defence Research Agency (FOI)
Swiss Agency for Development and Cooperation SDC
Task Consult
Texas A&M University
The 40 Foundation
The Climate Group
The Gold Standard Foundation
The Norwegian Institute for Nature Research
The Open University
The Prince of Wales Corporate Leader Group
The Royal Society
The Saudi Fund For Development
Tokyo Electric Power Company
Total Holdings UK Ltd
UK Chamber of Shipping
UK Collaborative on Development Sciences (UKCDS)
United Nations Environment Programme (UNEP)
University College London (UCL)
University of Cambridge
University of East Anglia (School of Environmental Sciences)
University of Edinburgh
University of Oxford (Department of Politics and International Relations)
US Department of State
USAID
Warwick Business School
WaterAid
World Coal Association
World Coal Institute
World Economic Forum
World Society for the Protection of Animals (WSPA)
World Vision UK
WWF-UK
Xynteo Ltd
Yorkshire Forward

Venue

Chatham House
10 St James's Square
London
SW1Y 4LE
UK

conferences@chathamhouse.org

Telephone: +44 (0)20 7957 5729
Fax: +44 (0)20 7957 5710

If you wish to book the venue for your event please phone +44 (0)20 7314 2764


Directions

The nearest tube station is Piccadilly Circus which is on the Piccadilly and the Bakerloo Underground lines. From Piccadilly follow Regent Street southwards towards Pall Mall and take the first road on the right called Jermyn Street. Duke of York Street is the second road on the left and leads to St James's Square. Chatham House is immediately on your right.

Map

Accommodation

Although we cannot book accommodation for delegates, we have arranged a reduced rate at some nearby hotels, where you can book your own accommodation. Please inform the hotel that you will be attending a conference at Chatham House (The Royal Institute of International Affairs) to qualify for the Institute's reduced rate.

Please note all rates are subject to availability.

Flemings Mayfair
Half Moon Street
Mayfair
London W1J 7BH
Tel: + 44 (0)20 7499 2964
Fax: + 44 (0)20 7499 1817
Standard Single from £199 + VAT

The Cavendish London
81 Jermyn Street
London
SW1Y 6JF
Tel: + 44 (0)20 7930 2111
Fax: + 44 (0)20 7839 2125
Standard Single £205 + VAT

To book The Cavendish online

The Stafford London by Kempinski
St James's Place
London
SW1A 1NJ
Tel: 020 7518 1125
Fax: 020 7493 7121
Standard Single £230 +VAT

This conference will be held under the Chatham House Rule. Information for journalists
Press can request a press pass.


Chatham House Conferences

+44 (0)20 7957 5729




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Inhibition of Mitochondrial Calcium Overload by SIRT3 Prevents Obesity- or Age-Related Whitening of Brown Adipose Tissue

The whitening and loss of brown adipose tissue (BAT) during obesity and aging promote metabolic disorders and related diseases. The imbalance of Ca2+ homeostasis accounts for the dysfunction and clearance of mitochondria during BAT whitening. Capsaicin, a dietary factor activating TRPV1, can inhibit obesity induced by high-fat diet (HFD), but whether capsaicin inhibits BAT loss and the underlying mechanism remain unclear. In this study, we determined that the inhibitory effects of capsaicin on HFD-induced obesity and BAT whitening were dependent on the participation of SIRT3, a critical mitochondrial deacetylase. SIRT3 also mediated all of the beneficial effects of capsaicin on alleviating reactive oxygen species generation, elevating mitochondrial activity, and restricting mitochondrial calcium overload induced by HFD. Mechanistically, SIRT3 inhibits mitochondrial calcium uniporter (MCU)-mediated mitochondrial calcium overload by reducing the H3K27ac level on the MCU promoter in an AMPK-dependent manner. In addition, HFD also inhibits AMPK activity to reduce SIRT3 expression, which could be reversed by capsaicin. Capsaicin intervention also inhibited aging-induced BAT whitening through this mechanism. In conclusion, this study emphasizes a critical role of the AMPK/SIRT3 pathway in the maintenance of BAT morphology and function and suggests that intervention in this pathway may be an effective target for preventing obesity- or age-related metabolic diseases.




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Cole wins arbitration case vs. Astros

All-Star right-hander Gerrit Cole won his arbitration case against the Astros on Wednesday, meaning he will make $13.5 million this season. The team offerred $11.425 million, a difference of $2,075,000.




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Cell-Permeable Peptide Inhibitors of JNK: Novel Blockers of {beta}-Cell Death

Christophe Bonny
Jan 1, 2001; 50:77-82
Islet Studies




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Elevated Levels of Acute-Phase Proteins and Plasminogen Activator Inhibitor-1 Predict the Development of Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study

Andreas Festa
Apr 1, 2002; 51:1131-1137
Complications




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Wood wins arbitration case with Reds

Reds left-hander Alex Wood won his arbitration case over the club on Wednesday. Wood will earn $9.65 million on his one-year contract this season. Cincinnati had offered $8.7 million.




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Inhibition of NFAT Signaling Restores Microvascular Endothelial Function in Diabetic Mice

Central to the development of diabetic macro- and microvascular disease is endothelial dysfunction, which appears well before any clinical sign but, importantly, is potentially reversible. We previously demonstrated that hyperglycemia activates nuclear factor of activated T cells (NFAT) in conduit and medium-sized resistance arteries and that NFAT blockade abolishes diabetes-driven aggravation of atherosclerosis. In this study, we test whether NFAT plays a role in the development of endothelial dysfunction in diabetes. NFAT-dependent transcriptional activity was elevated in skin microvessels of diabetic Akita (Ins2+/–) mice when compared with nondiabetic littermates. Treatment of diabetic mice with the NFAT blocker A-285222 reduced NFATc3 nuclear accumulation and NFAT-luciferase transcriptional activity in skin microvessels, resulting in improved microvascular function, as assessed by laser Doppler imaging and iontophoresis of acetylcholine and localized heating. This improvement was abolished by pretreatment with the nitric oxide (NO) synthase inhibitor l-NG-nitro-l-arginine methyl ester, while iontophoresis of the NO donor sodium nitroprusside eliminated the observed differences. A-285222 treatment enhanced dermis endothelial NO synthase expression and plasma NO levels of diabetic mice. It also prevented induction of inflammatory cytokines interleukin-6 and osteopontin, lowered plasma endothelin-1 and blood pressure, and improved mouse survival without affecting blood glucose. In vivo inhibition of NFAT may represent a novel therapeutic modality to preserve endothelial function in diabetes.




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Fossil Fuels Expert Roundtable: Managing Disputes and Arbitrations Involving the Extractive Sector in Africa

Invitation Only Research Event

30 September 2014 - 5:00pm to 6:30pm

Chatham House, London

Event participants

Paula Hodges QC, Partner; Head, Global Arbitration Practice, Herbert Smith Freehills
Stéphane Brabant, Partner; Chairman, Africa Practice Group, Herbert Smith Freehills

Disputes between international companies and national governments commonly arise in the extractive industry where high expectations from producer countries often run alongside emotive issues of ‘ownership’ and ‘exploitation’. In 2013, Chatham House published the report Conflict and Coexistence in the Extractives Industries, examining the rising occurrence of long-running and expensive company-government disputes. Continuing the conversation, the speakers will share their personal insights regarding doing business in Africa's oil and gas sector and preparing for crisis situations. They will outline why they believe the effective management of any crisis is critical to achieving an early settlement and why arbitration is the best formal mechanism for resolving disputes in Africa. They will also discuss what the preconditions of success are, and how companies must adjust to new commercial and political realities when engaging with national companies. 

Attendance at this event is by invitation only.

Owen Grafham

Manager, Energy, Environment and Resources Programme
+44 (0)20 7957 5708




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Use of sodium-glucose co-transporter 2 inhibitors and risk of serious renal events: Scandinavian cohort study




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Breaking the Habit: Why Major Oil Companies Are Not ‘Paris-Aligned’

Invitation Only Research Event

23 October 2019 - 8:30am to 10:00am

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Andrew Grant, Carbon Tracker Initiative
Chair: Siân Bradley, Research Fellow, Energy, Environment and Resources, Chatham House

The investment community is increasingly seeking to assess the alignment of their portfolios with the Paris Agreement. In a recent update to their Two Degrees of Separation report, Carbon Tracker assessed the capital expenditure of listed oil and gas producers against ‘well below’ 2C targets, and for the first time, against short-term actions at the project level.

The speaker will present the key findings of the report and will argue that every oil major is betting heavily against a low-carbon world by investing in projects that are contrary to the Paris goals.

This roundtable discussion will further explore the report findings and consider what investors, regulators and oil and gas companies can do to encourage alignment  with the Paris Agreement ahead of 2020.  

Attendance at this event is by invitation only.

Event attributes

Chatham House Rule




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COP26 Diplomatic Briefing: Climate Ambition in Europe and its Potential Global Impact

17 February 2020 - 8:30am to 10:00am

Chatham House | 10 St James's Square | London | SW1Y 4LE

Jacob Werksman, Principal Adviser to Directorate General for Climate Action, European Commission
Imke Lübbeke, Head of EU Climate and Energy Policy, WWF European Policy Office 
Simon Petrie, Head of International Climate Strategy - Europe, UK Department for Business, Energy and Industrial Strategy
Jen Austin, Policy Director, We Mean Business Coalition
Chair: Jill Duggan, Associate Fellow, Chatham House

The President of the European Commission, Ursula von der Leyen, has declared that she wants Europe to become ‘the first climate-neutral continent by 2050’, and in December 2019, the Commission presented the European Green Deal in order to achieve this objective. However, even though greenhouse gas emissions from the EU have fallen by more than 20 per cent since 1990, the Union remains the third largest emitter in the world, after the United States and China.

What are the opportunities and challenges for raising climate ambition in Europe?  Will the EU increase its Nationally Determined Contribution and what impact might this have globally? How might Brexit affect climate action in the EU and the UK?  The second event in the Chatham House COP26 Diplomatic Briefing Series will address these critical questions.

Anna Aberg

Research Analyst, Energy, Environment and Resources Programme
020 7314 3629




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Exploring the Potential of the SGLT2 Inhibitor Dapagliflozin in Type 1 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Pilot Study

Robert R. Henry
Mar 1, 2015; 38:412-419
Evolving Tactics With Inhibition of Sodium-Glucose Cotransporters




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Efficacy and Safety of Canagliflozin, a Sodium-Glucose Cotransporter 2 Inhibitor, as Add-on to Insulin in Patients With Type 1 Diabetes

Robert R. Henry
Dec 1, 2015; 38:2258-2265
Special Article Collection: Insulin




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Lower Risk of Death With SGLT2 Inhibitors in Observational Studies: Real or Bias?

Samy Suissa
Jan 1, 2018; 41:6-10
Perspectives in Care




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Sodium-Glucose Cotransporter 2 Inhibition and Glycemic Control in Type 1 Diabetes: Results of an 8-Week Open-Label Proof-of-Concept Trial

Bruce A. Perkins
May 1, 2014; 37:1480-1483
Novel Communications in Diabetes




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DPP-4 Inhibitors: Impact on glycemic control and cardiovascular risk factors

Dror Dicker
May 1, 2011; 34:S276-S278
Diabetes Treatments




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SGLT2 Inhibitors and the Diabetic Kidney

Paola Fioretto
Aug 1, 2016; 39:S165-S171
III. SGLT2 Therapy




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February JADA examines connection between healthy eating habits, untreated caries

Greater compliance with dietary guidelines may reduce the chance of untreated caries in adults, according to a study published in the February issue of The Journal of the American Dental Association.




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Narwhal exhibit to start U.S. tour March 28

Dr. Martin Nweeia began researching narwhals in 2000. He came to the conclusion that the prevailing research available about the narwhal’s tooth — such as Charles Darwin’s belief that the narwhal’s tooth was a secondary sexual characteristic like an antler or a horn — was only part of the story.




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Study: ACE inhibitors, ARBs don't increase risk for COVID-19

Certain high blood pressure medications may be linked with more serious illness from COVID-19, but they don't increase a person's risk for getting the disease, a new study published Tuesday by JAMA Cardiology reports.




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Metabolic Factors, Lifestyle Habits, and Possible Polyneuropathy in Early Type 2 Diabetes: A Nationwide Study of 5,249 Patients in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) Cohort

OBJECTIVE

To investigate the association of metabolic and lifestyle factors with possible diabetic polyneuropathy (DPN) and neuropathic pain in patients with early type 2 diabetes.

RESEARCH DESIGN AND METHODS

We thoroughly characterized 6,726 patients with recently diagnosed diabetes. After a median of 2.8 years, we sent a detailed questionnaire on neuropathy, including the Michigan Neuropathy Screening Instrument questionnaire (MNSIq), to identify possible DPN (score ≥4) and the Douleur Neuropathique en 4 Questions (DN4) questionnaire for possible associated neuropathic pain (MNSIq ≥4 + pain in both feet + DN4 score ≥3).

RESULTS

Among 5,249 patients with data on both DPN and pain, 17.9% (n = 938) had possible DPN, including 7.4% (n = 386) with possible neuropathic pain. In regression analyses, central obesity (waist circumference, waist-to-hip ratio, and waist-to-height ratio) was markedly associated with DPN. Other important metabolic factors associated with DPN included hypertriglyceridemia ≥1.7 mmol/L, adjusted prevalence ratio (aPR) 1.36 (95% CI 1.17; 1.59); decreased HDL cholesterol <1.0/1.2 mmol/L (male/female), aPR 1.35 (95% CI 1.12; 1.62); hs-CRP ≥3.0 mg/L, aPR 1.66 (95% CI 1.42; 1.94); C-peptide ≥1,550 pmol/L, aPR 1.72 (95% CI 1.43; 2.07); HbA1c ≥78 mmol/mol, aPR 1.42 (95% CI 1.06; 1.88); and antihypertensive drug use, aPR 1.34 (95% CI 1.16; 1.55). Smoking, aPR 1.50 (95% CI 1.24; 1.81), and lack of physical activity (0 vs. ≥3 days/week), aPR 1.61 (95% CI 1.39; 1.85), were also associated with DPN. Smoking, high alcohol intake, and failure to increase activity after diabetes diagnosis associated with neuropathic pain.

CONCLUSIONS

Possible DPN was associated with metabolic syndrome factors, insulin resistance, inflammation, and modifiable lifestyle habits in early type 2 diabetes.




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Using the BRAVO Risk Engine to Predict Cardiovascular Outcomes in Clinical Trials With Sodium-Glucose Transporter 2 Inhibitors

OBJECTIVE

This study evaluated the ability of the Building, Relating, Assessing, and Validating Outcomes (BRAVO) risk engine to accurately project cardiovascular outcomes in three major clinical trials—BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), Canagliflozin Cardiovascular Assessment Study (CANVAS), and Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction (DECLARE-TIMI 58) trial—on sodium–glucose cotransporter 2 inhibitors (SGLT2is) to treat patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Baseline data from the publications of the three trials were obtained and entered into the BRAVO model to predict cardiovascular outcomes. Projected benefits of reducing risk factors of interest (A1C, systolic blood pressure [SBP], LDL, or BMI) on cardiovascular events were evaluated, and simulated outcomes were compared with those observed in each trial.

RESULTS

BRAVO achieved the best prediction accuracy when simulating outcomes of the CANVAS and DECLARE-TIMI 58 trials. For the EMPA-REG OUTCOME trial, a mild bias was observed (~20%) in the prediction of mortality and angina. The effect of risk reduction on outcomes in treatment versus placebo groups predicted by the BRAVO model strongly correlated with the observed effect of risk reduction on the trial outcomes as published. Finally, the BRAVO engine revealed that most of the clinical benefits associated with SGLT2i treatment are through A1C control, although reductions in SBP and BMI explain a proportion of the observed decline in cardiovascular events.

CONCLUSIONS

The BRAVO risk engine was effective in predicting the benefits of SGLT2is on cardiovascular health through improvements in commonly measured risk factors, including A1C, SBP, and BMI. Since these benefits are individually small, the use of the complex, dynamic BRAVO model is ideal to explain the cardiovascular outcome trial results.




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Subprime Mortgages and Race: A Bit of Good News May Be Illusory

Subprime mortgages have been linked to a meltdown in housing and questionable Wall Street practices, and they may have been the original domino that set off America's current economic crisis.




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Open Door for Venezuelan and Nicaraguan Migrants in Latin America &amp; Caribbean Closes a Bit amid Scale of Flows, Strains on Public Services

WASHINGTON – Even as governments in Latin America and the Caribbean have taken generous and innovative steps to address forced displacement from Venezuela and more recently Nicaragua, the warm welcome has cooled in places amid the vast scale of the inflows, strains on public services and growing public concern.




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Phillippa's Gingerbread Rabbits

This recipe features on Foodie Tuesday, a weekly segment on 774 Drive with Raf Epstein, 3.30PM, courtesy of Phillippa Grogan. Phillippa's latest book is "Phillippa's Home Baking".




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SGLT-2 Inhibitors: A New Mechanism for Glycemic Control

Edward C. Chao
Jan 1, 2014; 32:4-11
Feature Articles




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Habit: A Response to the Unknown


David Hume explained that we believe by habit that logs will burn, stones will fall, and endless other past patterns will recur. No experiment can prove the future recurrence of past events. An experiment belongs to the future only until it is implemented; once completed, it becomes part of the past. In order for past experiments to prove something about the future, we must assume that the past will recur in the future. That's as circular as it gets.

But without the habit of believing that past patterns will recur, we would be incapacitated and ineffectual (and probably reduced to moping and sobbing). Who would dare climb stairs or fly planes or eat bread and drink wine, without the belief that, like in the past, the stairs will bear our weight, the wings will carry us aloft, and the bread and wine will nourish our body and soul. Without such habits we would become a jittering jelly of indecision in the face of the unknown.

But you can't just pull a habit out of a hat. We spend great effort instilling good habits in our children: to brush their teeth, tell the truth, and not pick on their little sister even if she deserves it.

As we get older, and I mean really older, we begin to worry that our habits become frozen, stodgy, closed-minded and constraining. Younger folks smile at our rigid ways, and try to loosen us up to the new wonders of the world: technological, culinary or musical. Changing your habits, or staying young when you aren't, isn't always easy. Without habits we're lost in an unknowable world.

And yet, openness to new ideas, tastes, sounds and other experiences of many sorts can itself be a habit, and perhaps a good one. It is the habit of testing the unknown, of acknowledging the great gap between what we do know and what we can know. That gap is an invitation to growth and awe, as well as to fear and danger.

The habit of openness to change is not a contradiction. It is simply a recognition that habits are a response to the unknown. Not everything changes all the time (or so we're in the habit of thinking), and some things are new under the sun (as newspapers and Nobel prize committees periodically remind us).

Habits, including the habit of open-mindedness, are a good thing precisely because we can never know for sure how good or bad they really are.