Identical twins compared vegan diet with meat-eating and exercise – Insider – INSIDER

The Turner twins have climbed a mountain and trekked to the most inaccessible points on every continent, all in the name of research, charitable causes, and exploration. For their latest adventure, brothers Hugo and Ross Turner trekked into even more fraught territory comparing the effects of a vegan diet to an omnivorous diet on two genetically identical people.

The Turners decided to study the two eating styles side by side over a 12-week fitness training regime from January to March this year. They were inspired by the growing popularity (and sometimes controversy) of vegan diets for athletes, following documentaries like "The Game Changers," according to Ross.

"We wanted to take bias and opinion out of it and take down to the genetic level. We can get science involved because we're twins and genetically identical, so we can compare ourselves in extreme environments," Ross told Insider.

The pair monitored how they felt during the course of the experiment and were followed by researchers from King's College, who tracked basic health metrics like weight, cholesterol, and muscle mass.

Both twins did endurance training at the gym five to six times a week, using a program designed by Ross, a personal trainer. They also ate an almost identical number of calories in meals prepared by the Mindful Chef delivery service.

By the end, they noticed some big differences in terms of muscle gains, fat loss, and digestive health.

Before giving up animal products for the experiment, Hugo weighed in about 185 pounds and 13% body fat. After about a month on the vegan diet, he said he had dropped nearly nine pounds. By the end of the experiment, he measured in at 181 pounds. Nearly all the weight lost was fat mass, with his overall body-fat composition dipping by a full percentage point, to 12%. His cholesterol levels also dropped.

Even more striking were his energy levels. Hugo said he felt significantly more alert during his lunchtime gym sessions, compared with his typical routine.

"On a vegan diet my mental focus was much better, I didn't have the mid-afternoon energy dips, and felt a bit more charged," he told Insider.

He said one explanation could be how the vegan diet changing his snacking habits. Since biscuits and chips aren't vegan, he'd switched to mainly fruit and nuts.

Hugo noticed one exception to his higher energy levels his libido, which he said dropped off sharply.

"I just lost it I really don't know what happened," he said, adding that his experience may not be true for everyone.

The twins did not conduct blood tests during the experiment, but said they would do so if they tried something similar in the future. They could measure testosterone, for example, to see if it explains some of the changes.

One of the meals Hugo Turner ate in the 12-week vegan-diet experiment, a buckwheat pizza with mushrooms. Mindful Chef

Ross has always been the slightly bigger of the brothers, and this was exacerbated by the experiment. From starting around 13% body fat, he put on 10 pounds of muscle, in addition to just over four pounds of fat. That brought his overall body fat percentage up slightly, to 15%, and his final weigh-in to 189 pounds.

His cholesterol levels stayed consistent throughout the 12-week duration.

Ross said the meal plan for this experiment was slightly more varied than his typical diet, and extremely balanced in terms of macronutrients, with array of chicken, fish, red meat, veggies, dairy, and grains.

Before this, a typical day of eating for the twins would include toast or porridge for breakfast, sandwiches for lunch, and some version of chicken, veggies, or pasta for dinner.

For Hugo, the dietary change was even more significant, since his usual animal-based protein was swapped out for things like tofu, tempeh (fermented soybeans), and jackfruit.

"Eating a vegan diet, you almost have to overcompensate with variety, so I was eating foods I wasn't really used to," Hugo said.

As a result, his gut microbiome the populations of beneficial bacteria that live in the human digestive system also changed in some interesting ways, based on fecal samples analyzed by Atlas Biomed before and after the experiment.

The changes potentially improved Hugo's resilience to some forms of chronic illness, according to the analysis, lowering his risk of obesity and type 2 diabetes. That supports previous research suggesting plant-based diets could reduce the risk of those conditions by improving the microbiome.

But to their surprise, both brothers saw a decrease in their microbial diversity, or the number of different bacteria species present in the gut. That's generally linked to less resilience against some types of chronic illness such as Crohn's disease.

Although Ross' microbiome changed slightly, it remained much more consistent than his brother's.

It's not clear why those changes occurred, although the Turners hypothesized that the abrupt change to a vegan diet, and the relatively short duration of the experiment, might have been factors.

One caveat of the experiment, the Turners said, was that 12 weeks wasn't a long time for a typical dietary study. If they could do it over, the brothers said they're prefer to trial the diets for six months to a year for better data.

But the brothers said they've learned a lot and plan to incorporate more plant-based eating in their lifestyle. The brothers are known for their endurance expeditions and want to test how vegan eating might benefits them on their treks.

"You lose about half a kilo of weight a day on an endurance trip, more than that if you're carrying extra weight, so we like to be lean and mean nothing in between on the trip," Hugo said.

He added that being forced to find vegan alternatives also greatly expanded his world of food options.

"One thing to come out of this is we don't eat nearly enough variety of foods. Often, we kind of just disguise the same foods in different forms," Hugo said. "But variety is the spice of life."

Ross said that there tends to be a reluctance for meat eaters to try vegan foods, and he hopes this experiment will encourage dedicated omnivores to branch out, since many plant-based substitutes like vegan burgers are similar in taste and texture to the classics.

If you're curious about trying veganism, he added, you don't to go "cold tofu" and jump in all at once. Based on his experience, Hugo recommends starting with your snacking habits, and swapping out between-meal treats with vegan options.

The twins concluded that their optimal diet is a mix of plant- and animal-based foods.

"Having a vegan diet has benefits and so does eating meat. I don't think either outshone the other here," he said. "We'll be doing a mix of both, having non-meat days and adding more vegan foods into our diet, eating better-quality meat and less of it. We've taken away the best of both worlds."

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Identical twins compared vegan diet with meat-eating and exercise - Insider - INSIDER

Is Trending Towards Veganism Is That Healthiest Option As It Seems To Be? – India Legal

In recent times the vegan way of life has soared in popularity both amongst the common public and elite group whether sportsman or celebrities all thriving on it. Though many tend to get confused with veganism and that of vegetarianism, vegan isnt just a diet rather it focuses on a broader perspective which can be seen as a complete lifestyle change, primarily excluding dairy products, meat, eggs and honey. Veganism relies completely on a plant-based diet, without compromising on the vital nutrients as it claims. It is somewhat can be seen as a restricted diet and a step ahead than a vegetarian.

On the other hand, the vegetarian diet is quite flexible, it does include dairy and eggs but excludes meat, poultry and fish.

Are u struggling to lose weight since long and want to gain muscle mass or get that perfect body type? Well, then many see veganism as the most appropriate answer.

Though it has become quite popular in American culture and even in the U.K there is a fourfold increase in vegans over the past 5yrs, but in a country like India, it is a completely a new concept.

A country that mainly includes dairy products, and indulges in many animals produced luxuries; I wonder how veganism can establish in its true sense? India, being one of the largest milk-producing countries, largely depends upon the dairy products which are an essential part of Indian dietary, comprising both rural and urban areas. I believe milk, butter or ghee are ubiquitous and integrated with our culture. Veganism isnt just a diet pattern rather its something beyond it, impacting an overall lifestyle shift.

Although transforming into a vegan has its own merits, it is believed that having whole food is better than having preservative contained and processed food. It has proved helpful in combating many lifelong severe diseases, like cardiovascular disease, obesity and diabetes. Making a slight change in the thinking process and indulging self into a better eating habit can bring a positive lifestyle change.

Our human body is made up of protein whether, its our skin, nails, hair our cell or muscle formation, you need a decent amount of protein quite regularly if you are engaging in any sort of workout or physical activities.

Then heres the great news!

For the intake of protein in your diet, you dont need to stay dependent upon animals meat, even by staying on a plant-based diet you can fulfil your protein requirement,thats right we can get all the necessary protein by being on a vegan diet too.

It is commonly believed that you are what you eat,it is, however, being blindly believed that protein is the main source of macronutrients, well in the vegan diet where can we get it from? the fact remains that the maximum of proteins is made up of plants only, we can have the benefits of having protein even by staying on a plant-based diet like lentils, chickpeas, peanuts, almonds, quinoa and tofu but some may lack in amino acids.

Does being completely on a vegan diet, is that advisable?

There is nothing called aperfect dietexist and is not necessarily will suit everyones health, despite having some advantages of veganism it may lead to depression and other mental illness. As some may see it as a threat to intelligence or limiting the functioning of the brain, therefore, to perform at its optimum level human brain needs fats, amino acids, omega 3, vitamins and minerals which we get easily and enormously from an animal diet.Whereas, getting completely devoid of animal-based diet may weaken the development of brain tissues and may damage the nervous system.

THERE ARE SEVERAL VITAL NUTRIENTS WHICH ARE MISSING FROM PLANT-BASED DIET MAINLYVITAMIN B12 deficiency of which may lead to Brain fog.

More often than not, we get to hear about what is required to cut out from a diet is to be included in criteria and less of what needed to be followed. Another factor which is incorporated in limitation of veganism can be seen inirondeficiency, we can get iron from lots of plant-based meals but we are likely to utilize it less efficiently.

Another fundamental component isVitamin Dwhich is required for healthy bones, muscle formation, and teeth. Nowadays while we are staying indoors and there is not enough sunlight, we need to compensate that through a Vitamin D rich diet plan which is particularly missing from a vegan diet.

Most people as an alternative, starting to rely upon supplements to meet the requirements for our overall functioning of the brain and cardiovascular system.

We needfatty acids, omega 3 and omega 6as they are responsible for the structural functioning of our brain and blood flow, which sources from fish, meat or eggs. As in a vegan diet, it can be consumed from algae oil supplements which cant be ignored.

Usually, these processed food or supplements are not acceptable by vegans but they are irreplaceable to avoid any deficiencies, whether you follow a vegan diet or not these vital supplements are necessary to maintain a balanced physical as well as mental health. Whereas plant-based diet excludes this and they overlook the importance of dairy products.

Though some believe that being a vegetarian or vegan is one of the healthiest option ever for the betterment of the ecosystem, but it can turn around to be an opposite situation. Relying on a plant-based diet is not entirely bad, but people dont possess enough knowledge to practically utilise its benefits, even being on a vegan diet it is advisable to track the calorie intake.

Another vital vitamin iszincwhich helps in collagen formation, DNA and acts as an immunity booster so whole grain, nuts are a great option for vegans but it gets harder for the human body to absorb it.

Like to have cheat meals while on a vegan diet? Well, if you think everything going vegan is healthy, stop and think twice.

If you prefer to have vegan cookies, ice creams and candies, which might seem to a healthy alternative but if you over eat high fat and processed food, you might end up gaining weight and additional health issues, which would do more harm than a normal diet.

It is prudent to combine the two lifestyle diet which means to adopt aFlexitarian Dietas this form of eating habit would give one enough space to include their favourite items in a meal without hampering the diet plan. So if you have an intermittent longing, even with including a small piece of meat wont throw you out of your diet routine, it works on calorie intake and proportional eating. Therefore, it is all about the art of balancing one needs to learn rather than sticking to any fashionable.

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Is Trending Towards Veganism Is That Healthiest Option As It Seems To Be? - India Legal

Lights Out Actress Teresa Palmer Goes Vegan For the Animals – The Beet

I just decided I dont want to add to any more suffering in the world, including [the] suffering of any sentient beings, says Teresa Palmer. The Australian actress, best known for her role as Rebecca in the horror movie, Lights Out, ditched meat for the sake of the animals. Palmer has always been an animal lover and"grew up with endangered species,"with her father's wildlife sanctuarylocated on their home in Australia.

Palmer, 37, had sporadically eaten veganthroughout her life, andwas alongtime pescetarian, and confessed that she ate fish because,'It didn't resemble an animal so I would eat it and not really think about the life that was that animal, and then as an animal lover and the more I read, I realized, "I actually can't do this anymore,"' she told Daily Mail UK. Palmer adds, "It didn't align with who I was, and I realized that I had this sort of cognitive dissonance and I was very disconnected from the food that I was eating."

Palmer explained toOK! Australiahow her son Bodhi and stepson Isaac encouraged her to make the switch to veganism for good."Their compassion and kindness [have] inspired me to adopt a more humane and considered approach to food. Bodhi saw some fish on display at Whole Foods Market one day and was completely scarred he didn't understand why they weren't swimming in the ocean and why someone would purposely catch the fish for people to eat."

LastApril, Palmer gave birth to her third child Poet, and sincehas been laser-focused on making healthy food choices. Palmer has a total of four children including her stepson Isaac, and reveals what her diet looks like after giving birth and having her hands full with kids. "Nursing Poet and Forest are so demanding on my body and I'm constantly feeling hungry." She adds, "I love heavy carbs and always want to eat pasta, bread, or pizza, but I find my energy levels plummet when I indulge in these foods continuously. A particular food focus for me at the moment is to eat a variety of nutrient-rich mixed greens every day. I can make them into a simple stir-fry or curry and enjoy a delicious, healthy meal in minutes." Palmer raises her children on plant-based diets and shares her story on her wellness website.

In 2018, the famous actress started an "all-encompassing community" online called Your Zen Mama where parents and caregivers discuss everything parenthood. Sarah Wright Olsen, an American actressknown for her role as Millicent Gergich in Parks and Recreation, collaborates with Palmer onthe wellness website. The two actresses both eat aplant-baseddiet and share recipes, information and advice about veganism from expected mothers,using their first-hand experiences to guide.

In Your Zen Mama blog post, Palmer was asked how she manages a vegan diet as a family, and said, "our family does it pretty seamlessly. We usually make sure we have a serving of veggies/fruit with each meal, a starch, and a plant-based protein whether it be quinoa, beans, or veggie meat made from pea protein. Our children feel really passionate about not eating animals and their drive and commitment to it keep inspiring us to stay on this path."

In addition, she advises her readers to ensure you're taking a great multivitamin, drink more water than you think you need, andconsumeenough protein. Palmer chooses plant-based proteins such as "beans, nut butter, lentils, quinoa, chia seeds, and oat barley," and enjoys vegan meals from well-known blogger, Angela Liddon, creator of Oh She Glows.

As a mother of four and raising her children as vegans, Teresa Palmerlikesquick and creative vegan snacks and meals.

Here is a list of her go-to snacks by Oh She Glows:

Palmeradmits she uses herVitamix, "abunch", and "pures lots of fruits and veggies for Forest to eat and sprinkle it with chia seeds for protein. He also downs my vegan banana bread." One of her easiest go-to snacks and her son's favorite snack is mashed cinnamon sweet potatoes. She explains how simple they are to make,instructing, "just bake peeled sweet potatoes in the oven, chuck in a bowl, add a dash of almond milk and cinnamon and smash it all together!"

When Palmer needs to satisfy her sweet tooth, she claims her guilty pleasures are anything "chocolate or caramel flavored." Palmer says,"It'sokay to treat yourself occasionally if you'refeeding your bodywith healthy choices the rest of the time, and it'sokay to have a day off from the gym if you need time to rest." The actress claims, "the worst I've ever felt and the sickest I've ever been was when I was working out five times a week for 90 minutes a day and eating the cleanest diet possible."

Shevonne Hunthosts Teresa Palmer on her Feed Love Play podcastand gets to the bottom of what zen means for the busy mother and famous actress.Palmer explains that zen is the "idea of finding balance, it exploits the idea of perfection." She advises parents and listeners of the podcast to "let go of the self-critical voice, everyday ill feel and look different--that's okay."

During the lockdown, Palmer is "riding the wave" and mentions how "some days I feel like I'm in the flow and other days are messier." She goes on to explain how her four kids are high maintenance and need to stay active or completely disconnect by spending the entire day watching TV. Palmer concludes, "I have to take the pressure off myself."

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Lights Out Actress Teresa Palmer Goes Vegan For the Animals - The Beet

For vegans in Newfoundland and Labrador, it’s not always easy being green – TheChronicleHerald.ca

ST. JOHN'S, N.L.

Theres a joke that goes, How can you tell someone is a vegan? Answer: You dont need to, theyll tell you themselves.

Its a joke vegans will tell you themselves. And its true. Poke your nose into the 2,500 NL Vegans Facebook page and youll see robust conversations about the best recipes and the hottest new restaurants. Youll also encounter a lot of passionate discussion of animal cruelty and the evils of meat.

Studies show that about one per cent of Canadians follow a strict vegan diet, which means they wont eat animals of any kind, or anything derived from them such as eggs and dairy products.

Still, thats more than 350,000people, and a 2018 Dalhousie University study found that two-thirds of them are under the age of 38. Veganism is trending upwards, and its mostly driven by Millennials and the Generation Y population.

Veganism is a philosophy. Its based on the conviction that animals are not to be harmed or exploited for human consumption even for clothes, in some circles.

It can be militant. While all vegans are adherents of the animal rights movement to some extent, some are more vocal about it than others. Theyll take undercover footage inside slaughterhouses or block trucks from entering processing plants.

Personal health and the environment also play a major role in the motivation for veganism. You can find many claims about both. While the numbers may be sketchy at times, the bottom line is that a whole-foods, plant-based (WFPB) diet can be one of the healthiest lifestyles choices you make and that meat production, especially beef, is a significant contributor to greenhouse gas emissions and a contributor to deforestation in some countries.

In a limited series starting today, well look at some of the people who make up the local vegan community. Theyll talk about their own reasons for embracing the diet, and how it has changed their lives. Well talk about health benefits and caveats, and even check out a recipe or two.

Time to chow down.

Chris Flynns voice cracks a little as he talks about the times hes joined other animal rights activists to briefly blockade trucks from the Country Ribbon chicken farm as they entered the processing plant in Pleasantville, St. John's.

While the trucks were stopped, it was a chance to poke their heads inside and snap a shot or two of all the chickens in cages.

Its pretty horrific, he said in a recent phone interview. Sometimes they cant even stand up because theyre so big and sometimes they still have yellow feathers because theyre only four weeks old when theyre killed. And sometimes their legs got ripped off because they got stuck in the cage.

He has to take a second to control his emotions.

Flynn, who works in IT, lives in Conception Bay South.

He and his fellow protesters are allied with an international lobby group called Anonymous for the Voiceless.

Not only are they vegans, but they want to convince everyone else to be vegans, too.

Vegans refuse to eat animal flesh or any byproduct of animals such as eggs or dairy. While health plays a part, the motivation is primarily ethical.

I respect the right for any conscious, sentient being to live their life free of intentional suffering, Flynn said. They certainly have a right not to be locked in a cage all their life and tortured.

Like many vegans these days, Flynn is a recent convert.

He became a vegan four years ago at the age of 24. His girlfriend was already a vegan at the time, but he didnt think much about it until he saw documentary called Food Choices.

I started to realize that meat is not required, that animal products are not required for anyone to be healthy, he said.

Flynn has thought long and hard about it ever since, and its hard to trip him up with the usual counterarguments.

Why is it not just a personal choice?

I cant say that its my personal choice to punch someone in the face, because that other person is affected by that choice, so its not a personal choice to eat an animal when that animal loses their life for it.

But dont animals eat each other?

I cant say that its my personal choice to punch someone in the face, because that other person is affected by that choice, so its not a personal choice to eat an animal when that animal loses their life for it. Chris Flynn

Certain wild animals like lions and tigers a lot of times theyll eat their own children. I dont think humans should do that. A lot of animals will just rape each other when theyre ready to mate, but I dont think we should do that either.

What about dairy, where the animal isnt harmed?

Cows will loudly pine when their calves are taken away from them, often to make veal, Flynn says. Then they have to give milk until theyre eventually slaughtered anyway.

Eggs?

Free-range chicken is just a marketing buzzword, he says. Even laying chickens, which are bred to lay eggs at an exhausting rate, are kept in cruel conditions, he says.

A 2018 Dalhousie study found that approximately one million Canadians consider themselves vegans, and that two-thirds of them are under the age of 38. The trend seems to be growing.

Chris Flynn falls well within that category, but Elizabeth Johnson is even younger.

An 18-year-old student at Memorial University who lives in Goulds, Johnson says she decided last year to research everything she could about the environment, climate change and politics.

I quickly started changing my habits started walking more, reusing and up-cycling old things from around my house, started sharing my viewpoints with my family and friends, and just overall my entire life changed, she wrote in an email.

With more research I realized just how damaging the agriculture industry is to the environment, and how becoming vegan is the single smallest thing you can do with the greatest impact on the environment, she said.

In Newfoundland, being a vegan is tough, Johnson continues. Not money-wise or finding vegan alternatives, but mainly because of the culture.

Even if youre not out protesting in the streets, some people get very defensive about the fact they eat meat.

Every time somebody would ask me why I was vegan, they would feel so defensive of their actions, she says. I have had people tell me to eat a steak and get over it.

But Johnson makes no apologies.

I did my research and understood the horrible effects that the meat, egg and dairy industry had on the animals, humans and the Earth, I knew what I was doing was wrong and I stopped valuing my tastebuds over the world. I may not be perfect, but its better for thousands of people to be vegan imperfectly than a handful of people doing it perfectly.

Peter Jackson is a Local Journalism Initiative reporter covering health care for The Telegram. Findhim on Twitter@pjackson_nl.

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For vegans in Newfoundland and Labrador, it's not always easy being green - TheChronicleHerald.ca

These Twins Trialled Veganism Against Meat-Eating. Here’s What Happened – Men’s Health

Hugo and Ross Turner or is that Ross and Hugo? have earned the nickname the adventure guinea pigs. In 2015, the twins scaled Europes highest peak, Mt Elbrus in the Caucasus, to compare traditional mountaineering gear with modern equipment (the latter proved to be mostly marketing). Theyve been to Greenland, where a replica of Sir Ernest Shackletons 1914 expedition kit uniformly outperformed the contemporary equivalent, from the Sunspel jumper and Crockett & Jones boots to a wooden sled.

Most recently, they embarked on a trial of a vegan diet versus a typical omnivorous one, with their body composition monitored by Virgin Active and their biomarkers tested by Kings College Londons Department of Twin Research. We caught up with them two months in to see what they'd learnt.

MH: This isnt the first time youve compared diets...

Ross: At the end of last year we did a test of high-fat vs high-carb. I was on a high-fat diet and I shredded. I lost about 3kg of fat; Hugo was on high-carb and he put on 3kg.

Hugo: Ross has always been slightly heavier, so, we met each other in the middle. At the end, we were 85kg each.

Ross: But I was much, much leaner.

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MH: How fun or not were those diets to follow?

Ross: I did miss carbs. I really did miss carbs. But as soon as I had them, I felt bloated, straight away.

MH: So, what are the main takeaways from meat versus veg?

Ross: My cholesterol has stayed the same about 6.5, quite high and Hugo [on the vegan diet] is down to 4.9.

Hugo: I was about 5.9 at the start, so its dropped drastically.

Ross: As well as your libido.

Hugo: Yeah, my libido went out the window. But my energy levels [were better]. I didnt get that sugar drop. Most snacks chocolate, biscuits, sweets I couldnt have. I was pretty much just on nuts and fruit.

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Ross: We had Mindful Chef delivering our food, so we had exactly the same calories going in give or take 50 calories across the day.

MH: How did going vegan affect your training?

Hugo: My energy levels in the gym were much, much better. We were going to the gym five, six times a week and I didnt have a session where I thought, I dont really have any energy.

Ross: I was the opposite. I was very hungry at 10 or 11 oclock. I had those big spikes of energy and then Id crash. But then the results [of our training] have been very different I put on weight, and Hugo has lost it.

Hugo: Ive shredded. I lost 4kg of fat in the first two or three weeks.

Ross: We wore continuous glucose monitors: they go on the back of your triceps and connect to your phone. I was spiking, going down, having that sugar low or meat low and Hugo was far more satiated.

MH: What kind of training were you doing?

Hugo: Its endurance-focused, so high-rep, low-weight, rather than trying to build up mass. On our expeditions, we dont want to be carrying extra weight.

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Ross: One of the ways we measure how fit were getting is with a submaximal test: what resistance youre on when you get to a certain heart rate on a Wattbike. Its simple but quite effective if you want to find out what your fitness level is.

MH: And less unpleasant than a VO2 max.

Ross: I dont mind the VO2 max. Its quite fun. An effective way weve found [to track] our endurance training is to count the total mass lifted. Weve gone from about three tonnes which sounds epic to 10 or 11 tonnes in an hour. If you add the weight up, it becomes really motivating.

MH: How much do you bench? A tonne

Ross: It is, though if you lift 100kg, 10 times, thats a tonne. If youve lost weight and youve doubled your lifting capacity, youre getting expedition fit.

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Hugo: Half of it is looking after your body. Whats the chassis like? Is it healthy? Weve got quite rusty chassis in the sense that weve always got painful backs, tight hamstrings and quads. So, its using a good proportion of a gym session on stretching, rolling and core.

Ross: And the other 10% is mindset. Ive been to the gym over the past few months and gone, I really cant be bothered. Thats the point at which you become expedition mind fit. Even if you do very little, but you do the full hour, youre training your mind not to give up. Its so easy not to flex the mental muscle.

On the vegan diet: Hugo lost 1kg of fat and gained 1.2kg of muscle massOn the omnivore diet: Ross gained 2.8kg of fat and 4kg of muscle mass

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Vegan Cheese Brand Miyoko’s Donates to Black Lives Matter to Fight Inherent Racism in the Food System – VegNews

Today, vegan brand Miyokos Creamery ceased posting its scheduled social media content for one week to stand in solidarity with the worldwide protests for justice for George Floyd, a Black man who was killed by Derek Chauvin and three other ex-police officers May 25. Miyokos announced that it is donating funds to social-justice organizations, including Black Lives Matter and National Association for the Advancement of Colored People (NAACP) to support their efforts in dismantling institutionalized racism.

Both of these are organizations on the forefront of creating a more just and compassionate social system, Miyokos Founder and CEO Miyoko Schinner told VegNews. Veganism is not just about diet or animals, it is about larger social justice issues. There is inherent racism in our food system that disempowers people of color. We need to all work together to create a food system that is compassionate and just for all people.

Miyokos is calling upon other businesses to support social-justice organizations, as well.

Please support independent vegan media and get the very best in news, recipes, travel, beauty, products, and more.Subscribe now to the worlds #1 plant-based magazine!

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Global Testosterone Replacement Therapy Market Business Outlook with COVID-19 Scenario -AbbVie, Upsher-Smith, Endo International, Pfizer, Actavis…

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The most significant players coated in global Testosterone Replacement Therapy market report: AbbVie, Upsher-Smith, Endo International, Pfizer, Actavis (Allergan), Eli lilly, Teva, Bayer, Mylan, Novartis, Ferring Pharmaceuticals, Acerus Pharmaceuticals, Kyowa Kirin

Scope of The Market Report:

The report offers a forward-looking perspective on different factors driving or limiting the market growth. An exceptionally workable estimation of the present industry scenario has been delivered in the study, and the global Testosterone Replacement Therapy market size with regards to the revenue and volume have also been mentioned. In short, the report provides a detailed analysis of the global market size, regional and country-level market size, segment growth, market share, competitive landscape, sales analysis, the impact of domestic and global market players, value chain optimization, trade regulations, and recent developments in different regions.

The report offers an in-depth assessment of the growth and other aspects of the market in key countries including the

North America (United States, Canada and Mexico)

Europe (Germany, France, UK, Russia and Italy)

Asia-Pacific (China, Japan, Korea, India and Southeast Asia)

South America (Brazil, Argentina, Colombia etc.)

Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa)

Global Testosterone Replacement Therapy market by Type: Gels, Injections, Patches, Other

Global Testosterone Replacement Therapy market by application: Hospitals, Clinics, Other

READ FULL REPORT: https://www.mrinsights.biz/report/global-testosterone-replacement-therapy-market-growth-2020-2025-236403.html

The Listing Supplies Hints On The Upcoming Pointers:

Business Diversification: Market information about new services, untapped geographies, the latest advances, and also investments.

Assessment: In-depth investigation of plans, services, and manufacturing capabilities of these top players.

Business Intelligence: Comprehensive information on Testosterone Replacement Therapy made accessible the very active players in the global sector.

Product Development/Innovation: Comprehensive information about technology, R&D pursuits, together with brand new product launches out of the global Testosterone Replacement Therapy market.

Market Development: Comprehensive information regarding flourishing emerging markets in which the report assesses the market to get worldwide records

Customization of the Report:This report can be customized to meet the clients requirements. Please connect with our sales team ([emailprotected]), who will ensure that you get a report that suits your needs.

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Global Testosterone Replacement Therapy Market Business Outlook with COVID-19 Scenario -AbbVie, Upsher-Smith, Endo International, Pfizer, Actavis...

Hormone Replacement Therapy Market 2020 Share Growing Rapidly With Latest Trends, Development, Revenue, Demand And Forecast To 2029 – WaterCloud News

The research study on Global Hormone Replacement Therapy market 2019 presents an extensive analysis of current Hormone Replacement Therapy market size, drivers, trends, opportunities, challenges, as well as key Hormone Replacement Therapy market segments. Further, it explains various definitions and classification of the Hormone Replacement Therapy industry, applications, and chain structure.In continuation of this data, the Hormone Replacement Therapy report covers various marketing strategies followed by key players and distributors. Also explains Hormone Replacement Therapy marketing channels, potential buyers and development history. The intent of global Hormone Replacement Therapy research report is to depict the information to the user regarding Hormone Replacement Therapy market forecast and dynamics for the upcoming years. The Hormone Replacement Therapy study lists the essential elements which influence the growth of Hormone Replacement Therapy industry. Long-term evaluation of the worldwide Hormone Replacement Therapy market share from diverse countries and regions is roofed within the Hormone Replacement Therapy report. Additionally, includes Hormone Replacement Therapy type wise and application wise consumption figures.

The Final Report will cover the impact analysis of COVID-19 on this industry.

Download Sample of This Strategic Report:https://www.kennethresearch.com/sample-request-10225607

After the basic information, the global Hormone Replacement Therapy Market study sheds light on the Hormone Replacement Therapy technological evolution, tie-ups, acquisition, innovative Hormone Replacement Therapy business approach, new launches and Hormone Replacement Therapy revenue. In addition, the Hormone Replacement Therapy industry growth in distinct regions and Hormone Replacement Therapy R;D status are enclosed within the report.The Hormone Replacement Therapy study also incorporates new investment feasibility analysis of Hormone Replacement Therapy. Together with strategically analyzing the key micro markets, the report also focuses on industry-specific drivers, restraints, opportunities, and challenges in the Hormone Replacement Therapy market.

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Global Hormone Replacement Therapy Market Segmentation 2019: Hormone Replacement TherapyThe study also classifies the entire Hormone Replacement Therapy market on basis of leading manufacturers, different types, various applications and diverse geographical regions. Overall Hormone Replacement Therapy market is characterized by the existence of well-known global and regional Hormone Replacement Therapy vendors. These established Hormone Replacement Therapy players have huge essential resources and funds for Hormone Replacement Therapy research as well as developmental activities. Also, the Hormone Replacement Therapy manufacturers focusing on the development of new Hormone Replacement Therapy technologies and feedstock. In fact, this will enhance the competitive scenario of the Hormone Replacement Therapy industry.

The Leading Players involved in global Hormone Replacement Therapy market are:

By Therapy Type (Human Growth Hormone (HGH) Replacement Therapy, Testosterone Replacement Therapy, Thyroid Replacement Therapy, Estrogen Replacement Therapy)

By Application (Growth Hormone Deficiency,Menopause, Hypothyroidism, Male Hypogonadism, and Others)

By Route of Administration (Oral, Parenteral, and Others)

By Distribution Channel (Hospital Pharmacies, Retail Pharmacies, and Online Pharmacies) 

By Region (North America, Latin America, Europe, Asia Pacific, Middle East, and Africa )

Download Sample of This Strategic Report:https://www.kennethresearch.com/sample-request-10225607

Worldwide Hormone Replacement Therapy Market Different Analysis:Competitors Review of Hormone Replacement Therapy Market: Report presents the competitive landscape scenario seen among top Hormone Replacement Therapy players, their company profile, revenue, sales, business tactics and forecast Hormone Replacement Therapy industry situations. Production Review of Hormone Replacement Therapy Market: It illustrates the production volume, capacity with respect to major Hormone Replacement Therapy regions, application, type, and the price. Sales Margin and Revenue Accumulation Review of Hormone Replacement Therapy Market: Eventually explains sales margin and revenue accumulation based on key regions, price, revenue, and Hormone Replacement Therapy target consumer. Supply and Demand Review of Hormone Replacement Therapy Market: Coupled with sales margin, the report depicts the supply and demand seen in major regions, among key players and for every Hormone Replacement Therapy product type. Also interprets the Hormone Replacement Therapy import/export scenario. Other key reviews of Hormone Replacement Therapy Market: Apart from the above information, correspondingly covers the company website, number of employees, contact details of major Hormone Replacement Therapy players, potential consumers and suppliers. Also, the strengths, opportunities, Hormone Replacement Therapy market driving forces and market restraints are studied in this report.

Highlights of Global Hormone Replacement Therapy Market Report:* This report provides in detail analysis of the Hormone Replacement Therapy and provides market size (US$ Million) and Cumulative Annual Growth Rate (CAGR (%)) for the forecast period: 2019 ; 2029. * It also elucidates potential revenue opportunity across different segments and explains attractive investment proposition matrix for world Hormone Replacement Therapy market. * This study also provides key insights about Hormone Replacement Therapy market drivers, restraints, opportunities, new product launches, approvals, regional outlook, and competitive strategies adopted by the leading Hormone Replacement Therapy players. * It profiles leading players in the worldwide Hormone Replacement Therapy market based on the following parameters ; company overview, financial performance, product portfolio, geographical presence, distribution strategies, key developments and strategies and future plans. * Insights from Hormone Replacement Therapy report would allow marketers and management authorities of companies to make an informed decision with respect to their future product launches, market expansion, and Hormone Replacement Therapy marketing tactics. * The world Hormone Replacement Therapy industry report caters to various stakeholders in Hormone Replacement Therapy market. That includes investors, device manufacturers, distributors and suppliers for Hormone Replacement Therapy equipment. Especially incorporates government organizations, Hormone Replacement Therapy research and consulting firms, new entrants, and financial analysts. *Various strategy matrices used in analyzing the Hormone Replacement Therapy market would provide stakeholders vital inputs to make strategic decisions accordingly.

Global Hormone Replacement Therapy Market Report Provides Comprehensive Analysis of Following: ; Hormone Replacement Therapy Market segments and sub-segments ; Industry size ; Hormone Replacement Therapy shares ; Hormone Replacement Therapy Market trends and dynamics ; Market Drivers and Hormone Replacement Therapy Opportunities ; Supply and demand of world Hormone Replacement Therapy industry ; Technological inventions in Hormone Replacement Therapy trade ; Hormone Replacement Therapy Marketing Channel Development Trend ; Global Hormone Replacement Therapy Industry Positioning ; Pricing and Brand Strategy ; Distributors/Traders List enclosed in Positioning Hormone Replacement Therapy Market.

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Moreover, the report organizes to provide essential information on current and future Hormone Replacement Therapy market movements, organizational needs and Hormone Replacement Therapy industrial innovations. Additionally, the complete Hormone Replacement Therapy report helps the new aspirants to inspect the forthcoming opportunities in the Hormone Replacement Therapy industry. Investors will get a clear idea of the dominant Hormone Replacement Therapy players and their future forecasts.

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Kenneth Research provides market research reports to different individuals, industries, associations and organizations with an aim of helping them to take prominent decisions. Our research library comprises of more than 10,000 research reports provided by more than 15 market research publishers across different industries. Our collection of market research solutions covers both macro level as well as micro level categories with relevant and suitable market research titles. As a global market research reselling firm, Kenneth Research provides significant analysis on various markets with pure business intelligence and consulting services on different industries across the globe. In addition to that, our internal research team always keep a track on the international and domestic market for any economic changes impacting the products demand, growth and opportunities for new and existing players.

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Hormone Replacement Therapy Market 2020 Share Growing Rapidly With Latest Trends, Development, Revenue, Demand And Forecast To 2029 - WaterCloud News

Healthy Living: Its OK to be anxious about things reopening – Q13 News Seattle

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SEATTLE -- We are finally reaching a point where we are seeing counties reopen. We are able to get back to some of the activities we enjoy. Some people may feel the changes are coming too late, while others think it is too soon.

Dr. Jim Polo is the Behavioral Health Medical Director with Regence, and he says change creates stress, and because this kind of change is complex as we go through phased recommendations, there is still a lot of uncertainty.

The pandemic isnt over. Theres still the risk that you can get infected and if you do get infected we dont know if that gives you immunity and we still dont quite have a vaccine," he says.

So what are some of the things you can do to handle uncertainty?

Dr. Polo says stay up to date on the recommendations and remember that the recommendations in your city or county may not be the same for somebody else.

Next, dont try to make sense of the recommendations. Dr. Polo says you may not like them, but follow them. the recommendations were made with your health in mind.

Next, set reasonable expectations.

Remember that there are going to be slow changes with phased recommendations over time. It will be a while before restaurants are fully operating at full capacity and you may not be enjoying the movies like you used to before. It might be some time before we can go to live football games or baseball games or basketball games, so set realistic expectations that there are still gonna be some things that you wont be able to enjoy.

Finally, Dr. Polo says its OK to grieve that you have lost some of your freedom. It is okay to recognize that youre disappointed and that you are going to be adjusting to a new reality.

You can take advantage of some things that will help you adjust into that new normal," he says.

Dr. Polo says routine is really important, as a routine can help create structure. Next, focus on the things you can control. You can also setup time to connect with people you can fully engage with like family and friends. Maybe you fill some of your time by taking up a new hobby.

Finally, Dr. Polo says there are the standards they recommend for good health, and that is to eat well, exercise and get adequate sleep.

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Healthy Living: Its OK to be anxious about things reopening - Q13 News Seattle

Press Release: Eastern Oregon Healthy Living Alliance Receives Oregon Community Recovery Fund Grant – The Lund Report

The Lund Report is offering this coverage for free to better inform the public at this difficult time. But we need your support to help us stretch our resources. Please sign up for a tax-deductible premium subscription or consider making a donation. That is also tax deductible because we're a 501(c)(3) organization.

Eastern Oregon Healthy Living Alliance (EOHLA) announced today that it has been awarded a $24,000 grant from the Oregon Community Recovery Fund to support a regional response to the coronavirus (COVID-19). This funding supports the work EOHLA, Nutrition Oregon Campaign, Oregon Food Bank, and Eastern Oregon Coordinated Care Organization (EOCCO) have under way to support food access during the pandemic by expanding available fruits and vegetables through existing Veggie Rx programs in Sherman, Gilliam, Wheeler, Harney, Wallowa, and Malheur counties; increasing the local volunteer base by developing and maintaining an Eastern Oregon Mutual Aid Network; and supporting local food pantries in need.

Philanthropic partners, businesses and individuals across the state have taken quick action with contributions to the Oregon Community Recovery Fund. The fund, established by many partners throughout Oregon, and hosted by the Oregon Community Foundation (OCF), was established in March to rapidly deploy resources to community-based organizations at the front lines of the coronavirus outbreak. Resources are prioritized where and when they are critically needed, with a focus on Oregons most vulnerable populations.

Eastern Oregon Healthy Living Alliance (EOHLA) is part of the Nutrition Oregon Campaign, a statewide campaign grounded in the science of the developmental origins of health and disease (DOHaD) that shows the relationship between early life environment, including nutrition, and lifelong chronic disease risk, and how that risk is passed from one generation to the next. The campaign, which is a program of OHSUs Moore Institute, uses education, advocacy and capacity building to address chronic disease risk at the community level. DOHaD research has shown us the long-term, multigenerational health impacts of a dramatic change in nutrition access among populations, as well as the health impacts of poor nutrition before and during pregnancy and in the earliest years of life.

We are at a moment when we can see access to food quickly slipping away from many in our communities, including those who were already living on the edge said Kent Thornburg, Ph.D., Director of the OHSU Bob and Charlee Moore Institute for Nutrition & Wellness.Now is the time to find strategies to mutually benefit all organizations dedicated to improving the health of our communities. EOHLA is an example of an organization who cares enough to take action. More than ever we cant do this work alone.

Prior to the pandemic, Eastern Oregon communities struggled with food access. A community health assessment conducted by the EOCCO indicates that there are 26,180 people in Eastern Oregon who are food insecure with higher food insecurity rates than Oregon statewide in eight of twelve Eastern Oregon counties including Grant, Baker, Harney, Lake, Sherman, Union, Wallowa, and Wheeler counties. Food insecurity, a social determinant of health that can impact overall health, including obesity and chronic disease, is a regional health priority within EOCCOs Regional Community Health Improvement Plan. The 2010-13 Behavioral Risk Factor Surveillance System (BRFSS) indicates an average of 31.1% of adults in Eastern Oregon are obese as compared to Oregon 26.9%.

Anyone may contribute to the Oregon Community Recovery Fund. Donations are accepted online. Nonprofit organizations working to respond to this crisis can review funding guidelines and apply for grants on the OCF website.

Oregon Community Foundation (OCF) puts donated money to work in Oregon more than $100 million in grants and scholarships annually. For more than 45 years, OCF grantmaking, research, advocacy and community-advised solutions have helped individuals, families, businesses and organizations create charitable funds to improve lives for all Oregonians. Impactful givingtime, talent and resources from many generous Oregonianscreates measurable change.

For more information about OCF, please visit: http://www.oregoncf.orgFor more information about the EOHLA, please visit: http://www.eohla.org

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Press Release: Eastern Oregon Healthy Living Alliance Receives Oregon Community Recovery Fund Grant - The Lund Report

YMCA Of The Okoboji’s Announces Permanent Closure Of Its Healthy Living Program Center In Downtown Spirit Lake – exploreokoboji.com

(Spirit Lake)-- The ongoing COVID-19 pandemic continues to have a significant negative financial impact on the YMCA of the Okoboji's, which announced today (Fri.) it will be permanently closing its Healthy Living Program Center in downtown Spirit Lake. CEO Andrew Fisher says the financial impacts on the organization are beginning to cascade...SLHLPC Closing01

"All of this through the pandemic has really forced us to shrink down our organization to withstand all of the challenges of this. The majority of our revenue streams have been cut off through this, even the programs that we were able to offer such as our child care programs at the school districts right now helping out the community, the limitations of it, have hurt us so bad financially that we have to start to look at restructuring our debt as an organization. We have to lose some things. We had to restructure some staffing, and so it's been very challenging through this process and I really appreciate the volunteer board that's been helping with this and we look forward to continuing to serve the community. We just know it has to be different."

Fisher adds the downtown Spirit Lake location has been closed since the pandemic started. He says the Milford location is not affected by today's (Fri.) announcement...SLHLPC Closing02

"Our membership structure allows all of our members to utilize all of our facilities and that means the Bedell Family YMCA and the Milford HLPC. So all members still have full access to all of those facilities. We are going to be restructuring the Bedell facility and adding an expansive weight room to what we call our family gym, and restructuring the building to accommodate more health and wellness needs which that's what the Spirit Lake Health Living Program Center helped us do. We'll begin on that starting next week and that will be transitioning through. In terms of the building, we are going through the process of exploring a couple of different opportunities of selling the facility. We will be looking to do that down the road and we'll have more details on that to come."

He says the Jiu Jitsu Okoboji program, which conducted self-defense training classes at the Spirit Lake HLPC site, will be relocated to the Bedell Family YMCA once restrictions related to COVID-19 are lifted.

Fisher says the YMCA will proceed with projects currently underway at the Bedell Family YMCA and Camp Foster to increase capacities and improve member and camper experiences.

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YMCA Of The Okoboji's Announces Permanent Closure Of Its Healthy Living Program Center In Downtown Spirit Lake - exploreokoboji.com

HEALTHY LIVING Stay safe around water this summer – Port Arthur News – The Port Arthur News

Here in southeast Texas, we are fortunate to be surrounded by water: lakes, ponds, rivers, bayous, beaches and, of course, pools.

When the weather turns warm, everyone wants to be in or around the water. Hanging out at the pool or the beach on a hot day is a great way to beat the heat. There are so many opportunities to enjoy the water; unfortunately, this also presents circumstances for accidental drownings.

For people between the ages of 5 and 24, drowning is the second leading cause of accidental death. Drowning can occur in as little as two inches of water, in as little as 90 seconds.

It doesnt have to be that way, though. Most water-related accidents can be avoided by knowing how to stay safe and following a few simple guidelines. Learning how to swim is essential if you plan on being on or near water. Please, get your children, grandchildren and yourself into a certified swim instruction course. Before signing up with anyone, make sure that instructor has received training from a certified program.

Aside from having your children and yourself properly instructed in swim skills, there are a few tips you need to keep in mind when heading out to enjoy the water:

Buddy up!

Never swim alone. Always swim with a partner, every time whether youre swimming in a backyard pool or in a lake. Even experienced swimmers can become tired or get muscle cramps, which might make it difficult to get out of the water. When people swim together, they can help each other or go for help in case of an emergency.

Get skills

Speaking of emergencies, its good to be prepared. Learning some life-saving skills, such as CPR and rescue techniques, can help you save a life. A number of organizations offer classes for beginning and experienced swimmers and boaters. Check with your YMCA, local hospital, or chapter of the Red Cross.

Know your limits

Swimming can be a lot of fun and you might want to stay in the water as long as possible. If youre not a good swimmer or youre just learning to swim, dont go in water thats so deep you cant touch the bottom and dont try to keep up with skilled swimmers. That can be hard, especially when your friends are challenging you but its a pretty sure bet theyd rather have you safe and alive.

Swim in safe areas only

Its a good idea to swim only in places that are supervised by a lifeguard. No one can anticipate changing ocean currents, rip currents, sudden storms or other hidden dangers. Pay attention when warnings are posted. In the event that something does go wrong, lifeguards are trained in rescue techniques.

Alcohol and water never mix

Alcohol is involved in numerous water-related injuries and up to half of all water-related deaths. The statistics for teenage guys are particularly scary: One half of all adolescent male drownings are tied to alcohol use.

If you cant see them, you cant save them

Dont depend solely on the lifeguard. Yes, they are highly trained to save lives, but they are also watching many other swimmers.

If you bring your children to the pool, watch them. Dont get so involved with visiting with others, reading or your phone/tablet that you are not always aware of their location.

Be prepared, stay aware, and have fun!

Jody Holton writes about health in The Port Arthur News. She can be reached at jholton3@gt.rr.com.

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HEALTHY LIVING Stay safe around water this summer - Port Arthur News - The Port Arthur News

HEALTHY LIVING: What a pain – NWAOnline

Strains and sprains are the two most common acute soft-tissue injuries and typically occur because of trauma, which can be anything from a rough hit while playing sports to stepping off a curb the wrong way. Though both share one major symptom -- pain -- there are significant differences between the two injuries:

Strains involve tears to muscle fibers or tendons. Two of the most common locations strains occur are the hamstring and the back. Depending on the severity, symptoms typically include pain, swelling and sometimes limited range of motion.

Sprains on the other hand, involve tears to ligaments. This tearing, depending on the severity, can affect joint stability and typically cause pain and swelling.

If your sprain or strain isn't severe, there are things you can do to treat them at home. Following the RICE protocol helps most soft-tissue injuries. Rest the injured area, use ice packs for 20-minute intervals, use a compression bandage of some kind on the affected area and elevate your injury so that it is higher than your heart.

If pain is affecting your ability to move or work, or you cannot put any weight on the injured joint or limb, it's probably a good idea to seek medical attention. Northwest Health Urgent Care Siloam Springs offers care that is fast, safe and compassionate 8 a.m.-5 p.m. Monday-Friday. Walk-ins are always welcome and no appointment is needed. The clinic is located at 3721 U.S. 412, Suite B, in Siloam Springs. Visit us online at MyNorthwestUrgentCare.com or call (479) 215-3080 for more information.

Seeking medical attention also applies if you've injured the same joint or limb in the past, if the injured area is misshapen in any way or if you're unsure how to care for it. The provider will not only determine the appropriate course of treatment, but also design, or refer you to someone who can design, a rehabilitation plan that will help you get active again as soon as possible, and do it in a safe way.

Is it broken?

If you put too much pressure on a bone, chances are it's going to break. This break is called a fracture. It's easy to tell something is broken if the bone punctures the skin or if the area is visibly misshapen, but not all fractures cause physical symptoms this obvious. If yours is one of the sneakier breaks, here's how to spot it. Symptoms include:

Pain, usually intense

Swelling

Bruising or bleeding

Numbness or tingling of the affected limb

Limited mobility of the affected limb

If you suspect you or a loved one may have a broken bone, seek medical attention immediately. Broken bones typically have to be set in braces, splints or casts so they heal correctly and don't cause you any problems down the road.

General News on 05/27/2020

Print Headline: What a pain

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HEALTHY LIVING: What a pain - NWAOnline

Healthy Living: Get balance in your life and diet – Longford Leader

Can you believe it's been over two months since the children finished school! And to think we have another three months before they go back in September (hopefully).

You're probably sick of hearing 'I'm starving' and 'there is never anything to eat in this house!!!'

This makes it very tempting to reach for the processed convenience foods such as, pizzas, chicken nuggets, chips etc.!

And this is okay occasionally, it's when it becomes part of your daily diet that it causes issues down the line with your health and your waistline!

You might remember my article here a couple of weeks ago where I give you my top tips on how to stall the covid stone?

Well I'm back this week to give you more tips on how to help you on your family get some balance back in your life and your diet.

START WITH A PLAN

One of the best things you can do for yourself is to get into the habit of planning your family meals, this will save you time and money.

Planning meals in advance ensures you use up the ingredients you have before buying more, therefore preventing waste. Get the whole family involved by allowing everyone pick a meal and agreeing to trying each others meal.

There is a meal planner in my 28-day rescue plan, download it free from my website and get writing!

WRITE A LIST

Write a shopping list for the ingredients you need to put your meal plan into action, this will save you time wandering around the shop wondering what to buy and save you money as you will be less likely to put unwanted items in your trolley.

PLAN FOR LEFTOVERS

Plan for leftovers to be used the next day as lunch, for example leftover chili is delicious the next day, heated in a wholemeal pitta bread or wrap with grated cheese, avocado and salad.

Leftover roast chicken is so versatile and can be used in salads or wraps, my personal favorite is to make an egg fried rice with it. Leftover potatoes can be mixed with a tin of tuna, onions, peppers and some herbs to make lovely fishcakes for lunch.

PREPARE FOOD IN BATCHES

If your family are great at coming up with the meal plan ideas but not so great at helping to prep or cook it, then lighten your load by prepping once to eat multiple times.

Chop and wash a variety of veg all at once, then place them in an airtight container in the fridge to use as snacks. Carrots, celery, peppers all make great snacks to dip in hummus or cream cheese.

Double your recipe ingredients and store them in the fridge or freezer and you will have a meal ready to be cooked when you want it. This works great for curries, just pop your chicken and veg that has been marinating in the lovely spices into a pot with a tin of coconut milk, simmer for 20minutes & you have a tasty meal on the table that the whole family will love. Check out my curry recipe from my 28-day guide free to download on my website http://www.thenutricoach.ie

ENSURE YOU ARE GETTING A WIDE RANGE OF NUTRIENTS

Its important to remember there is no specific food or supplement that will prevent you from getting Covid-19 or prevent you from gaining weight. However, a healthy balanced diet thats low in sugar and processed food & high in nutrients that support the immune system such as, vitamin c (berries, tomatoes, peppers, citrus fruit) vitamin A ( sweet potato, spinach) vitamin D (oily fish, mushrooms) zinc ( meat, shellfish, dairy) is the best thing you can do for your immune system and your waistline.

EAT REGULARLY

Youre probably sick of hearing Im hungry but by having set mealtimes and including snacks will help to keep your blood sugar stable.

Skipping meals is never a good idea, going long periods without eating causes your blood sugar to drop, which leads to fatigue and cravings for sugary snacks and stimulants (think the 11am/3pm slump).

Aim for three main meals a day and include a maximum of two nutritious snacks, such as a piece of fruit with 4-5 nuts, vegetable crudits with hummus or sliced apple dipped in nut butter or try out my no bake energy balls for a sweet treat.

EAT A SOURCE OF PROTEIN WITH EVERY MEAL OR SNACK

When you eat carbohydrates alone they quickly get digested and converted into sugar, which is then absorbed into your blood stream causing a spike in blood sugar.

However including a source of protein with your meal or snack slows down digestion.

This leads to a slower absorption of carbohydrates, therefore a lower rise in blood sugar, so less of the fat storing hormone insulin is needed, and protein will help you feel full for longer resulting in less snacking.

STAY HYDRATED

I know I sound like a broken record with this one, but it really is vital, every cell in our body relies on water to function properly. Drinking water has many benefits, including boosting your metabolism and suppressing your appetite.

When you dont drink enough water, your body receives mixed signals from the hypothalamus, which is the part of the brain that regulates appetite and thirst, so a lot of the time when we think we are hungry, we are actually thirsty!

Aim to drink two litres of water a day.

This can be achieved by starting your day with hot water and lemon, adding lemon slices, cucumber and mint leaves to a jug of water and sipping throughout the day and having some herbal teas.

SIP AWAY

Personally, I find by using the same refillable bottle and sipping it every time I pass it really helps to get my two litres a day.

FOLLOW THE HEALTHY PLATE GUIDE

The healthy plate guide is an easy way to make sure you are having a well-balanced meal, just fill half your plate with vegetables, your plate protein/healthy fats e.g. chicken, meat, fish, eggs, lentils, and your plate low GL carbohydrates e.g. sweet potato, brown pasta or rice, quinoa.

Do you have a nutrition question you would like answered or a topic you would like to see me cover? If so just pop me a message, contact details below.

Debbie Devane from The Nutri Coach is a qualified nutritionist and health coach, Debbie runs her clinic from the Glenard Clinic in Mountmellick and also offers one to one and group online consultations. Debbie is also Nutritionist to the Offaly GAA senior footballers. For more information or to make an appointment email Debbie at

info@thenutricoach.ie

Ph: 086-1720055

Facebook: The Nutri Coach @debbiedevanethenutricoach

Instagram: the_nutricoach

To download your free 28-day plan go to http://www.thenutricoach.ie

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Healthy Living: Get balance in your life and diet - Longford Leader

The Best Non-Expensive Indian Superfoods You Should Eat for Strong Immunity and Healthy Living – Krishi Jagran

Whenever we hear the term Superfoods we subconsciously think of Broccoli, Greek Yogurt, Avocados, Kale etc. This is the power of marketing in the present time. But the superfoods we have mentioned above are not local to India. They all are foreign foods. Moreover, not all of them are pocket friendly and easily available. Every week a new superfood comes in market and this is the new trend now.

Any food should be considered Superfood only if it can be used in multiple ways to benefit health, have plethora of benefits and should suit every body type. They should add diversity in your diet and should be nutrients rich. The Indian Superfoodswhich we are going to discuss here are produced in India, have amazing health benefits and have stood the test of time in our culture.

Lets dive in to the list of these amazing Indian Superfoods:

Our Indian culture considers Coconut as Shree Phal for its amazing benefits and versatility. We Indians break coconut before starting any important thing. By eating coconut our body gets physical strength andit soothes our mind. Coconut helps in fat burning and is stomach friendly. It provides much better hydration than other hydrating cola drinks. Coconut water and its raw Malai is really good for digestion and constipation. Now various studies also agrees that coconut oil is best for cooking and healthy heart. You can also use coconut water for curing hangover. Truly a Superfood, is it not?

By almonds we mean local desi almonds and not California almonds. Desi almonds are higher in nutrition and our bodies can absorb them better. Rich in OMEGA fatty acids, almonds truly are tonic for your heart and brain.Soak 4-5 almonds in water in night and have them the next morning after peeling their skin. You can also have almond oil in lukewarm milk at night. It will help with all digestion problems.

Our Indian culture have propagated numerous benefits of Desi Ghee for thousands of years. It can be used in both ways,Internallyor Externally. The gold color of ghee indicates that it is a goldmine of nutrients. There are so much false rumors around ghee of being fattening, increasing cholesterol and causing heart problems. These are completely false. Now, even our Indian Celebrities are also having ghee regularly in their diet.Ghee has the highest smoking point among cooking oils, making it ideal for cooking and deep frying.Having ghee on your meals helps in reducing their glycemic index and increases nutrients absorption. 2-4 tea spoons can be included in our regular diet.

Banana is truly a superfood as it is really versatile, high in nutrition and easily available. It contains ample amount of Fiber, Calcium, Potassium and Vitamin C, which helps in giving you instant energy. It is really good for your digestive system as it is a Natural Prebiotic. Having banana every morning empty stomach helps in burning fat as it has plant sterol.

Amlaor Indian Gooseberry has been a part of Indian culture for thousands of years. It is an amazing immunity booster. Its other benefits are Amazing for eyes, Highest in vitamin C, Helps in reproductive problems and anti-viral and anti-cancer properties. Have boiledAmlawith your meals, it tastes like pickle and will really enhance the meal taste. It also helps in anti-ageing processes like dull skin, grey hair, hair fall, wrinkles. Everyone should include this superfood in their diets.

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The Best Non-Expensive Indian Superfoods You Should Eat for Strong Immunity and Healthy Living - Krishi Jagran

Vitamin D Deficiency: Know The Signs And Symptoms And Why The Sunshine Vitamin Is Important For You – NDTV

Vitamin D deficiency can cause weak bones and muscle pain

Vitamin D deficiency is quite common. As many as one billion people across the world have low levels of the sunshine vitamin in their blood. Vitamin D is an important nutrient for the body. It required for absorbing calcium and helps in building bones. The vitamin is synthesised in the body in the presence of sunlight.

Building a strong immunity is an important role played by Vitamin D. A strong immunity enables you to fight off illness causing bacteria and viruses. Vitamin D directly interacts which cells that fight infection and thus if you fall sick too often, it could be a sign of Vitamin D deficiency.

Also read:Can Vitamin D Help Fight Acne? Let's Find Out And Know The Best Sources Of Vitamin D

Vitamin D helps in improving absorption of calcium. If you experience bone or back pain regularly, then it could be a sign of Vitamin D deficiency. Studies have also found a link between deficiency of the sunshine vitamin and chronic back pain.

Studies have found that Vitamin D increases production of compounds which are crucial for forming new skin that is a part of the wound-healing process. Slow healing of wounds after an injury or surgery could be indicative of low levels of Vitamin D.

Calcium absorption and bone metabolism are two of the most important functions of Vitamin D. According to healthline.com, people who are diagnosed with bone loss in old age may be deficient in Vitamin D, along with loss of calcium and other minerals.

Also read:These Are The 3 Most Important Minerals For Strong Bones

One of the many causes of Vitamin D deficiency could be muscle pain. The receptor of Vitamin D is present in nerve cells known as nociceptors. These nerve cells sense pain.

Excessive tiredness and fatigue, despite living a healthy lifestyle and sleeping well, could be a sign of Vitamin D deficiency.

Vitamin D deficiency can cause tiredness and fatiguePhoto Credit: iStock

Deficiency of Vitamin D could be linked to depression, especially in older adults. Some studies have found that taking supplements can improve mood and reduce feelings of depression.

Severe hair loss is surely associated with a nutrition deficiency, including low levels of Vitamin D. Female pattern hair loss female-pattern hair loss or alopecia areata could be linked to deficiency of Vitamin D.

Also read:7 Foods That Can Boost Your Hair Growth Naturally

What can you do about Vitamin D deficiency?

In prescribed amounts, taking Vitamin D supplements can help in meeting deficiency of Vitamin D. Spending five to 10 minutes under the sun every day can also be beneficial, as the body synthesises Vitamin D in the presence of sunlight.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Vitamin D Deficiency: Know The Signs And Symptoms And Why The Sunshine Vitamin Is Important For You - NDTV

Chat and a cuppa offer for those isolated due to coronavirus – Keighley News

A FRIENDLY chat on the phone beckons Keighley people at the Conversation Caf.

Keighley Healthy Living is hosting the caf as part of its health and wellbeing support services for local people during the coronavirus pandemic.

Melanie Hey, chief officer at KHL, said people could book a regular weekly slot with one of the volunteers, who would call them up, and could also give support and signpost information in many areas.

Melanie said: The KHL team are missing seeing our regular groups and our local community each week. We appreciate the importance of having regular contact and meeting people.

"Although we have moved many of our groups online we know one of the benefits of attending a group is the opportunity to have a good chat and catch up with people.

"We hope that our conversation cafes will help to support people to feel connected and we look forward to hearing from you.

Anyone who would like to book a weekly chat or a one-off chat, is asked to make themselves a cuppa, pick up the phone and call 01535 677177.

KHL also runs several online groups, a YouTube channel, a Facebook page and a regular newsletter.

Visit khl.org.uk or the Facebook page for further information.

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Chat and a cuppa offer for those isolated due to coronavirus - Keighley News

Chinese alchemical elixir poisoning – Wikipedia

In Chinese alchemy, elixir poisoning refers to the toxic effects from elixirs of immortality that contained metals and minerals such as mercury and arsenic. The official Twenty-Four Histories record numerous Chinese emperors, nobles, and officials who died from taking elixirs in order to prolong their lifespans. The first emperor to die from elixir poisoning was likely Qin Shi Huang (d. 210 BCE) and the last was Yongzheng (d. 1735). Despite common knowledge that immortality potions could be deadly, fangshi and Daoist alchemists continued the elixir-making practice for two millennia.

The etymology of English elixir derives from Medieval Latin elixir, from Arabic (al-iksr), probably from Ancient Greek (xrion "a desiccative powder for wounds"). Elixir originated in medieval European alchemy meaning "A preparation by the use of which it was sought to change metals into gold" (elixir stone or philosopher's stone) or "A supposed drug or essence with the property of indefinitely prolonging life" (elixir of life). The word was figuratively extended to mean "A sovereign remedy for disease. Hence adopted as a name for quack medicines" (e.g., Daffy's Elixir) and "The quintessence or soul of a thing; its kernel or secret principle". In modern usage, elixir is a pharmaceutical term for "A sweetened aromatic solution of alcohol and water, serving as a vehicle for medicine" (Oxford English Dictionary, 2nd ed., 2009). Outside of Chinese cultural contexts, English elixir poisoning usually refers to accidental contamination, such as the 1937 elixir sulfanilamide mass poisoning in the United States.

Dn "cinnabar; vermillion; elixir; alchemy" is the keyword for Chinese immortality elixirs. The red mineral cinnabar (dnsh lit. "cinnabar sand") was anciently used to produce the pigment vermilion (zhhng ) and the element mercury (shuyn "watery silver" or gng ).

According to the ABC Etymological Dictionary of Old Chinese, the etymology of Modern Standard Chinese dn from Old Chinese *tn (< *tlan?) "red; vermillion; cinnabar", gn in dngn from *tn-kn (< *tlan-klan?) "cinnabar; vermillion ore", and zhn from *tan "a red flag" derive from Proto-Kam-Sui *h-lan "red" or Proto-Sino-Tibetan *tja-n or *tya-n "red". The *t- initial and *t- or *k- doublets indicate that Old Chinese borrowed this item. (Schuessler 2007: 204).

Although the word dan "cinnabar; red" frequently occurs in oracle script from the late Shang Dynasty (c. 16001046 BCE) and bronzeware script and seal script from the Zhou Dynasty (1045256 BCE), paleographers disagree about the graphic origins of the logograph and its ancient variants and . Early scripts combine a dot or stroke (depicting a piece of cinnabar) in the middle of a surrounding frame, which is said to represent:

Many Chinese elixir names are compounds of dan, such as jndn (with "gold") meaning "golden elixir; elixir of immortality; potable gold" and xindn (with "Daoist immortal") "elixir of immortality; panacea", and shndn (with "spirit; god") "divine elixir". Bs zh yo "drug of deathlessness" was another early name for the elixir of immortality. Chinese alchemists would lindn (with "smelt; refine") "concoct pills of immortality" using a dndng (with "tripod cooking vessel; cauldron") "furnace for concocting pills of immortality". In addition, the ancient Chinese believed that other substances provided longevity and immortality, notably the lngzh "Ganoderma mushroom".

The transformation from chemistry-based waidan "external elixir/alchemy" to physiology-based neidan "internal elixir/alchemy" gave new analogous meanings to old terms. The human body metaphorically becomes a ding "cauldron" in which the adept forges the Three Treasures (essence, life-force, and spirit) within the jindan Golden Elixir within the dntin (with "field") "lower part of the abdomen".

In early China, alchemists and pharmacists were one and the same. Traditional Chinese medicine also used less concentrated cinnabar and mercury preparations, and dan means "pill; medicine" in general, for example, dnfng semantically changed from "prescription for elixir of immortality" to "medical prescription". Dan was lexicalized into medical terms such as dnj "pill preparation" and dnyo "pill medicine".

The Chinese names for immortality elixirs have parallels in other cultures and languages, for example, Indo-Iranian soma or haoma, Sanskrit amrita, and Greek ambrosia.

In Chinese history, the alchemical practice of concocting elixirs of immortality from metallic and mineral substances began circa the 4th century BCE in the late Warring states period, reached a peak in the 9th century CE Tang dynasty when five emperors died, and, despite common knowledge of the dangers, elixir poisoning continued until the 18th century Qing dynasty.

The earliest mention of alchemy in China occurs in connection with fangshi ("masters of the methods") specialists in cosmological and esoteric arts employed by rulers from the 4th century BCE (De Woskin 1981: 19).

The 3rd-century BCE Zhanguo Ce and Han Feizi both record a story about King Qingxiang of Chu (r. 298263 BCE) being presented a busi zhi yao "immortality medicine". As the chamberlain was taking the elixir into the palace, a guard asked if it was edible and when he answered yes, the guard grabbed and ate it. The king was angered and condemned the guard to death. A friend of the guard tried to persuade the king, saying, "After all the guard did ask the chamberlain whether it could be eaten before he ate it. Hence the blame attaches to the chamberlain and not to him. Besides what the guest presented was an elixir of life, but if you now execute your servant after eating it, it will be an elixir of death (and the guest will be a liar). Now rather than killing an innocent officer in order to demonstrate a guest's false claim, it would be better to release the guard." This logic convinced the king to let the guard live (Needham and Ho 1970: 316).

Qin Shi Huang, the founder of the Qin dynasty (221206 BCE), feared death and spent the last part of his life seeking the elixir of life. He reportedly died from elixir poisoning (Wright 2001: 49). The first emperor also sent Xu Fu to sail an expeditionary fleet into the Pacific seeking the legendary Mount Penglai where the busi zhi shu "tree of deathlessness" grew, but they never returned.

Interest in elixirs of immortality increased during the Han dynasty (206 BC220 AD). Emperor Wu (15687 BCE) employed many fangshi alchemists who claimed they could produce the legendary substance. The Book of Han says that around 133 BCE the fangshi Li Shaojun said to Emperor Wu, "Sacrifice to the stove [zao ] and you will be able to summon ' things ' [i.e. spirits]. Summon spirits and you will be able to change cinnabar powder into yellow gold. With this yellow gold you may make vessels to eat and drink out of. You will then increase your span of life. Having increased your span of life, you will be able to see the [xian ] of [Penglai] that is in the midst of the sea. Then you may perform the sacrifices feng [] and shan [], and escape death." (tr. Waley 1930: 2).

Wei Boyang's c. 142 Cantong qi, which is regarded as the oldest complete alchemical book extant in any culture, influenced developments in elixir alchemy. It listed mercury and lead as the prime ingredients for elixirs, which limited later potential experiments and resulted in numerous cases of poisoning. It is quite possible that "many of the most brilliant and creative alchemists fell victim to their own experiments by taking dangerous elixirs" (Needham et al. 1976: 74). There is a famous story about animal testing of elixirs by Wei Boyang. Wei entered the mountains to prepare the elixir of immortality, accompanied by three disciples, two of whom were skeptical. When the alchemy was completed he said, "Although the gold elixir is now accomplished we ought first to test it by feeding it to a white dog. If the dog can fly after taking it then it is edible for man; if the dog dies then it is not." The dog fell over and died, but Wei and his disciple Yu took the medicine and immediately died, after which the two cautious disciples fled. Wei and Yu later revived, rejoiced in their faith, took more of the elixir and became immortals (Needham and Ho 1970: 322).

Elixir ingestion is first mentioned in the c. 81 BCE Discourses on Salt and Iron (Pregadio 2000: 166).

During the turbulent Six dynasties period (220589), self-experimentation with drugs became commonplace, and many people tried taking poisonous elixirs of immortality as well as the psychoactive drug Cold-Food Powder. At this time, Daoist alchemists began to record the often fatal side effects of elixirs. In an unusual case of involuntary elixir poisoning, Empress Jia Nanfeng (257300) was forced to commit suicide by drinking "jinxiaojiu" "wine with gold fragments" (Needham and Ho 1970: 326).

The Daoist scholar Ge Hong's c. 320 Baopuzi lists 56 chemical preparations and elixirs, 8 of which were poisonous, with visions from mercury poisoning the most commonly reported symptom (Needham et al. 1976: 8996).

The individuals who experimented with Six Dynasties alchemy often had different understandings and intentions. A single alchemical formula could be interpreted as being "suicidal, therapeutic, or symbolic and contemplative", and its implementation might be "a unique, decisive event or a repeated, ritual phantasmagoria" (Strickmann 1979: 192).

Emperor Ai of Jin (r. 361365) died at the age of twenty-five, as the result of his desire to avoid growing old. The Book of Jin says the emperor practiced bigu "grain avoidance" and consumed alchemical elixirs, but was poisoned from an overdose and "no longer knew what was going on around him" (Needham and Ho 1970: 317). In a sardonic sense, the emperor fulfilled his desire since the elixir "did actually prevent him from growing any older" (Ho 2000: 184).

Emperor Daowu (r. 371409), founder of the Northern Wei dynasty, was cautiously interested in alchemy and used condemned criminals for clinical trials of immortality elixirs (like Mithridates VI of Pontus r. 12063 BCE) . The Book of Wei records that in 400, he instituted the office of the Royal Alchemist, built an imperial laboratory for the preparation of drugs and elixirs, and reserved the Western mountains for the supply of firewood (used in the alchemical furnaces). "Furthermore, he ordered criminals who had been sentenced to death to test (the products) against their will. Many of them died and (the experiments gave) no decisive result." (tr. Needham and Ho 1970: 321).

Many texts from the Six dynasties period specifically warned about the toxicity of elixirs. For instance, the Shangqing School Daoist pharmacologist Tao Hongjing's 499 Zhen'gao (, Declarations of the Perfected) describes taking a White Powder elixir.

When you have taken a spatulaful of it, you will feel an intense pain in your heart, as if you had been stabbed there with a knife. After three days you will want to drink, and when you have drunk a full hu [about 50 liters] your breath will be cut off. When that happens, it will mean that you are dead. When your body has been laid out, it will suddenly disappear, and only your clothing will remain. Thus you will be an immortal released in broad daylight by means of his waistband. If one knows the name of the drug [or, perhaps, the secret names of its ingredients] he will not feel the pain in his heart, but after he has drunk a full hu he will still die. When he is dead, he will become aware that he has left his corpse below him on the ground. At the proper time, jade youths and maidens will come with an azure carriage to take it away. If one wishes to linger on in the world, he should strictly regulate his drinking during the three days when he feels the pain in his heart. This formula may be used by the whole family. (tr. Strickmann 1979: 137138)

Within this context, Strickmann says a prospective Daoist alchemist must have been strongly motivated by faith and a firm confidence in his posthumous destiny, in effect, "he would be committing suicide by consecrated means." Tao Hongjing's disciple Zhou Ziliang (497516) had repeated visions of Maoshan divinities who said his destiny was to become an immortal, and instructed him to commit ritual suicide with a poisonous elixir composed of mushrooms and cinnabar (Strickmann 1994: 40). In 517, Tao edited the Zhoushi mingtong ji (Records of Mr. Zhou's Communications with the Unseen) detailing his disciples visions.

The Liang dynasty founder Emperor Wu (r. 502549) was cautious about taking elixirs of immortality. He and Tao Hongjing were old friends, and the History of the Southern Dynasties says the emperor requested him to study elixir alchemy. After Tao had learned the secret art of making elixirs, he was worried about the shortage of materials. "So the emperor supplied him with gold, cinnabar, copper sulphate, realgar, and so forth. When the process was accomplished the elixirs had the appearance of frost and snow and really did make the body feel lighter. The emperor took an elixir and found it effective." (tr. Needham et al. 1976: 120). Tao spent his last years working on different elixirs and presented three to the emperor, who had refused immortality elixirs from Deng Yu (who claimed to have lived 30 years without food, only consuming pieces of mica in stream water).

Emperor Wenxuan (r. 550559) of the Northern Qi dynasty was an early skeptic about immortality elixirs. He ordered alchemists to make the jiuhuan jindan (Ninefold Cyclically Transformed Elixir), which he kept in a jade box, and explained, "I am still too fond of the pleasures of the world to take flight to the heavens immediatelyI intend to consume the elixir only when I am about to die." (tr. Needham and Ho 1970: 320).

At least five Tang dynasty (618907) emperors were incapacitated and killed by immortality elixirs. In the 9th century Tang imperial order of succession, two father-son emperor pairs died from elixirs: first Xianzong (r. 805820) and Muzong (r. 820824), then Wuzong (r. 840846) and Xuanzong (r. 847859). In historic recurrences, the newly enthroned emperor understandably executed the Daoist alchemists whose elixirs had killed his father, and then subsequently came to believe in other charlatans enough to consume their poisonous elixirs (Ho 2000: 184).

Emperor Xianzong (r. 805820) indirectly lost his life due to elixir poisoning. The Xu Tongzhi (Supplement to the Historical Collections) says, "Deluded by the sayings of the alchemists, [Xianzong] ingested gold elixirs and his behaviour became very abnormal. He was easily offended by those officials whom he daily met, and thus the prisons were left with little vacant space." (tr. Needham and Ho 1970: 317). In response, an official wrote an 819 memorial to the throne that said:

Of late years, however, (the capital) has been overrun by a host of pharmacists and alchemists ... recommending one another right and left with ever wilder and more extravagant claims. Now if there really were immortals, and scholars possessing the Tao, would they not conceal their names and hide themselves in mountain recesses far from the ken of man? ... The medicines of the sages of old were meant to cure bodily illnesses, and were not meant to be taken constantly like food. How much less so these metallic and mineral substances which are full of burning poison! ... Of old, as the Li Chi says, when the prince took physic, his minister tasted it first, and when a parent was sick, his son did likewise. Ministers and sons are in the same position. I humbly pray that all those persons who have elixirs made from transformed metals and minerals, and also those who recommend them, may be compelled to consume (their own elixirs) first for the space of one year. Such an investigation will distinguish truth from falsehood, and automatically clarify the matter by experiment. (abridged, tr. Needham and Ho 1970: 318)

After the emperor rejected this appeal, the palace eunuchs Wang Shoucheng and Chen Hongzhi assassinated him in 820.

When Xianzong's son and successor Emperor Muzong (r. 820824) came to the throne, he executed the alchemists who had poisoned his father, but later began to take immortality elixirs himself. An official wrote Muzong an 823 memorial that warned:

Medicines are for use against illnesses, and should not be taken as food. ... Even when one is ill medicines must be used with great circumspection; how much more so when one is not ill. If this is true for the common people how much more so will it be for the emperor! Your imperial predecessor believed the nonsense of the alchemists and thus became ill; this your majesty already knows only too well. How could your majesty still repeat the same mistake? (tr. Needham and Ho 1970: 319)

The emperor appreciated this reasoning but soon afterwards fell ill and died from poisoning. Palace eunuchs supposedly used poisonous elixirs to assassinate Muzong's young successor Emperor Jingzong (r. 824827) (Needham et al. 1976: 151, 182).

The next Tang emperor to die from elixir poisoning was Wuzong (r. 840846). According to the Old Book of Tang, "The emperor [Wuzong] favoured alchemists, took some of their elixirs, cultivated the arts of longevity and personally accepted (Taoist) talismans. The medicines made him very irritable, losing all normal self-control in joy or anger; finally when his illness took a turn for the worse he could not speak for ten days at a time." Chancellor Li Deyu and others requested audiences with the emperor, but he refused and subsequently died in 846 (Needham and Ho 1970: 319).

Wuzong's successor Emperor Xunzong (r. 846849) astonishingly also died of elixir poisoning. Xunzong made himself the patron of some Daoists who concocted immortality elixirs of vegetable origin, possibly because his father Wuzong had died from metallic and mineral elixir poisoning (Needham et al. 1976: 146). The New Book of Tang records that the emperor received a wine tincture of ivy (, Hedera helix) that the Daoist adept Jiang Lu claimed would turn white hair black and provide longevity. However, when the emperor heard that many people died a violent death after drinking ivy tincture, he stopped taking it. Jiang was publicly shamed and the emperor granted his request to search in the mountains for the right plant, but he never appeared again (Needham et al. 1976: 147). According to the 890 Dongguan zuoji (Record of Memorials from the Eastern Library), "A medical official, Li [Xuanbo], presented to the emperor [Xuanzong] cinnabar which had been heated and subdued by fire, in order to gain favour from him. Thus the ulcerous disease of the emperor was all attributable to his crime." (tr. Needham and Ho 1970: 319).

Besides emperors, many Tang literati were interested in alchemy. Both Li Bai (Waley 1950: 5556) and Bai Juyi (Ho, Goh, and Parker 1974) wrote poems about the Cantong qi and alchemical elixirs. Other poets, including Meng Haoran, Liu Yuxi, and Liu Zongyuan also referred to elixir compounding in their works (Pregadio 2000: 171).

The influential Tang physician and alchemist Sun Simiao's c. 640 alchemical Taiqing zhenren dadan (Great Purity Essentials of Elixir Manuals for Oral Transmission) recommends 14 elixir formulas he found successful, most of which seem poisonous, containing mercury and lead, if not arsenic, as ingredients (Needham et al. 1976: 133). Sun's medical c. 659 Qianjin yifang (Supplement to the Thousand Golden Remedies) categorically states that mercury, realgar, orpiment, sulphur, gold, silver, and vitriol are poisonous, but prescribed them in much larger amounts for elixirs than for medicines. In contrast to drinking soluble arsenic (as in groundwater), when powdered arsenic is eaten "astonishing degrees of tolerance can be achieved", and Sun Simiao might have thought that when human beings reached to a level "approaching that of the immortals their bodies would no longer be susceptible to poison" (Needham et al. 1976: 135).

Tang alchemists were well aware of elixir poisoning. The c. 8th9th century Zhenyuan miaodao yaole (Synopsis of the Essentials of the Mysterious Dao of the True Origin) lists 35 common mistakes in elixir preparation: cases where people died from eating elixirs made from cinnabar, mercury, lead, and silver; cases where people suffered from boils on the head and sores on the back by ingesting cinnabar prepared by roasting together mercury and sulphur, and cases where people became seriously ill through drinking melted "liquid lead" (Needham and Ho 1970: 330). The c. 850 Xuanjie lu (Record of Mysterious Antidotes)which is notable as the world's oldest printed book on a scientific subjectrecommends a potent herbal composition that serves both as an elixir and as an antidote for common elixir poisoning (Needham and Ho 1970: 335). The procedure to make Shouxian wuzi wan (Five-herbs Immortality-safeguarding Pills) is to take 5 ounces each of Indian gooseberry, wild raspberry, dodder, five-flavor berry, and broadleaf plantain and pound them into flour. Mix it with boxthorn juice and false daisy juice and dry. Heat almonds and good wine in a silver vessel, and add foxglove, tofu, and "deer glue". Combine this with the five herbs, and dry into small pills. The usual dosage is 30 pills a day taken with wine, but one should avoid eating pork, garlic, mustard, and turnips when taking the medicine (Needham and Ho 1970: 335).

During the Tang period, Chinese alchemists divided into two schools of thought about elixir poisoning. The first altogether ignored the poison danger and considered the unpleasant symptoms after taking an elixir as signs of its efficacy. The c. 6th century Taiqing shibi ji (Records of the Rock Chamber) described away the side effects and recommended methods of bringing relief.

After taking an elixir, if your face and body itch as though insects were crawling over them, if your hands and feet swell dropsically, if you cannot stand the smell of food and bring it up after you have eaten it, if you feel as though you were going to be sick most of the time, if you experience weakness in the four limbs, if you have to go often to the latrine, or if your head or stomach violently achedo not be alarmed or disturbed. All these effects are merely proofs that the elixir you are taking is successfully dispelling your latent disorders. (tr. Needham and Lu 1974: 283)

Many of these symptoms are characteristic of metallic poisoning: formication, edema, and weakness of the extremities, later leading to infected boils and ulcers, nausea, vomiting, gastric and abdominal pain, diarrhea, and headaches (Needham and Lu 1974: 283). For relieving the side-effects when the elixir takes effect, the Taiqing shibi ji recommends that one should take hot and cold baths, and drink a mixture of scallion, soy sauce, and wine. If that does not bring relief, then one should combine and boil a hornets' nest, spurge, Solomon's seal, and ephedra into a medicine and take one dose (Needham and Ho 1970: 331).

The second school of alchemists, admitted that some metal and mineral elixir constituents were poisonous and tried either to neutralize them or to replace them with less dangerous herbal substances (Needham et al. 1976: 182). For instance, the 8th-century Zhang zhenren jinshi lingsha lun (The Adept Zhang's Discourse on Metals, Minerals, and Cinnabar) emphasized the poisonous nature of gold, silver, lead, mercury, and arsenic, and described witnessing many cases of premature death brought about by consuming cinnabar. Zhang believed however that the poisons could be rendered harmless by properly choosing and combining adjuvant and complimentary ingredients; for example gold should always be used together with mercury, while silver can only be used when combined with gold, copper carbonate, and realgar for the preparation of the jindan Golden Elixir (tr. Needham and Ho 1970: 331). Many Tang alchemical writers returned to the fashion of using obscure synonyms for ingredients, perhaps because of the alarming number of elixir poisonings, and the desire to dissuade amateur alchemists from experimenting on themselves (Needham et al. 1976: 138). By the end of the Yuan dynasty (12711368), the more cautious alchemists had generally changed the elixirs ingredients from minerals and metals to plants and animals (Ho and Lisowski 1997: 39).

The late Tang or early Song Huangdi jiuding shendan jingjue (Explanation of the Yellow Emperor's Manual of the Nine-Vessel Magical Elixir) says, "The ancient masters (lit. sages) all attained longevity and preserved their lives (lit. bones) by consuming elixirs. But later disciples (lit. scholars) have suffered loss of life and decay of their bones as the result of taking them." The treatise explains the secret ancient methods for rendering elixir ingredients harmless by treating them with wine made from chastetree leaves and roots, or with saltpeter and vinegar. Another method of supposedly removing the poison from mercury was to put it in three-year-old wine, add sal ammoniac and boil it for 100 days (Needham and Ho 1970: 3323).

Two rulers died from elixir poisoning during the Five Dynasties period (907979) of political turmoil after the overthrow of the Tang dynasty. Zhu Wen or Emperor Taizu (r. 907912), the founder of the Later Liang dynasty, became seriously incapacitated as a result of elixir poisoning, and fell victim to an assassination plot. Li Bian or Emperor Liezu (r. 937943), the founder of the Southern Tang kingdom, took immortality elixirs that made him irritable and deathly ill (Needham et al. 1976: 180).

The Daoist adept Chen Tuan (d. 989) advised two emperors that they should not worry about elixirs but direct their minds to improving the state administration, Chai Rong or Emperor Shizong of Later Zhou in 956, and then Emperor Taizu of Song in 976 (Needham et al. 1976: 194).

After its heyday in the Tang dynasty Daoist alchemy continued to flourish during the Song dynasty (9601279) period. However, since six Tang emperors and many court officials died from elixir poisoning, Song alchemists exercised more caution, not only in the composition of the elixirs themselves, but also in attempts to find pharmaceutical methods of counteracting the toxic effects. The number of ingredients used in elixir formulas was reduced and there was a tendency to return to the ancient and difficult terminology of the Cantongqi, perhaps to conceal the processes from rash and ignorant operators. Psycho-physiological neidan alchemy became steadily more popular than laboratory waidan alchemy (Needham et al. 1976: 208).

During the Song dynasty, the practice of consuming metallic elixirs was not confined to the imperial court and expanded to anyone wealthy enough to pay. The author and official Ye Mengde (10771148) described how two of his friends had died from elixirs of immortality in one decade. First, Lin Yanzhen, who boasted about his health and muscular strength, took an elixir for three years, "Whereupon ulcers developed in his chest, first near the hairs as large as rice-grains, then after a couple of days his neck swelled up so that chin and chest seemed continuous." Lin died after ten months of suffering, and his doctors discovered cinnabar powder had accumulated in his pus and blood. Second, whenever Xie Renbo "heard of anyone who had some cinnabar subdued by fire he went after it, caring nothing about the distance, and his only fear was that he would not have enough." He also developed ulcers on the chest. Although his friends noticed changes in his appearance and behavior, Xie did not recognize that he had been poisoned, "till suddenly it came upon him like a storm of wind and rain, and he died in a single night." (tr. Needham and Ho 1970: 320)

The scientist and statesman Shen Kuo's 1088 Dream Pool Essays suggested that mercury compounds might be medicinally valuable and needed further studyforeshadowing the use of metallic compounds in modern medicine, such as mercury in salvarsan for syphilis or antimony for visceral leishmaniasis. Shen says his cousin once transformed cinnabar into an elixir, but one of his students mistakenly ate a leftover piece, became delirious, and died the next day.

Now cinnabar is an extremely good drug and can be taken even by a newborn baby, but once it has been changed by heat it can kill an (adult) person. If we consider the change and transformation of opposites into one another, since (cinnabar) can be changed into a deadly poison why should it not also be changed into something of extreme benefit? Since it can change into something which kills, there is good reason to believe that it may have the pattern-principle [li] of saving life; it is simply that we have not yet found out the art (of doing this). Thus we cannot deny the possibility of the existence of methods for transforming people into feathered immortals, but we have to be very careful about what we do. (tr. Needham and Ho 1970: 327).

Su Shi (10371101), the Song dynasty scholar and pharmacologist, was familiar with the life-prolonging claims of alchemists, but wrote in a letter that, "I have recently received some cinnabar (elixir) which shows a most remarkable colour, but I cannot summon up enough courage to try it." (tr. Needham and Ho 1970: 320).

The forensic medical expert Song Ci was familiar with the effects of metal poisoning, and his c. 1235 Collected Cases of Injustice Rectified handbook for coroners gives a test for mercury poisoning: plunge a piece of gold into the intestine or tissues and see if a superficial amalgam forms. He also describes the colic, cramps, and discharge of blood from arsenic poisoning, and gives several antidotes including emetics.

Ming dynasty (13681644) authorities strongly disapproved of immortality elixirs, but the Jiajing Emperor (r. 15211567) supposedly died from consuming them. The emperor was interested in the art of immortality and put great confidence in Daoist physicians, magicians, and alchemists. One named Wang Jin , who was appointed a Physician-in-Attendance in the Imperial Academy of Medicine, convinced the emperor that eating and drinking from vessels made of alchemical gold and silver would bring about immortality, but it only resulted in his death. Wang fled but was caught and exiled to the frontiers in 1570 (Needham et al. 1976: 212).

Li Shizhen's classic 1578 Compendium of Materia Medica discusses the historical tradition of producing gold and cinnabar elixirs, and concludes, "(the alchemists) will never realise that the human body, which thrives on water and the cereals, is unable to sustain such heavy substances as gold and other minerals within the stomach and intestines for any length of time. How blind it is, in the pursuit of longevity, to lose one's life instead!" (tr. Needham and Ho 1970: 325326). In another section, Li criticizes alchemists and pharmacologists for perpetuating the belief in mercury elixirs.

I am not able to tell the number of people who since the Six Dynasties period (3rd to 6th centuries) so coveted life that they took (mercury), but all that happened was that they impaired their health permanently or lost their lives. I need not bother to mention the alchemists, but I cannot bear to see these false statements made in pharmacopoeias. However, while mercury is not to be taken orally, its use as a medicine must not be ignored. (tr. Needham and Ho 1970: 325326)

The Qing dynasty Yongzheng Emperor (r. 17221735) was the last Chinese ruler known to die from elixir poisoning. He was a superstitious man, affected by portents and omens, and a firm believer in Daoist longevity techniques. Taking immortality elixirs is thought to have caused his sudden death in 1735 (Zelin 2002: 229).

The Chinese tradition of using toxic heavy metals in elixirs of immortality has historical parallels in Ayurvedic medicine. Rasa shastra is the practice of adding metals and minerals to herbal medicines, rasayana is an alchemical tradition that used mercury and cinnabar for lengthening lifespan, rasevara is a tradition that advocated the use of mercury to make the body immortal, and samskara is a process said to detoxify heavy metals and toxic herbs.

The historians of Chinese science Joseph Needham and Ho Peng-Yoke wrote a seminal article about poisonous alchemical elixirs (1959, 1970). Based upon early Chinese descriptions of elixir poisoning, they decisively demonstrated a close correspondence with the known medical symptoms of mercury poisoning, lead poisoning, and arsenic poisoning. Compare the historical descriptions of Jin Emperor Ai (d. 365) who "no longer knew what was going on around him" and Tang Emperor Wuzong (d. 846) who was "very irritable, losing all normal self-control in joy or anger ... he could not speak for ten days at a time" with the distinctive psychological effects of mercury poisoning: progressing from "abnormal irritability to idiotic, melancholic, or manic conditions" (1970: 327). Needham and his collaborators further discussed elixir poisoning in the Science and Civilisation in China series, particularly Needham and Lu Gwei-djen (1974), and Needham, Ho, and Lu (1976).

Although Chinese elixir poisoning may lead some to dismiss Chinese alchemy as another example of human follies in history, Ho Peng-Yoke and F. Peter Lisowski note its positive aspect upon Chinese medicine. The caution given to elixir poisoning later led Chinese alchemy to "shade imperceptibly" into iatrochemistry, the preparation of medicine by chemical methods, "in other words chemotherapy" (1997: 39).

A recent study found that Chinese emperors lived comparatively short lives, with a mean age at death of emperors at 41.3, which was significantly lower than that of Buddhist monks at 66.9 and traditional Chinese doctors at 75.1. Causes of imperial death were natural disease (66.4%), homicide (28.2%), drug toxicity (3.3%), and suicide (2.1%). Homicide resulted in a significantly lower age of death (mean age 31.1) than disease (45.6), suicide (38.8), or drug toxicity (43.1, mentioning Qin Shi Huang taking mercury pills of immortality). Lifestyles seem to have been a determining factor, and 93.2% of the emperors studied were overindulgent in drinking alcohol, sexual activity, or both (Zhao et al. 2006: 1295). The study does not refer to the Chinese belief that the arsenic sulphides realgar and orpiment, frequently used in immortality elixirs, had aphrodisiac properties (Needham and Lu 1974: 285).

A significant question remains unanswered. If the insidious dangers of alchemical elixir poisoning were common knowledge, why did people continue to consume them for centuries? Joseph Needham and his collaborators suggested three hypothetical explanations, and Michel Strickmann proposed another.

Needham and Lu's first explanation is that many alchemical mineral preparations were capable of giving an "initial exhilaration" or transient sense of well-being, usually involving weight loss and increased libido. These preliminary tonic effects could have acted as a kind of "bait" inveigling an elixir-taker deeper into substance intoxication, even to the point of death (1974: 282). Chinese medical texts recorded that realgar (arsenic disulphide) and orpiment (arsenic trisulphide) were aphrodisiacs and stimulated fertility, while cinnabar and sulphur elixirs increased longevity, averted hunger, and "lightened the body" (namely, qngshn , which is a common description of elixir effects) (1974: 285).

Wine, as mentioned above, was both prescribed to be drunk when taking elixir pills and to relieve the unpleasant side-effects of elixir poisoning. Needham and Lu further suggest the possibility that elixir alchemy included hallucinogenic drugs, tentatively identifying the busi zhi yao "drug of deathlessness" as fly-agaric and busi zhi shu "tree of deathlessness" as birch (1974: 117). The elixir that Tao Hongjing's disciple Zhou Ziliang took to commit suicide "probably had hallucinogenic and toxic mushrooms" (1974: 296). In the present day, realgar wine is traditionally consumed as part of the Dragon Boat Festival.

The apparent incorruptibility of an elixir-taker's corpse is Needham and Lu's second explanation for the persistent belief in immortality elixirs. They suggest that in some cases a body did not decompose because the deceased had died from mercury or arsenic poisoning, which is forensically known to often preserve a corpse from decay. For a believer in Daoist immortality drugs, even when an elixir-taker had unmistakably died, if the corpse was comparatively undecomposed, that could be interpreted as proof that the adept had become a xian immortal, as well as evidence for the alchemical elixir's efficacy. (1974: 298).

Terminal incorruptibility was an ancient Chinese belief associated with jade, gold, and cinnabar. The Baopuzi says, "When gold and jade are inserted into the nine orifices, corpses do not decay. When salt and brine are absorbed into flesh and marrow, dried meats do not spoil. So when men ingest substances which are able to benefit their bodies and lengthen their days, why should it be strange that (some of these) should confer life perpetual?" The abolition of decay was believed to demonstrate the power of elixirs, "the corruptible had put on incorruptibility" (Needham and Lu 1974: 284). Chinese jade burial suits are a better known example of using a mineral to preserve corpses.

There is a possibility that Sun Simiao (above) died from taking mercury elixirs (Needham and Ho 1970: 330). According to Sun's hagiography in the 10th-century Xuxian zhuan (Further Biographies of the Immortals), after his death in 682 there was no visible sign of putrefaction, "After more than a month had passed there was no change in his appearance, and when the corpse was raised to be placed in the coffin it was as light as (a bundle of) empty clothes." (tr. Needham and Lu 1974:298).

The incorruptibility stories about elixir users were not all myth, and recent archeological evidence showed that the ancient Chinese knew how "to achieve an almost perpetual conservation". The 1972 excavation of a tomb at Mawangdui discovered the extremely well-preserved body of Xin Zhui or Lady Dai, which resembled that of "a person who had died only a week or two before" (Needham and Lu 1974: 303304). A subsequent autopsy on her corpse found "abnormally high levels" of mercury and lead in her internal organs (Brown 2002: 213).

Needham and Lu's third justification for taking poisonous elixirs is a drug-induced "temporary death", possibly a trance or coma. In the classic legend (above) about Wei Boyang drinking an elixir of immortality, he appears to die, subsequently revives, and takes more elixir to achieve immortality.

The Baopuzi describes a Five Mineral-based multicolored Ninefold Radiance Elixir that can bring a corpse back to life: "If you wish to raise a body that has not been dead for fully three days, bathe the corpse with a solution of one spatula of the blue elixir, open its mouth, and insert another spatula full; it will revive immediately." (tr. Ware 1966:82).

A Tang Daoist text prescribes taking an elixir in doses half the size of a millet grain, but adds, "If one is sincerely determined, and dares to take a whole spatula-full all at once, one will temporarily die [zns ] for half a day or so, and then be restored to life like someone waking from sleep. This however is perilous in the extreme." (tr. Needham and Lu 1974: 295).

Michel Strickmann, a scholar of Daoist and Buddhist studies, analyzed the well-documented Shangqing School's alchemy in the Maoshan revelations and in the life of Tao Hongjing, and concluded that scholars need to reexamine the Western stereotype of "accidental elixir poisoning" that supposedly applied to "misguided alchemists and their unwitting imperial patrons". Since Six Dynasties and Tang period Daoist literature thoroughly, "even rapturously", described the deadly toxic qualities of many elixirs, and Strickmann proposed that some of the recorded alchemical deaths were intentional ritual suicide (1979: 191). Two reviewers disagreed about Strickmann's conclusions. The first questions why he defends the logic of alchemical suicide rather than simply accepting the idea of accidental elixir poisoning, and says Tao Hongjing never experimented with alchemy seriously enough to achieve suicide himselfbut fails to mention Strickmann's prime example: Tao's disciple Zhou Ziliang whom Shangqing deities reportedly instructed to prepare a poisonous elixir and commit suicide in order to achieve immortality (Chen 1981: 547). The second describes Strickmann's chapter as "one of the most thorough and useful" in the volume, and says he proves that it is "almost ludicrous to assume that a Taoist (commoner or emperor) could have died from accidental elixir poisoning" (Cass 1982: 9293).

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Chinese alchemical elixir poisoning - Wikipedia

Synthesis of proteins by automated flow chemistry – Science Magazine

Fully synthetic whole proteins in reach

Solid-phase peptide synthesis of homogeneous peptides longer than about 50 amino acids has been a long-standing challenge because of inefficient coupling and side reactions. Hartrampf et al. used an automated chemistry platform to optimize fast-flow peptide synthesis and were able to produce fully synthetic single-domain proteins (see the Perspective by Proulx). The targets included proinsulin and enzymes such as barnase and a version of HIV-1 protease containing multiple noncanonical amino acids. Refolded peptides were nearly indistinguishable from recombinant proteins, and the synthesized enzymes had activity close to that of their ribosomally synthesized counterparts. This method will enable fast, on-demand synthesis of small proteins with a vastly expanded pool of precursor amino acids.

Science, this issue p. 980; see also p. 941

Ribosomes can produce proteins in minutes and are largely constrained to proteinogenic amino acids. Here, we report highly efficient chemistry matched with an automated fast-flow instrument for the direct manufacturing of peptide chains up to 164 amino acids long over 327 consecutive reactions. The machine is rapid: Peptide chain elongation is complete in hours. We demonstrate the utility of this approach by the chemical synthesis of nine different protein chains that represent enzymes, structural units, and regulatory factors. After purification and folding, the synthetic materials display biophysical and enzymatic properties comparable to the biologically expressed proteins. High-fidelity automated flow chemistry is an alternative for producing single-domain proteins without the ribosome.

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Synthesis of proteins by automated flow chemistry - Science Magazine

Oncoprotein SND1 hijacks nascent MHC-I heavy chain to ER-associated degradation, leading to impaired CD8+ T cell response in tumor – Science Advances

INTRODUCTION

Exploring the strategies for tumor immunotherapy is highly dependent on the discovery of molecular mechanisms of tumor immune escape. Tumor cells can escape immune response through loss of antigenicity and/or immunogenicity or by coordinating a suppressive immune microenvironment. Therefore, distinct therapeutic strategies may be required, depending on the mechanisms. Tumor immunotherapy strategies mediated by T cells rely on the functional competence of multiple immunological elements. For example, therapeutic monoclonal antibodies designed to disrupt inhibitory signals received by T cells through the Cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) and Programmed cell death protein 1 (PD-1) have been demonstrating long-term survival benefits for some patients with metastatic melanoma (1, 2). However, not all tumors appear to respond effectively. The heterogeneity of cancer suggests the necessity to explore the additional immunoregulatory mechanisms. Defect in the surface expression of major histocompatibility complex class I (MHC-I) molecules is one of the most important reasons for tumor immune escape due to decreased recognition by CD8+ T cells, which has been found in approximately 20 to 60% of common solid cancers, including melanoma and lung, breast, renal, prostate, and bladder cancers, (3, 4). The molecular mechanisms underlying these changes vary according to the tumor type. These alterations can be genetic or regulatory at the transcriptional or posttranscriptional level (511).

Staphylococcal nuclease and tudor domain containing 1 (SND1) is a newly identified oncoprotein that is highly expressed in almost all the detected different tumor cells (1214). SND1 was first identified as a transcriptional coactivator for Epstein-Barr virus nuclear antigen 2. It is a ubiquitously expressed and highly conserved protein in mammals and plays important physiological roles in a variety of cellular processes (15). It comprises a tandem repeat of four staphylococcal nuclease (SN)like domains (referred to as SN domains) at the N terminus and a fusion of a Tudor domain with a partial SN domain at the C terminus (referred to as TSN domain) (16). Our current studies and others studies have demonstrated that SND1 regulates the differentiation and migration of different tumor cells via variant signal pathways at the cellular level (1719). For example, SND1 expression is up-regulated in breast cancer tissues, and it associates with transforming growth factor signaling pathway to promote epithelial-mesenchymal transition in breast cancer (20). SND1 regulates the cadherin switch for epithelial-mesenchymal transition in ovary SKOV3 cells (17). However, the fundamental impact of SND1 on the tumorigenesis in vivo is largely unknown. In the present study, we demonstrate that in tumor cells, SND1 is a novel endoplasmic reticulum (ER)associated protein hijacking the nascent heavy chain (HC) of MHC-I to ER-associated degradation (ERAD) process. With reduced expression of MHC-I on tumor cell membrane, it would be easy for tumor cells to orchestrate a cancer-favored immune microenvironment and escape immune response.

To investigate the fundamental role of oncoprotein SND1 in tumor proliferation, we performed affinity purification and mass spectrometry to identify SND1-associated proteins from cellular extracts of HeLa cells with stable expression of SND1-FLAG. As shown in Fig. 1A, a group of ER-related proteins were coprecipitated with SND1, including human leukocyte antigenA (HLA-A; the HC of human MHC-I), Valosin-containing protein (VCP), SEC61 translocon subunit alpha (SEC61A), and ribosomal protein L7a (RPL7A). As MHC-I molecule plays essential roles in antigen presentation, we therefore focused on investigating the relationship between SND1 and HLA-A. Coimmunoprecipitation (Co-IP) assay was performed to verify the association of SND1 and HLA-A in HeLa cells. As shown in Fig. 1B, the endogenous HLA-A was efficiently associated with ectopically overexpressed SND1-FLAG. In addition, anti-HC10 antibody that could specifically recognize immature (unfolded/partially folded) conformation of HLA-A, HLA-B, and HLA-C was used to detect the in vivo physical association of endogenous SND1 and HLA-A. The endogenous SND1 was efficiently coimmunoprecipitated with anti-HC10 antibody (Fig. 1C) and vice versa. HLA-A or HLA-B was coimmunoprecipitated with anti-SND1 antibody (Fig. 1D). Consistently, the Duolink assay [Fig. 1E, red dots indicate the proximity ligation assay (PLA) probe signal] and immunofluorescence assay (Fig. 1F) further confirmed the cellular colocalization of SND1 and HLA-A. We then mapped the interaction domain between SND1 and HLA-A by glutathione S-transferase (GST) pull-down assay. The bacterially produced GST-fusion protein containing full-length SND1 (GST-SND1), SN domain (GST-SN), TSN domain (GST-TSN) (as indicated in Fig. 1G), or GST alone was purified using glutathione agarose beads and used to incubate with HLA-A in vitrotranslated from rabbit reticulocytes. As shown in Fig. 1G, the full length of SND1 or SN domain, but not TSN domain, efficiently associated with HLA-AFLAG. Likewise, the GST-fusion proteins containing full-length HLA-A (GSTHLA-A), A1 domain (GSTHLA-AA1), A2 domain (GSTHLA-AA2), A3 domain (GSTHLA-AA3), C domain (GSTHLA-AC) (as indicated in Fig. 1H), or GST alone were used to incubate with recombinant histidine-tagged SND1 (His-SND1) purified from Escherichia coli. As shown in Fig. 1H, the full length of HLA-A, domain A1, domain A3, or domain C, but not domain A2, efficiently associated with His-SND1. To further consolidate the molecular interface required for the interaction between SND1 and HLA-A, FLAG-tagged different domain deletion mutants of SND1 were generated. Immunoprecipitation analysis in HeLa SND1-KO (knockout) cells demonstrated that the SN3 region of SND1 was required for the interaction of HLA-A (Fig. 1I). These data prompted us to interrogate the three-dimensional conformation for the complex of SND1 and HLA-A. Because the complex structure was not determined experimentally, we performed docking and molecular dynamics simulation to predict their associated conformation (2123). The resulting structure (Fig. 1J) showed that the interacting interface was located between the SN3 region of SND1 and domains A1 and A3 of HLA-A. The electrostatic interaction between the basic and acidic amino acids on SN3 region and A3 domain might play an important role in the association process. The key residues on the interface included K484, K496, K490, K401, K450, and R384 in SN3 domain and E232, E229, and D227 in A3 domain. The interaction between K401-E232, K496-E229, and K496-D227 were identified to be vital for the association of SND1 with HLA-A. These results indicated that SND1 could physically interact with the immature form of HC in partially folded/unfolded conformation, which raises the question about the functional association of SND1 with nascent HC of MHC-I.

(A) Immunopurification and mass spectrometry of SND1-containing protein complexes. Cellular extracts from HeLa cells stably expressing SND1-FLAG were immunopurified with anti-FLAG affinity beads and eluted with FLAG peptide. The elutes were resolved on SDS-PAGE and silver-stained. The protein bands on the gel were recovered by trypsinization and analyzed by mass spectrometry. (B) Co-IP analysis of the association between SND1 and HLA-A. Whole-cell extracts from HeLa cells with SND1-FLAG expression were immunoprecipitated with anti-FLAG beads, followed by Western blot with antibodies against the HLA-A. (C) Co-IP analysis of the association between SND1 and HC10. Whole-cell extracts from HeLa cells were immunoprecipitated with anti-HC10, followed by immunoblot (IB) with antibodies against the SND1. (D) Cellular extracts from HeLa cells were immunoprecipitated with anti-SND1 antibody, followed by Western blot with antibodies against the indicated proteins. (E) Duolink in situ PLA was adopted for detecting the association between SND1 and HLA-A. Two PLA probes were designed to respectively recognize either mouse or rabbit antibody against SND1 or HLA-A. Immunoglobulin G (IgG) was used as staining control. Scale bar, 20 m. (F) Immunostaining and confocal microscopic analysis of subcellular colocalization of SND1 and HLA-AFLAG (C terminus) in HeLa cells. HeLa cells were fixed and immunostained with antibodies against the indicated proteins. Scale bar, 10 m. (G) GST pull-down analysis of the bacterially produced GST-fusion protein containing full-length SND1 (GST-SND1), SN domain (GST-SN), and TSN domain (GST-TSN) involved in the interaction with in vitrotranslated HLA-A from rabbit reticulocytes. Coomassie blue staining for GST-fusion proteins refers to fig. S1A. aa, amino acid. (H) GST pull-down analysis of the different domains of HLA-A involved in the interaction with SND1. The His-SND1 and sample of GST-tagged different domains of HLA-A were purified from E. coli bacteria cells. Coomassie blue staining for GST-fusion proteins refers to fig. S1B. (I) Immunoprecipitation analysis of the domains involved in the interaction between SND1 and HLA-A with FLAG-tagged deletion mutants of SND1 purified from HeLa SND1-KO cells. The immunoprecipitation of FLAG refers to fig. S1C. (J) The spatial conformation of SND1-HLA-A complex predicted by the database of ZDOCK (http://zdock.umassmed.edu/) was further analyzed using the Gromacs package. The structural stability and binding energy refer to fig. S1 (E and F).

Since the nascent HC is synthesized on the ER membrane and matured in the ER lumen (9), it raises the question of where the interaction of SND1 and HC occurs. By analyzing and comparing our previous mass spectrometry data from Jurkat cells with the present data from HeLa cells, we found 221 proteins (fig. S2A) in the overlapped set of SND1-associated proteins, including ribosomal (RPLs or RPSs) or ER-associated proteins, such as HLA-A, SEC61A, ribosome binding protein 1 (RRBP1), VCP, signal recognition particle 72 (SRP72), etc. We then performed immunofluorescence to investigate the cellular colocalization of SND1 and ER-associated proteins. As shown in Fig. 2A, SND1 colocalized with RRBP1 (a ribosome receptor on ER; top) and SEC61A (a core component of ER translocation channel; middle). The colocalization of HLA-A and RRBP1 (bottom) was used as positive control. It indicated that SND1 was a potential ER-associated protein.

(A) Immunostaining for cellular colocalizations, followed by confocal microscopic analysis by using antibody against SND1, RRBP1, SEC61A, and HLA-AFLAG. Scale bar, 10 m. (B) HeLa cells were transfected with the ER reporter plasmids, GFG, HLA-SP-GFG, UGGT1-SP-GFG, GAPDH-NP-GFG, and SND1-NP-GFG, respectively. Western blot for molecular weight of these GFG-tagged fusion proteins expressed in HeLa cells. (C) Colocalizations of these GFG-tagged fusion proteins with SEC61A were detected by confocal microscopy. UGGT1 was used as a positive control for ER-associating protein, while GAPDH was used as a negative control. Scale bar, 20 m. Fluorescence intensity profiles of regions indicated by short lines are shown in the bottom. (D) Co-IP by antibody against SEC61A for interaction with SND1-GFP or SND1-NP/-GFP in HeLa cells transfected with either SND1-GFP (lane 3) or SND1-NP/-GFP vector (lane 4). (E) Co-IP by antibody against FLAG for interaction with SND1-NP in HeLa cells transfected with either GFG (lane 3) or SND1-NP-GFG vector (lane 4). (F) Ectopically increased expression of either SND1-GFP or SND1-NP/-GFP in SND1-KO HeLa cells followed by Western blot for SND1 and HLA-A expression. WT, wild type.

ER lumen or secretory proteins containing an N-terminal signaling peptide (SP) composed of hydrophobic amino, which is recognized by SRP and subsequently cleaved by signal peptidase in the ER lumen (24), such as HLA-A and UGGT1 (a glucosyltransferase in ER lumen) (as illustrated in fig. S2B). We noticed a hydrophobic amino acid sequence at N terminus (NP) of SND1 protein. To investigate whether it is an SP, we developed an ER reporter assay by constructing a pair of two ER luminal reporter vectors. One is named GFG containing green fluorescent protein (GFP)FLAGGFP sequences after the multiple cloning sites that could insert the sequence of designated peptide. The other one is GFG-KDEL with an additional sequence of peptide KDEL following GFP-FLAG-GFP sequences. KDEL is a specific peptide sequence at the C terminus of ER lumen proteins that keeps the protein in the ER lumen (25). Using these vectors, we constructed a series of plasmids containing the SP of HLA-A (HLA-ASPGFG and HLA-ASPGFG-KDEL) or UGGT1 (UGGT1SPGFG and UGGT1SPGFG-KDEL), respectively, as positive control of ER-associated proteins. The N-terminal sequence of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) (GAPDH-NP-GFG and GAPDHNPGFG-KDEL) was used as negative control of ER-associated proteins. The N-terminal sequence of SND1 was inserted to construct SND1-NP-GFG and SND1NPGFG-KDEL (fig. S2B). The plasmids were transfected into HeLa cells, respectively, and Western blot was performed to observe whether the S(N)P could be cleaved from the S(N)P-GFG fusion protein by signal peptidase (Fig. 2B). The molecular mass of SND1-NP-GFG(-KDEL) (lanes 7 and 8) was heavier than that of the GFG(-KDEL) control (lanes 1 and 2) (molecular mass is about 55 kDa), HLA-ASPGFG(-KDEL) (lanes 3 and 4), or UGGT1-SP-GFG(-KDEL) (lanes 5 and 6) but at the same level as negative control GAPDH-NP-GFG(-KDEL) (lanes 9 and10). It demonstrated that the SP of HLA-ASPGFG(-KDEL) and UGGT1-SP-GFG(-KDEL) was successfully cleaved from the fusion protein by signal peptidase, but not the NP of SND1-NP-GFG(-KDEL) or GAPDH-NP-GFG(-KDEL). All these data indicate that SND1 is an ER-associated protein but not an ER lumen protein since the NP of SND1 is not an SP. Therefore, it is likely that SND1 associates with HLA-A on ER membrane.

To further clarify the localization of SND1, the above X-S(N)P-GFG plasmids were transfected into HeLa cells, respectively; then, the colocalization of the X-S(N)P-GFG with endogenous SEC61A and RRBP1 was detected by immunofluorescence assay. Fluorescence intensity profiles were used to quantify the degree of localization. As shown in Fig. 2C and fig. S2C, the GFG control protein did not colocalize with SEC61A (Fig. 2C, a) or RRBP1 (fig. S2C, a). HLA-ASPGFG or UGGT1-SP-GFG was well colocalized with SEC61A (Fig. 2C, b and c) and RRBP1 (fig. S2C, b and c). There was no obvious colocalization of GAPDH-NP-GFG with SEC61A (Fig. 2C, d) or RRBP1 (fig. S2C, d). SND1-NP-GFG was colocalized with SEC61A (Fig. 2C, e) or RRBP1 (fig. S2C, e) respectively, which is in accordance with the results of S(N)PGFG-KDEL (fig. S2D). It is understandable that the colocalization of HLA-ASPGFG or UGGT1-SP-GFG with SEC61A and RRBP1 is due to the distribution of the GFG in the ER lumen cleaved by SP. How to explain the colocalization of SND1-NP-GFG with SEC61A and RRBP1?

In eukaryotes, ER membranelocated SEC61 translocation complex is the core component of the translocon that transports proteins to the ER (26). We thus performed Co-IP assay to explore the potential interaction of SND1 with SEC61A. HeLa cells were transfected with the expression plasmid containing full-length SND1 tagged with GFP (SND1-GFP) or N-terminal peptidedeficient SND1 tagged with GFP (SND1-NP/-GFP), respectively. As shown in Fig. 2D, SEC61A coprecipitated with ectopically overexpressed SND1-GFP (lane 3) but not SND1-NP/-GFP (lane 4). In addition, the endogenous SEC61A was coprecipitated with anti-FLAG for SND1-NP-GFG (Fig. 2E, lane 4) but not the GFG alone (lane 3). All these data suggest that the NP of SND1 is required for the efficient interaction of SND1 and SEC61A. Consistently, fig. S2E showed that the full-length SND1-GFP, but not SND1-NP/-GFP, was well colocalized with endogenous SEC61A. In HeLa cells with deletion of endogenous SND1, the protein level of HLA-A was reduced with ectopically overexpressed SND1-GFP in a dose-dependent manner (Fig. 2F, lanes 3 and 4), while there was no obvious alteration with overexpressed SND1-NP/-GFP (lanes 5 and 6). Together, it is likely that SND1 is an ER-associated protein anchored on ER membrane by binding SEC61A upon where nascent MHC-I HC is caught.

To determine the relevance between SND1/HC association and the presentation of MHC-I molecules, we carried out flow cytometry to detect the protein level of HLA-A/B/C on the surface of tumor cells with deletion of SND1 (SND1-KO) by CRISPR-Cas9 system. As shown in Fig. 3A, the protein level of HLA-A/B/C molecules was increased in two different SND1-KO HeLa cell clones. Likewise, the similar changes were observed in two SKOV3 ovarian cancer cell clones with deletion of SND1 (shSND1#1 and shSND1#2) (fig. S3B). The Western blot further confirmed that the protein level of HLA-A was enhanced in the cells with deletion of SND1 (Fig. 3B, left), while it is reduced in the cells with ectopic overexpression of SND1 (Fig. 3B, right). However, there was no obvious alteration at the mRNA level (fig. S3A). The same results were observed in SKOV3 cells (fig. S3, B to F). We then detected the half-life of endogenous HLA-A in HeLa cells with treatment of cycloheximide (CHX). As shown in Fig. 3C, HLA-A was gradually degraded in parental HeLa cells [wild type (WT)]; however, the degradation of HLA-A was noticeably retarded in SND1-KO cells. In addition, the protein level of HLA-A was significantly increased in the cells pretreated with proteasome inhibitor MG132 (Fig. 3D, lane 2) but not in the cells pretreated with lysosomal inhibitor chloroquine (Fig. 3D, lane 3). Therefore, we examined the ubiquitylation of HLA-A to determine whether SND1-promoted HLA-A destabilization is via ubiquitin mediatedproteasome pathway. As shown in Fig. 3E, compared with the control cells (lanes 1 and 3), the ubiquitylation of ectopically overexpressed HLA-A was obviously decreased in SND1-KO cells (lane 4) but relatively increased in the cells with overexpression of SND1 (SND1-HA) (lane 2). On the basis of the aforementioned data, it is likely that SND1 leads to HLA-A degradation through the ubiquitin-proteasome pathway.

(A) Two clones of HeLa cells with stable depletion of SND1 by CRISPR-Cas9 system were analyzed by flow cytometry for human MHC-I using antibody simultaneously against HLA-A/B/C. (B) Two clones of HeLa cells with stable depletion of SND1 by CRISPR-Cas9 system and HeLa cells stably expressing SND1-FLAG were collected, followed by Western blot using antibodies against HLA-A. (C) The effect of KO SND1 on the half-life of HLA-A was evaluated in HeLa cells treated with CHX (50 g/ml) and harvested at the indicated time point, followed by Western blot. The protein half-life curves were obtained by quantifying relative intensities. (D) HeLa cells with ectopic HLA-A expression were pretreated with proteasome inhibitor MG132 (10 mM) or lysosomal inhibitor chloroquine (100 mM) for 8 hours and subjected to Western blot with antiHLA-A antibody. DMSO, dimethyl sulfoxide. (E) WT and SND1-KO HeLa cells were transfected with HLA-AFLAG and treated with MG132 (10 mM) for 8 hours. Cellular extracts were immunoprecipitated with anti-FLAG, followed by Western blot with anti-ubiquitin (Ub) antibody. (F) HeLa cells were cotransfected with control vector or SND1-HA and HLA-AFLAG or with control small interfering RNA (siRNA) or SND1 siRNA and HLA-AFLAG, and whole-cell lysates were collected and immunoprecipitated with anti-FLAG, followed by Western blot with indicating antibodies. (G) The Duolink in situ PLA was adopted for detecting the direct association between HLA-A and calnexin or 2-microglobulin (2m) in the presence of SND1-HA or in the absence of SND1. Scale bar, 20 m. The signal dots were calculated and plotted. *P < 0.05 and ****P < 0.0001, by unpaired t test.

In ER lumen, the nascent unfolded HLA-A can be initially retained by a key chaperone, calnexin, to ensure proper folding and quality control before ultimate assembly with 2-microglobulin (2m) to form mature MHC-I (27). The catching of nascent HLA-A by SND1 may have an impact on the association of calnexin and HLA-A and lead to a misfolding process of HLA-A. Immunoprecipitation assay revealed that the binding efficiency of HLA-A to calnexin, and HLA-A to 2m, was remarkably reduced in the presence of ectopically overexpressed SND1 (Fig. 3F, left) but was obviously increased in the absence of SND1 (right). According to the red dots of PLA probe signal from confocal images, Duolink assay (Fig. 3G) further validated that the binding efficiency of calnexin and 2m to HLA-A was decreased by overexpression of SND1 (SND1-HA), while it was significantly increased by deletion of SND1 (si-SND1). Moreover, glycosylation sitemutated HLA-A (N110Q) is not able to associate with both calnexin and 2m but sufficiently interacts with SND1 (fig. S3H). These observations suggest that SND1 hindering the normal assembly process of MHC-I in the ER lumen, consequently guiding the nascent HLA-A for degradation.

Misfolded or nascent HC, which fails to achieve the native conformation in complex with 2m, is dislocated from ER to cytosol and ubiquitinated for ERAD process (28). To investigate the underlying mechanisms of SND1-mediated HC degradation, we used affinity purification and mass spectrometry to identify HLA-Aassociated proteins in HeLa cells with stable expression of HLA-AFLAG. There were 278 affinity-purified proteins (fig. S4A) overlapping in both HLA-Aassociated and SND1-associated proteins. These overlapped proteins were further filtered by Kyoto Encyclopedia of Genes and Genomes analysis (fig. S4B). The top-ranking proteins include SND1, HLA-A, VCP, calnexin (Fig. 4A), SEC61A, etc. (fig. S4C).

(A) Immunopurification and mass spectrometry of HLA-Acontaining protein complexes. Cellular extracts from HeLa cells stably expressing HLA-AFLAG were immunopurified with anti-FLAG affinity beads and eluted with FLAG peptide. The elutes were resolved on SDSpolyacrylamide gel electrophoresis (SDS-PAGE) and silver-stained. The protein bands on the gel were recovered by trypsinization and analyzed by mass spectrometry. HLA-Ainteracted proteins were highlighted. (B) HeLa cells were coimmunoprecipitated by HLA-A antibody and subjected to Western blot by antibody against VCP. (C) HeLa cells were coimmunoprecipitated by SND1 antibody and subjected to Western blot by antibody against VCP. (D) Duolink assay followed by confocal microscopic analysis for direct molecular interactions among SND1, VCP, and HLA-A. IgG was used as a negative control. Scale bar, 20 m. (E) HeLa cells were cotransfected with control vector or SND1-HA and HLA-AFLAG or cotransfected with control siRNA or SND1 siRNA and HLA-AFLAG, and whole-cell lysates were collected and immunoprecipitated with anti-FLAG, followed by Western blot with anti-SND1, anti-VCP, anti-VIMP, and anti-HRD1 antibodies. Results of input were shown in fig. S4D. (F) HeLa cells were cotransfected with vector or HRD1-HA and HLA-AFLAG with the treatment of MG132. Cellular extracts were immunoprecipitated with anti-FLAG, followed by Western blot with anti-ubiquitin antibody.

As VCP plays essential roles in ERAD, we then validated the association of VCP, SND1, and HLA-A. Co-IP experiments revealed that VCP was able to physically interact with both HLA-A (Fig. 4B) and SND1 (Fig. 4C) in vivo. Moreover, Duolink assay (Fig. 4D) further demonstrated the association of these three proteins. Comparatively, the binding ability of SND1 and HLA-A (a) or HLA-A and VCP (b) was stronger than SND1 and VCP (c). It was reported that VIMP (the cofactor of VCP) and HRD1 (the E3 ligase) are the key participants in the degradation of HLA-A (29); meanwhile, the interaction of HRD1 with SND1 was found in our present study by Co-IP (fig. S4E). We therefore investigated the correlation of the SND1 expression and the association of VCP/VIMP/HRD1 with HLA-A. As shown in Fig. 4E, the interaction of VCP, VIMP, and HRD1 to HLA-A was remarkably increased in the presence of ectopically overexpressed SND1 (left) but was largely decreased in the absence of SND1 (right). Furthermore, compared with the control cells, the ubiquitylation of ectopically overexpressed HLA-A was obviously increased in the cells with overexpression of HRD1 (HRD1-HA) (Fig. 4F). These observations suggest that SND1 sequestrates the nascent HC of MHC-I and redirects it to the ERAD pathway for proteasomal degradation.

To explore the consequence of SND1-mediated HC degradation in vivo, we used murine syngeneic tumor models on the C57BL/6 background by using two murine cancer cell lines, B16F10 melanoma cells and MC38 colon adenocarcinoma cells. B16F10SND1-KO and MC38SND1-KO cell clones with deletion of SND1 were obtained by using CRISPR-Cas9 system. Consistent with previous results, both Western blot detection (Fig. 5A) and flow cytometry analysis (Fig. 5B) demonstrated that the protein level of H2Kb (HC of mouse MHC-I) was increased in different B16F10SND1-KO cells. The same results were observed in MC38SND1-KO cells (fig. S5, A and B). We then subcutaneously inoculated 5 105 parental or B16F10SND1-KO cells into the flank of C57BL/6 mice, and the tumor growth was monitored in the following days. Compared with the parental B16F10 tumor, the growth of B16F10SND1-KO cells with SND1 deficiency was markedly slow in terms of the developmental kinetics (Fig. 5C and fig. S5C). Consistently, the tumor size (Fig. 5D for B16F10 and fig. S5D for MC38) and weight (Fig. 5E for B16F10 and fig. S5E for MC38) were also smaller in SND1-KO cells with SND1 deletion than those in the control parental cells. As MHC-I molecules play essential roles in tumor antigen presentation for CD8+ T cellmediated immune response, we thus investigated the infiltration of CD8+ T cells in tumor tissues by immunofluorescence and flow cytometry. Compared with the parental tumor tissue, there were more CD8+ T cells (red) infiltrated in B16F10SND1-KO (Fig. 5F) and MC38SND1-KO tumor tissues (fig. S5F). The flow cytometry analysis further revealed that the infiltration of CD45.2+ leukocytes (Fig. 5, G and H) and CD8+ T cells (Fig. 5, G and I) was significantly increased in the B16F10SND1-KO tumor tissue and the MC38SND1-KO tumor tissue (fig. S5, G to I) compared with the parental tumor tissue. Specifically, the proportion of CD8+ T cells among CD45.2+ leukocytes was significantly increased in the B16F10SND1-KO tumors (Fig. 5J) and MC38SND1-KO tumors (fig. S5J). Besides, we also detected the potential exhaustion of CD8+ T cells in tumor tissues. Compared with the control parental, there was no apparent discrepancy in the percentage of PD-1+ CD8+ T cells with deletion of SND1 (Fig. 5K). Furthermore, we clarified that SND1 deficiency in mice melanoma (fig. S6, A to D) and colon carcinoma (fig. S6, E to H) resulted in no significant changes in regulating cell proliferation, apoptosis, or cell cycle in vitro. We also performed the experiments by using RAG-1 (recombination activating gene 1) KO mice (Rag-1/ mice) that lack mature T and B cells to investigate whether the absence of SND1 would affect tumor growth in vivo. We initially inoculated 5 105 WT or SND1-KO B16F10 cells subcutaneously into the flank of C57BL/6 WT mice and Rag-1/ mice. By comparison between WT cells and SND1-KO B16F10 cells inoculated in either C57BL/6 WT mice or Rag-1/ mice (fig. S6, I to K), we found that the size and weight of SND1-KO tumors were significantly decreased in the group of C57BL/6 WT mice, whereas in the group of Rag-1/ mice, the tumors were comparable between WT and SND1-KO B16F10 cells in terms of the tumor size and weight. Together, these observations imply that deletion of SND1 in tumor cells is likely to promote CD8+ T cellmediated cellular immune responses in the tumor microenvironment.

(A) Three clones of B16F10 cells with stable depletion of SND1 by CRISPR-Cas9 system were collected, followed by IB for murine MHC-I (H2Kb). (B) Two clones of B16F10 cells with stable depletion of SND1 by CRISPR-Cas9 system were analyzed by flow cytometry for murine MHC-I (H2Kb/H2Db) using antibody simultaneously against H2Kb/H2Db. (C to E) 5 105 of either WT or SND1-KO B16F10 cells were subcutaneously transplanted into C57BL/6 mice. The tumor growth was monitored at the indicated times. C57BL/6 mice were sacrificed at day 11. Tumors were removed and photographed. The tumor tissues were weighed and plotted. Data are presented as means SD; n = 5 tumors for each group. *P < 0.05, two-tailed t test. (F) Immunofluorescence images of CD4+ T and CD8+ T cells in B16F10 tumor sections (scale bar, 20 m). (G) C57BL/6 mice injected with equal numbers of WT or SND1-KO B16F10 cells were sacrificed at day 11. The digested tumor suspensions stained with antibodies against CD8 and CD45.2 (pan-leukocyte marker) were subjected to flow cytometry. (H to J) Percentages of infiltrating CD45.2+ cells and CD8+ T cells among total tumor tissuederived cells and the percentage of infiltrating CD8+ T cells among total CD45+ leucocytes. n = 5 tumors for each group. *P < 0.05 and **P < 0.01, by unpaired t test. The experiments were performed and repeated at least three times, independently. (K) The percentage of infiltrating PD-1+ CD8+ T cells among total CD8+ T cells. n = 5 tumors for each group. n.s., not significant.

Moreover, in light of our observation that SN domain of SND1 is responsible for the association of SND1 with MHC-I HC, it is tempting to speculate the crucial function of SN domain in vivo. Our supplementary data support that the rescue of SN domain of SND1 significantly increased the tumor growth through mobilizing less CD8+ T cells infiltrating in tumors [fig. S7, A to H (B16F10) and I to P (MC38)].

To further clarify the influence of high expression of SND1 on CD8+ T cellmediated cellular immune responses in tumor, we used transgenic OT-I mice. OT-I mice are ovalbumin (OVA)specific T cell receptor transgenic (OT-I) mice whose CD8+ T cells could recognize the specific peptides (257 to 264 SIINFEKL) of chicken OVA, a surrogate tumor antigen that can be conveniently used to investigate CD8+ T cellmediated immune responses directed against the OVA antigen (30). Meanwhile, B16F10-OVA cells and MC38-OVA cells were constructed by stably expressing the OVA antigen, which is able to be presented by MHC-I complex and specifically recognized by CD8+ T cells derived from OT-I mice. The identical expression of OVA was observed in both B16F10-OVA WT cells and B16F10-OVA SND1-KO cells with SND1 deletion (Fig. 6A), as well as in MC38-OVA WT and MC38-OVA SND1-KO cells (fig. S8A). The flow cytometry analysis demonstrated that higher level of MHC-I was detected in B16F10-OVA SND1-KO (Fig. 6B) or MC38-OVA SND1-KO cells (fig. S8B), which suggested that more OVA peptides might be presented in tumor cells in the absence of SND1. To interrogate the in vivo effect of antigen presentation, we subcutaneously inoculated equal numbers of B16F10-OVA WT or B16F10-OVA SND1-KO cells into OT-I mice. The tumor volume was monitored accordingly. The growth curve illustrated that SND1 deficiency in B16F10-OVA cells markedly inhibited the tumor growth in vivo (Fig. 6C). At day 19, the tumors were resected and the size and weight were measured. With deletion of SND1 (B16F10-OVA SND1-KO), the tumor size (Fig. 6D) and weight (Fig. 6E) were remarkably smaller than those of the control tumor (B16F10-OVA). The flow cytometry assay revealed that more CD45.2+ cells (Fig. 6F and G) and CD8+ T cells (Fig. 6F and H) were infiltrated in the tumor tissue of B16F10-OVA with SND1 deficiency (B16F10-OVA SND1-KO), and the ratio of CD8+ T cells to CD45.2+ leukocytes was significantly increased (Fig. 6I). These results further verified the impact of SND1 on MHC-I/antigenic peptide presenting in tumor cells and consequently affecting the infiltration of cytotoxic CD8+ T cells in tumor tissue.

(A) B16F10 cells with stable depletion of SND1 by CRISPR-Cas9 system were stably transfected with OVA vector, followed by IB. (B) B16F10-OVA with SND1 deficiency was analyzed by flow cytometry for murine MHC-I (H2Kb/H2Db). (C to E) OT-I mice were injected with equal numbers of WT or SND1-KO B16F10-OVA cells, and tumor growth was observed over time. Then tumors were removed, photographed, and weighted. *P < 0.05 and **P < 0.01. (F) Flow cytometry was used for the analysis of CD45.2+ leucocyte and CD8+ T cell infiltration in tumor tissues. (G to I) Percentages of infiltrating CD45.2+ leucocytes and CD8+ T cells among total tumor tissuederived cells and the percentage of infiltrating CD8+ T cells among total CD45.2+ leucocytes. n = 5 tumors for each group. **P < 0.01 and ***P < 0.001, by unpaired t test. (J) CD8+ T cells were purified from spleens of tumor-bearing OT-I mice and stimulated with 257 to 264 (SIINFEKL) peptide of OVA for 24 hours. Percentages of IFN+CD8+ T cells among total CD8+ T cells in the culture system were measured by flow cytometry. (n = 5, **P < 0.01). The experiments were repeated two times independently. (K) CD8+ T cells recognizing specific peptide of OVA (SIINFEKL) were purified from spleens of OT-I and then cocultured with WT or SND1-KO B16F10 cells stably expressing OVA (CD8+ T:B16F10-OVA, 10:1). Representative images were taken under a bright field at different time points. Scale bar, 20 m. (L) In vitro comparison of cytolysis rates against CD8+ T cells purified from spleens of OT-I mice between WT and SND1-KO B16F10-OVA cells at different cell rates of CD8+ T (effector cells) to B16F10 (target cells) with/without antiMHC class I antibodies (Ab) (E:T, 5:1, 10:1, 15:1, or 20:1). A lactate dehydrogenasereleasing cytotoxicity assay was performed to measure the cytolysis efficiency of CD8+ T cells on tumor cells. Each bar represents mean SD for biological triplicate experiments. ****P < 0.0001, two-way analysis of variance (ANOVA).

To further examine the contribution of SND1 to cytotoxic CD8+ T cellmediated immune response in tumor, we isolated CD8+ T cells from spleen of OT-I mice bearing B16F10-OVA-WT or B16F10OVASND1-KO tumor, respectively, and tested the cytotoxic CD8+ T cell population. As shown in Fig. 6J, the amount of interferon- (IFN)producing CD8+ splenic T cells was significantly increased in SND1-KO group compared to WT control, suggesting that SND1 deficiency in tumor cells promoted and activated the OVA-specific CD8+ T cell response in the peripheral immune organ. To examine whether the enhanced antigen presentation in the SND1-KO cells results in robust recruitment and activation of CD8+ T cellmediated cytotoxicity in the tumor environment, CD8+ T cells were isolated from OT-I mice and cocultured with tumor cells expressing OVA in the presence or absence of SND1. Representative time-lapse images showed that B16F10-OVA cells with SND1 deficiency were recognized and killed by more cytotoxic CD8+ T cells after 12 hours, while the parental B16F10-OVA cells survived after 12 hours with less aggregated CD8+ T cells (Fig. 6K). Furthermore, the amount of lactate dehydrogenase released from lysed target cells was used as indicator for cytolysis. Accordingly, the cytolysis value was higher in SND1-KO group in an E/T cell ratiodependent manner and significantly abolished with the treatment of MHC-blocking antibodies (AF6-88.5) (Fig. 6L, red), which indicated an efficient cytotoxic effect mediated by CD8+ T cells. Consistently, the same results were also observed in MC38-OVA cells (fig. S8, C and D). Collectively, these findings illustrated that SND1 impaired tumor antigen presentation to cytotoxic CD8+ T cells and sabotaged the CD8+ T cellmediated cellular immune response, supporting our previous data that deletion of SND1 in tumor cells promoted CD8+ T cellmediated cellular immune response, and, as a result, inhibited the tumor growth in vivo.

To illustrate the significant relevance of high SND1 expression with tumor immune response in human, we screened the Tumor Immune Estimation Resource (TIMER) database at http://cistrome.org/TIMER/, a comprehensive resource for systematic analysis of immune infiltrates across diverse cancer types from The Cancer Genome Atlas (31). We analyzed the correlation of SND1 expression and the infiltration of CD8+ T cells in melanoma and colon adenocarcinoma (fig. S9, A and C). The results showed that SND1 expression was moderately negatively correlated with infiltration level of CD8+ T cells in melanoma (r = 0.247, P = 1.68 107) and colon adenocarcinoma (r = 0.393, P = 2.10 1016).

In addition, we analyzed the correlation of SND1 with cancer patients prognosis by using PrognoScan database at http://dna00.bio.kyutech.ac.jp/PrognoScan/index.html (32). Notably, SND1 expression significantly affects the prognosis in melanoma. The cohort of melanoma (GSE19234) included 38 samples at different stages of melanoma and showed that high SND1 expression was significantly associated with poorer prognosis [Overall survival (OS) hazard ratio (HR) = 7.39, 95% confidence interval (CI) = 1.51 to 36.30, Cox P = 0.000912] (fig. S9B). Consistently, similar trend between SND1 expression with prognosis was observed in colorectal cancer (GSE17536; OS HR = 1.49, 95% CI = 0.69 to 3.22, Cox P = 0.314186) (fig. S9D). Since SND1 was negatively associated with the infiltration of CD8+ T cells and the survival of patients, we speculated that targeting SND1 might be a potentially therapeutic approach to enhance immune response and suppress tumor growth.

In conclusion, as shown in the working model (fig. S9E), SND1, localized on the membrane of ER in tumor cells, is able to hijack MHC-I HC from normally assembling and physically associating with its chaperone calnexin in the ER lumen at an early stage of ER processing, thereby leading MHC-I HC to the proteasomal pathway of ERAD promoted by VCP, cofactor VIMP, and E3 ligase HRD1 and sensitizing tumor to the diminished immune surveillance with decreased cytotoxic CD8+ T cells. Thus, SND1 profoundly facilitates immune evasion from tumor immune microenvironment through inhibition of antigen presentation and that this effect is mediated by down-regulation of MHC-I HC molecule (left). On the other hand, the absence of SND1 in either melanoma or colon carcinoma from subcutaneously tumor-bearing WT mouse results in growth inhibition and promotes tumor inflammation with more cytotoxic CD8+ T cells (right). Genetic ablation of SND1 in OVA-expressed tumors on OT-I mice induces sufficient antigen presentation to cytotoxic CD8+ T cells and enhances antitumor immunity. Therefore, SND1 determines the fate of MHC-I HC maturation and orchestrates a cancer-favored immune microenvironment. This model proposes the blockade of SND1MHC-I HC axis in tumors as a viable option for immune system against cancer.

In the present study, we demonstrate that SND1 promotes immune escape of tumor cells through inhibition of MHC-I antigen presentation pathway, leading to impaired antitumor CD8+ T cell response in tumor microenvironment. Physiologically, the nascent unfolded HC of MHC-I would be stabilized by the chaperone calnexin before association with the 2m in ER. Here, we revealed that SND1 physically interacted with the nascent HC of MHC-I molecule in tumor cells. Instead of promoting the assembly of MHC-I molecule, SND1 recruits the nascent HC to VIMP/VCP complex for ERAD pathway. As a result, the MHC-I expression on tumor cell membrane is reduced, leading to impaired CD8+ T cell activation in tumor microenvironment.

SND1 is highly expressed in various cancers and is newly identified as a novel oncoprotein. We have previously reported that SND1 plays important physiological roles in a variety of cellular processes (1719, 33). By using various methodologies, we identified cytoplasmic SND1 as an ER-associated protein and physically interacting with the nascent HC on the ER membrane in tumor cells. The biogenesis of transmembrane proteins requires the activity of the SEC61 complex, in which the subunit SEC61A has been proposed to act as a gate for the membrane insertion of nascent polypeptides (34). The MHC-I HC is synthesized on membrane-associated ribosomes and inserted cotranslationally into the ER through the translocon composed of SEC61 complex. In ER lumen, the nascent HC associates with its chaperones and glycosylation-related enzymes to generate a properly folded glycoprotein, and the formation of HC-2m dimers indicates the maturity of MHC-I molecules (35). We have previously reported that SND1 protein is composed of SN and TSN domain (35). Here, we illustrated that SND1 protein is an ER-associated protein containing a functional N-terminal sequence (NP) that could associate with SEC61A on ER membrane. The predicted spatial conformation three-dimensional model of SND1-HLA-A complex is consistent with the mapping data, corroborating that SN domain of SND1 could physically interact with the A1 and A3 domain of HC. It indicates a fundamental and preceding role for SND1 at the early phase of HC assembly in the ER machinery. We further reveal that SND1 efficiently facilitates HC disassociation with calnexin and 2m, which interrupt the regular maturation and assembly of MHC-I molecule.

Previous studies have demonstrated that unfolded or misfolded HC that fails to form a proper structure can be recognized, dislocated, and degraded by the ERAD machinery (28). Accordingly, we, by far, are able to investigate how SND1 manages to hijack the nascent HLA-A for further degradation process on ER membrane. Although MHC-I HC is highly polymorphic and its potential ubiquitylation sites are variable (3), it is worthwhile to study the molecular mechanisms of how SND1 determines the fate of MHC-I HC precisely via the ubiquitin proteasome system. As a central element of the ubiquitin-proteasome system, VCP plays a key role in ERAD (36). During dislocation from the ER, misfolded or misassembled MHC-I HC as an ERAD substrate is ubiquitylated on the cytosolic side of the ER membrane and is degraded by the cytosolic proteasome (36). In the present study, we identified VCP, cofactor VIMP, and E3 ligase HRD1 of ERAD components as potential interactors of SND1, as revealed by mass spectrometric and coimmunoprecipitated analysis. Moreover, the results revealed that in the presence of SND1, more MHC-I HC was directed to the ERAD pathway for degradation.

We used mice model bearing tumors, especially transgenic OT-I mice, to illustrate the in vivo consequences of the tumor growth and immune response. With the absence of SND1 in either melanoma or colon carcinoma, the inoculated subcutaneous tumor growth was markedly inhibited but the amount of infiltrated CD8+ T cells in the tumor tissue was greatly increased. In accordance with the evidence from human database, we deduce that the highly expressed SND1 sabotages tumor antigen presentation to cytotoxic CD8+ T cell, thereby creating an immune niche with impaired surveillance that favors tumor growth.

Underlying the physiological relevance of our findings, the protein level of SND1 and MHC-I HC was negatively correlated with each other in human cervical and ovarian cancer cells, as well as in murine melanoma and colon cancerous cells. It is known that SND1 was robustly overexpressed in a variety of tumorigenic tissues and relatively highly expressed in normal tissues, and it was suggested that SND1 was an attractive target for anticancer therapy and a potent tumor marker (16). For more than a decade, it has been recognized that intact antigen presentation machinery, including MHC expression, in malignant cells is critical for T celldependent antitumor immunity because HLA-I antigen expression in tumors directly correlates with the degree of tumor T cell infiltration inside the tumor nests (3, 37). More recently, this knowledge has been underscored by findings showing that MHC class I molecule can be used as an independent prognostic factor for colorectal cancer and for predicting the efficacy of immunotherapy in bladder cancer and chemotherapy in ovarian cancer (1, 5, 38, 39). However, there is a long way to go before the different molecular mechanisms responsible for MHC-I alterations are precisely defined in different tumor types. For example, the mechanisms responsible for total MHC-I loss in about 60% of patients with breast cancer, in 50% of patients with prostate cancer, in 15% of patients with laryngeal cancer, or in 40% of patients with gastric cancer are yet to be identified (2, 6, 39, 40). However, it was proposed that during tumor development, tumors are heterogeneous with both HLA-positive and HLA-negative cells at early stages and are infiltrated by lymphocytes and M1 macrophages as a part of an active antitumor T helper 1 response (40). Thus, it is necessary to analyze tumor HLA expression and monitor HLA changes taking place during immunotherapy to understand how, when, and why the MHC/HLA alterations occur. In a way, our current study provides direct evidence for the idea of how the expression of MHC-I HC was regulated by an endogenously expressed protein SND1, the mechanism of which could be extendedly applied in the nonmalignant cells that may explain when and how MHC-I HC was altered during tumor initiation. Thus, SND1 could be a potential therapeutic target, at least for the treatment of malignancies with MHC-I defects in which the MHC-I is not genetically compromised.

To sum up, SND1 profoundly facilitates immune evasion from tumor immune microenvironment, and this effect is mediated by reducing the expression of MHC-I HC molecule. As a newly identified ER-associated protein, SND1 is able to hijack nascent MHC-I HC that is guided to ERAD-related proteasomal pathway, thereby impairing the proper assembling of HC with 2m in the ER lumen and sensitizing tumor cells to a diminished immune surveillance with abolished antigen presentation to cytotoxic CD8+ T cells. This novel finding may shed light on orchestrating the cancer-favored immune microenvironment via blockade of SND1MHC-I HC axis in tumors as a viable option for immune system against cancer.

HeLa, B16F10, and MC38 cells were obtained from the American Type Culture Collection (ATCC) and cultured using the standard conditions according to the ATCC instructions. B16F10 and HeLa cells were cultured in Dulbeccos modified Eagles medium [Biological Industries (BI)] supplemented with 10% fetal bovine serum (FBS; BI), and MC38 cells were cultured with RPMI 1640 (BI) supplemented with 10% FBS. The human SKOV3 cell line was purchased from China Infrastructure of Cell Line Resources (Beijing, China), and SKOV3 cells were cultured with McCoys 5A Medium (Sigma-Aldrich) supplemented with 10% FBS. All cell lines were cultured under an atmosphere of 5% CO2 at 37C. All of the cells were authenticated by examination of morphology and were confirmed to be mycoplasma-free.

Cells were transiently transfected with a Cas9 and single-guide RNA expression plasmid encoding puromycin resistance. The CRISPR-transfected cells will thus acquire transient resistance to puromycin, and the guide sequences were described as using the optimized CRISPR design at http://crispr.mit.edu. We confirmed that SND1-KO cells were not sensitive to puromycin after expansion, indicating a transient expression of CRISPR-Cas9 system in those cells.

Six- to 8-week-old male C57BL/6 mice were originally purchased from the Academy of Military Medical Sciences. OT-I transgenic mice, whose T cell receptor was designed to recognize OVA residues 257 to 264, were provided by Z. Dong from Tsinghua University. RAG-1 KO mice (Rag-1/ mice) that lack mature T and B cells were purchased from Nanjing Biomedical Research Institute of Nanjing University. The gene phenotype was routinely confirmed by polymerase chain reaction (PCR) using specific primers. All animal procedures were approved by the Committee on the Use and Care of Animals of Tianjin Medical University.

For xenograft experiments, B16F10 cells or MC38 cells (5 105) (WT and SND1-KO) were subcutaneously transplanted into the flank of C57BL/6 mice or Rag-1/ mice. Tumor height and width were measured with a caliper every 2 to 3 days to calculate tumor volume (= width2 height 0.523). Mice were sacrificed when tumors reached maximum allowed size (15 mm in diameter) or when signs of ulceration were evident. Likewise, 5 105 of B16-OVA or MC38-OVA cells were subcutaneously transplanted into the flank of OT-I mice. In all experiments, the initial implantation was conducted to animals at the age of 6 to 8 weeks.

Several plasmids were obtained from corporations including pCIpA102-G-HLA-A2-GFP (Addgene plasmid, no. 85162) and pcDNA3.1+ (Invitrogen, V79020), and several plasmids were gifts, including the following: pLV-IRES-Puro, pET-28a-c (+) vector from L. Shi (Tianjin Medical University), and CRISPR-Cas9 constructs px462 from X. Wu (Tianjin Medical University). Lentivirus plasmids expressing SND1 short hairpin RNA (shRNA) and the vector plasmid pLKO were purchased from MilliporeSigma (SHCLNG-NM_014390). The target sequences of shSND1 are shown as previously described (17). The FLAG-tagged or HA-tagged SND1 carried by pLV-IRES-Puro vector or pcDNA3.1+ were amplified from cDNA of HeLa cells or B16F10 cells with specific PCR primers. For exogenous HLA-A expression, the full length of HLA-A cloned from pCIpA102-G-HLA-A2-GFP with a FLAG tag at the C terminus was inserted into the lentiviral vector pLV-IRES-Puro. The HLA-A(N110Q)-FLAG mutant plasmid carried by pLV-IRES-Puro vector was constructed by the GENEWIZ Inc. The SN domain (SN-HA, 1 to 660 amino acids) or TSN domain (TSN-HA, 661 to 910 amino acids) of SND1 (mouse) protein with an HA tag at the C terminus was inserted into the lentiviral vector pLV-IRES-Puro. The FLAG-tagged full-length and truncation mutants of SND1 (human) were carried by pCMV-Blank vector for transient transfection. The pGEXT-4T-1 plasmids containing full length of SND1, SN domain, or TSN domain were generated as previously described (35). The pGEXT-4T-1 plasmids were inserted with full length of HLA-A(GST-HLA-A, 1 to 365 amino acids) and fragments (GSTHLA-AA1, 25 to 114 amino acids; GSTHLA-AA2, 115 to 206 amino acids; GSTHLA-AA3, 207 to 298 amino acids; and GSTHLA-AC, 299 to 365 amino acids) for GST pull-down assay.

An ER reporter plasmid was constructed with fusion protein (GFP-FLAG-GFP) and Eco RI/Xho I sites at the N terminus, which could be inserted with different signal peptides, such as HLA-A, UGGT, GAPDH, and SND1. KDEL, a target peptide sequence located on the C terminus, which prevents protein from secreting from the ER, was added at the N terminus of the fusion protein. Full length and deletion of N-terminal peptides (1 to 35 amino acids) of SND1 were inserted into the vector pcDNA3.1+ with a GFP tag at the C terminus.

Tumors were removed from sacrificed mice and digested by collagenase I (1.5 mg/ml) and deoxyribonuclease I (100 g/ml; Solarbio) in RPMI 1640 for 1 hour at 37C. The cell suspensions were passed through 70-m filters (Falcon) to remove undigested tumor tissues, and then, the erythrocytes were removed by ACK lysis buffer. Cell suspensions were incubated in mouse Fc block (anti-CD16/CD32, BioLegend) before staining. Fluorochrome-conjugated anti-mouse CD45.2 (clone 104, eBioscience), CD8a (clone 53-6.7, BD Biosciences), IFN (clone XMG1.2, BioLegend), and PD-1 (clone RMP1-30, BioLegend) antibodies were used following the manufacturers protocol. Flow cytometry results were analyzed using FlowJo software.

Cells were collected and lysed with radioimmunoprecipitation assay buffer on ice. Protein concentration was determined by the bicinchoninic acid assay. Equal amounts of protein from each cell lysate were subjected to 10% SDSpolyacrylamide gel electrophoresis (SDS-PAGE). The resolved proteins were transferred to polyvinylidene difluoride membranes and blotted with indicated antibodies. -Actin or GAPDH was used as an internal control.

Lysates from HeLa cells with or without SND1-FLAG expression were immunoprecipitated using Anti-FLAG M2 affinity beads (Sigma-Aldrich, A2220) for 12 hours at 4C with constant rotation. After extensive washing with phosphate-buffered saline (PBS) plus 0.1% Tween, the bound proteins were eluted with excess FLAG peptides for 12 hours at 4C with constant rotation, concentrated with Amicons (Ultra-0.5, 3 kDa, MilliporeSigma), and then visualized by silver staining on 8% SDS-PAGE. The distinct protein bands on the gel were recovered by trypsinization and analyzed by mass spectrometry.

Cellular lysates were prepared by incubating the cells in cell lysis buffer [50 mM tris-HCl (pH 8.0), 150 mM NaCl, 0.2% Nonidet P-40, and 2 mM EDTA] in the presence of protease inhibitor cocktail for 20 min at 4C with vortex every 5 min, followed by centrifugation at 13,000 rpm for 10 min at 4C. For immunoprecipitation, about 1 mg of protein was incubated with control [immunoglobulin G (IgG)] or specific antibodies (1 to 2 g) for 12 hours at 4C with constant rotation. A total of 50 l of 50% protein A/G agarose beads was then added, and the incubation was continued for an additional 6 hours. Beads were then washed five times using the PBS with 0.1% Tween. Between washes, the beads were collected by centrifugation at 2000 rpm for 5 min at 4C. The precipitated proteins were eluted from the beads by resuspending the beads in 2.5 SDS-PAGE loading buffer and boiling for 10 min. The boiled immune complexes were subjected to SDS-PAGE, followed by immunoblotting with appropriate antibodies.

Cells were fixed for 10 min at room temperature with 4% paraformaldehyde in PBS and permeabilized with 0.1% Triton X-100 in PBS for 10 min at room temperature. Samples were then blocked in 3% bovine serum albumin and incubated consecutively with primary antibodies to SND1/calnexin (ProteinTech, 60265-1-Ig/10427-2-AP) and the appropriate secondary antibodies coupled to Alexa Fluor 488 or 594 (Invitrogen). Cells were covered with a drop of 4,6-diamidino-2-phenylindole (DAPI) for 5 min. After washing with PBS, slides were mounted for observation. Confocal images were captured on Leica DMi8 using a 63 oil objective. The fluorescence intensity profiles of the targeted regions were obtained with a Leica DMi8 microscope and LAS X version 3.5.5.

Duolink assay was performed using the Duolink In Situ Red Starter Kit Mouse/Rabbit following the manufacturers instructions (Sigma-Aldrich, DUO92004), and its basic protocols of fixation, retrieval, and permeabilization are the same as immunofluorescence. Samples were incubated with blocking solution for 1 hour at 37C in a humidity chamber and then overnight at 4C with anti-SND1 mouse antibody and anti-calnexin rabbit antibody. Slides were then incubated for 1 hour at 37C with a mix of the MINUS (anti-mouse) and PLUS (anti-rabbit) PLA probes. Hybridized probes were ligated using the ligation-ligase solution for 30 min at 37C and then amplified using the amplification-polymerase solution for 100 min at 37C. Slides were covered with a drop of DAPI (Invitrogen) for 5 min and mounted for observation with a Leica DMi8 confocal microscope.

GST-fusion proteins that contained full length or truncations of SND1 and HLA-A were produced in BL21 E. coli and purified using glutathione agarose beads. Recombinant proteins (HLA-A) were expressed with rabbit reticulocyte lysate (TNT systems, Promega) according to the manufacturers recommendation. His-SND1 was purified in BL21(DE3) E. coli and purified using HIS-Select Nickel Affinity Gel (Sigma-Aldrich) according to the standard procedures.

In GST pull-down assays, the bead-bound GST-fusion proteins were incubated with in vitro transcribed/translated products at 4C for 10 hours. The beads were then washed five times with binding buffer containing 75 mM NaCl and detected by Western blotting.

OT-I mice were injected with WT or SND1-KO B16F10-OVA cells, and CD8+ T cells were collected by microbeads (no. 130-116-478, Miltenyi Biotec), restimulated ex vivo with SIINFEKL peptide (OVA-derived peptide being presented through the MHC class I molecules; no. S7951, Sigma-Aldrich) for 20 hours, and lastly cultured with brefeldin A (no. 420601, BioLegend) for 4 hours. Then, the cells were subjected to flow cytometric analysis, and the percentages of IFN+CD8+ T cells among total CD8+ T cells was measured by flow cytometry.

A cytotoxicity detection kit (R&D Systems) was used to measure the cytolysis rate elicited by CD8+ T cells against different tumor cells. B16F10-OVA or MC38-OVA (WT or SND1-KO) cells (2 104) were cocultured with CD8+ T cells in an E/T cell ratiodependent manner (1 105/2 105/3 105/4 105) isolated from OT-I mice with or without the treatment of MHC-blocking antibodies (AF6-88.5; 0.25 g for 1 105 CD8+ T cells) in sterile 96-well tissue culture plates for 12 hours. The microplate was centrifuged at 250g for 10 min, and supernatant was removed to incubate with reaction mixture. The absorbance of the samples was measured at 490 or 492 nm with an enzyme-linked immunosorbent assay reader.

The amount of lactate dehydrogenase released from lysed target cells was used as an indicator for cytolysis. Cytolysis rate (percentage) was calculated on the basis of the following equation: cytotoxicity (%) = (effector/target cell mix effector cell control low control)/(high control low control) 100. Under the same conditions, B16F10-OVA or MC38-OVA (WT or SND1-KO) cells (1 105) were cocultured with CD8+ T cells (1 106) in sterile 24-well culture plates, and images were taken under a bright field using a Leica microscope at different time points.

The three-dimensional structure of SND1 and HLA-A were generated using I-TASSER. Then, the ZDOCK website was used to predict the possible binding conformation between SND1 and HLA-A. The structure with the lowest binding free energy was chosen as the initial binding conformation, which was further optimized using molecular dynamics (MD) simulation. MD simulation was carried out with Gromacs package (version 5.0.1) and GROMOS96 54A7 force field. The binding complex of SND1 and HLA-A was first placed in a cube box with a minimum distance of 1.0 nm from the edge of box. Then, the complex was solvated with TIP3P water molecules and neutralized with the addition of Na+ and Cl ions. A total of 1000 steps steepest descent energy minimization was conducted to remove local contacts, and the equilibration was performed including 1-ns NVT (Constant volume) and 5-ns NPT (Constant pressure) relaxations. Last, 50-ns MD simulations were performed at 300 K and 1.0-atm pressure under periodic boundary conditions. In all simulation steps, the SHAKE algorithm was applied to constrain all bonds involving hydrogen atoms, Particle mesh Ewald method was used to treat long-range electrostatics, and a cutoff distance of 1.0 nm was used for short-range electrostatic and van der Waals. On the basis of the resulting MD trajectory, we can analyze the structural stability of the complex, calculate the binding free energy using Molecular Mechanics Poisson Boltzmann Surface Area (MM-PBSA) method and identify key residues to the association process.

The correlation between SND1 and cancer immune infiltrates was investigated via TIMER (https://cistrome.shinyapps.io/timer/). The strength of correlations was evaluated using the Spearman correlation test; the Spearman coefficient was considered to indicate poor correlation if <0.2, moderate if <0.4, relatively strong if <0.6, strong if <0.8, and very strong if >0.8. P values <0.05 were considered statistically significant. The correlation between SND1 expression and survival in different cancers was analyzed by the PrognoScan database (http://dna00.bio.kyutech.ac.jp/PrognoScan/index.html). The threshold was adjusted to a Cox P < 0.05.

Data from biological triplicate experiments are presented with error bars as means SD unless otherwise noted. Two-tailed unpaired t test was used to compare two groups of data, and analysis of variance (ANOVA) with Bonferronis correction was used to compare multiple groups of data used for statistical analysis. All of the statistical testing results were determined using GraphPad Prism 7.0 software.

Acknowledgments: We thank Z. Dong from Tsinghua University for sharing the OT-I mouse model. Funding: This work was supported by grant 31125012 from the National Science Foundation for Distinguished Young Scholars of China (to J.Y.); grant IRT13085 from the Innovation Team Development Plan of the Ministry of Education (to J.Y.); grant 31300709 (to X.W.), grants 31870747 and 31370749 (to J.Y.), and grant 81572882 (to Z.Y.) from the National Natural Science Foundation of China; and the High-Level Innovation and Entrepreneurship Team of Tianjin Talent Development Special Support Plan (to J.Y.). This work also received support from grant YJSCX201814 (to Y.W.) from the Postgraduate Innovation Fund of 13th Five-Year Comprehensive Investment, Tianjin Medical University. Author contributions: Y.W., X.W., and J.Y. generated the initial idea and conducted key experiments. Y.W., X.C., H.L., C.H., and L.X. performed the research. Y.W., X.W., X.C., and J.Y. analyzed the data and wrote the manuscript. Y.Z., T.Z., and K.Z. helped with the bioinformatics analysis. J.Y., X.Y., and Z.Y. critically revised the manuscript for important intellectual content. L.G., X.L., J.H., Y.R., W.Z., and X.S. provided administrative, technical, or material support. J.Y. supervised the study. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. Additional data related to this paper may be requested from the authors.

Original post:
Oncoprotein SND1 hijacks nascent MHC-I heavy chain to ER-associated degradation, leading to impaired CD8+ T cell response in tumor - Science Advances