The acrosome reaction has long been thought to be induced by the zona pellucida. Here we report the identification and function of a novel human sperm glycosylphosphatidylinositol (GPI)-anchored membrane protein, NYD-SP8. The release of the protein during sperm-egg interaction and its binding to the cumulus, the first layer of egg investment, elicits cross-talk between the gametes and produces calcium dependant release of progesterone, which lead to the acrosome reaction. An in vivo mouse model of NYD-SP8 immunization is also established showing a reduced fertility rate. Thus, contrary to accepted dogma, our study demonstrates for the first time that, prior to reaching the zona pellucida, sperm may release a surface protein that acts on the cumulus cells leading to the acrosome reaction, which may be important for determining the outcome of fertilization.

Introduction:Menopause has been associated with elevated risk of mood disturbances. This relationship has been attributed to a number of factors including alterations in hormone levels, psychosocial factors, and insomnia associated with menopause. While cognitive behavioral therapy for insomnia (CBT-I) has been shown to also reduce depression in the general population, the effectiveness of CBT-I in reducing depression associated with menopause has not been tested. Methods: 122 females with insomnia concurrent with menopause were randomized into three conditions: CBT-I (N=41), Sleep Restriction Therapy (SRT, N=41) and an Information-only control condition (IC, N=40). Outcome measures included Insomnia Severity Index (ISI), and Beck Depression Inventory (BDI-II; sans sleep items). All measures were conducted pre-, post-treatments, and at 6 months follow-up. Results: dCBT-I resulted in a robust significant improvement in ISI (-8.2 ± 5.3 points) compared to control (-4.0 ± 4.2 points). The post-treatment remission rate (ISI≤10) was significantly greater in the dCBT-I condition (67.1%) compared to the control group (33.7%; p<.01). Similar results were observed for depression symptoms, with the dCBT-I condition exhibiting decreased depression severity (-3.0 ± 4.1 points, from 7.2 ± 4.2 pre-treatment) compared to the control condition (-1.2 ± 3.2 points, from 7.1 ± 3.9 pre-treatment, p<.01). Whereas depression rates (QIDS≥10) were comparable between conditions at pre-treatment (control: 28.3%; dCBT-I: 24.0%, p>.05), the dCBT-I condition exhibited a significantly lower rate of clinically significant depression at post-treatment (8.2%) compared to the control group (19.0%, p<.01). Results stratified by demographics indicated that dCBT-I yielded a near identical and significant decrease in both insomnia and depression symptom severity across all demographic groups. Conclusion: Findings from this study provide evidence for the effectiveness of CBT-I for insomnia associated with menopause, and also suggest its potential for reducing concurrent depression. Furthermore, gains in depression symptoms appear to be sustained up to 6 months following CBT-I, and may also continue to decrease over time.

Objective To investigate the ocular phenotype and gene mutation of a Chinese pedigree with familial amyloid polyneuropathy (FAP) and vitreous amyloidosis. Methods A Chinese pedigree with familial amyloid polyneuropathy and vitreous amyloidosis was recruited. Combined phacoemulsification, vitrectomy and intraocular lens implantation were performed on the right eye of the index patient. Ophthalmic investigations were performed before and after surgery. The DNA from the pedigree was sequenced for the transthyretin (TTR) gene. Results After vitrectomy, the best-corrected visual acuity of the patient improved from counting finger to 20/20. Red-free confocal ophthalmoscopy demonstrated perifoveal ring and several perivessel white sheaths. Optical coherence tomography (OCT) revealed cotton wool like reflections on the vitreoretinal interface. Electroretinogram and autofluorescence was normal. Amyloid was present in the vitreous specimen. A substitution of T to G at nucleotide 381 in exon 4 of TTR DNA (Ile107Met) was found. This mutation co-segregated with phenotype in the pedigree and was not detected in 200 controls. Conclusions TTR Ile107Met mutation is associated with vitreous amyloidosis and FAP. OCT and red-free imaging are helpful in identifying amyloid deposits in the retina.