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Conserved intermolecular salt bridge required for activation of protein kinases PKR, GCN2, and PERK.

The protein kinases PKR, GCN2, and PERK phosphorylate translation initiation factor eIF2alpha to regulate general and genespecific protein synthesis under various cellular stress conditions. Recent x-ray crystallographic structures of PKR and GCN2 revealed distinct dimeric configurations of the kinase domains. Whereas PKR kinase domains dimerized in a back-to-back and parallel orientation, the GCN2 kinase domains displayed an antiparallel orientation. The dimerization interfaces on PKR and GCN2 were localized to overlapping surfaces on the N-terminal lobes of the kinase domains but utilized different intermolecular contacts. A key feature of the PKR dimerization interface is a salt bridge interaction between Arg(262) from one protomer and Asp(266) from the second protomer. Interestingly, these two residues are conserved in all eIF2alpha kinases, although in the GCN2 structure, the two residues are too remote to interact. To test the importance of this potential salt bridge interaction in PKR, GCN2, and PERK, the residues constituting the salt bridge were mutated either independently or together to residues with the opposite charge. Single mutations of the Asp (or Glu) and Arg residues blocked kinase function both in yeast cells and in vitro. However, for all three kinases, the double mutation designed to restore the salt bridge interaction with opposite polarity resulted in a functional kinase. Thus, the salt bridge interaction and dimer interface observed in the PKR structure is critical for the activity of all three eIF2alpha kinases. These results are consistent with the notion that the PKR structure represents the active state of the eIF2alpha kinase domain, whereas the GCN2 structure may represent an inactive state of the kinase.

Animals↗

A PERK-like receptor kinase interacts with the geminivirus nuclear shuttle protein and potentiates viral infection.

The nuclear shuttle protein (NSP) from bipartite geminiviruses facilitates the intracellular transport of viral DNA from the nucleus to the cytoplasm and acts in concert with the movement protein (MP) to promote the cell-to-cell spread of the viral DNA. A proline-rich extensin-like receptor protein kinase (PERK) was found to interact specifically with NSP of Cabbage leaf curl virus (CaLCuV) and of tomato-infecting geminiviruses through a yeast two-hybrid screening. The PERK-like protein, which we designated NsAK (for NSP-associated kinase), is structurally organized into a proline-rich N-terminal domain, followed by a transmembrane segment and a C-terminal serine/threonine kinase domain. The viral protein interacted stably with defective versions of the NsAK kinase domain, but not with the potentially active enzyme, in an in vitro binding assay. In vitro-translated NsAK enhanced the phosphorylation level of NSP, indicating that NSP functions as a substrate for NsAK. These results demonstrate that NsAK is an authentic serine/threonine kinase and suggest a functional link for NSP-NsAK complex formation. This interpretation was corroborated by in vivo infectivity assays showing that loss of NsAK function reduces the efficiency of CaLCuV infection and attenuates symptom development. Our data implicate NsAK as a positive contributor to geminivirus infection and suggest it may regulate NSP function.

Active Transport, Cell Nucleus↗

Corneal topography as a predictor of refractive change in the prospective evaluation of radial keratotomy (PERK) study.

The first operated eyes of 435 patients undergoing radial keratotomy in the Prospective Evaluation of Radial Keratotomy (PERK) study were evaluated by photokeratography to document the preoperative and postoperative corneal shape. We determined by regression analysis and analysis of variance that the corneal shape preoperatively improved the prediction of the corneal shape 6 months postoperatively in the 3-mm-clear-zone population. The reduction of myopia in all 435 eyes ranged from 1.25 to 9.75 diopters. We studied the effect of the preoperative corneal shape on this variability in the outcome of the surgery using rings 2 and 7 on photokeratography and corneal diameter. In the 3-mm-clear-zone group, eyes with flat prolate corneas had a greater reduction in myopia (4.65 D); those with steeper, more spherical corneas had less reduction in myopia (3.48 D). In addition, eyes with a 3-mm clear zone and flat central corneas alone (8.0 mm = 42.19 D) flattened approximately 0.75 D more than those with steep central corneas (7.0 mm = 48.21 D). In the 3.5-mm and 4.0-mm clear zone groups, the change in corneal curvature was not related to the preoperative curvature. A stepwise regression analysis of the 151 eyes in the 3.0-mm-clear-zone population demonstrated the following predictive equation for radial keratotomy; change in cycloplegic refraction = -14.55 + [-2.097 x average ring-2 radius] + [3.605 x average ring-7 radius] + [0.69 x horizontal corneal diameter] + [0.079 x age] + [-0.379 x spherical equivalent cycloplegic refraction]. There was a 1.17-D observed difference in the effect of radial keratotomy between those eyes with a steep/steep corneal topography (7.2% of the 3.0-mm-clear-zone population) and the flat/flat topography (29% of the 3.0-mm-clear-zone PERK population). A knowledge of corneal topography provides an additional tool for understanding the operative variability of radial keratotomy.

Cornea↗

Symmetry of refractive and visual acuity outcome in the Prospective Evaluation of Radial Keratotomy (PERK) study.

In the Prospective Evaluation of Radial Keratotomy (PERK) study, the symmetry of refractive and visual acuity outcome was analyzed in 269 patients with bilateral radial keratotomy with a single operation in each eye. Patients were required to wait 1 year after surgery on the first eye before having surgery on the second eye. At 1 year after surgery on the second eye, 98% of patients had 3.00 diopters or less difference between their two eyes in the spherical equivalent of the cycloplegic refraction (100% before surgery), and 96% of patients had 3.00 D or less difference between their two eyes in the amount of refractive power in the vertical meridian (100% before surgery). Thus, surgically induced refractive anisometropia was not a major complication in the PERK study. However, 14% of patients had four to eight Snellen lines difference in the uncorrected visual acuity between their two eyes (1% before surgery), emphasizing that induced asymmetry of refraction is a potential clinical problem for some patients.

Adult↗

Reported satisfaction, fluctuation of vision, and glare among patients one year after surgery in the Prospective Evaluation of Radial Keratotomy (PERK) Study.

We studied satisfaction with the results of radial keratotomy one year after surgery on one eye as reported by 354 patients in the Prospective Evaluation of Radial Keratotomy (PERK) Study. We measured satisfaction using an index based on ten questions that were part of a longer psychometric questionnaire. Patients were generally satisfied with the results of radial keratotomy-48% were very satisfied, 42% were moderately satisfied, and 10% were dissatisfied. A lot of trouble with fluctuating vision was reported by 12% of patients before surgery and by 34% one year after surgery; 17% reported a lot of trouble with glare both before surgery and one year after surgery. The three major factors that influenced satisfaction were uncorrected visual acuity, residual refractive error, and subjective daily fluctuation in vision. A multiple regression equation that incorporated these three variables, glare, and patient sex was able to predict only 46% of the variance in patient satisfaction.

Adult↗

Factors affecting outcome and predictability of radial keratotomy in the PERK Study.

The Prospective Evaluation of Radial Keratotomy (PERK) study used a standardized surgical technique that included a central clear zone with a diameter of 4.0, 3.5, or 3.0 mm. Multiple regression analysis of the outcome in one eye from each of 411 patients disclosed that the diameter of the central clear zone, patient age, and depth of the incision scar were the major factors affecting the change in refraction one year after surgery. Preoperative factors examined that did not have a significant influence on the outcome were sex, average central keratometric power, corneal thickness, corneal diameter, intraocular pressure, and ocular rigidity. The predictability of radial keratotomy, ie, the precision with which the outcome can be estimated, was measured by the 90% confidence interval for the change in refraction based on the regression equation. The width of this interval within each clear zone group was as follows: 4.0 mm, 2.49 diopters; 3.5 mm, 3.38 D; 3.0 mm, 4.12 D. For all 411 eyes, the 90% confidence interval was approximately 3.50 D wide. Thus, the surgeon could be 90% certain that an individual patient's refraction would be within 1.75 D of the predicted value one year after surgery.

Age Factors↗

Relationship between refractive error and visual acuity in the Prospective Evaluation of Radial Keratotomy (PERK) Study.

As part of the Prospective Evaluation of Radial Keratotomy (PERK) study, we examined the relationship between post-operative refractive error and visual acuity without correction. We included 394 eyes (one eye per patient) with refractive errors ranging from -3.00 to +3.00 diopters one year after radial keratotomy. Within each 1-D range of the spherical equivalent of the refractive error, the visual acuity spanned five to ten Snellen lines. For visual acuities of 20/16 to 20/50, the refractive error spanned 3 to 5 D. Additionally, operated eyes had a better average uncorrected visual acuity than unoperated eyes with a similar refractive error. Within the narrow range of refraction between -2.00 and -2.50 D, the mean uncorrected visual acuity was 20/125 for 56 unoperated eyes and 20/63 for 29 operated eyes, a difference of three Snellen lines.

Adult↗

Genome-wide characterization of the tomato PERK gene family and its expression profiling under abiotic stresses.

UNLABELLED: This study presents the first systematic genome-wide characterization of the proline-rich extensin-like receptor kinases (PERK) gene family in tomato (Solanum lycopersicum) and their transcriptional responses under abiotic stresses. Using the latest SL4.0/ITAG4.0 genome assembly, we identified six SlPERK genes, all harboring the conserved Ser/Thr protein kinase domain. Evolutionary and structural analyses revealed strong purifying selection (Ka/Ks&#x2009;<&#x2009;1), distinct exon-intron organizations, and the presence of stress- and hormone-responsive cis-regulatory elements in their promoters. Furthermore, post-transcriptional regulation by 57 miRNAs and complex protein-protein interaction networks were predicted. To validate their stress-responsive roles, two tomato cultivars (GMOTL-1 and Roma) were subjected to cold, heat, and salinity treatments. Quantitative RT-PCR analysis revealed cultivar-specific expression dynamics: SlPERK4 exhibited strong transient induction under cold and heat stress, while SlPERK6 was highly responsive to salinity. Notably, the GMOTL-1 cultivar displayed significantly higher and broader stress-responsive expression profiles compared to Roma, indicating a potential role of these SlPERK genes in cultivar-specific stress tolerance. These findings provide a comprehensive genomic resource and establish a critical foundation for the functional validation and molecular breeding for stress-resilience tomato cultivars. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1007/s13205-026-05044-y.

Abiotic stress↗

Renal ischemia and reperfusion activates the eIF 2 alpha kinase PERK.

Inhibition of protein synthesis occurs in the post-ischemic reperfused kidney but the molecular mechanism of renal translation arrest is unknown. Several pathways have been identified whereby cell stress inhibits translation initiation via phosphorylation of the alpha subunit of eukaryotic initiation factor 2 (eIF 2 alpha, phospho-form eIF 2 alpha(P)]. Here, we report a 20-fold increase in eIF 2 alpha(P) in kidney homogenates following 10 min of cardiac arrest-induced ischemia and 10 min reperfusion. Using immunohistochemistry, we observed eIF 2 alpha(P) in tubular epithelial cells in both cortex and medulla, where the greatest eIF 2 alpha(P) staining was found in epithelial cells of the so-called watershed area at the corticomedullary junction. We further show that increased eIF 2 alpha(P) is accompanied by activation of the PKR-like endoplasmic reticulum eIF 2 alpha kinase (PERK). These observations indicate that renal ischemia and reperfusion induce stress to the endoplasmic reticulum and activate the unfolded protein response in renal epithelial cells. As the unfolded protein response can result alternatively in a pro-survival or pro-apoptotic outcome, the present study demonstrates an new additional mechanism involved in cell damage and/or repair in ischemic and reperfused kidney.

Animals↗

Results of the prospective evaluation of radial keratotomy (PERK) study one year after surgery.

The Prospective Evaluation of Radial Keratotomy (PERK) study is a nine-center, self-controlled clinical trial of a standardized technique of radial keratotomy in 435 patients who had physiologic myopia with a preoperative refraction between -2.00 and -8.00 diopters. The surgical technique consisted of eight incisions using a diamond micrometer knife with blade length determined by intraoperative ultrasonic pachymetry and the diameter of central clear zone determined by preoperative refraction. At one year after surgery, myopia was reduced in all eyes; 60% were within +/- 1.00 diopter of emmetropia; 30% were undercorrected and 10% were overcorrected by more than 1.00 diopter (range of refraction, -4.25 to +3.38 D). Uncorrected visual acuity was 20/40 or better in 78% of eyes. The operation was most effective in eyes with a refraction between -2.00 and -4.25 diopters. Thirteen percent of patients lost one or two Snellen lines of best corrected visual acuity. However, all but three eyes could be corrected to 20/20. Ten percent of patients increased astigmatism more than 1.00 diopter. Disabling glare was not detected with a clinical glare tester, but three patients reduced their driving at night because of glare. Between six months and one year, the refraction changed by greater than 0.50 diopters in 19% of eyes.

Adult↗

Comparison of ultrasonic corneal thickness measurements before and during surgery in the prospective evaluation of Radial Keratotomy (PERK) Study.

Central corneal thickness, determined by an ultrasonic pachymeter, was studied in one eye each of 395 patients enrolled in the Prospective Evaluation of Radial Keratotomy (PERK) Study, to determine the changes in central corneal thickness between preoperative and intraoperative measurements. There was no statistical difference between the preoperative and the intraoperative measurement. However, 9.4% of the corneas were 0.03 to 0.08 mm thinner intraoperatively and 3.3% were 0.03 to 0.06 mm thicker intraoperatively, indicating that clinically meaningful changes in corneal thickness occurred between the preoperative and intraoperative measurements in some eyes. We conclude that the most reliable way to use ultrasonic pachymetry readings to set the length of the knife blade for radial keratotomy surgery is to measure the corneal thickness intraoperatively.

Cornea↗

Diurnal change in refraction, corneal curvature, visual acuity, and intraocular pressure after radial keratotomy in the PERK Study.

Selected patients who complained of fluctuating visual acuity in the Prospective Evaluation of Radial Keratotomy (PERK) Study were examined before 8:00 a.m. and after 7:00 p.m. on the same day to determine diurnal change in uncorrected visual acuity, best corrected visual acuity, manifest refractive error, average central keratometric power, and intraocular pressure. Sixty-three operated eyes were examined at three months, while 46 operated and 40 unoperated contralateral eyes were examined at one year after radial keratotomy. One year after surgery, 42% of the operated eyes had an increase in minus power of the manifest refraction of 0.50 to 1.25 diopters, 26% of the eyes changed their uncorrected visual acuity by 2 to 4 Snellen lines, and 35% of the operated eyes showed central steepening of the cornea by 0.50 to 1.25 diopters. These changes in the operated eyes at one year were similar to the changes at three months. Minimal diurnal changes occurred in the unoperated eyes at one year. Only 11% of the unoperated eyes changed their manifest refraction by 0.50 to 1.00 diopters, none changed their uncorrected visual acuity by 2 to 4 Snellen lines, and only one of the unoperated eyes changed its central keratometric power by 0.50 diopters. This study documents that many patients who experience diurnal fluctuation of vision have steepening of the cornea and an increase in the minus power of their refraction during the day.

Biomechanical Phenomena↗

Three-year results of the Prospective Evaluation of Radial Keratotomy (PERK) Study.

The Prospective Evaluation of Radial Keratotomy (PERK) study is a nine-center clinical trial of a standardized technique of radial keratotomy in 435 patients who had simple myopia with a preoperative refractive error between -2.00 and -8.00 diopters (D). The authors report results for one eye of each patient. The surgical technique consisted of eight incisions using a diamond micrometer knife with the blade length determined by intraoperative ultrasonic pachymetry and the diameter of the central clear zone determined by the preoperative refractive error. At 3 years after surgery, 58% of eyes had refractive error within 1.00 D of emmetropia; 26% were undercorrected and 16% were overcorrected by more than 1.00 D. Uncorrected visual acuity was 20/40 or better in 76% of eyes. The operation was more effective in eyes with a preoperative refractive error between -2.00 and -4.37 D. Between 1 and 3 years after surgery, the refractive error changed by 1.00 D or more in 12% of eyes, indicating a lack of stability in some eyes. In the 435 eyes, there was a small number of complications including six eyes that lost two or three lines of best-corrected acuity, 16 that experienced vascularization of the incisions, 2 that had delayed bacterial keratitis, and 4 that had recurrent epithelial erosions.

Follow-Up Studies↗

Morning-to-evening change in refraction, corneal curvature, and visual acuity 2 to 4 years after radial keratotomy in the PERK Study.

The authors previously reported morning-to-evening changes in ophthalmic measurements at 3 months and at 1-year after radial keratotomy in a self-selected group of patients in the Prospective Evaluation of Radial Keratotomy (PERK) study. Fifty-two patients included in the earlier study were examined again between 2 1/2 and 4 years after surgery before 10:00 AM and after 5:30 PM on the same day to determine if the changes persisted beyond 1 year after surgery. Between the morning and evening examinations, 31% of the eyes had an increase in minus spherical equivalent power of the manifest refraction of 0.50 to 1.50 diopters; 12% had a change in cylinder power of 0.50 to 1.00 D; 19% had a decrease in uncorrected visual acuity of two to five Snellen lines; and 29% showed central corneal steepening by 0.50 to 1.00 D. Thus, in some patients, morning-to-evening fluctuation persisted until 2 1/2 to 4 years after radial keratotomy.

Circadian Rhythm↗

Morning-to-evening change in refraction, corneal curvature, and visual acuity 11 years after radial keratotomy in the prospective evaluation of radial keratotomy study. The PERK Study Group.

PURPOSE: Previous reports demonstrate morning-to-evening changes in ophthalmic measurements at 3 months, 1 year, and 4 years after radial keratotomy. The authors determine whether diurnal change in refractive error persists 11 years after radial keratotomy surgery in the Prospective Evaluation of Radial Keratotomy (PERK) study. METHODS: Seventy-one patients were examined in the morning and evening a mean of 11.1 +/- 0.6 years (range, 10-12.7 years) after undergoing radial keratotomy under a standardized protocol using a diamond blade. RESULTS: Between the morning and evening examinations, the mean change in the spherical equivalent of refraction was a 0.31 +/- 0.58-diopter (D) increase in minus power in first eyes. Thirty-six (51%) eyes had an increase in minus power of the manifest refraction of 0.50 to 1.62 D; 22 (31%) had a change in refractive cylinder power of 0.50 to 1.25 D; 9 (13%) had a decrease in uncorrected visual acuity of two to seven Snellen lines; and 25 (35%) showed central corneal steepening measured by keratometry of 0.50 to 1.94 D. Two (3%) eyes lost two lines of spectacle-corrected visual acuity, whereas one (1%) eye gained two lines. In patients whose both eyes underwent surgery, a high degree of symmetry was observed in morning-to-evening refractive change. CONCLUSION: In some patients after radial keratotomy, morning-to-evening change of refraction and visual acuity persists for at least 11 years, although in most patients the magnitude of this change is small. Thus, diurnal fluctuation may be a permanent sequela of radial keratotomy in some individuals.

Circadian Rhythm↗

Replication of a cytopathic strain of bovine viral diarrhea virus activates PERK and induces endoplasmic reticulum stress-mediated apoptosis of MDBK cells.

Endoplasmic reticulum (ER) stress signaling is an adaptive cellular response to the loss of ER Ca(2+) homeostasis and/or the accumulation of misfolded, unassembled, or aggregated proteins in the ER lumen. ER stress-activated signaling pathways regulate protein synthesis initiation and can also trigger apoptosis through the ER-associated caspase 12. Viruses that utilize the host cell ER as an integral part of their life cycle would be predicted to cause some level of ER stress. Bovine viral diarrhea virus (BVDV) is a positive-stranded RNA virus of the Flaviviridae family. BVDV and related flaviviruses use the host ER as the primary site of envelope glycoprotein biogenesis, genomic replication, and particle assembly. We are using a cytopathic strain of BVDV (cpBVDV) that causes cellular apoptosis as a model system to determine how virus-induced ER stress contributes to pathogenesis. We show that, in a natural infection of MDBK cells, cpBVDV activates the ER transmembrane kinase PERK (PKR-like ER kinase) and causes hyperphosphorylation of the translation initiation factor eIF2 alpha, consistent with the induction of an ER stress response. Additionally, we show that initiation of cellular apoptosis correlates with downregulation of the antiapoptotic Bcl-2 protein, induced expression of caspase 12, and a decrease in intracellular glutathione levels. Defining the molecular stress pathways leading to cpBVDV-induced apoptosis provides the basis to study how other ER-tropic viruses, such as hepatitis C and B viruses, modulate the host cell ER stress response during the course of persistent infection.

Animals↗

The evaluation of corneal endothelial permeability in PERK study patients.

Sixteen patients enrolled in the PERK study were evaluated by fluorophotometry 24 hours or six months following radial keratotomy. A comparison of eyes operated and not operated upon showed that endothelial permeability was not significantly altered 24 hours and six months after surgery. Aqueous humour flow rates and anterior chamber elimination coefficients were significantly higher 24 hours after surgery in the eyes operated on than in those not operated on. Six months after surgery there was no longer a significant difference in these factors. The increase in aqueous humour flow rates 24 hours after surgery may represent a subclinical breakdown in the blood-aqueous barrier.

Adult↗

Rhode Island's got the Blues. But the state's Blues plan isn't the only one drawing fire over its reserves, executive perks and compensation.

It's been a strained few months at Blue Cross and Blue Shield of Rhode Island. Outrage over corporate excess led to a flurry of reforms at the insurer, headed by Chairman Frank Montanaro, left, including banning loans to employees and dropping lavish perks. Other Blues have been catching flak for their burgeoning bottom lines, but executives say they need ample reserves since that's their only capital.

Administrative Personnel↗