NO, CO and H2S: A Trinacrium of Bioactive Gases in the Brain

Oxygen and carbon dioxide are time honored gases that have direct bearing on almost all life forms, but over the past thirty years, and in large part due to the Nobel Prize Award in Medicine for the elucidation of nitric oxide (NO) as a bioactive gas, the research and medical communities now recognize other gases as critical for survival. In addition to NO, hydrogen sulfide (H₂S) and carbon monoxide (CO) have emerged as a triumvirate or Trinacrium of gases with analogous importance and that serve important homeostatic functions. Perhaps, one of the most intriguing aspects of these gases is the functional interaction between them, which is intimately linked by the enzyme systems that produce them. Despite the need to better understand NO, H₂S and CO biology, the notion that these are environmental pollutants remains ever present. For this reason, incorporating the concept of hormesis becomes imperative and must be included in discussions when considering developing new therapeutics that involve these gases. While there is now an enormous literature base for each of these gasotransmitters, we provide here an overview of their respective physiologic roles in the brain.

Hormesis induced by silver iodide, hydrocarbons, microplastics, pesticides, and pharmaceuticals: Implications for agroforestry ecosystems health

Increasing amounts of silver iodide (AgI) in the environment are expected because of the recent massive expansion of weather modification programs. Concurrently, pharmaceuticals, microplastics, hydrocarbons, and pesticides in terrestrial ecosystems continue contaminating forests and agroforests. Our review supports that AgI induces hormesis, a biphasic dose response characterized by often beneficial low-dose responses and toxic high-dose effects, which adds to the evidence for pharmaceuticals, microplastics, hydrocarbons, and pesticides induced hormesis in numerous species. Doses smaller than the no-observed-adverse-effect-level (NOAEL) positively affect defense physiology, growth, biomass, yields, survival, lifespan, and reproduction. They also lead to negative or undesirable outcomes, including stimulation of pathogenic microbes, pest insects, and weeds with enhanced resistance to drugs and potential negative multi- or trans-generational effects. Such sub-NOAEL effects perplex terrestrial ecosystems managements and may compromise combating outbreaks of disease vectors that can threaten not only forest and agroforestry health but also sensitive human subpopulations living in remote forested areas.

Hormesis is an evolutionary expectation: implications for aging

This article argues that evolution and the concept of hormesis are biologically inseparable. It proposes that evolutionary processes led to the selection of inducible adaptive hormetic strategies that are necessary for wellbeing and survival. Hormesis has been demonstrated in essentially all organisms in which it has been studied from bacteria to humans, showing its highly conserved features. This evolution-hormesis integration should be a central feature in both understanding the biology of aging but also in ways to enhance improved health-based aging strategies.

Treatment of Early-Stage Alzheimer’s Disease With CT Scans of the Brain: A Case Report

We report the case of a patient in Massachusetts with early-stage Alzheimer’s disease who was treated with low doses of ionizing radiation to the brain. He requested this treatment after reading about a patient with severe Alzheimer’s in Michigan who improved remarkably after receiving 4 CT scans. After his first treatment in April 2016, mental clarity improved. His impaired conversation, reading, and sense of humor were restored, especially his virtuosic clarinet jazz-playing. However, executive function remained deficient. He requested a treatment every 2 weeks, but his neurologist denied this, fearing opposition to this treatment, a diagnostic procedure that used ionizing radiation. Limited recovery was observed after each CT scan, lasting from several weeks to months, depending on the endpoints/behavior and the periodicity. Despite the positive responses, the physician was reluctant to continue beyond 6 due to concerns about adverse effects and disapproval for prescribing them. The patient began hyperbaric oxygen therapy as an alternative. But after 43 treatments, no conclusive benefit was observed. The patient died in September 2020 at age 77. This experience suggests CT scans may have value in treating Alzheimer’s patients and restoring, at least temporarily, important aspects of normal life activities. Such observations need testing and validation.

Hormesis: A General Biological Principle

Hormesis drives biological modifications from cells to higher levels of biological organization and emerges as a general basic principle of biology, integrating evolution, ecology, medicine, physiology, toxicology, and public health.

Enhancing health span: muscle stem cells and hormesis

Sarcopenia is a significant public health and medical concern confronting the elderly. Considerable research is being directed to identify ways in which the onset and severity of sarcopenia may be delayed/minimized. This paper provides a detailed identification and assessment of hormetic dose responses in animal model muscle stem cells, with particular emphasis on cell proliferation, differentiation, and enhancing resilience to inflammatory stresses and how this information may be useful in preventing sarcopenia. Hormetic dose responses were observed following administration of a broad range of agents, including dietary supplements (e.g., resveratrol), pharmaceuticals (e.g., dexamethasone), endogenous ligands (e.g., tumor necrosis factor α), environmental contaminants (e.g., cadmium) and physical agents (e.g., low level laser). The paper assesses both putative mechanisms of hormetic responses in muscle stem cells, and potential therapeutic implications and application(s) of hormetic frameworks for slowing muscle loss and reduced functionality during the aging process.

Induced Pluripotent Stem Cells and Hormesis

This paper represents the first assessment of agent-induced hormetic dose responses in induced pluripotent stem cells and their derived cells. The hormetic dose responses were induced by a broad range of chemicals, including pharmaceuticals (eg, metformin), dietary supplements/extracts from medicinal plants (eg, curcumin), and endogenous agents (eg, melatonin). The paper assesses the mechanistic foundations of these induced hormetic dose responses, their therapeutic implications and comparison with hormetic responses in multiple adult and embryonic stem cells.

Hormesis and Endothelial Progenitor Cells

Hormetic-biphasic dose response relationships are reported herein for human endothelial progenitor cells involving estradiol, nicotine, the anti-diabetic agent pioglitazone, resveratrol, and progesterone. In general, these studies demonstrate the capacity of these agents to enhance EPC proliferation and angiogenesis functional applications, having a focus on repairing endothelial tissue damage due to acute injury (e.g., stroke), as well as damage from chronic conditions (e.g., atherosclerosis) and normal aging processes.

Redox modulation by plant polyphenols targeting vitagenes for chemoprevention and therapy: Relevance to novel anti-cancer interventions and mini-brain organoid technology

The scientific community, recently, has focused notable attention on the chemopreventive and therapeutic effects of dietary polyphenols for human health. Emerging evidence demonstrates that polyphenols, flavonoids and vitamins counteract and neutralize genetic and environmental stressors, particularly oxidative stress and inflammatory process closely connected to cancer initiation, promotion and progression. Interestingly, polyphenols can exert antioxidant or pro-oxidant cytotoxic effects depending on their endogenous concentration. Notably, polyphenols at high dose act as pro-oxidants in a wide type of cancer cells by inhibiting Nrf2 pathway and the expression of antioxidant vitagenes, such as NAD(P)H-quinone oxidoreductase (NQO1), glutathione transferase (GT), GPx, heme oxygenase-1 (HO-1), sirtuin-1 (Sirt1) and thioredoxin (Trx) system which play an essential role in the metabolism of reactive oxygen species (ROS), detoxification of xenobiotics and inhibition of cancer progression, by inducing apoptosis and cell cycle arrest according to the hormesis approach. Importantly, mutagenesis of Nrf2 pathway can exacerbate its "dark side" role, representing a crucial event in the initiation stage of carcinogenesis. Herein, we review the hormetic effects of polyphenols and nanoincapsulated-polyphenols in chemoprevention and treatment of brain tumors via activation or inhibition of Nrf2/vitagenes to suppress carcinogenesis in the early stages, and thus inhibit its progression. Lastly, we discuss innovative preclinical approaches through mini-brain tumor organoids to study human carcinogenesis, from basic cancer research to clinical practice, as promising tools to recapitulate the arrangement of structural neuronal tissues and biological functions of the human brain, as well as test drug toxicity and drive personalized and precision medicine in brain cancer.

Estimating the no-observed-adverse-effect-level (NOAEL) of hormetic dose-response relationships in meta-data evaluations

The number of studies reporting hormetic responses is rapidly increasing, and quantitative evaluations are needed to improve the understanding of hormetic dose responses. However, there is no standardized methodology to estimate the no-observed-adverse-effect-level (NOAEL) of hormetic dose-response relationships developed using data mined from the published literature. Here, we propose a protocol that can be followed to estimate NOAEL, a process that is illustrated using a specific example. This protocol can be used for maintaining a mutual language (since NOAEL can be defined in different ways), permitting comparisons among different studies, and facilitating cumulative science.

Hormesis and neural stem cells

This paper provides a detailed identification and assessment of hormetic dose responses in neural stem cells (NSCs) as identified in a number of animal models and human tissues, with particular emphasis on cell proliferation and differentiation. Hormetic dose responses were commonly observed following administration of a number of agents, including dietary supplements [e.g., berberine, curcumin, (-)-epigallocatechin-3-gallate (EGCG), Ginkgo Biloba, resveratrol], pharmaceuticals (e.g., lithium, lovastatin, melatonin), endogenous ligands [e.g., hydrogen sulfide (H₂S), magnesium, progesterone, taurine], environmental contaminants (e.g., arsenic, rotenone) and physical agents [e.g., hypoxia, ionizing radiation, electromagnetic radiation (EMF)]. These data indicate that numerous agents can induce hormetic dose responses to upregulate key functions of such as cell proliferation and differentiation in NSCs, and enhance resilience to inflammatory stresses. The paper assesses both putative mechanisms of hormetic responses in NSCs, and the potential therapeutic implications and application(s) of hormetic frameworks in clinical approaches to neurological injury and disease.

Human dental pulp stem cells and hormesis

This paper represents the first assessment of hormetic dose responses by human dental pulp stem cells (hDPSCs) with particular emphasis on cell renewal (proliferation) and differentiation. Hormetic dose responses were commonly reported in this model, encompassing a broad range of chemicals, including principally pharmaceuticals (e.g., metformin and artemisinin), dietary supplements/extracts from medicinal plants (e.g., berberine, N-acetyl-L-cysteine, and ginsenoside Rg1) and endogenous agents (e.g., ATP, TNF-α). The paper assesses mechanistic foundations of the hDPSCs hormetic dose responses for both cell proliferation and cell differentiation, study design considerations, and therapeutic implications.

Disinfectant-induced hormesis: An unknown environmental threat of the application of disinfectants to prevent SARS-CoV-2 infection during the COVID-19 pandemic?

Massive additional quantities of disinfectants have been applied during the COVID-19 pandemic as infection preventive and control measures. While the application of disinfectants plays a key role in preventing the spread of SARS-CoV-2 infection, the effects of disinfectants applied during the ongoing pandemic on non-target organisms remain unknown. Here we collated evidence from multiple studies showing that chemicals used for major disinfectant products can induce hormesis in various organisms, such as plants, animal cells, and microorganisms, when applied singly or in mixtures, suggesting potential ecological risks at sub-threshold doses that are normally considered safe. Among other effects, sub-threshold doses of disinfectant chemicals can enhance the proliferation and pathogenicity of pathogenic microbes, enhancing the development and spread of drug resistance. We opine that hormesis should be considered when evaluating the effects and risks of such disinfectants, especially since the linear-no-threshold (LNT) and threshold dose-response models cannot identify or predict their effects.

Hormesis and embryonic stem cells

This paper provides an identification and detailed assessment of hormetic dose responses of embryonic stem cells (ESCs) with particular emphasis on cell renewal (proliferation) and differentiation, underlying mechanistic foundations and potential therapeutic implications. Hormetic dose responses were commonly reported, being induced by a broad range of chemicals, including pharmaceuticals (e.g., atorvastatin, isoproterenol, lithium, nicotine, ouabain), dietary supplements (e.g., curcumin, multiple ginsenosides, resveratrol), endogenous agents (e.g., estrogen, hydrogen peroxide, melatonin), and physical stressor agents (e.g., hypoxia, ionizing radiation). ESC-hormetic dose responses are similar for other stem cell types (e.g., adipose-derived stem cells, apical papilla, bone marrow stem cells, dental pulp stem cells, endothelial stem cells, muscle stem cells, periodontal ligament stem cells, neural stem cells), indicating a high degree of generality for the hormetic-stem cells response. The widespread occurrence of hormetic dose responses shown by ESCs and other stem cells suggests that the hormetic dose response may represent a fundamental and highly conserved evolutionary strategy.

Hormetic dose responses induced by antibiotics in bacteria: A phantom menace to be thoroughly evaluated to address the environmental risk and tackle the antibiotic resistance phenomenon

The environmental contamination of antibiotics caused by their over or inappropriate use is a major issue for environmental and human health since it can adversely impact the ecosystems and promote the antimicrobial resistance. Indeed, considering that in the environmental matrices these drugs are present at low levels, the possibility that bacteria exhibit a hormetic response to increase their resilience when exposed to antibiotic subinhibitory concentrations might represent a serious threat. Information reported in this review showed that exposure to different types of antibiotics, either administered individually or in mixtures, is capable of exerting hormetic effects on bacteria at environmentally relevant concentrations. These responses have been reported regardless of the type of bacterium or antibiotic, thus suggesting that hormesis would be a generalized adaptive mechanism implemented by bacteria to strengthen their resistance to antibiotics. Hormetic effects included growth, bioluminescence and motility of bacteria, their ability to produce biofilm, but also the frequency of mutation and plasmid conjugative transfer. The evaluation of quantitative features of antibiotic-induced hormesis showed that these responses have both maximum stimulation and dose width characteristics similar to those already reported in the literature for other stressors. Notably, mixtures comprising individual antibiotic inducing stimulatory responses might have distinct combined effects based on antagonistic, synergistic or additive interactions between components. Regarding the molecular mechanisms of action underlying the aforementioned effects, we put forward the hypothesis that the adoption of adaptive/defensive responses would be driven by the ability of antibiotic low doses to modulate the transcriptional activity of bacteria. Overall, our findings suggest that hormesis plays a pivotal role in affecting the bacterial behavior in order to acquire a survival advantage. Therefore, a proactive and effective risk assessment should necessarily take due account of the hormesis concept to adequately evaluate the risks to ecosystems and human health posed by antibiotic environmental contamination.

Brain health promotion: Tactics within a strategic approach based upon valid, yet evolving scientific evidence

There is growing interest in finding ways to enhance longevity and the quality of life. This paper summarizes a vast scientific literature over the past two decades that has suggested approaches to enhancing biological resilience - and particularly neurological function - via hormetic and preconditioning processes. The employment of hormesis and preconditioning has been shown to protect biological systems from many of the effects of aging, both by sustaining structural and functional integrity, and by affording relative protection against certain types of diseases. The paper confronts the challenges - and opportunities - for society when considering possible practical use of evolving evidence about the mechanisms, processes and effects of these biological phenomena.

Tradeoffs of chemicals regulation - The science and tacit knowledge of decisions

In this paper, we want to shed light on the tradeoffs of chemicals regulation. We will discuss two types of tradeoffs: the social-economic impacts of regulation such as cost-induced fatalities and the tradeoffs between 'old' and 'new' chemicals, that is the established chemicals in industry and society deemed in need of replacement with 'new' chemicals. We will show that the progression from the science of chemicals risk assessment to regulation requires the science of regulatory (economic) analyses, with added insight from the philosophy of science. Indeed, risk assessment as such, which is significantly driven but is not limited to the broad toxicological context, does not unescapably dictate regulatory choices. The science of regulatory and economic analyses, we believe, could add considerably to the science of toxicology in a combined effort to improve upon the protection of public health and the environment.

Metformin-enhances resilience via hormesis

The present paper demonstrates that metformin (MF) induced a broad spectrum of hormetic biphasic dose responses in a wide range of experimental studies, affecting multiple organ systems, cell types, and endpoints enhancing resilience to chemical stresses in preconditioning and co-current exposure protocols. Detailed mechanistic evaluations indicate that MF-induced hormetic-adaptive responses are mediated often via the activation of adenosine monophosphate-activated kinase (AMPK) protein and its subsequent upregulation of nuclear factor erythroid 2-related factor 2 (Nrf2). Hormesis-induced protective responses by MF are largely mediated via a vast and highly integrated anti-inflammatory molecular network that enhances longevity and delays the onset and slows the progression of neurodegenerative and other chronic diseases.

A gift from parent to offspring: transgenerational hormesis

Hormesis is a biological phenomenon characterized by opposite effects between low and high doses of stresses that can result in stimulatory and adaptive benefits to individuals within a population. While evidence of hormesis is well established, two recent studies (Nogueira et al., Belz and Sinkkonen) suggest that hormesis can also offer transgenerational benefit.

Hormesis and bone marrow stem cells: Enhancing cell proliferation, differentiation and resilience to inflammatory stress

This paper identifies and provides the first detailed assessment of hormetic dose responses by bone marrow stem cells (BMSCs) from a broad range of animal models and humans with particular emphasis on cell renewal (proliferation), cell differentiation and enhancing resilience to inflammatory stress. Such hormetic dose responses are commonly reported, being induced by a broad range of chemicals, including pharmaceuticals (e.g., caffeine, dexamethasone, nicotine), dietary supplements (e.g., curcumin, Ginkgo biloba, green tea extracts. resveratrol, sulforaphane), endogenous agents (e.g., hydrogen sulfide, interleukin 10), environmental contaminants (e.g., arsenic, PFOS) and physical stressor agents (e.g., EMF, shockwaves). Hormetic dose responses reported here for BMSCs are similar to those induced with other stem cell types [e.g., adipose-derived stem cells (ADSCs), dental pulp stem cells (DPSCs), periodontal ligament stem cells (PDLSCs), neuro stem cells (NSCs), embryonic stem cells (ESCs)], indicating a substantial degree of generality for hormetic responses in stem cells. The paper assesses both the underlying mechanistic foundations of BMSC hormetic responses and their potential therapeutic implications.