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Silbermann E, Spain RI. Serum Neurofilament Light Chain for Multiple Sclerosis Relapses: Too Little Too Late? Neurology 2024; 102:e209456. [PMID: 38648605 DOI: 10.1212/wnl.0000000000209456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Affiliation(s)
- Elizabeth Silbermann
- From Oregon Health & Science University (E.S., R.I.S.); and VA Portland Health Care System (E.S., R.I.S.), Portland, OR
| | - Rebecca I Spain
- From Oregon Health & Science University (E.S., R.I.S.); and VA Portland Health Care System (E.S., R.I.S.), Portland, OR
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Bourdette D, Silbermann E. What Are the Risks of Guillain-Barré Syndrome After SARS-CoV-2 Infection and COVID-19 Vaccination? Neurology 2023; 101:875-876. [PMID: 37852787 DOI: 10.1212/wnl.0000000000207998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Dennis Bourdette
- From the Department of Neurology (D.B., E.S.), Oregon Health & Science University; and Department of Veterans Affair Medical Center (E.S.), Portland, OR.
| | - Elizabeth Silbermann
- From the Department of Neurology (D.B., E.S.), Oregon Health & Science University; and Department of Veterans Affair Medical Center (E.S.), Portland, OR
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Chase E, Chen V, Martin K, Lane M, Wooliscroft L, Adams C, Rice J, Silbermann E, Hollen C, Fryman A, Purnell JQ, Vong C, Orban A, Horgan A, Khan A, Srikanth P, Yadav V. A low-fat diet improves fatigue in multiple sclerosis: Results from a randomized controlled trial. Mult Scler 2023; 29:1659-1675. [PMID: 37941305 PMCID: PMC10655900 DOI: 10.1177/13524585231208330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND Fatigue can be a disabling multiple sclerosis (MS) symptom with no effective treatment options. OBJECTIVE Determine whether a low-fat diet improves fatigue in people with MS (PwMS). METHODS We conducted a 16-week randomized controlled trial (RCT) and allocated PwMS to a low-fat diet (active, total daily fat calories not exceeding 20%) or wait-list (control) group. Subjects underwent 2 weeks of baseline diet data collection (24-hour diet recalls (24HDRs)), followed by randomization. The active group received 2 weeks of nutrition counseling and underwent a 12-week low-fat diet intervention. One set of three 24HDRs at baseline and week 16 were collected. We administered a food frequency questionnaire (FFQ) and Modified Fatigue Impact Scale (MFIS) every 4 weeks. The control group continued their pre-study diet and received diet training during the study completion. RESULTS We recruited 39 PwMS (20-active; 19-control). The active group decreased their daily caloric intake by 11% (95% confidence interval (CI): -18.5%, -3.0%) and the mean MFIS by 4.0 (95% CI: -12.0, 4.0) compared to the control (intent-to-treat). Sensitivity analysis strengthened the association with a mean MFIS difference of -13.9 (95% CI: -20.7, -7.2). CONCLUSIONS We demonstrated a significant reduction in fatigue with a low-fat dietary intervention in PwMS.
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Affiliation(s)
- Emma Chase
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Vicky Chen
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Kayla Martin
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Michael Lane
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Lindsey Wooliscroft
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Claire Adams
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Jessica Rice
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Elizabeth Silbermann
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Christopher Hollen
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Allison Fryman
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
| | - Jonathan Q. Purnell
- Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
| | - Carly Vong
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Anna Orban
- Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Angela Horgan
- Oregon Clinical & Translational Research Institute, Portland, OR
| | - Akram Khan
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland, OR
| | - Priya Srikanth
- School of Public Health, Oregon Health & Science University-Portland State University Portland, OR
| | - Vijayshree Yadav
- Department of Neurology, Oregon Health & Science University, Portland, OR
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR
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Shangraw K, Murchison CF, Silbermann E, Spain RI. Effect of Vascular Comorbidity on Visual and Disability Outcomes in a Secondary Progressive Multiple Sclerosis Clinical Trial Cohort. Int J MS Care 2022; 24:169-174. [DOI: 10.7224/1537-2073.2021-049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
Background:
Vascular comorbidity (VC) is associated with multiple sclerosis (MS) disease progression and visual dysfunction. The longitudinal effect of VC in people with secondary progressive MS (SPMS) is unclear. This study explored the impact of VC on standard clinical, MRI, and visual outcomes in people with SPMS enrolled in a clinical trial.
Methods:
Data were extracted from a 2-year randomized controlled trial (N = 51) testing the supplement lipoic acid in people with SPMS who underwent annual Expanded Disability Status Scale, Timed 25-Foot Walk test, MRI, visual acuity testing, and retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layer (GCIPL) thicknesses per optical coherence tomography (OCT). Post hoc linear mixed-effects regression analysis compared baseline and annualized outcomes between participants without VC (VC–) and with 1 or more VCs (VC+) (hypertension, dyslipidemia, obesity, diabetes, peripheral or cardiovascular disease, tobacco use).
Results:
The VC– (n = 19) and VC+ (n = 28) participants were similar in age, sex, and MS disease duration and had comparable MS disability, mobility, and brain atrophy at baseline and throughout the 2-year parent study. The VC+ participants had worse baseline visual acuity than those in the VC– group by 0.13 logMAR (P = .041). No significant differences were detected in RNFL or GCIPL baseline thickness or atrophy between groups.
Conclusions:
In an SPMS cohort, VC had an inconsistent effect on standard clinical, MRI, and exploratory OCT outcomes, suggesting that the effect of VC may not be evident in smaller cohort studies. Using a more refined definition of VC in future, adequately powered investigations may help effectively elucidate and account for the interaction between vascular risk burden and MS disability.
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Affiliation(s)
- Kathleen Shangraw
- From the Department of Neurology, Oregon Health & Science University, Portland, OR, USA (KS, ES, RIS)
| | - Charles F. Murchison
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (CFM)
| | - Elizabeth Silbermann
- From the Department of Neurology, Oregon Health & Science University, Portland, OR, USA (KS, ES, RIS)
| | - Rebecca I. Spain
- From the Department of Neurology, Oregon Health & Science University, Portland, OR, USA (KS, ES, RIS)
- Department of Neurology, Veterans Affairs Portland Health Care System, Portland, OR, USA (RIS)
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Merino JG, Ciccarelli O, Worrall BB, Amato AA, Burch R, Clardy SL, Hedera P, Hershey LA, Jobst BC, Shellhaas RA, Silbermann E, Strowd RE, Tarawneh R. Message From the Editors to Our Reviewers. Neurology 2022. [DOI: 10.1212/wnl.0000000000013044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Rice J, Hildebrand A, Spain R, Senders A, Silbermann E, Wooliscroft L, Yadav V, Bourdette D, Cameron M. A cross-sectional survey of cannabis use by people with MS in Oregon and Southwest Washington. Mult Scler Relat Disord 2021; 55:103172. [PMID: 34332457 DOI: 10.1016/j.msard.2021.103172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Evidence supports that cannabinoids reduce self-reported spasticity and neuropathic pain in people with MS (PwMS), and legal access to cannabis for medical and recreational use continues to rise. However, there are limited data regarding patterns of cannabis use and perceived benefits of cannabis among PwMS in the US. This study describes the prevalence of cannabis use, routes of administration, perceived benefit of cannabis for MS, and characteristics associated with cannabis use and perception of benefit among a population of PwMS living in two states where cannabis is legal for both medical and recreational use. METHODS A survey about treatments used by PwMS, focusing on complementary and alternative medicine (CAM), was sent to PwMS living in Oregon and Southwest Washington. This survey included questions about current and past cannabis use, route of cannabis administration, and perceived benefits, as well as personal demographics. RESULTS Of the 1188 returned surveys, 1000 had at least 75% complete survey responses and also completed the questions about current and past cannabis use. Thirty percent (n=303) of respondents reported currently using cannabis, 21% (n=210) used in the past but not currently, and 49% (n=487) had never used cannabis. Among current users, rates of use by smoking, vaping, topicals, tinctures and oils, or edibles were similar (35-46%), and most (59%) reported using multiple routes of administration. Most (64-78%, varying by route) current and past users reported cannabis being very or somewhat beneficial for their MS. The odds of current cannabis use were higher in PwMS who: 1) were younger (OR 2.24 [95% CI 1.39-3.61] for those age 18-40 compared with age >60]; 2) had lower household income (OR 3.94 [95% CI 2.55-6.09] with annual income <$25k compared with those with >$100k); 3) had secondary progressive MS (OR 1.77 [95% CI 1.07-2.92]); and 4) had more than minimal MS disability (OR 2.05 [95% CI 1.03-4.10] for those using a walker compared to those with none/minimal disability). The odds of perceiving cannabis as beneficial for MS were higher in: 1) younger individuals (OR 5.61 [95% CI 2.62-11.98] for those age 18-40 compared with age >60); 2) those with lower household income (OR 3.35 [95% CI 1.65-6.80] with annual income <$25k compared with those with >$100k), 3) those not currently using disease modifying therapies (OR 2.32 [95% CI 1.30-4.13]), and 4) those with the greatest disability (OR 17.96; [95% CI 2.00-161.22]). CONCLUSION In this survey, 30% of PwMS reported currently using cannabis for their MS, mostly by multiple routes of administration, and most of these people report this being helpful for their MS. People who were younger, had lower household income, had progressive disease, and had more than minimal disability were more likely to use cannabis and report it was beneficial for their MS. People who were not using disease modifying therapies were also more likely to report benefit from cannabis use.
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Affiliation(s)
- Jessica Rice
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA.
| | - Andrea Hildebrand
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Rebecca Spain
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Angela Senders
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Elizabeth Silbermann
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Lindsey Wooliscroft
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Vijayshree Yadav
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Dennis Bourdette
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Michelle Cameron
- Department of Neurology Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA; Department of Neurology, Portland VA Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
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Aravamuthan B, Landsness EC, Silbermann E. ANA Webinars: implementation of a conference-based virtual networking event. Ann Clin Transl Neurol 2020; 8:525-528. [PMID: 33352002 PMCID: PMC7886028 DOI: 10.1002/acn3.51278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To describe the design and implementation of a virtual network event at the American Neurological Association (ANA) annual meeting led by the Junior and Early Career Member (JECM) Committee. METHODS We designed a one-hour virtual networking session featuring three 15-minute small group meetings preceded and followed by general remarks. Each small group session consisted of one senior mentor, a junior/early career faculty moderator, and three to four junior/early career mentees. All participants completed an exit survey to evaluate perceived benefit of this event. RESULTS We recruited 103 mentees, 26 moderators, and 26 mentors for the event. Mentees were primarily at the resident training level or above (17% students). 56% of registered mentees, 100% of moderators and 96% of mentors attended the event for a total of 110 participants. Due to mentee attrition, each room contained 2-3 mentees. 90% of respondents felt the session met their goals very well or extremely well. Further, 99% felt this session was at least comparable to in-person networking at conferences and 60% felt this session was better than in-person networking. INTERPRETATION Virtual networking sessions between junior and senior academic neurologists are feasible and are at least comparable to, if not better than, in-person conference networking. Future events should consider nuanced mechanisms of matching mentors and mentees, inclusion of ad hoc small groups to foster organic networking, and measures to safeguard against mentee attrition. Future studies should evaluate the long-term benefits of this event to determine if virtual networking should be utilized moving forward.
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Affiliation(s)
- Bhooma Aravamuthan
- Department of Neurology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Eric C Landsness
- Department of Neurology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - Elizabeth Silbermann
- Department of Neurology, VA Portland Health Care System, Portland, Oregon, USA.,Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
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Wooliscroft L, Boespflug E, Hildebrand A, Shangraw K, Silbermann E, Bourdette D, Spain R. Enlarged perivascular spaces are not associated with vascular co-morbidities, clinical outcomes, and brain volumes in people with secondary progressive multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6:2055217320964502. [PMID: 33110618 PMCID: PMC7557790 DOI: 10.1177/2055217320964502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/15/2020] [Indexed: 11/27/2022] Open
Abstract
In secondary progressive multiple sclerosis (SPMS) significance of enlarged perivascular spaces (ePVS) is unknown. Objectives, Methods: Analysis of associations between vascular co-morbidities, clinical outcomes, and volumetrics with categorical ePVS scores in midbrain, basal ganglia (BG), and centrum semiovale (CSO) in SPMS(n-46). Results, Conclusion: In BG, advancing age (Z = 2.68) and lower Expanded Disability Status Scale (Z = −2.04) were associated with increasing ePVS score. In CSO, advancing age (Z = 2.66) and male gender (Z = 2.45) were associated with increasing ePVS score. No associations between ePVS score and vascular co-morbidities or volumetrics existed; ePVS may not be an informative marker for SPMS.
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Affiliation(s)
| | - Erin Boespflug
- Neurology, Oregon Health & Science University, Portland, OR, USA
| | | | - Kathleen Shangraw
- Neurology, Oregon Health & Science University, Portland, OR, USA.,Neurology, Veterans Affairs Portland Health Care System, Portland, OR, USA
| | | | - Dennis Bourdette
- Neurology, Oregon Health & Science University, Portland, OR, USA.,Neurology, Veterans Affairs Portland Health Care System, Portland, OR, USA
| | - Rebecca Spain
- Neurology, Oregon Health & Science University, Portland, OR, USA.,Neurology, Veterans Affairs Portland Health Care System, Portland, OR, USA
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Wooliscroft L, Brown D, Cohen J, Skolarus L, Silbermann E. Continuing Clinical Research During Shelter-in-Place. Ann Neurol 2020; 88:658-660. [PMID: 32621372 PMCID: PMC7361568 DOI: 10.1002/ana.25840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Lindsey Wooliscroft
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA.,Department of Neurology, VA Portland Health Care System, Portland, OR, USA
| | - Devin Brown
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Jeffrey Cohen
- Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
| | - Lesli Skolarus
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Elizabeth Silbermann
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA.,Department of Neurology, VA Portland Health Care System, Portland, OR, USA
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Clark G, Silbermann E, Seals S, Thiessen J, Nesbit G, Yadav V, Wooliscroft L. Spinal adhesive arachnoiditis mimicking sarcoid myelitis with nodular dural enhancement: A case report. Mult Scler Relat Disord 2020; 44:102257. [PMID: 32535503 DOI: 10.1016/j.msard.2020.102257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 01/30/2023]
Abstract
Spinal adhesive arachnoiditis (SAA) is a rare, but often devastating, cause of compressive myelopathy. We report a patient with SAA resulting in a longitudinally extensive T2-hyperintense spinal cord lesion with initial nodular pial and dural enhancement mimicking neurosarcoidosis. Neurologists should be aware of this entity, especially in patients who have pertinent risk factors, such as prior meningitis, spinal cord trauma, or surgery.
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Affiliation(s)
- Grace Clark
- School of Medicine, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Elizabeth Silbermann
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; VA Portland Health Care System, Portland, OR, USA
| | - Shannon Seals
- Department of Neurology, Ochsner Medical Center, New Orleans, LA, USA
| | - Jaclyn Thiessen
- Department of Neuroradiology, Oregon Health & Science University, Portland, OR, USA
| | - Gary Nesbit
- Dotter Department of Interventional Radiology, Oregon Health & Science University, Portland, OR, USA
| | - Vijayshree Yadav
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; VA Portland Health Care System, Portland, OR, USA
| | - Lindsey Wooliscroft
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA; VA Portland Health Care System, Portland, OR, USA.
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Affiliation(s)
- Elizabeth Silbermann
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Dennis Bourdette
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA.
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Wooliscroft L, Silbermann E, Cameron M, Bourdette D. Approaches to Remyelination Therapies in Multiple Sclerosis. Curr Treat Options Neurol 2019; 21:34. [DOI: 10.1007/s11940-019-0574-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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13
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Zabala V, Silbermann E, Re E, Andreani T, Tong M, Ramirez T, Gundogan F, de la Monte SM. Potential Co-Factor Role of Tobacco Specific Nitrosamine Exposures in the Pathogenesis of Fetal Alcohol Spectrum Disorder. ACTA ACUST UNITED AC 2016; 2:112-125. [PMID: 28845454 PMCID: PMC5570438 DOI: 10.17140/goroj-2-125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Cerebellar developmental abnormalities in Fetal Alcohol Spectrum Disorder (FASD) are linked to impairments in insulin signaling. However, co-morbid alcohol and tobacco abuses during pregnancy are common. Since smoking leads to tobacco specific Nitrosamine (NNK) exposures which have been shown to cause brain insulin resistance, we hypothesized that neurodevelopmental abnormalities in FASD could be mediated by ethanol and/or NNK. Methods Long Evans rat pups were intraperitoneal (IP) administered ethanol (2 g/kg) on postnatal days (P) 2, 4, 6 and/or NNK (2 mg/kg) on P3, P5, and P7 to simulate third trimester human exposures. The Cerebellar function, histology, insulin and Insulin-like Growth Factor (IGF) signaling, and neuroglial protein expression were assessed. Results Ethanol, NNK and ethanol+NNK groups had significant impairments in motor function (rotarod tests), abnormalities in cerebellar structure (Purkinje cell loss, simplification and irregularity of folia, and altered white matter), signaling through the insulin and IGF-1 receptors, IRS-1, Akt and GSK-3β, and reduced expression of several important neuroglial proteins. Despite similar functional effects, the mechanisms and severity of NNK and ethanol+NNK induced alterations in cerebellar protein expression differed from those of ethanol. Conclusions Ethanol and NNK exert independent but overlapping adverse effects on cerebellar development, function, insulin signaling through cell survival, plasticity, metabolic pathways, and neuroglial protein expression. The results support the hypothesis that tobacco smoke exposure can serve as a co-factor mediating long-term effects on brain structure and function in FASD.
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Affiliation(s)
- Valerie Zabala
- Molecular Pharmacology and Physiology Graduate Program, Brown University, Providence, RI, USA
| | | | - Edward Re
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Tomas Andreani
- Graduate Program in Neuroscience, Northwestern University, Chicago, IL, USA
| | - Ming Tong
- Liver Research Center, Division of Gastroenterology and Department of Medicine, Rhode Island Hospital and the Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Fusun Gundogan
- Department of Pathology, Women and Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI, USA
| | - Suzanne M de la Monte
- Departments of Neurology, Neurosurgery, and Pathology, Rhode Island Hospital and the Alpert Medical School of Brown University, Providence, RI, USA
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Andreani T, Tong M, Gundogan F, Silbermann E, de la Monte SM. Differential Effects of 3rd Trimester-Equivalent Binge Ethanol and Tobacco-Specific Nitrosamine Ketone Exposures on Brain Insulin Signaling in Adolescence. J Diabetes Relat Disord 2016; 1:105. [PMID: 29242853 PMCID: PMC5726776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is associated with impairments in insulin and insulin-like growth factor (IGF) signaling through Akt pathways and altered expression of neuro-glial proteins needed for structural and functional integrity of the brain. However, alcohol abuse correlates with smoking, and tobacco smoke contains 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), which like other nitrosamines, impairs insulin and IGF signaling. HYPOTHESIS NNK exposure can serve as a co-factor in mediating long-term neuro-developmental abnormalities associated with FASD. DESIGN Long Evans rat pups were IP administered ethanol (2 g/kg) on postnatal days (P) 2, 4, 6 and/or NNK (2 mg/kg) on P3, P5, and P7, simulating third trimester human exposures. Temporal lobes from P30 rats (young adolescent) were used to measure signaling through the insulin/IGF-1/Akt pathways by multiplex ELISAs, and expression of neuroglial proteins by duplex ELISAs. RESULTS Ethanol, NNK, and ethanol + NNK exposures significantly inhibited insulin receptor tyrosine phosphorylation, and IRS-1 and myelin-associated glycoprotein expression. However, the major long-term adverse effects on Akt pathway downstream signaling and its targeted proteins including choline acetyltransferase, Tau, pTau, ubiquitin, and aspartate-β-hydroxylase were due to NNK rather than ethanol. CONCLUSION Alcohol and tobacco exposures can both contribute to long-term brain abnormalities currently regarded fetal ethanol effects. However, the findings suggest that many of the adverse effects on brain function are attributable to smoking, including impairments in signaling through survival and metabolic pathways, and altered expression of genes that regulate myelin synthesis, maturation and integrity and synaptic plasticity. Therefore, public health measures should address both substances of abuse to prevent "FASD".
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Affiliation(s)
- Tomas Andreani
- Department of Medicine, Division of Gastroenterology, and the Liver
Research Center Rhode Island Hospital, Providence, RI, USA
| | - Ming Tong
- Department of Medicine, Division of Gastroenterology, and the Liver
Research Center Rhode Island Hospital, Providence, RI, USA,Warren Alpert Medical School of Brown University, Providence, RI,
USA
| | - Fusun Gundogan
- Department of Pathology, Women and Infants Hospital of Rhode Island,
Providence, RI, USA,Warren Alpert Medical School of Brown University, Providence, RI,
USA
| | | | - Suzanne M. de la Monte
- Department of Medicine, Division of Gastroenterology, and the Liver
Research Center Rhode Island Hospital, Providence, RI, USA,Departments of Pathology and Neurology, and the Division of
Neuropathology, Rhode Island Hospital, Providence, RI, USA,Warren Alpert Medical School of Brown University, Providence, RI,
USA,Corresponding author: Suzanne M. de la Monte, Pierre
Galletti Research Building, Rhode Island Hospital, 55 Claverick Street, Room
419, Providence, RI 02903. Tel: 401-444-7364; Fax: 401-444-2939;
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Tong M, Yu R, Silbermann E, Zabala V, Deochand C, de la Monte SM. Differential Contributions of Alcohol and Nicotine-Derived Nitrosamine Ketone (NNK) to White Matter Pathology in the Adolescent Rat Brain. Alcohol Alcohol 2015; 50:680-9. [PMID: 26373813 DOI: 10.1093/alcalc/agv102] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 08/17/2015] [Indexed: 12/30/2022] Open
Abstract
AIM Epidemiologic studies have demonstrated high rates of smoking among alcoholics, and neuroimaging studies have detected white matter atrophy and degeneration in both smokers and individuals with alcohol-related brain disease (ARBD). These findings suggest that tobacco smoke exposure may be a co-factor in ARBD. The present study examines the differential and additive effects of tobacco-specific nitrosamine (NNK) and ethanol exposures on the structural and functional integrity of white matter in an experimental model. METHODS Adolescent Long Evans rats were fed liquid diets containing 0 or 26% ethanol for 8 weeks. In weeks 3-8, rats were treated with nicotine-derived nitrosamine ketone (NNK) (2 mg/kg, 3×/week) or saline by i.p. injection. In weeks 7-8, the ethanol group was binge-administered ethanol (2 g/kg; 3×/week). RESULTS Ethanol, NNK and ethanol + NNK caused striking degenerative abnormalities in white matter myelin and axons, with accompanying reductions in myelin-associated glycoprotein expression. Quantitative RT-PCR targeted array and heatmap analyses demonstrated that ethanol modestly increased, whereas ethanol + NNK sharply increased expression of immature and mature oligodendroglial genes, and that NNK increased immature but inhibited mature oligodendroglial genes. In addition, NNK modulated expression of neuroglial genes in favor of growth cone collapse and synaptic disconnection. Ethanol- and NNK-associated increases in FOXO1, FOXO4 and NKX2-2 transcription factor gene expression could reflect compensatory responses to brain insulin resistance in this model. CONCLUSION Alcohol and tobacco exposures promote ARBD by impairing myelin synthesis, maturation and integrity via distinct but overlapping mechanisms. Public health measures to reduce ARBD should target both alcohol and tobacco abuses.
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Affiliation(s)
- Ming Tong
- Department of Medicine, Division of Gastroenterology, and the Liver Research Center, Rhode Island Hospital, Providence, RI, USA Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Rosa Yu
- Departments of Pathology and Neurology, and the Division of Neuropathology, Rhode Island Hospital, Providence, RI, USA
| | | | - Valerie Zabala
- Molecular Pharmacology and Physiology Graduate Program, Brown University, Providence, RI, USA
| | - Chetram Deochand
- Biotechnology Graduate Program, Brown University, Providence, RI, USA
| | - Suzanne M de la Monte
- Department of Medicine, Division of Gastroenterology, and the Liver Research Center, Rhode Island Hospital, Providence, RI, USA Warren Alpert Medical School of Brown University, Providence, RI, USA Departments of Pathology and Neurology, and the Division of Neuropathology, Rhode Island Hospital, Providence, RI, USA
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Robinson JM, Jakobowicz R, Williams L, Moore F, Silbermann E. Passage of doetal cells into the maternal circulation in Rh negative women. Bibl Haematol 2015; 29:274-9. [PMID: 4973599 DOI: 10.1159/000384618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Zabala V, Tong M, Yu R, Ramirez T, Yalcin EB, Balbo S, Silbermann E, Deochand C, Nunez K, Hecht S, de la Monte SM. Potential contributions of the tobacco nicotine-derived nitrosamine ketone (NNK) in the pathogenesis of steatohepatitis in a chronic plus binge rat model of alcoholic liver disease. Alcohol Alcohol 2015; 50:118-31. [PMID: 25618784 DOI: 10.1093/alcalc/agu083] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIMS Alcoholic liver disease (ALD) is linked to binge drinking and cigarette smoking. Heavy chronic ± binge alcohol, or low-level exposures to dietary nitrosamines cause steatohepatitis with insulin resistance and oxidative stress in animal models. This study examines hepatotoxic effects of sub-mutagenic exposures to tobacco-specific nitrosamine (NNK) in relation to ALD. METHODS Long Evans rats were fed liquid diets containing 0 or 26% (caloric) ethanol (EtOH) for 8 weeks. In Weeks 3 through 8, rats were treated with NNK (2 mg/kg) or saline by i.p. injection, 3×/week, and in Weeks 7 and 8, EtOH-fed rats were binge-administered 2 g/kg EtOH 3×/week; controls were given saline. RESULTS EtOH ± NNK caused steatohepatitis with necrosis, disruption of the hepatic cord architecture, ballooning degeneration, early fibrosis, mitochondrial cytopathy and ER disruption. Severity of lesions was highest in the EtOH+NNK group. EtOH and NNK inhibited insulin/IGF signaling through Akt and activated pro-inflammatory cytokines, while EtOH promoted lipid peroxidation, and NNK increased apoptosis. O(6)-methyl-Guanine adducts were only detected in NNK-exposed livers. CONCLUSION Both alcohol and NNK exposures contribute to ALD pathogenesis, including insulin/IGF resistance and inflammation. The differential effects of EtOH and NNK on adduct formation are critical to ALD progression among alcoholics who smoke.
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Affiliation(s)
- Valerie Zabala
- Department of Medicine, Division of Gastroenterology, and The Liver Research Center, Rhode Island Hospital, Providence, RI, USA Department of Molecular Pharmacology and Physiology, Brown University, Providence, RI, USA
| | - Ming Tong
- Department of Medicine, Division of Gastroenterology, and The Liver Research Center, Rhode Island Hospital, Providence, RI, USA Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Rosa Yu
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Teresa Ramirez
- Department of Molecular Pharmacology and Physiology, Brown University, Providence, RI, USA
| | - Emine B Yalcin
- Department of Medicine, Division of Gastroenterology, and The Liver Research Center, Rhode Island Hospital, Providence, RI, USA Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Silvia Balbo
- Masonic Cancer Center, University of Minnesota, Cancer and Cardiovascular Research Building, 2231 6th Street SE, Minneapolis, MN 55455, USA
| | | | - Chetram Deochand
- Biotechnology Graduate Program, Brown University, Providence, RI, USA
| | - Kavin Nunez
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Stephen Hecht
- Masonic Cancer Center, University of Minnesota, Cancer and Cardiovascular Research Building, 2231 6th Street SE, Minneapolis, MN 55455, USA
| | - Suzanne M de la Monte
- Department of Medicine, Division of Gastroenterology, and The Liver Research Center, Rhode Island Hospital, Providence, RI, USA Warren Alpert Medical School of Brown University, Providence, RI, USA Departments of Pathology and Neurology, and the Division of Neuropathology, Rhode Island Hospital, Providence, RI, USA
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Mellion ML, Silbermann E, Gilchrist JM, Machan JT, Leggio L, de la Monte S. Small-fiber degeneration in alcohol-related peripheral neuropathy. Alcohol Clin Exp Res 2014; 38:1965-72. [PMID: 24961481 DOI: 10.1111/acer.12470] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/10/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Alcohol-related peripheral neuropathy (ALN) is generally characterized as an axonal large-fiber polyneuropathy caused by thiamine deficiency. We hypothesized, based on clinical observations, that ALN is associated with a small-fiber polyneuropathy that can be diagnosed with skin biopsy in heavy alcohol drinking subjects with normal thiamine status. METHODS Eighteen individuals (9 heavy alcohol drinking subjects and 9 healthy control subjects) were assessed for the potential utility of skin biopsies in detecting ALN-associated small nerve fiber degeneration. Heavy drinking was defined as greater than 4 drinks/d and 5 drinks/d in women and men, respectively, as determined by the Timeline Follow-Back and lifetime drinking history. All subjects underwent neurological examination, nerve conduction studies, and skin biopsies to quantify end nerve fiber densities (ENFD). Other causes of neuropathy were excluded and thiamine status was assessed. RESULTS Average ENFD were significantly decreased at the calf in the alcohol group as compared with control group (p < 0.0001). Histological sections demonstrated striking attrition and architectural simplification of intraepidermal nerve fibers in the heavy alcohol drinking subjects. There were no significant intergroup differences with respect to clinical assessments of neuropathy or thiamine status. CONCLUSIONS ALN is associated with a small-fiber neuropathy that can be detected with skin biopsy in heavy alcohol drinking individuals with normal thiamine status. Skin biopsy is a useful, minimally invasive biomarker that could extend studies to understand the effect of alcohol on the peripheral nerves and to evaluate potential therapeutic agents in larger clinical trials.
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Affiliation(s)
- Michelle L Mellion
- Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
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Silbermann E, Moskal P, Bowling N, Tong M, de la Monte SM. Role of aspartyl-(asparaginyl)-β-hydroxylase mediated notch signaling in cerebellar development and function. Behav Brain Funct 2010; 6:68. [PMID: 21050474 PMCID: PMC2988696 DOI: 10.1186/1744-9081-6-68] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 11/04/2010] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Aspartyl-(Asparaginyl)-β-Hydroxylase (AAH) is a hydroxylating enzyme that promotes cell motility by enhancing Notch-Jagged-HES-1 signaling. Ethanol impaired cerebellar neuron migration during development is associated with reduced expression of AAH. METHODS To further characterize the role of AAH in relation to cerebellar development, structure, and function, we utilized an in vivo model of early postnatal (P2) intracerebro-ventricular gene delivery to silence AAH with small interfering RNA (siAAH), or over-express it with recombinant plasmid DNA (pAAH). On P20, we assessed cerebellar motor function by rotarod testing. Cerebella harvested on P21 were used to measure AAH, genes/proteins that mediate AAH's downstream signaling, i.e. Notch-1, Jagged-1, and HES-1, and immunoreactivity corresponding to neuronal and glial elements. RESULTS The findings demonstrated that: 1) siAAH transfection impaired motor performance and blunted cerebellar foliation, and decreased expression of neuronal and glial specific genes; 2) pAAH transfection enhanced motor performance and increased expression of neuronal and glial cytoskeletal proteins; and 3) alterations in AAH expression produced similar shifts in Notch-1, Jagged-1, and HES-1 protein or gene expression. CONCLUSIONS The results support our hypothesis that AAH is an important mediator of cerebellar development and function, and link AAH expression to Notch signaling pathways in the developing brain.
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Lyn-Cook LE, Lawton M, Tong M, Silbermann E, Longato L, Jiao P, Mark P, Wands JR, Xu H, de la Monte SM. Hepatic ceramide may mediate brain insulin resistance and neurodegeneration in type 2 diabetes and non-alcoholic steatohepatitis. J Alzheimers Dis 2009; 16:715-29. [PMID: 19387108 DOI: 10.3233/jad-2009-0984] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Obesity, type 2 diabetes mellitus (T2DM), and non-alcoholic steatohepatitis (NASH) can be complicated by cognitive impairment and neurodegeneration. Experimentally, high fat diet (HFD)-induced obesity with T2DM causes mild neurodegeneration with brain insulin resistance. Since ceramides are neurotoxic, cause insulin resistance, and are increased in T2DM, we investigated the potential role of ceramides as mediators of neurodegeneration in the HFD obesity/T2DM model. We pair-fed C57BL/6 mice with a HFD or control diet for 4-20 weeks and examined pro-ceramide gene expression in liver and brain and neurodegeneration in the temporal lobe. HFD feeding gradually increased body weight, but after 16 weeks, liver weight surged (P<0.001) due to lipid (triglyceride) accumulation (P<0.001), and brain weight declined (P<0.0001-Trend analysis). HFD feeding increased ceramide synthase, serine palmitoyl transferase, and sphingomyelinase expression in liver (P<0.05-P<0.001), but not brain. In HFD fed mice, temporal lobe levels of ubiquitin (P<0.001) and 4-hydroxynonenal (P<0.05 or P<0.01) increased, and tau, beta-actin, and choline acetyltransferase levels decreased (P<0.05-P<0.001) with development of NASH. In obesity, T2DM, or NASH, neurodegeneration with brain insulin resistance may be mediated by excess hepatic production of neurotoxic ceramides that readily cross the blood-brain barrier.
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Affiliation(s)
- Lascelles E Lyn-Cook
- Department of Medicine, Division of Gastroenterology, and the Liver Research Center, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
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Carter JJ, Tong M, Silbermann E, Lahousse SA, Ding FF, Longato L, Roper N, Wands JR, de la Monte SM. Ethanol impaired neuronal migration is associated with reduced aspartyl-asparaginyl-beta-hydroxylase expression. Acta Neuropathol 2008; 116:303-15. [PMID: 18478238 PMCID: PMC10010160 DOI: 10.1007/s00401-008-0377-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2007] [Revised: 03/24/2008] [Accepted: 04/05/2008] [Indexed: 01/30/2023]
Abstract
Cerebellar hypoplasia in fetal alcohol spectrum disorders (FASD) is associated with inhibition of insulin and insulin-like growth factor (IGF) signaling in the brain. Aspartyl (asparaginyl)-beta-hydroxylase (AAH) is a mediator of neuronal motility, and stimulated by insulin and IGF activation of PI3 kinase-Akt, or inhibition of GSK-3beta. Since ethanol inhibits PI3 Kinase-Akt and increases GSK-3beta activity in brain, we examined the effects of ethanol and GSK-3beta on AAH expression and directional motility in neuronal cells. Control and ethanol-exposed (100 mM x 48 h) human PNET2 cerebellar neuronal cells were stimulated with IGF-1 and used to measure AAH expression and directional motility. Molecular and biochemical approaches were used to characterize GSK-3beta regulation of AAH and neuronal motility. Ethanol reduced IGF-1 stimulated AAH protein expression and directional motility without inhibiting AAH's mRNA. Further analysis revealed that: (1) AAH protein could be phosphorylated by GSK-3beta; (2) high levels of GSK-3beta activity decreased AAH protein; (3) inhibition of GSK-3beta and/or global Caspases increased AAH protein; (4) AAH protein was relatively more phosphorylated in ethanol-treated compared with control cells; and (5) chemical inhibition of GSK-3beta and/or global Caspases partially rescued ethanol-impaired AAH protein expression and motility. Ethanol-impaired neuronal migration is associated with reduced IGF-I stimulated AAH protein expression. This effect may be mediated by increased GSK-3beta phosphorylation and Caspase degradation of AAH. Therapeutic strategies to rectify CNS developmental abnormalities in FASD should target factors underlying the ethanol-associated increases in GSK-3beta and Caspase activation, e.g. IGF resistance and increased oxidative stress.
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Affiliation(s)
- Jade J Carter
- Department of Medicine, Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
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