Granulocyte macrophage colony-stimulating factor-induced macrophages of individuals with autism spectrum disorder adversely affect neuronal dendrites through the secretion of pro-inflammatory cytokines

BACKGROUND

A growing body of evidence suggests that immune dysfunction and inflammation in the peripheral tissues as well as the central nervous system are associated with the neurodevelopmental deficits observed in autism spectrum disorder (ASD). Elevated expression of pro-inflammatory cytokines in the plasma, serum, and peripheral blood mononuclear cells of ASD has been reported. These cytokine expression levels are associated with the severity of behavioral impairments and symptoms in ASD. In a prior study, our group reported that tumor necrosis factor-α (TNF-α) expression in granulocyte-macrophage colony-stimulating factor-induced macrophages (GM-CSF MΦ) and the TNF-α expression ratio in GM-CSF MΦ/M-CSF MΦ (macrophage colony-stimulating factor-induced macrophages) was markedly higher in individuals with ASD than in typically developed (TD) individuals. However, the mechanisms of how the macrophages and the highly expressed cytokines affect neurons remain to be addressed.

METHODS

To elucidate the effect of macrophages on human neurons, we used a co-culture system of control human-induced pluripotent stem cell-derived neurons and differentiated macrophages obtained from the peripheral blood mononuclear cells of five TD individuals and five individuals with ASD. All participants were male and ethnically Japanese.

RESULTS

Our results of co-culture experiments showed that GM-CSF MΦ affect the dendritic outgrowth of neurons through the secretion of pro-inflammatory cytokines, interleukin-1α and TNF-α. Macrophages derived from individuals with ASD exerted more severe effects than those derived from TD individuals.

LIMITATIONS

The main limitations of our study were the small sample size with a gender bias toward males, the use of artificially polarized macrophages, and the inability to directly observe the interaction between neurons and macrophages from the same individuals.

CONCLUSIONS

Our co-culture system revealed the non-cell autonomous adverse effects of GM-CSF MΦ in individuals with ASD on neurons, mediated by interleukin-1α and TNF-α. These results may support the immune dysfunction hypothesis of ASD, providing new insights into its pathology.

Brain-derived neurotrophic factor from microglia regulates neuronal development in the medial prefrontal cortex and its associated social behavior

Microglia and brain-derived neurotrophic factor (BDNF) are essential for the neuroplasticity that characterizes critical developmental periods. The experience-dependent development of social behaviors-associated with the medial prefrontal cortex (mPFC)-has a critical period during the juvenile period in mice. However, whether microglia and BDNF affect social development remains unclear. Herein, we aimed to elucidate the effects of microglia-derived BDNF on social behaviors and mPFC development. Mice that underwent social isolation during p21-p35 had increased Bdnf in the microglia accompanied by reduced adulthood sociability. Additionally, transgenic mice overexpressing microglial Bdnf-regulated using doxycycline at different time points-underwent behavioral, electrophysiological, and gene expression analyses. In these mice, long-term overexpression of microglial BDNF impaired sociability and excessive mPFC inhibitory neuronal circuit activity. However, administering doxycycline to normalize BDNF from p21 normalized sociability and electrophysiological function in the mPFC, whereas normalizing BDNF from later ages (p45-p50) did not normalize electrophysiological abnormalities in the mPFC, despite the improved sociability. To evaluate the possible role of BDNF in human sociability, we analyzed the relationship between adverse childhood experiences and BDNF expression in human macrophages, a possible proxy for microglia. Results show that adverse childhood experiences positively correlated with BDNF expression in M2 but not M1 macrophages. In summary, our study demonstrated the influence of microglial BDNF on the development of experience-dependent social behaviors in mice, emphasizing its specific impact on the maturation of mPFC function, particularly during the juvenile period. Furthermore, our results propose a translational implication by suggesting a potential link between BDNF secretion from macrophages and childhood experiences in humans.

Brain-derived neurotrophic factor from microglia regulates neuronal development in the medial prefrontal cortex and its associated social behavior

Microglia and brain-derived neurotrophic factor (BDNF) are essential for the neuroplasticity that characterizes critical developmental periods. The experience-dependent development of social behaviors-associated with the medial prefrontal cortex (mPFC)-has a critical period during the juvenile period in mice. However, whether microglia and BDNF affect social development remains unclear. Herein, we aimed to elucidate the effects of microglia-derived BDNF on social behaviors and mPFC development. Mice that underwent social isolation during p21-p35 had increased Bdnf in the microglia accompanied by reduced adulthood sociability. Additionally, transgenic mice overexpressing microglia Bdnf-regulated using doxycycline at different time points-underwent behavioral, electrophysiological, and gene expression analyses. In these mice, long-term overexpression of microglia BDNF impaired sociability and excessive mPFC inhibitory neuronal circuit activity. However, administration of doxycycline to normalize BDNF from p21 normalized sociability and electrophysiological functions; this was not observed when BDNF was normalized from a later age (p45-p50). To evaluate the possible role of BDNF in human sociability, we analyzed the relationship between adverse childhood experiences and BDNF expression in human macrophages, a possible substitute for microglia. Results show that adverse childhood experiences positively correlated with BDNF expression in M2 but not M1 macrophages. Thus, microglia BDNF might regulate sociability and mPFC maturation in mice during the juvenile period. Furthermore, childhood experiences in humans may be related to BDNF secretion from macrophages.

Osteonecrosis in patients with systemic lupus erythematosus develops very early after starting high dose corticosteroid treatment

OBJECTIVES

To investigate the actual time of onset of osteonecrosis (ON) after high dose corticosteroid treatment in systemic lupus erythematosus (SLE).

METHODS

72 patients with active SLE, who received high dose corticosteroid for the first time, for the development of ON at hips and knees were monitored by magnetic resonance imaging for at least 12 months.

RESULTS

ON lesions were detected in 32/72 patients (44%) between one and five months (3.1 months on average) after starting high dose corticosteroid treatment. No osteonecrotic lesion was newly detected from the sixth month of treatment until the end of the follow up period.

CONCLUSION

The findings suggested that the actual time of onset of ON in SLE is within the first month of high dose corticosteroid treatment.

Diastereoselective ruthenium-Cp complexation of enantiopure arene compounds possessing stereogenic benzylic alcohol functionalities

[reaction--see text] Enantiopure (arene)ruthenium compounds possessing a stereogenic benzylic alcohol functionality were stereoselectively synthesized by diastereoselective ruthenium-Cp complexation to a distinct arene face. This diastereoselective ruthenium-Cp complexation was further extended to biaryl compounds linked with a six-membered lactone bridge for the synthesis of enantiomerically pure, axially chiral biaryls.

Stereoselective synthesis of the axially chiral A-B ring system of vancomycin utilizing a planar chiral arene chromium complex

[reaction: see text] The axial biaryl ring system of vancomycin was stereoselectively synthesized by utilizing a planar chiral tricarbonyl(arylhalide)chromium complex. Both enantiomers of the planar chiral (arylbromide)chromium complexes, (+)-9 and ent-(-)-9, can be stereoselectively transferred to an absolutely identical key intermediate 23 for the vancomycin A-B ring system by the diastereoselective Suzuki-Miyaura cross-coupling reaction as key step.

Catalytic asymmetric vinylation of ketone enolates

[see reaction]. A protocol for the catalytic asymmetric vinylation of ketone enolates has been developed. Key to the success of this process was the development of new electron-rich chiral monodentate ligands.

Differential effects of oxidised and non-oxidised polyethylene particles on human monocyte/macrophages in vitro

Sterilisation by gamma irradiation in the presence of air causes free radicals generated in polyethylene (PE) to react with oxygen, which could lead to loss of physical properties and reduction in fatigue strength. Tissue retrieved from failed total hip replacements often has large quantities of particulate PE and most particles associated with peri-implant osteolysis are oxidised. Consequently, an understanding of the cellular responses of oxidised PE particles may lead to clarification of the pathogenesis of osteolysis and aseptic loosening.

We have used the agarose system to demonstrate the differential effects of oxidised and non-oxidised PE particles on the release of proinflammatory products such as interleukin-1β (IL-1β), IL-6, and tumour necrosis factor-α (TNF-α) from monocytes/ macrophages (M/M). Oxidised PE particles were shown to stimulate human M/M to phagocytose and to release cytokines. Oxidation may alter the surface chemistry of the particles and enhance the response to specific membrane receptors on macrophages, such as scavenger-type receptors.

Differential effects of oxidised and non-oxidised polyethylene particles on human monocyte/macrophages in vitro

Sterilisation by gamma irradiation in the presence of air causes free radicals generated in polyethylene (PE) to react with oxygen, which could lead to loss of physical properties and reduction in fatigue strength. Tissue retrieved from failed total hip replacements often has large quantities of particulate PE and most particles associated with peri-implant osteolysis are oxidised. Consequently, an understanding of the cellular responses of oxidised PE particles may lead to clarification of the pathogenesis of osteolysis and aseptic loosening. We have used the agarose system to demonstrate the differential effects of oxidised and non-oxidised PE particles on the release of proinflammatory products such as interleukin-1beta (IL-1beta), IL-6, and tumour necrosis factor-alpha (TNF-alpha) from monocytes/macrophages (M/M). Oxidised PE particles were shown to stimulate human M/M to phagocytose and to release cytokines. Oxidation may alter the surface chemistry of the particles and enhance the response to specific membrane receptors on macrophages, such as scavenger-type receptors.

Comparison of antimycobacterial activity of grepafloxacin against Mycobacterium avium with that of levofloxacin: accumulation of grepafloxacin in human macrophages

The bactericidal activity of two new quinolones, grepafloxacin and levofloxacin, against five strains of Mycobacterium avium was investigated in vitro. The minimum inhibitory concentrations (MICs) of these two quinolones, determined by the broth microdilution method, were comparable for all strains tested. In contrast, grepafloxacin suppressed the intracellular growth of all the strains in monocyte-derived macrophages more strongly than levofloxacin, when the cells infected with these strains were incubated for 7 days in the presence of various concentrations of the two new quinolones. To find the reason for the strengthened intracellular killing activity of grepafloxacin, we determined the ratio of the concentration of the new quinolones in the cells to that in the medium (C/M concentration ratio). The C/M concentration ratio of grepafloxacin was increased to 34.7 by 7 days, whereas that of levofloxacin at 7 days was only 12.3. These data suggested that a higher level of intraphagocytic accumulation of grepafloxacin endows it with greater mycobactericidal activity.

Sustained hemostatic abnormality in patients with steroid-induced osteonecrosis in the early period after high-dose corticosteroid therapy

To determine whether the development of steroid-induced osteonecrosis in collagen disease patients was related to hemostatic abnormality after corticosteroid administration, we examined levels of thrombin-antithrombin III complex (TAT) and plasmin-alpha2-plasmin inhibitor complex (PIC) in 32 patients who were treated with high-dose corticosteroid. All were prospectively followed for osteonecrosis, with serial magnetic resonance imaging (MRI), for at least 12 months from the beginning of corticosteroid therapy. MRI was performed on bilateral hips and knees. Of the 32 patients, 17 (53.1%) had osteonecrosis in the hip or knee. Osteonecrosis was detected on MRI at an average 3.1 months after the start of high-dose corticosteroid therapy. PIC levels were significantly higher in the group of 17 patients with osteonecrosis (ON group) than in the group of 15 patients without osteonecrosis (non-ON group) (P < 0.0001). The difference in PIC levels was most prominent 20 days after the start of the high-dose corticosteroid therapy. Moreover, the number of osteonecrotic joints was significantly correlated with PIC levels (P < 0.0001). The sustained hemostatic abnormality after corticosteroid therapy in the ON group suggests that microvascular coagulation participates in the development of osteonecrosis.

Acetabular labrum: abnormal findings at MR imaging in asymptomatic hips

PURPOSE

To determine the prevalence of abnormalities of the acetabular labrum in asymptomatic hips by means of magnetic resonance (MR) imaging and to correlate such abnormalities with age and the portion of the labrum.

MATERIALS AND METHODS

MR imaging was performed in 71 asymptomatic hips that were radially sectioned perpendicular to the acetabular labrum at 30 degrees intervals.

RESULTS

The shape of the labrum was triangular in 80% (304 of 382) of the labral segments, round in 13% (49 of 382), irregular in 7% (27 of 382), and not identified in 1% (two of 382). A homogeneous low signal intensity was observed in 56% (212 of 382). The frequencies of labral irregularity or its absence and of high signal intensity increased both with subject age and with a more anterior anatomic labral location.

CONCLUSION

In asymptomatic hips, abnormal findings regarding the shape and signal intensity of the acetabular labrum can be detected by means of MR imaging. The fact that the findings vary according to age and labral portion should be considered in interpreting MR images in patients suspected of having a labral lesion.

[A case of reflex sympathetic dystrophy following a retinous surgery]

We present a case of a 54-year-old female with post-operative severe continuous ocular pain which occurred 3 months after retinal operation. Her general and mental conditions were good. We diagnosed it reflex sympathetic dystrophy and treated with stellate ganglion blocks (SGB) and continuous cervical epidural blocks. SGB and continuous cervical epidural blocks were effective. With increasing numbers of retinal surgery in recent years, more patients will suffer from postoperative ocular pain. We conclude that SGB or epidural block is useful for the therapy of ocular pain which can not be controlled by drugs and other therapy.

[von Hippel-Lindau disease--hemangioblastoma associated with pheochromocytoma]

The association of a pheochromocytoma with von Hippel-Lindau disease is uncommon. We had a family with eight patients affected by von Hippel-Lindau disease, of whom five had hemangioblastoma of the central nervous system and seven had pheochromocytoma. As other lesions, retinal angiomatosis, spinal A-V malformation and spinal hemangioma were included in this family. In this paper five hemangioblastomas, four of whom had the association of hemangioblastoma and pheochromocytoma, are presented and clinical features of hemangioblastoma associated with pheochromocytoma are discussed, comparing to the 16 reported cases that had the association of hemangioblastoma and pheochromocytoma. The mean age of our own five cases at the onset of clinical symptoms was 32.2 years (ranging from 24 to 41 years) and that of reported 16 cases was 33.9 years (ranging from 18 to 55 years). These ages are slightly younger than that of sporadic hemangioblastoma. On the other hand, the mean age at the onset of pheochromocytoma was 28.3 years in our cases and 31.0 years in reported cases. This may suggest that hemangioblastoma when it is associated with pheochromocytoma presents its symptoms several years after the signs and symptoms of pheochromocytoma are manifested. In our cases a male to female ratio was 4:1 and in reported ones it was 9:7, showing that hemangioblastoma associated with pheochromocytoma as well as sporadic hemangioblastoma is likely to occur more in male.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhanced intestinal absorption of amino acids and amino acid-like drug by possible formation of enamine in administered solution by the presence of ethylacetoacetate

Ethylacetoacetate promoted the colonic and the jejunal absorption of amino acids such as L-phenylalanine and D-phenylalanine when administered in aqueous solution. Enhanced absorption of these isomers of amino acid might occur via a formation of enamine, which was observed in aqueous solution by monitoring ultraviolet absorbance at 288 nm. Since mixture of L- or D-phenylalanine and ethylacetoacetate in aqueous solution enhanced colonic absorption of cefmetazole while the solution did not affect so much on the jejunal absorption of cefmetazole compared to the colonic absorption of it, enhancing action of enamine probably produced in aqueous solution may be more effective at the colonic compartment.

[Fractionated intracavitary radiation for glioblastoma with remote afterloading system]

Three patients harboring glioblastoma were treated by fractionated intracavitary radiation using remote afterloading system. For this therapy, a special intracranial applicator was designed and used. Radiation schedule was planned to deliver 3000 rads to the margin of the tumor in 3 fractions over 10 days. The advantages of this treatment are that complete elimination of all unnecessary radiation exposure is possible, and that placing a radioactive source in the tumor provides maximal delivery of radiation to the tumor with relative sparing of surrounding normal brain. The method of treatment is presented and discussed with the reports of the clinical cases.

Partial hydrocephalus with chronic subdural hematoma

Two adult patients with unilateral chronic subdural hematomas are reported because of the presence of dilatation of the lateral ventricle opposite the hematoma. In both cases, dilatation was limited to the contralateral atrium and the occipital and temporal horns. The selective dilatation, we believe, is explained on the basis of the anatomy of the skull base and the falx. This phenomenon may contribute to an increase of the supratentorial pressure, originally elevated by the hematoma. This characteristic finding on computed tomographic scans should be regarded as critical in cases of chronic subdural hematoma.

Prevention of postoperative complications after a transoral transclival approach to basilar aneurysms. Technical note

The authors describe the techniques employed in three patients with basilar artery aneurysms that were treated via the transoral transclival approach. To prevent the formation of cerebrospinal fluid fistulas and the risk of consequent meningitis, complete postoperative closure of the nasopharyngeal mucosa is essential. Long-term nasopharyngeal packing and continuous spinal drainage were found to be effective in these cases.

[Delayed radiation necrosis of the brain simulating a brain tumor--report of two cases (author's transl)]

Two cases of delayed radiation necrosis of the brain were reported. Case 1 was a 50-year-old man who had right hemiparesis and disorientation 26 months after Linac irradiation (5,000 rad), preceded by the operation for right maxillar carcinoma. A left carotid angiogram demonstrated a left temporal mass lesion, extending the frontal lobe. Case 2 was a 41-year-old man who had previously the operation for right intraorbital plasmocytoma, followed by two times Co irradiation (6,400 rad, and 5,000 rad). He had the signs and symptoms of intracranial hypertension 36 months after last irradiation. A left carotid angiogram demonstrated a left temporal mass lesion. Both cases were treated by administration of steroid hormone, which alleviated the signs and symptoms, followed by the temporal lobectomy. Microscopic examinations showed necrosis of the brain tissues associated with hyaline degeneration of blood vessel walls and perivascular cell infiltration. The signs and symptoms of intracranial hypertension subsided postoperatively. The other thirteen cases as same as ours were collected from literature, which showed the signs and symptoms simulating a brain tumor (like a metastic brain tumor) after the irradiation to extracranial malignant tumors, and the diagnosis of radiation necrosis were made by the operation or autopsy. A follow-up for a long time is necessary, because the pathological changes in the brain may be progressive and extending in some cases, although the decompressive operations for mass lesion are excellent in result.

Neuroepithelial Cyst of the cerebellar vermis

A cyst located in the cerebellar vermis and causing obstructive hydrocephalus is described. The wall of the cyst was lined with ciliated and non-ciliated cuboidal epithelial cells which were completely invested by a basement membrane.

[Clinical evaluation of brain scintigrams for basal midline lesions (author's transl)]

Brain scintigrams with 8-10 mci of pertechnetate were studied refering to surgical, histological and other neuroradiological findings in 91 cases with diagnosis or suspect of basal midline lesions. Anterior view of 45 cases was stored in high speed magnetic tape, displayed on CRT of our data processing system and studied of the ratio of average count for regions of interest, 2 cm x 2 cm in size, placed on the areas of lesion, the sagittal sinus and the normal brain hemispheres. In 18 pituitary adenomas, excluding acromegaly and other intrasellar lesions, 89% of cases with surgical indication for optic nerve symptoms were reported as abnormal scintigrams. In 20 craniopharyngiomas, 11 positive cases consisted mainly of solid, recurrent or thick cystic tumors. Five of 6 ectopic pinealomas and all 6 parasellar or medial sphenoidal ridge meningiomas showed positive uptake. Average counts of the regions of interest placed on tumor areas were 169.4% of normal hemispheric areas in 9 pituitary adenomas, 192.5% in 3 solid craniopharyngiomas, 192.3% in 6 meningiomas and 193.3% in ectopic pinealomas. The difference in the average ratio of the lesion count to the normal hemispheric count was statistically significant between cystic craniopharyngioma and adenoma, ectopic pinealoma, meningioma, glioma and solid craniopharyngioma, and between adenoma and acromegaly with p less than 0.005, and between solid craniopharyngioma and acromegaly, and between glioma and acromegaly with p less than 0.025. In the ratio of the lesion count to the sagittal sinus count, on the other hand, the difference of the average ratio was significant with p less than 0.005, only between cystic craniopharyngioma and ectopic pinealoma, and between cystic and solid craniopharyngioma. These facts suggested that the sagittal sinus count was unsuitable to be the standard count of an anterior scintigram to compare with basal midline count. The routine Polaroid scintigram with Tc99m pertechnetate proved their useful clinical diagnostic value for various basal midline lesions, the size of which indicated the surgical procedures. The digital analysis of anterior scintigrams supported the clinical value of the routine brain scintigram in the detection of these lesions. The ratio of the average count of the basal midline lesion to the normal brain area on the anterior scintigram presents more useful clinical information than the ratio of the lesion to the sagittal sinus count. Brain scintigram is found to be very helpful for the differential diagnosis between solid and cystic sellar tumors which is very important for the decision of surgical indications, and is not always possible by any other conventional neuroradiological procedures.