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Schaler L, Giblin A, Glover LE, Wingfield M. Assisted human reproduction legislation: Acknowledging the voice of health care professionals. Eur J Obstet Gynecol Reprod Biol 2023; 280:28-33. [PMID: 36379181 DOI: 10.1016/j.ejogrb.2022.11.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/13/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Ireland is one of 5 European countries which currently lacks specific legislation on Assisted Human Reproduction (AHR). Draft legislation was introduced in 2017 and revised in 2022 with a view to enacting legislation this year (2022). This study sought to ascertain the views of healthcare professionals to proposed AHR legislation, prior to the implementation of that legislation. STUDY DESIGN A survey questionnaire based on all clinically relevant aspects of the Irish draft AHR Bill 2017 was distributed to relevant healthcare professionals using an online platform. RESULTS Over 200 healthcare personnel indicated strong support for the availability of AHR techniques, access to treatment for all patient populations regardless of relationship or gender status, and appropriate legislation and regulation in the field. Views of respondents are at variance with several proposals surrounding surrogacy, with 84 % favouring a pre-birth order to assign parentage from birth, rather than the proposed birth order 6 weeks after birth. The majority also support legislation around international surrogacy. Contrary to the draft Bill, respondents believe that men, as well as women, should be able to use posthumously any stored gametes or embryos belonging to the deceased partner or the couple. While the majority favour altruistic gamete donation, respondents support more generous compensation for donors, such as compensation for time lost at work. CONCLUSION This study has uniquely ascertained the views of healthcare professionals to imminent AHR legislation. It is hoped that the results will help inform the national legislation as it nears completion. Similar studies could help other countries, and policy bodies such as ESHRE to frame good legislation in this extremely specialised and complex field.
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Affiliation(s)
- L Schaler
- Merrion Fertility Clinic, 60 Lower Mount Street, Dublin 2, Ireland; Department of Obstetrics and Gynaecology, National Maternity Hospital, Holles Street, Dublin 2, Ireland; School of Medicine, University College Dublin, Dublin 4, Ireland.
| | - A Giblin
- Merrion Fertility Clinic, 60 Lower Mount Street, Dublin 2, Ireland; School of Medicine, University College Dublin, Dublin 4, Ireland
| | - L E Glover
- Merrion Fertility Clinic, 60 Lower Mount Street, Dublin 2, Ireland; School of Medicine, University College Dublin, Dublin 4, Ireland
| | - M Wingfield
- Merrion Fertility Clinic, 60 Lower Mount Street, Dublin 2, Ireland; Department of Obstetrics and Gynaecology, National Maternity Hospital, Holles Street, Dublin 2, Ireland; School of Medicine, University College Dublin, Dublin 4, Ireland
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2
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Schaler L, Glover LE, Wingfield M. COVID-19 Vaccine and Fertility: The Male Perspective. Ir Med J 2022; 115:543. [PMID: 35418174] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Aims The expedited development of multiple COVID-19 vaccines has raised concerns for some, with vaccine hesitancy described in many populations. A U.S. study assessing fertility patients attitudes towards the COVID -19 vaccine revealed that over half were unsure, or would not accept the vaccine if offered. Only 7.4% of participants in this study were male. We therefore sought to assess the perspective of male fertility patients towards COVID-19 vaccination. Methods Men with a fertility appointment were invited to complete an anonymous 21-item questionnaire. Results Willingness to accept the COVID-19 vaccination was influenced by stage of fertility journey. Overall, 76% (n=102) of participants were willing to receive the COVID-19 vaccine. Men with a pregnant partner were most likely to accept or have already accepted the vaccine (97%, 30/31). Conclusion Although concerns around COVID-19 vaccines persist, this study demonstrates the growing rate of acceptance and engagement among the male fertility population.
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Affiliation(s)
- L Schaler
- Merrion Fertility Clinic, 60 Lower Mount Street, Dublin 2, Ireland
- Department of Obstetrics and Gynaecology, the National Maternity Hospital, Holles Street, Dublin 2, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
| | - L E Glover
- Merrion Fertility Clinic, 60 Lower Mount Street, Dublin 2, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
| | - M Wingfield
- Merrion Fertility Clinic, 60 Lower Mount Street, Dublin 2, Ireland
- Department of Obstetrics and Gynaecology, the National Maternity Hospital, Holles Street, Dublin 2, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
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3
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Crosby DA, Glover LE, Brennan EP, Kelly P, Cormican P, Moran B, Giangrazi F, Downey P, Mooney EE, Loftus BJ, McAuliffe FM, Wingfield M, O'Farrelly C, Brennan DJ. Dysregulation of the interleukin-17A pathway in endometrial tissue from women with unexplained infertility affects pregnancy outcome following assisted reproductive treatment. Hum Reprod 2021; 35:1875-1888. [PMID: 32614049 DOI: 10.1093/humrep/deaa111] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 03/02/2020] [Revised: 04/22/2020] [Indexed: 12/25/2022] Open
Abstract
STUDY QUESTION Which transcriptomic alterations in mid-luteal endometrial scratch biopsies, taken prior to the assisted reproductive treatment (ART) treatment cycle are associated with unsuccessful pregnancy? SUMMARY ANSWER Dysregulated interleukin-17 (IL-17) pathway components are demonstrated in women who fail to become pregnant after ART. WHAT IS KNOWN ALREADY Implantation failure is now recognised as a critical factor in unexplained infertility and may be an important component of failed ART. STUDY DESIGN, SIZE, DURATION Using a prospective longitudinal study design, 29 nulliparous women with unexplained infertility undergoing ART were recruited between October 2016 and February 2018. Mid-luteal stage endometrium and matched serum samples were collected, and patients underwent a single embryo transfer in the subsequent cycle. RNA-seq analysis of endometrial biopsies was performed on the discovery cohort (n = 20). PARTICIPANTS/MATERIALS, SETTING, METHODS Gene set enrichment analysis of the differentially expressed genes (DEGs) was performed. Endometrium and serum were then prepared for IL-17A analysis by ELISA. MAIN RESULTS AND THE ROLE OF CHANCE There were 204 differentially expressed protein-coding genes identified in tissue from women who became pregnant (n = 9) compared with tissue from women who failed to become pregnant (n = 11) (false discovery rate; P < 0.05). Of the 204 DEGs, 166 were decreased while 38 were increased in the pregnant compared to the non-pregnant groups. Gene set enrichment analysis of the DEGs identified an over-representation of IL-17 and Pl3K-Akt signalling pathways. All the DEGs within the IL-17 signalling pathway (MMP3, MMP1, IL1β, LCN2, S100A9 and FOSL1) demonstrated decreased expression in the pregnant group. Serum IL-17 protein levels were increased in the non-pregnant discovery cohort (n = 11) and these findings were confirmed a validation cohort (n = 9). LIMITATIONS, REASONS FOR CAUTION Limitations of our study include the cohort size and the lack of aneuploidy data for the embryos; however, all embryos transferred were single good or top-quality blastocysts. WIDER IMPLICATIONS OF THE FINDINGS These findings demonstrate dysregulated IL-17 pathway components in women who fail to become pregnant after ART. Elevated serum levels of the pro-inflammatory cytokine IL-17 may predict failure of ART in women with unexplained infertility. Future trials of anti-IL-17 therapies in this cohort warrant further investigation. STUDY FUNDING/COMPETING INTEREST(S) Funding from the UCD Wellcome Institutional Strategic Support Fund, which was financed jointly by University College Dublin and the SFI-HRB-Wellcome Biomedical Research Partnership (ref 204844/Z/16/Z), is acknowledged. The authors have no competing interests. TRIAL REGISTRATION NUMBER NA.
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Affiliation(s)
- D A Crosby
- Department of Reproductive Medicine, Merrion Fertility Clinic, Dublin, D2, Ireland.,Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, D2, Ireland
| | - L E Glover
- Department of Reproductive Medicine, Merrion Fertility Clinic, Dublin, D2, Ireland
| | - E P Brennan
- UCD Diabetes Complications Research Centre, UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine, University College Dublin, D4, Ireland
| | - P Kelly
- Comparative Immunology Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, D2, Ireland.,School of Medicine, Trinity College Dublin, D2, Ireland
| | - P Cormican
- Animal and Bioscience Research Department, Animal and Grassland Research and Innovation Centre, Teagasc, Grange, County Meath, Ireland
| | - B Moran
- Cancer Biology and Therapeutics Laboratory, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, D4, Ireland
| | - F Giangrazi
- Comparative Immunology Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, D2, Ireland
| | - P Downey
- Department of Pathology & Laboratory Medicine, National Maternity Hospital, Dublin, D2, Ireland
| | - E E Mooney
- Department of Pathology & Laboratory Medicine, National Maternity Hospital, Dublin, D2, Ireland
| | - B J Loftus
- School of Medicine, Conway Institute, University College Dublin, D4, Ireland
| | - F M McAuliffe
- Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, D2, Ireland.,UCD Perinatal Research Centre, School of Medicine, University College Dublin, D4, Ireland
| | - M Wingfield
- Department of Reproductive Medicine, Merrion Fertility Clinic, Dublin, D2, Ireland.,Department of Obstetrics and Gynaecology, National Maternity Hospital, Dublin, D2, Ireland.,School of Medicine, Trinity College Dublin, D2, Ireland.,UCD Perinatal Research Centre, School of Medicine, University College Dublin, D4, Ireland
| | - C O'Farrelly
- Comparative Immunology Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, D2, Ireland.,School of Medicine, Trinity College Dublin, D2, Ireland
| | - D J Brennan
- Cancer Biology and Therapeutics Laboratory, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, D4, Ireland.,Systems Biology Ireland, UCD School of Medicine, University College Dublin, D4, Ireland
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4
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Crosby DA, Glover LE, Martyn F, Wingfield M. CA125 measured during menstruation can be misleading. Ir Med J 2018; 111:738. [PMID: 30488683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of these case reports and literature review is to report the importance of cyclical variation of serum CA-125 levels in two patients with endometriosis. Two case reports and a literature review of cyclical variation in serum CA-125 levels are discussed. There was significant variation in serum CA-125 levels taken during menses and mid-cycle in these two cases. Serum CA-125 levels increase dramatically during menstruation in women with endometriosis. This is important when assessing disease status.
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Affiliation(s)
- D A Crosby
- Merrion Fertility Clinic, 60 Mount Street, Dublin 2
- National Maternity Hospital, Holles Street, Dublin 2
| | - L E Glover
- Merrion Fertility Clinic, 60 Mount Street, Dublin 2
| | - F Martyn
- Merrion Fertility Clinic, 60 Mount Street, Dublin 2
- National Maternity Hospital, Holles Street, Dublin 2
| | - M Wingfield
- Merrion Fertility Clinic, 60 Mount Street, Dublin 2
- National Maternity Hospital, Holles Street, Dublin 2
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5
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Aherne CM, Saeedi B, Collins CB, Masterson JC, McNamee EN, Perrenoud L, Rapp CR, Curtis VF, Bayless A, Fletcher A, Glover LE, Evans CM, Jedlicka P, Furuta GT, de Zoeten EF, Colgan SP, Eltzschig HK. Epithelial-specific A2B adenosine receptor signaling protects the colonic epithelial barrier during acute colitis. Mucosal Immunol 2015; 8:1324-38. [PMID: 25850656 PMCID: PMC4598274 DOI: 10.1038/mi.2015.22] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 02/17/2015] [Indexed: 02/04/2023]
Abstract
Central to inflammatory bowel disease (IBD) pathogenesis is loss of mucosal barrier function. Emerging evidence implicates extracellular adenosine signaling in attenuating mucosal inflammation. We hypothesized that adenosine-mediated protection from intestinal barrier dysfunction involves tissue-specific signaling through the A2B adenosine receptor (Adora2b) at the intestinal mucosal surface. To address this hypothesis, we combined pharmacologic studies and studies in mice with global or tissue-specific deletion of the Adora2b receptor. Adora2b(-/-) mice experienced a significantly heightened severity of colitis, associated with a more acute onset of disease and loss of intestinal epithelial barrier function. Comparison of mice with Adora2b deletion on vascular endothelial cells (Adora2b(fl/fl)VeCadCre(+)) or intestinal epithelia (Adora2b(fl/fl)VillinCre(+)) revealed a selective role for epithelial Adora2b signaling in attenuating colonic inflammation. In vitro studies with Adora2b knockdown in intestinal epithelial cultures or pharmacologic studies highlighted Adora2b-driven phosphorylation of vasodilator-stimulated phosphoprotein (VASP) as a specific barrier repair response. Similarly, in vivo studies in genetic mouse models or treatment studies with an Adora2b agonist (BAY 60-6583) recapitulate these findings. Taken together, our results suggest that intestinal epithelial Adora2b signaling provides protection during intestinal inflammation via enhancing mucosal barrier responses.
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Affiliation(s)
- CM Aherne
- Department of Anesthesiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA,Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - B Saeedi
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - CB Collins
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA,Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children’s Hospital Colorado, Aurora, Colorado, USA
| | - JC Masterson
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA,Gastrointestinal Eosinophilic Diseases Program, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children’s Hospital Colorado, Aurora, Colorado, USA
| | - EN McNamee
- Department of Anesthesiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA,Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - L Perrenoud
- Department of Anesthesiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA,Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - CR Rapp
- Department of Anesthesiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA,Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - VF Curtis
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - A Bayless
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - A Fletcher
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - LE Glover
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - CM Evans
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - P Jedlicka
- Department of Pathology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - GT Furuta
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA,Gastrointestinal Eosinophilic Diseases Program, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children’s Hospital Colorado, Aurora, Colorado, USA
| | - EF de Zoeten
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA,Section of Pediatric Gastroenterology, Hepatology and Nutrition, Digestive Health Institute, Children’s Hospital Colorado, Aurora, Colorado, USA
| | - SP Colgan
- Mucosal Inflammation Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - HK Eltzschig
- Department of Anesthesiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Kaneko Y, Tajiri N, Shinozuka K, Glover LE, Weinbren NL, Cortes L, Borlongan CV. Cell therapy for stroke: emphasis on optimizing safety and efficacy profile of endothelial progenitor cells. Curr Pharm Des 2012; 18:3731-4. [PMID: 22574986 DOI: 10.2174/138161212802002733] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 02/17/2012] [Indexed: 01/07/2023]
Abstract
Endothelial progenitor cells (EPCs) correspond to a population of cells with novel properties capable of angiogenesis and vasculogenesis, thus they are likely to display unique role in the reconstitution of the blood brain barrier (BBB) after stroke. Laboratory evidence supports safety and efficacy of cell therapy for stroke, with limited clinical trials recently initiated. This lab-to-clinic ascent of cell-based therapeutics has been aided by the establishment of consortium consisting of thought-leaders from academia, industry, National Institutes of Health (NIH) and the United States Food and Drug Administration (FDA). However, there remain unanswered questions prior to realization of large-scale application of cell transplantation in patients. This review article discusses translational challenges associated in cell therapy, emphasizing the need for optimizing both safety and efficacy profiles for advancing the clinical applications of EPC transplantation for stroke patients.
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Affiliation(s)
- Yuji Kaneko
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, Florida 33612, USA
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8
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Borlongan CV, Glover LE, Sanberg PR, Hess DC. Permeating the blood brain barrier and abrogating the inflammation in stroke: implications for stroke therapy. Curr Pharm Des 2012; 18:3670-6. [PMID: 22574981 DOI: 10.2174/138161212802002841] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 01/24/2012] [Indexed: 01/18/2023]
Abstract
Cell therapy has been shown as a potential treatment for stroke and other neurological disorders. Human umbilical cord blood (HUCB) may be a promising source of stem cells for cell therapy. The most desired outcomes occur when stem cells cross the blood brain barrier (BBB) and eventually reach the injured brain site. We propose, from our previous studies, that mannitol is capable of disrupting the BBB, allowing the transplanted cells to enter the brain from the periphery. However, when the BBB is compromised, the inflammatory response from circulation may also be able to penetrate the brain and thus may actually exacerbate the stroke rather than afford therapeutic effects. We discuss how an NF-kB decoy can inhibit the inflammatory responses in the stroke brain thereby reducing the negative effects associated with BBB disruption. In this review, we propose the combination of mannitol-induced BBB permeation and NF-kB decoy for enhancing the therapeutic benefits of cell therapy in stroke.
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Affiliation(s)
- Cesar V Borlongan
- Department of Neurology, Georgia Health Sciences University, Augusta, Georgia 30912, USA.
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Tajiri N, Lau T, Glover LE, Shinozuka K, Kaneko Y, van Loveren H, Borlongan CV. Cerebral aneurysm as an exacerbating factor in stroke pathology and a therapeutic target for neuroprotection. Curr Pharm Des 2012; 18:3663-9. [PMID: 22574980 DOI: 10.2174/138161212802002724] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 01/24/2012] [Indexed: 11/22/2022]
Abstract
Stroke remains a major cause of death in the US and around the world. Despite major scientific advances in our understanding of stroke pathology, the only FDA-approved drug for ischemic stroke is tissue plasminogen activator (tPA). Moreover, the therapeutic window for tPA is confined to the acute phase of stroke, thereby greatly limiting its benefits to less than 3% of ischemic stroke patients. Many treatment strategies for stroke have targeted the subacute or chronic phase in an effort to abrogate the secondary cell death that ensues after the initial stroke insult. Here, we advance the hypothesis that blood vessel disruption, or aneurysm, in the brain is an exacerbating factor for stroke, especially in the evolution of the penumbra or peri-infarct area. A better understanding of aneurysm, specifically its dynamic onset and juxtaposition to the ischemic brain tissue should facilitate the development of novel strategies for attenuating the secondary cell death associated with stroke. To this end, we discuss the laboratory and clinical evidence implicating aneurysm formation in stroke and also provide insights on how stem cell therapy may prove efficacious in combating aneurysm and stroke.
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Affiliation(s)
- Naoki Tajiri
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA
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10
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Tajiri N, Acosta S, Glover LE, Bickford PC, Jacotte Simancas A, Yasuhara T, Date I, Solomita MA, Antonucci I, Stuppia L, Kaneko Y, Borlongan CV. Intravenous grafts of amniotic fluid-derived stem cells induce endogenous cell proliferation and attenuate behavioral deficits in ischemic stroke rats. PLoS One 2012; 7:e43779. [PMID: 22912905 PMCID: PMC3422299 DOI: 10.1371/journal.pone.0043779] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 07/25/2012] [Indexed: 01/11/2023] Open
Abstract
We recently reported isolation of viable rat amniotic fluid-derived stem (AFS) cells [1]. Here, we tested the therapeutic benefits of AFS cells in a rodent model of ischemic stroke. Adult male Sprague-Dawley rats received a 60-minute middle cerebral artery occlusion (MCAo). Thirty-five days later, animals exhibiting significant motor deficits received intravenous transplants of rat AFS cells or vehicle. At days 60–63 post-MCAo, significant recovery of motor and cognitive function was seen in stroke animals transplanted with AFS cells compared to vehicle-infused stroke animals. Infarct volume, as revealed by hematoxylin and eosin (H&E) staining, was significantly reduced, coupled with significant increments in the cell proliferation marker, Ki67, and the neuronal marker, MAP2, in the dentate gyrus (DG) [2] and the subventricular zone (SVZ) of AFS cell-transplanted stroke animals compared to vehicle-infused stroke animals. A significantly higher number of double-labeled Ki67/MAP2-positive cells and a similar trend towards increased Ki67/MAP2 double-labeling were observed in the DG and SVZ of AFS cell-transplanted stroke animals, respectively, compared to vehicle-infused stroke animals. This study reports the therapeutic potential of AFS cell transplantation in stroke animals, possibly via enhancement of endogenous repair mechanisms.
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Affiliation(s)
- Naoki Tajiri
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
| | - Sandra Acosta
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
| | - Loren E. Glover
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
| | - Paula C. Bickford
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
| | - Alejandra Jacotte Simancas
- Departamento de Psicobiologia y Metodologia de las Cièncias de la Salud, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Takao Yasuhara
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Marianna A. Solomita
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
- Department of Biomedical Sciences, G. d'Annunzio University, Chieti-Pescara, Italy
- Department of Neuroscience and Imaging, School of Advanced Studies G.d'Annunzio, Chieti University and Stem TeCh Group, Aging Research Center, Chieti- Pescara, Italy
| | - Ivana Antonucci
- Department of Biomedical Sciences, G. d'Annunzio University, Chieti-Pescara, Italy
- Department of Neuroscience and Imaging, School of Advanced Studies G.d'Annunzio, Chieti University and Stem TeCh Group, Aging Research Center, Chieti- Pescara, Italy
| | - Liborio Stuppia
- Department of Biomedical Sciences, G. d'Annunzio University, Chieti-Pescara, Italy
- Department of Neuroscience and Imaging, School of Advanced Studies G.d'Annunzio, Chieti University and Stem TeCh Group, Aging Research Center, Chieti- Pescara, Italy
| | - Yuji Kaneko
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
| | - Cesar V. Borlongan
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
- * E-mail:
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Kaneko Y, Tajiri N, Yu S, Hayashi T, Stahl CE, Bae E, Mestre H, Franzese N, Rodrigues A, Rodrigues MC, Ishikawa H, Shinozuka K, Hethorn W, Weinbren N, Glover LE, Tan J, Achyuta AH, van Loveren H, Sanberg PR, Shivsankar S, Borlongan CV. Nestin overexpression precedes caspase-3 upregulation in rats exposed to controlled cortical impact traumatic brain injury. Cell Med 2012; 4:55-63. [PMID: 23101029 DOI: 10.3727/215517912x639306] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Our understanding of biological mechanisms and treatment options for traumatic brain injury (TBI) is limited. Here, we employed quantitative real-time PCR (QRT-PCR) and immunohistochemical analyses to determine the dynamic expression of cell proliferation and apoptosis in an effort to provide insights into the therapeutic window for developing regenerative strategies for TBI. For this purpose, young adult Sprague-Dawley rats were subjected to experimental TBI using a controlled cortical impactor, then euthanized 1-48 hours after TBI for QRT-PCR and immunohistochemistry. QRT-PCR revealed that brains from TBI exposed rats initially displayed nestin mRNA expression that modestly increased as early as 1-hour post-TBI, then significantly peaked at 8 hours, but thereafter reverted to pre-TBI levels. On the other hand, caspase-3 mRNA expression was slightly elevated at 8 hours post-TBI, which did not become significantly upregulated until 48 hours. Immunofluorescent microscopy revealed a significant surge in nestin immunoreactive cells in the cortex, corpus callosum, and subventricular zone at 24 hours post-TBI, whereas a significant increase in the number of active caspase-3 immunoreactive cells was only found in the cortex and not until 48 hours. These results suggest that the injured brain attempts to repair itself via cell proliferation immediately after TBI, but that this endogenous regenerative mechanism is not sufficient to abrogate the secondary apoptotic cell death. Treatment strategies designed to amplify cell proliferation and to prevent apoptosis are likely to exert maximal benefits when initiated at the acute phase of TBI.
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Affiliation(s)
- Yuji Kaneko
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL 33612, USA
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12
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Rodrigues MCO, Rodrigues AA, Glover LE, Voltarelli J, Borlongan CV. Peripheral nerve repair with cultured schwann cells: getting closer to the clinics. ScientificWorldJournal 2012; 2012:413091. [PMID: 22701355 PMCID: PMC3373143 DOI: 10.1100/2012/413091] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [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: 01/09/2012] [Accepted: 01/26/2012] [Indexed: 02/06/2023] Open
Abstract
Peripheral nerve injuries are a frequent and disabling condition, which affects 13 to 23 per 100.000 persons each year. Severe cases, with structural disruption of the nerve, are associated with poor functional recovery. The experimental treatment using nerve grafts to replace damaged or shortened axons is limited by technical difficulties, invasiveness, and mediocre results. Other therapeutic choices include the adjunctive application of cultured Schwann cells and nerve conduits to guide axonal growth. The bone marrow is a rich source of mesenchymal cells, which can be differentiated in vitro into Schwann cells and subsequently engrafted into the damaged nerve. Alternatively, undifferentiated bone marrow mesenchymal cells can be associated with nerve conduits and afterward transplanted. Experimental studies provide evidence of functional, histological, and electromyographical improvement following transplantation of bone-marrow-derived cells in animal models of peripheral nerve injury. This paper focuses on this new therapeutic approach highlighting its direct translational and clinical utility in promoting regeneration of not only acute but perhaps also chronic cases of peripheral nerve damage.
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Affiliation(s)
- Maria Carolina O Rodrigues
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulvard, Tampa, FL 33612, USA
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Glover LE, Tajiri N, Lau T, Kaneko Y, van Loveren H, Borlongan CV. Immediate, but not delayed, microsurgical skull reconstruction exacerbates brain damage in experimental traumatic brain injury model. PLoS One 2012; 7:e33646. [PMID: 22438975 PMCID: PMC3306278 DOI: 10.1371/journal.pone.0033646] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 02/14/2012] [Indexed: 11/19/2022] Open
Abstract
Moderate to severe traumatic brain injury (TBI) often results in malformations to the skull. Aesthetic surgical maneuvers may offer normalized skull structure, but inconsistent surgical closure of the skull area accompanies TBI. We examined whether wound closure by replacement of skull flap and bone wax would allow aesthetic reconstruction of the TBI-induced skull damage without causing any detrimental effects to the cortical tissue. Adult male Sprague-Dawley rats were subjected to TBI using the controlled cortical impact (CCI) injury model. Immediately after the TBI surgery, animals were randomly assigned to skull flap replacement with or without bone wax or no bone reconstruction, then were euthanized at five days post-TBI for pathological analyses. The skull reconstruction provided normalized gross bone architecture, but 2,3,5-triphenyltetrazolium chloride and hematoxylin and eosin staining results revealed larger cortical damage in these animals compared to those that underwent no surgical maneuver at all. Brain swelling accompanied TBI, especially the severe model, that could have relieved the intracranial pressure in those animals with no skull reconstruction. In contrast, the immediate skull reconstruction produced an upregulation of the edema marker aquaporin-4 staining, which likely prevented the therapeutic benefits of brain swelling and resulted in larger cortical infarcts. Interestingly, TBI animals introduced to a delay in skull reconstruction (i.e., 2 days post-TBI) showed significantly reduced edema and infarcts compared to those exposed to immediate skull reconstruction. That immediate, but not delayed, skull reconstruction may exacerbate TBI-induced cortical tissue damage warrants a careful consideration of aesthetic repair of the skull in TBI.
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Affiliation(s)
| | | | | | | | | | - Cesario V. Borlongan
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, Florida, United States of America
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Rodrigues MCO, Glover LE, Weinbren N, Rizzi JA, Ishikawa H, Shinozuka K, Tajiri N, Kaneko Y, Sanberg PR, Allickson JG, Kuzmin-Nichols N, Garbuzova-Davis S, Voltarelli JC, Cruz E, Borlongan CV. Toward personalized cell therapies: autologous menstrual blood cells for stroke. J Biomed Biotechnol 2011; 2011:194720. [PMID: 22162629 PMCID: PMC3227246 DOI: 10.1155/2011/194720] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 09/12/2011] [Indexed: 01/14/2023] Open
Abstract
Cell therapy has been established as an important field of research with considerable progress in the last years. At the same time, the progressive aging of the population has highlighted the importance of discovering therapeutic alternatives for diseases of high incidence and disability, such as stroke. Menstrual blood is a recently discovered source of stem cells with potential relevance for the treatment of stroke. Migration to the infarct site, modulation of the inflammatory reaction, secretion of neurotrophic factors, and possible differentiation warrant these cells as therapeutic tools. We here propose the use of autologous menstrual blood cells in the restorative treatment of the subacute phase of stroke. We highlight the availability, proliferative capacity, pluripotency, and angiogenic features of these cells and explore their mechanistic pathways of repair. Practical aspects of clinical application of menstrual blood cells for stroke will be discussed, from cell harvesting and cryopreservation to administration to the patient.
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Affiliation(s)
- Maria Carolina O. Rodrigues
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
- Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, 14049-900 Ribeirão Preto, SP, Brazil
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Loren E. Glover
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Nathan Weinbren
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Jessica A. Rizzi
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Hiroto Ishikawa
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Kazutaka Shinozuka
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Naoki Tajiri
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Yuji Kaneko
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Paul R. Sanberg
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | | | | | - Svitlana Garbuzova-Davis
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
| | - Julio Cesar Voltarelli
- Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, 14049-900 Ribeirão Preto, SP, Brazil
| | - Eduardo Cruz
- Cryopraxis, Cell Praxis, BioRio, Póde Biotechnologia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cesar V. Borlongan
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
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Borlongan CV, Glover LE, Tajiri N, Kaneko Y, Freeman TB. The great migration of bone marrow-derived stem cells toward the ischemic brain: therapeutic implications for stroke and other neurological disorders. Prog Neurobiol 2011; 95:213-28. [PMID: 21903148 PMCID: PMC3185169 DOI: 10.1016/j.pneurobio.2011.08.005] [Citation(s) in RCA: 163] [Impact Index Per Article: 12.5] [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] [Received: 06/20/2011] [Revised: 08/10/2011] [Accepted: 08/15/2011] [Indexed: 02/08/2023]
Abstract
Accumulating laboratory studies have implicated the mobilization of bone marrow (BM)-derived stem cells in brain plasticity and stroke therapy. This mobilization of bone cells to the brain is an essential concept in regenerative medicine. Over the past ten years, mounting data have shown the ability of bone marrow-derived stem cells to mobilize from BM to the peripheral blood (PB) and eventually enter the injured brain. This homing action is exemplified in BM stem cell mobilization following ischemic brain injury. Various BM-derived cells, such as hematopoietic stem cells (HSCs), mesenchymal stem cells (MSCs), endothelial progenitor cells (EPCs) and very small embryonic-like cells (VSELs) have been demonstrated to exert therapeutic benefits in stroke. Here, we discuss the current status of these BM-derived stem cells in stroke therapy, with emphasis on possible cellular and molecular mechanisms of action that mediate the cells' beneficial effects in the ischemic brain. When possible, we also discuss the relevance of this therapeutic regimen in other central nervous system (CNS) disorders.
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Affiliation(s)
- Cesar V Borlongan
- Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612, USA.
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