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Ascona M, Tieu EK, Gonzalez-Vega E, Liebl DJ, Brambilla R. A deep learning-based approach for unbiased kinematic analysis in CNS injury. bioRxiv 2024:2024.04.08.588606. [PMID: 38645091 PMCID: PMC11030365 DOI: 10.1101/2024.04.08.588606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Traumatic spinal cord injury (SCI) is a devastating condition that impacts over 300,000 individuals in the US alone. Depending on the severity of the injury, SCI can lead to varying degrees of sensorimotor deficits and paralysis. Despite advances in our understanding of the underlying pathological mechanisms of SCI and the identification of promising molecular targets for repair and functional restoration, few therapies have made it into clinical use. To improve the success rate of clinical translation, more robust, sensitive, and reproducible means of functional assessment are required. The gold standards for the evaluation of locomotion in rodents with SCI are the Basso Beattie Bresnahan (BBB) and Basso Mouse Scale (BMS) tests. To overcome the shortcomings of current methods, we developed two separate marker-less kinematic analysis paradigms in mice, MotorBox and MotoRater, based on deep-learning algorithms generated with the DeepLabCut open-source toolbox. The MotorBox system uses an originally designed, custom-made chamber, and the MotoRater system was implemented on a commercially available MotoRater device. We validated the MotorBox and MotoRater systems by comparing them with the traditional BMS test and extracted metrics of movement and gait that can provide an accurate and sensitive representation of mouse locomotor function post-injury, while eliminating investigator bias and variability. The integration of MotorBox and/or MotoRater assessments with BMS scoring will provide a much wider range of information on specific aspects of locomotion, ensuring the accuracy, rigor, and reproducibility of behavioral outcomes after SCI. Highlights MotorBox and MotoRater systems are two novel marker-less kinematic analysis paradigms in mice, based on deep-learning algorithms generated with DeepLabCut.MotorBox and MotoRater systems are highly sensitive, accurate and unbiased in analyzing locomotor behavior in mice.MotorBox and MotoRater systems allow for sensitive detection of SCI-induced changes in movement metrics, including range of motion, gait, coordination, and speed.MotorBox and MotoRater systems allow for detection of movement metrics not measurable with the BMS.
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Dickey EM, Bianchi A, Amirian H, Hosein PJ, Faustman D, Brambilla R, Datta J. Transmembrane TNF-TNFR2 signaling as a critical immunoregulatory node in pancreatic cancer. Oncoimmunology 2024; 13:2326694. [PMID: 38481728 PMCID: PMC10936673 DOI: 10.1080/2162402x.2024.2326694] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
Pancreatic cancer is characterized by extreme therapeutic resistance. In pancreatic cancers harboring high-risk genomes, we describe that cancer cell-neutrophil signaling circuitry provokes neutrophil-derived transmembrane (tm)TNF-TNFR2 interactions that dictate inflammatory polarization in cancer-associated fibroblasts and T-cell dysfunction - two hallmarks of therapeutic resistance. Targeting tmTNF-TNFR2 signaling may sensitize pancreatic cancer to chemo±immunotherapy.
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Affiliation(s)
- Erin M. Dickey
- Division of Surgical Oncology, DeWitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Anna Bianchi
- Division of Surgical Oncology, DeWitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Haleh Amirian
- Division of Surgical Oncology, DeWitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Peter J. Hosein
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Denise Faustman
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jashodeep Datta
- Division of Surgical Oncology, DeWitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
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Raffaele S, Thougaard E, Laursen CCH, Gao H, Andersen KM, Nielsen PV, Ortí-Casañ N, Blichfeldt-Eckhardt M, Koch S, Deb-Chatterji M, Magnus T, Stubbe J, Madsen K, Meyer M, Degn M, Eisel ULM, Wlodarczyk A, Fumagalli M, Clausen BH, Brambilla R, Lambertsen KL. Microglial TNFR2 signaling regulates the inflammatory response after CNS injury in a sex-specific fashion. Brain Behav Immun 2024; 116:269-285. [PMID: 38142915 DOI: 10.1016/j.bbi.2023.12.025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023] Open
Abstract
Microglia, the resident immune cells of the central nervous system (CNS), play a major role in damage progression and tissue remodeling after acute CNS injury, including ischemic stroke (IS) and spinal cord injury (SCI). Understanding the molecular mechanisms regulating microglial responses to injury may thus reveal novel therapeutic targets to promote CNS repair. Here, we investigated the role of microglial tumor necrosis factor receptor 2 (TNFR2), a transmembrane receptor previously associated with pro-survival and neuroprotective responses, in shaping the neuroinflammatory environment after CNS injury. By inducing experimental IS and SCI in Cx3cr1CreER:Tnfrsf1bfl/fl mice, selectively lacking TNFR2 in microglia, and corresponding Tnfrsf1bfl/fl littermate controls, we found that ablation of microglial TNFR2 significantly reduces lesion size and pro-inflammatory cytokine levels, and favors infiltration of leukocytes after injury. Interestingly, these effects were paralleled by opposite sex-specific modifications of microglial reactivity, which was found to be limited in female TNFR2-ablated mice compared to controls, whereas it was enhanced in males. In addition, we show that TNFR2 protein levels in the cerebrospinal fluid (CSF) of human subjects affected by IS and SCI, as well as healthy donors, significantly correlate with disease stage and severity, representing a valuable tool to monitor the inflammatory response after acute CNS injury. Hence, these results advance our understanding of the mechanisms regulating microglia reactivity after acute CNS injury, aiding the development of sex- and microglia-specific, personalized neuroregenerative strategies.
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Affiliation(s)
- Stefano Raffaele
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark; Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, 20133 Milan, Italy
| | - Estrid Thougaard
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark
| | - Cathrine C H Laursen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark; BRIDGE-Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5230 Odense M, Denmark
| | - Han Gao
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, 510630 Guangzhou, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, 510630 Guangzhou, China
| | - Katrine M Andersen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark
| | - Pernille V Nielsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark
| | - Natalia Ortí-Casañ
- Department of Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen 9713 AV, Netherlands
| | - Morten Blichfeldt-Eckhardt
- Department of Anaesthesiology, Vejle Hospital, 7100 Vejle, Denmark; Department of Clinical Research, University of Southern Denmark, 5230 Odense M, Denmark
| | - Simon Koch
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Milani Deb-Chatterji
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Tim Magnus
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jane Stubbe
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark
| | - Kirsten Madsen
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark
| | - Morten Meyer
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark; BRIDGE-Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5230 Odense M, Denmark; Department of Neurology, Odense University Hospital, 5000 Odense C, Denmark
| | | | - Ulrich L M Eisel
- Department of Molecular Neurobiology, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen 9713 AV, Netherlands
| | - Agnieszka Wlodarczyk
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark; BRIDGE-Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5230 Odense M, Denmark
| | - Marta Fumagalli
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università degli Studi di Milano, 20133 Milan, Italy
| | - Bettina H Clausen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark; BRIDGE-Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5230 Odense M, Denmark
| | - Roberta Brambilla
- BRIDGE-Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5230 Odense M, Denmark; The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami FL, USA.
| | - Kate L Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5230 Odense M, Denmark; BRIDGE-Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5230 Odense M, Denmark; Department of Neurology, Odense University Hospital, 5000 Odense C, Denmark.
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Newman J, Tong X, Tan A, Yeasky T, De Paiva VN, Presicce P, Kannan PS, Williams K, Damianos A, Tamase Newsam M, Benny MK, Wu S, Young KC, Miller LA, Kallapur SG, Chougnet CA, Jobe AH, Brambilla R, Schmidt AF. Chorioamnionitis accelerates granule cell and oligodendrocyte maturation in the cerebellum of preterm nonhuman primates. J Neuroinflammation 2024; 21:16. [PMID: 38200558 PMCID: PMC10777625 DOI: 10.1186/s12974-024-03012-y] [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] [Received: 07/03/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Preterm birth is often associated with chorioamnionitis and leads to increased risk of neurodevelopmental disorders, such as autism. Preterm birth can lead to cerebellar underdevelopment, but the mechanisms of disrupted cerebellar development in preterm infants are not well understood. The cerebellum is consistently affected in people with autism spectrum disorders, showing reduction of Purkinje cells, decreased cerebellar grey matter, and altered connectivity. METHODS Preterm rhesus macaque fetuses were exposed to intra-amniotic LPS (1 mg, E. coli O55:B5) at 127 days (80%) gestation and delivered by c-section 5 days after injections. Maternal and fetal plasma were sampled for cytokine measurements. Chorio-decidua was analyzed for immune cell populations by flow cytometry. Fetal cerebellum was sampled for histology and molecular analysis by single-nuclei RNA-sequencing (snRNA-seq) on a 10× chromium platform. snRNA-seq data were analyzed for differences in cell populations, cell-type specific gene expression, and inferred cellular communications. RESULTS We leveraged snRNA-seq of the cerebellum in a clinically relevant rhesus macaque model of chorioamnionitis and preterm birth, to show that chorioamnionitis leads to Purkinje cell loss and disrupted maturation of granule cells and oligodendrocytes in the fetal cerebellum at late gestation. Purkinje cell loss is accompanied by decreased sonic hedgehog signaling from Purkinje cells to granule cells, which show an accelerated maturation, and to oligodendrocytes, which show accelerated maturation from pre-oligodendrocytes into myelinating oligodendrocytes. CONCLUSION These findings suggest a role of chorioamnionitis on disrupted cerebellar maturation associated with preterm birth and on the pathogenesis of neurodevelopmental disorders among preterm infants.
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Affiliation(s)
- Josef Newman
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Xiaoying Tong
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - April Tan
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Toni Yeasky
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Vanessa Nunes De Paiva
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Pietro Presicce
- Division of Neonatology, Department of Pediatrics, University of California Los Angeles, Los Angeles, USA
| | - Paranthaman S Kannan
- Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Kevin Williams
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Andreas Damianos
- Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Marione Tamase Newsam
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Merline K Benny
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Shu Wu
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Karen C Young
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA
| | - Lisa A Miller
- California National Primate Research Center, University of California, Davis, USA
| | - Suhas G Kallapur
- Division of Neonatology, Department of Pediatrics, University of California Los Angeles, Los Angeles, USA
| | - Claire A Chougnet
- Division of Immunobiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Alan H Jobe
- Division of Neonatology and Pulmonary Biology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Augusto F Schmidt
- Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine/Holtz Children's Hospital, Jackson Health System, Miami, USA.
- Batchelor Children's Research Institute, 1580 NW 10Th Ave, Room 348, Miami, FL, 33146, USA.
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Thougaard E, Nielsen PV, Forsberg A, Phuong V, Velasco AM, Wlodarczyk A, Wajant H, Lang I, Mikkelsen JD, Clausen BH, Brambilla R, Lambertsen KL. Systemic treatment with a selective TNFR2 agonist alters the central and peripheral immune responses and transiently improves functional outcome after experimental ischemic stroke. J Neuroimmunol 2023; 385:578246. [PMID: 37988839 DOI: 10.1016/j.jneuroim.2023.578246] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Ischemic stroke often leaves survivors with permanent disabilities and therapies aimed at limiting detrimental inflammation and improving functional outcome are still needed. Tumor necrosis factor (TNF) levels increase rapidly after ischemic stroke, and while signaling through TNF receptor 1 (TNFR1) is primarily detrimental, TNFR2 signaling mainly has protective functions. We therefore investigated how systemic stimulation of TNFR2 with the TNFR2 agonist NewSTAR2 affects ischemic stroke in mice. We found that NewSTAR2 treatment induced changes in peripheral immune cell numbers and transiently affected microglial numbers and neuroinflammation. However, this was not sufficient to improve long-term functional outcome after stroke in mice.
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Affiliation(s)
- Estrid Thougaard
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000 Odense C, Denmark.
| | - Pernille Vinther Nielsen
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000 Odense C, Denmark; Department of Neurology, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense C, Denmark.
| | - Amalie Forsberg
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark.
| | - Victoria Phuong
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark.
| | - Aitana Martínez Velasco
- Neurobiology Research Unit, University Hospital Rigshospitalet, Inge Lehmanns Vej 6, 2100 Copenhagen, Denmark
| | - Agnieszka Wlodarczyk
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000 Odense C, Denmark.
| | - Harald Wajant
- Division of Molecular Internal Medicine, Department of Internal Medicine II, University Hospital Würzburg, Oberdürrbacher Straße 6, Würzburg 97080, Germany.
| | - Isabell Lang
- Division of Molecular Internal Medicine, Department of Internal Medicine II, University Hospital Würzburg, Oberdürrbacher Straße 6, Würzburg 97080, Germany.
| | - Jens D Mikkelsen
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark; Neurobiology Research Unit, University Hospital Rigshospitalet, Inge Lehmanns Vej 6, 2100 Copenhagen, Denmark; Department of Neuroscience, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Bettina Hjelm Clausen
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000 Odense C, Denmark.
| | - Roberta Brambilla
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000 Odense C, Denmark; The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, Lois Pope LIFE Center, Miami, FL 33136, USA.
| | - Kate Lykke Lambertsen
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, J. B. Winsløwsvej 21 st, 5000 Odense C, Denmark; BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000 Odense C, Denmark; Department of Neurology, Odense University Hospital, J.B. Winsløwsvej 4, 5000 Odense C, Denmark.
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Thougaard E, Carney B, Wlodarczyk A, Brambilla R, Lambertsen KL. Peripherally derived myeloid cells induce disease-dependent phenotypic changes in microglia. Front Cell Neurosci 2023; 17:1295840. [PMID: 38155863 PMCID: PMC10752942 DOI: 10.3389/fncel.2023.1295840] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 11/23/2023] [Indexed: 12/30/2023] Open
Abstract
In central nervous system (CNS) injury and disease, peripherally derived myeloid cells infiltrate the CNS parenchyma and interact with resident cells, propagating the neuroinflammatory response. Because peripheral myeloid populations differ profoundly depending on the type and phase of injury, their crosstalk with CNS resident cells, particularly microglia, will lead to different functional outcomes. Thus, understanding how peripheral myeloid cells affect the phenotype and function of microglia in different disease conditions and phases may lead to a better understanding of disease-specific targetable pathways for neuroprotection and neurorepair. To this end, we set out to develop an in vitro system to investigate the communication between peripheral myeloid cells and microglia, with the goal of uncovering potential differences due to disease type and timing. We isolated peripheral myeloid cells from mice undergoing experimental autoimmune encephalomyelitis (EAE), a model of multiple sclerosis, or acute cerebral ischemia by permanent middle cerebral artery occlusion (pMCAO) at different times after disease and probed their ability to change the phenotype of primary microglia isolated from the brain of adult mice. We identified changes not only dependent on the disease model, but also on the timepoint after disease onset from which the myeloid cells were isolated. Peripheral myeloid cells from acute EAE induced morphological changes in microglia, followed by increases in expression of genes involved in inflammatory signaling. Conversely, it was the peripheral myeloid cells from the chronic phase of pMCAO that induced gene expression changes in genes involved in inflammatory signaling and phagocytosis, which was not followed by a change in morphology. This underscores the importance of understanding the role of infiltrating myeloid cells in different disease contexts and phases. Furthermore, we showed that our assay is a valuable tool for investigating myeloid cell interactions in a range of CNS neuroinflammatory conditions.
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Affiliation(s)
- Estrid Thougaard
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Brianna Carney
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Agnieszka Wlodarczyk
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Roberta Brambilla
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Kate Lykke Lambertsen
- Neurobiology Research, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- BRIDGE - Brain Research - Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Neurology, Odense University Hospital, Odense, Denmark
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Bracchi-Ricard V, Nguyen K, Ricci D, Gaudette B, Henao-Meija J, Brambilla R, Martynyuk T, Gidalevitz T, Allman D, Bethea JR, Argon Y. Increased activity of IRE1 improves the clinical presentation of EAE. FASEB J 2023; 37:e23283. [PMID: 37983957 PMCID: PMC10662669 DOI: 10.1096/fj.202300769rr] [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] [Received: 04/19/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 11/22/2023]
Abstract
Activation of the endoplasmic reticulum (ER) stress sensor inositol-requiring enzyme-1α (IRE1α) contributes to neuronal development and is known to induce neuronal remodeling in vitro and in vivo. On the contrary, excessive IRE1 activity is often detrimental and may contribute to neurodegeneration. To determine the consequences of increased activation of IRE1α, we used a mouse model expressing a C148S variant of IRE1α with increased and sustained activation. Surprisingly, the mutation did not affect the differentiation of highly secretory antibody-producing cells but exhibited a beneficial effect in a mouse model of experimental autoimmune encephalomyelitis (EAE). Although mechanical allodynia was unaffected, significant improvement in motor function was found in IRE1C148S mice with EAE relative to wild type (WT) mice. Coincident with this improvement, there was reduced microgliosis in the spinal cord of IRE1C148S mice, with reduced expression of proinflammatory cytokine genes. This was accompanied by reduced axonal degeneration and enhanced 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNPase) levels, suggesting improved myelin integrity. Interestingly, while the IRE1C148S mutation is expressed in all cells, the reduction in proinflammatory cytokines and in the microglial activation marker ionized calcium-binding adapter molecule (IBA1), along with preservation of phagocytic gene expression, all point to microglia as the cell type contributing to the clinical improvement in IRE1C148S animals. Our data suggest that sustained increase in IRE1α activity can be beneficial in vivo, and that this protection is cell type and context dependent. Considering the overwhelming but conflicting evidence for the role of ER stress in neurological diseases, a better understanding of the function of ER stress sensors in physiological contexts is clearly needed.
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Affiliation(s)
| | - Kayla Nguyen
- Department of Biology, Drexel University, Philadelphia, PA
| | - Daniela Ricci
- Department of Pathology and Lab Medicine, The Children’s Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA, USA
| | - Brian Gaudette
- Department of Pathology and Lab Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - Jorge Henao-Meija
- Department of Pathology and Lab Medicine, The Children’s Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA, USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
- BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | | | | | - David Allman
- Department of Pathology and Lab Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - John R. Bethea
- Department of Biology, Drexel University, Philadelphia, PA
| | - Yair Argon
- Department of Pathology and Lab Medicine, The Children’s Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA, USA
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8
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Gao H, Di J, Clausen BH, Wang N, Zhu X, Zhao T, Chang Y, Pang M, Yang Y, He R, Wang Y, Zhang L, Liu B, Qiu W, Lambertsen KL, Brambilla R, Rong L. Distinct myeloid population phenotypes dependent on TREM2 expression levels shape the pathology of traumatic versus demyelinating CNS disorders. Cell Rep 2023; 42:112773. [PMID: 37393623 DOI: 10.1016/j.celrep.2023.112773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
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Gao H, Di J, Clausen BH, Wang N, Zhu X, Zhao T, Chang Y, Pang M, Yang Y, He R, Wang Y, Zhang L, Liu B, Qiu W, Lambertsen KL, Brambilla R, Rong L. Distinct myeloid population phenotypes dependent on TREM2 expression levels shape the pathology of traumatic versus demyelinating CNS disorders. Cell Rep 2023; 42:112629. [PMID: 37289590 DOI: 10.1016/j.celrep.2023.112629] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/23/2023] [Accepted: 05/24/2023] [Indexed: 06/10/2023] Open
Abstract
Triggering receptor expressed on myeloid cell 2 (TREM2) signaling often drives opposing effects in traumatic versus demyelinating CNS disorders. Here, we identify two distinct phenotypes of microglia and infiltrating myeloid populations dependent on TREM2 expression levels at the acute stage and elucidate how they mediate the opposing effects of TREM2 in spinal cord injury (SCI) versus multiple sclerosis animal models (experimental autoimmune encephalomyelitis [EAE]). High TREM2 levels sustain phagocytic microglia and infiltrating macrophages after SCI. In contrast, moderate TREM2 levels sustain immunomodulatory microglia and infiltrating monocytes in EAE. TREM2-ablated microglia (purine-sensing phenotype in SCI and reduced immunomodulatory phenotype in EAE) drive transient protection at the acute stage of both disorders, whereas reduced phagocytic macrophages and lysosome-activated monocytes lead to contrasting neuroprotective and demyelinating effects in SCI versus EAE, respectively. Our study provides comprehensive insights into the complex roles of TREM2 in myeloid populations across diverse CNS disorders, which has crucial implications in devising TREM2-targeting therapeutics.
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Affiliation(s)
- Han Gao
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China.
| | - Jiawei Di
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China
| | - Bettina Hjelm Clausen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
| | - Nanxiang Wang
- Department of Orthopaedic Surgery, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Xizhong Zhu
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China
| | - Tianlun Zhao
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China
| | - Yanyu Chang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Mao Pang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China
| | - Yang Yang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China
| | - Ronghan He
- Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Liangming Zhang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China
| | - Bin Liu
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China
| | - Wei Qiu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Kate Lykke Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; Department of Neurology, Odense University Hospital, 5000 Odense, Denmark; BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Roberta Brambilla
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark; The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33161, USA.
| | - Limin Rong
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou 510630, China.
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10
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Lund MC, Ellman DG, Nielsen PV, Raffaele S, Fumagalli M, Guzman R, Degn M, Brambilla R, Meyer M, Clausen BH, Lambertsen KL. Selective Inhibition of Soluble Tumor Necrosis Factor Alters the Neuroinflammatory Response following Moderate Spinal Cord Injury in Mice. Biology (Basel) 2023; 12:845. [PMID: 37372129 DOI: 10.3390/biology12060845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Clinical and animal model studies have implicated inflammation and glial and peripheral immune cell responses in the pathophysiology of spinal cord injury (SCI). A key player in the inflammatory response after SCI is the pleiotropic cytokine tumor necrosis factor (TNF), which exists both in both a transmembrane (tmTNF) and a soluble (solTNF) form. In the present study, we extend our previous findings of a therapeutic effect of topically blocking solTNF signaling after SCI for three consecutive days on lesion size and functional outcome to study the effect on spatio-temporal changes in the inflammatory response after SCI in mice treated with the selective solTNF inhibitor XPro1595 and compared to saline-treated mice. We found that despite comparable TNF and TNF receptor levels between XPro1595- and saline-treated mice, XPro1595 transiently decreased pro-inflammatory interleukin (IL)-1β and IL-6 levels and increased pro-regenerative IL-10 levels in the acute phase after SCI. This was complemented by a decrease in the number of infiltrated leukocytes (macrophages and neutrophils) in the lesioned area of the spinal cord and an increase in the number of microglia in the peri-lesion area 14 days after SCI, followed by a decrease in microglial activation in the peri-lesion area 21 days after SCI. This translated into increased myelin preservation and improved functional outcomes in XPro1595-treated mice 35 days after SCI. Collectively, our data suggest that selective targeting of solTNF time-dependently modulates the neuroinflammatory response by favoring a pro-regenerative environment in the lesioned spinal cord, leading to improved functional outcomes.
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Affiliation(s)
- Minna Christiansen Lund
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
| | - Ditte Gry Ellman
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
| | - Pernille Vinther Nielsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
- Department of Neurology, Odense University Hospital, 5000 Odense, Denmark
| | - Stefano Raffaele
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
| | - Marta Fumagalli
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milan, Italy
| | - Raphael Guzman
- Department of Biomedicine, University of Basel, 4031 Basel, Switzerland
| | - Matilda Degn
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Roberta Brambilla
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Brain Research Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, 5000 Odense, Denmark
- Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Morten Meyer
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
- Department of Neurology, Odense University Hospital, 5000 Odense, Denmark
- Brain Research Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, 5000 Odense, Denmark
| | - Bettina Hjelm Clausen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
- Brain Research Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, 5000 Odense, Denmark
| | - Kate Lykke Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
- Department of Neurology, Odense University Hospital, 5000 Odense, Denmark
- Brain Research Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, 5000 Odense, Denmark
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11
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Bianchi A, De Castro Silva I, Deshpande NU, Singh S, Mehra S, Garrido VT, Guo X, Nivelo LA, Kolonias DS, Saigh SJ, Wieder E, Rafie CI, Dosch AR, Zhou Z, Umland O, Amirian H, Ogobuiro IC, Zhang J, Ban Y, Shiau C, Nagathihalli NS, Montgomery EA, Hwang WL, Brambilla R, Komanduri K, Villarino AV, Toska E, Stanger BZ, Gabrilovich DI, Merchant NB, Datta J. Cell-Autonomous Cxcl1 Sustains Tolerogenic Circuitries and Stromal Inflammation via Neutrophil-Derived TNF in Pancreatic Cancer. Cancer Discov 2023; 13:1428-1453. [PMID: 36946782 PMCID: PMC10259764 DOI: 10.1158/2159-8290.cd-22-1046] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/13/2023] [Accepted: 02/24/2023] [Indexed: 03/23/2023]
Abstract
We have shown that KRAS-TP53 genomic coalteration is associated with immune-excluded microenvironments, chemoresistance, and poor survival in pancreatic ductal adenocarcinoma (PDAC) patients. By treating KRAS-TP53 cooperativity as a model for high-risk biology, we now identify cell-autonomous Cxcl1 as a key mediator of spatial T-cell restriction via interactions with CXCR2+ neutrophilic myeloid-derived suppressor cells in human PDAC using imaging mass cytometry. Silencing of cell-intrinsic Cxcl1 in LSL-KrasG12D/+;Trp53R172H/+;Pdx-1Cre/+(KPC) cells reprograms the trafficking and functional dynamics of neutrophils to overcome T-cell exclusion and controls tumor growth in a T cell-dependent manner. Mechanistically, neutrophil-derived TNF is a central regulator of this immunologic rewiring, instigating feed-forward Cxcl1 overproduction from tumor cells and cancer-associated fibroblasts (CAF), T-cell dysfunction, and inflammatory CAF polarization via transmembrane TNF-TNFR2 interactions. TNFR2 inhibition disrupts this circuitry and improves sensitivity to chemotherapy in vivo. Our results uncover cancer cell-neutrophil cross-talk in which context-dependent TNF signaling amplifies stromal inflammation and immune tolerance to promote therapeutic resistance in PDAC. SIGNIFICANCE By decoding connections between high-risk tumor genotypes, cell-autonomous inflammatory programs, and myeloid-enriched/T cell-excluded contexts, we identify a novel role for neutrophil-derived TNF in sustaining immunosuppression and stromal inflammation in pancreatic tumor microenvironments. This work offers a conceptual framework by which targeting context-dependent TNF signaling may overcome hallmarks of chemoresistance in pancreatic cancer. This article is highlighted in the In This Issue feature, p. 1275.
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Affiliation(s)
- Anna Bianchi
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Iago De Castro Silva
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nilesh U. Deshpande
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Samara Singh
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Siddharth Mehra
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Vanessa T. Garrido
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Xinyu Guo
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Luis A. Nivelo
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Despina S. Kolonias
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Eric Wieder
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Christine I. Rafie
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Austin R. Dosch
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Zhiqun Zhou
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Oliver Umland
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Haleh Amirian
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ifeanyichukwu C. Ogobuiro
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jian Zhang
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yuguang Ban
- Department of Public Health Sciences; University of Miami Miller School of Medicine, Miami, FL, USA Miami, FL, USA
| | - Carina Shiau
- Center for Systems Biology, Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nagaraj S. Nagathihalli
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Elizabeth A. Montgomery
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - William L. Hwang
- Center for Systems Biology, Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Krishna Komanduri
- Department of Medicine, University of California San Francisco Health, San Francisco, CA, USA
| | - Alejandro V. Villarino
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eneda Toska
- Department of Oncology, Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ben Z. Stanger
- Division of Gastroenterology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Nipun B. Merchant
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Jashodeep Datta
- Division of Surgical Oncology, Dewitt Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, Miami, FL, USA
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12
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Bracchi-Ricard V, Nguyen K, Ricci D, Gaudette B, Henao-Meija J, Brambilla R, Martynyuk T, Gidalevitz T, Allman D, Bethea JR, Argon Y. Increased activity of IRE1 improves the clinical presentation of EAE. bioRxiv 2023:2023.04.19.537391. [PMID: 37131811 PMCID: PMC10153167 DOI: 10.1101/2023.04.19.537391] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Activation of the ER stress sensor IRE1α contributes to neuronal development and is known to induce neuronal remodeling in vitro and in vivo. On the other hand, excessive IRE1 activity is often detrimental and may contribute to neurodegeneration. To determine the consequences of increased activation of IRE1α, we used a mouse model expressing a C148S variant of IRE1α with increased and sustained activation. Surprisingly, the mutation did not affect the differentiation of highly secretory antibody-producing cells, but exhibited a strong protective effect in a mouse model of experimental autoimmune encephalomyelitis (EAE). Significant improvement in motor function was found in IRE1C148S mice with EAE relative to WT mice. Coincident with this improvement, there was reduced microgliosis in the spinal cord of IRE1C148S mice, with reduced expression of pro-inflammatory cytokine genes. This was accompanied by reduced axonal degeneration and enhanced CNPase levels, suggestiing improved myelin integrity. Interestingly, while the IRE1C148S mutation is expressed in all cells, the reduction in proinflammatory cytokines and in the activation of microglial activation marker IBA1, along with preservation of phagocytic gene expression, all point to microglia as the cell type contributing to the clinical improvement in IRE1C148S animals. Our data suggest that sustained increase in IRE1α activity can be protective in vivo, and that this protection is cell type and context dependent. Considering the overwhelming but conflicting evidence for the role of the ER stress in neurological diseases, a better understanding of the function of ER stress sensors in physiological contexts is clearly needed.
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Affiliation(s)
| | - Kayla Nguyen
- Department of Biology, Drexel University, Philadelphia, PA
| | - Daniela Ricci
- Department of Pathology and Lab Medicine, The Children's Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA, USA
| | - Brian Gaudette
- Department of Pathology and Lab Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - Jorge Henao-Meija
- Department of Pathology and Lab Medicine, The Children's Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA, USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
- BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | | | | | - David Allman
- Department of Pathology and Lab Medicine, the University of Pennsylvania, Philadelphia, PA, USA
| | - John R Bethea
- Department of Biology, Drexel University, Philadelphia, PA
| | - Yair Argon
- Department of Pathology and Lab Medicine, The Children's Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA, USA
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13
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Chédotal H, Narayanan D, Povlsen K, Gotfredsen CH, Brambilla R, Gajhede M, Bach A, Clausen MH. Small-molecule modulators of tumor necrosis factor signaling. Drug Discov Today 2023; 28:103575. [PMID: 37003513 DOI: 10.1016/j.drudis.2023.103575] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/15/2022] [Revised: 03/21/2023] [Accepted: 03/25/2023] [Indexed: 04/03/2023]
Abstract
Tumor necrosis factor (TNF) is a pleiotropic cytokine with a major role in immune system homeostasis and is involved in many inflammatory and autoimmune diseases, such as rheumatoid arthritis (RA), psoriasis, Alzheimer's disease (AD), and multiple sclerosis (MS). Thus, TNF and its receptors, TNFR1 and TNFR2, are relevant pharmacological targets. Biologics have been developed to block TNF-dependent signaling cascades, but they display serious side effects, and their pharmacological effectiveness decreases over time because of their immunogenicity. In this review, we present recent discoveries in small molecules targeting TNF and its receptors and discuss alternative strategies for modulating TNF signaling. Teaser: This review presents several recent and innovative strategies for the modulation of tumor necrosis factor function, with a focus on small molecules.
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Affiliation(s)
- Henri Chédotal
- Technical University of Denmark, Center for Nanomedicine and Theranostics, Department of Chemistry, Kemitorvet 207, 2800 Kgs. Lyngby, Denmark
| | - Dilip Narayanan
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark
| | - Katrine Povlsen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark
| | - Charlotte H Gotfredsen
- Technical University of Denmark, Department of Chemistry, Kemitorvet 207, 2800 Kgs. Lyngby, Denmark
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Neurobiology Research, Institute of Molecular Medicine, and BRIDGE - Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Michael Gajhede
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark
| | - Anders Bach
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen, Denmark.
| | - Mads H Clausen
- Technical University of Denmark, Center for Nanomedicine and Theranostics, Department of Chemistry, Kemitorvet 207, 2800 Kgs. Lyngby, Denmark.
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14
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Stöckl H, Brambilla R, Mshana G, Malibwa D, Sichalwe S, Kapiga S. Young men’s gambling and violence perpetration in Mwanza, Tanzania. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.057] [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: 11/13/2022] Open
Abstract
Abstract
Background
The prevalence of intimate partner violence (IPV) in Tanzania is one of the highest in the sub-Saharan African region. Studies have shown that traditionally “manly” behaviours, such as risk-taking, are at the root of IPV perpetration. Only few studies investigated the co-occurrence of gambling and IPV, and none from LMICs.
Methods
Cross-sectional survey data of 1002 men aged 18-24 from Mwanza, Tanzania were analysed. Physical, sexual, emotional and economic IPV perpetration were measured using acts-based questions. Gambling was assessed through a question on whether the man bet or spent money on gambling or gambling machines. Consequences of gambling behaviours were assessed through four further questions. We conducted multivariate logistic regressions to control for potential confounders.
Results
21% of the men in the sample confirmed they had bet or spent money on gambling in the previous 12 months; the prevalence raises to 24% for men who had been in a relationship in the previous 12 months (N = 755). Of these, 23% had ever perpetrated physical IPV, 29% sexual IPV, 56% emotional IPV and 37% economic IPV in their lifetimes. Of those who gambled, 24% had ever perpetrated physical IPV, 46% ever committed sexual IPV, 66% emotional IPV and 45% economic IPV. Gambling was statistically significantly associated sexual IPV (aOR: 2.39; 95% CI: 1.66-3.45) and emotional IPV (aOR: 1.48; 95% CI: 1.03-2.14) even after controlling for age, alcohol use, depressive symptoms and suicidal ideation. Gambling was not associated with physical and economic IPV after adjusting for those confounders.
Implications
The analysis shows that young men's practice of gambling is an additional risk factor for IPV perpetration that needs to be addressed. More research is needed to understand how current prevention efforts can be expanded to include problem gambling treatment to curb the incidence of IPV and give couples conflict resolutions skills for issues that might arise from gambling.
Key messages
• Problem gambling has so far remained vastly under-researched in violence research.
• Gambling as well as drinking were associated with increased odds of physical and sexual IPV perpetration.
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Affiliation(s)
- H Stöckl
- Ludwig-Maximilians-Universität München , München, Germany
- LSHTM , London, UK
| | - R Brambilla
- Ludwig-Maximilians-Universität München , München, Germany
| | - G Mshana
- National Institute for Medical Research , Mwanza, Tanzania
- Mwanza Intervention Trials Unit , Mwanza, Tanzania
| | - D Malibwa
- Mwanza Intervention Trials Unit , Mwanza, Tanzania
| | - S Sichalwe
- Mwanza Intervention Trials Unit , Mwanza, Tanzania
| | - S Kapiga
- Mwanza Intervention Trials Unit , Mwanza, Tanzania
- LSHTM , London, UK
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15
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Pinto M, Diaz F, Nissanka N, Guastucci CS, Illiano P, Brambilla R, Moraes CT. Adult-Onset Deficiency of Mitochondrial Complex III in a Mouse Model of Alzheimer's Disease Decreases Amyloid Beta Plaque Formation. Mol Neurobiol 2022; 59:6552-6566. [PMID: 35969330 PMCID: PMC9464722 DOI: 10.1007/s12035-022-02992-3] [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] [Received: 04/27/2022] [Accepted: 08/07/2022] [Indexed: 11/26/2022]
Abstract
For decades, mitochondrial dysfunctions and the generation of reactive oxygen species have been proposed to promote the development and progression of the amyloid pathology in Alzheimer's disease, but this association is still debated. It is unclear whether different mitochondrial dysfunctions, such as oxidative phosphorylation deficiency and oxidative stress, are triggers or rather consequences of the formation of amyloid aggregates. Likewise, the role of the different mitochondrial oxidative phosphorylation complexes in Alzheimer's patients' brain remains poorly understood. Previous studies showed that genetic ablation of oxidative phosphorylation enzymes from early age decreased amyloid pathology, which were unexpected results. To better model oxidative phosphorylation defects in aging, we induced the ablation of mitochondrial Complex III (CIIIKO) in forebrain neurons of adult mice with amyloid pathology. We found that mitochondrial Complex III dysfunction in adult neurons induced mild oxidative stress but did not increase amyloid beta accumulation. On the contrary, CIIIKO-AD mice showed decreased plaque number, decreased Aβ42 toxic fragment, and altered amyloid precursor protein clearance pathway. Our results support the hypothesis that mitochondrial dysfunctions alone, caused by oxidative phosphorylation deficiency, is not the cause of amyloid accumulation.
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Affiliation(s)
- Milena Pinto
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Francisca Diaz
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nadee Nissanka
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Chelsey S Guastucci
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Placido Illiano
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Carlos T Moraes
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
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16
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Plastini MJ, Desu HL, Ascona MC, Lang AL, Saporta MA, Brambilla R. Transcriptional abnormalities in induced pluripotent stem cell-derived oligodendrocytes of individuals with primary progressive multiple sclerosis. Front Cell Neurosci 2022; 16:972144. [PMID: 36246526 PMCID: PMC9554611 DOI: 10.3389/fncel.2022.972144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple sclerosis (MS) is the most common neurological disorder in young adults and is classically defined as a chronic inflammatory demyelinating disease of the central nervous system (CNS). Although MS affects millions of people worldwide, its underlying cause remains unknown making discovery of effective treatments challenging. Whether intrinsic or extrinsic factors contribute to MS initiation and progression is still unclear. This is especially true for primary progressive MS (PPMS), the rarest form of the disease, in which progressive and irreversible loss of neurological function is often observed in the absence of an overt immune-inflammatory response. To test the hypothesis that intrinsic dysfunction in oligodendrocytes (OLs), the primary targets of damage in MS, may contribute to PPMS etiopathology, we differentiated human induced pluripotent stem cell (hiPSC) lines derived from PPMS and healthy individuals into mature OLs to compare their transcriptional profile. PPMS derived OLs displayed hundreds of differentially expressed genes compared to control OLs, many associated with cell adhesion, apoptosis and inflammation, including the inflammasome component Nlrp2, which was highly upregulated. NLRP2 immunoreactivity in OLs was confirmed in post-mortem PPMS brain tissues, with higher expression than in control tissues. Altogether, our findings suggest that mature OLs in PPMS affected individuals carry intrinsic abnormalities that could contribute, at least in part, to the pathophysiology of this form of the disease.
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Affiliation(s)
- Melanie J. Plastini
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
- The Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Haritha L. Desu
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
- The Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Maureen C. Ascona
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
- The Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Anna L. Lang
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Mario A. Saporta
- The Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
- The Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- BRIDGE-Brain Research-Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- *Correspondence: Roberta Brambilla,
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17
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Chavez L, Meguro J, Chen S, de Paiva VN, Zambrano R, Eterno JM, Kumar R, Duncan MR, Benny M, Young KC, Dietrich WD, Brambilla R, Wu S, Schmidt AF. Circulating extracellular vesicles activate the pyroptosis pathway in the brain following ventilation-induced lung injury. J Neuroinflammation 2021; 18:310. [PMID: 34965880 PMCID: PMC8717639 DOI: 10.1186/s12974-021-02364-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/17/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Mechanical ventilation of preterm newborns causes lung injury and is associated with poor neurodevelopmental outcomes. However, the mechanistic links between ventilation-induced lung injury (VILI) and brain injury is not well defined. Since circulating extracellular vesicles (EVs) are known to link distant organs by transferring their cargos, we hypothesized that EVs mediate inflammatory brain injury associated with VILI. METHODS Neonatal rats were mechanically ventilated with low (10 mL/kg) or high (25 mL/kg) tidal volume for 1 h on post-natal day 7 followed by recovery for 2 weeks. Exosomes were isolated from the plasma of these rats and adoptively transferred into normal newborn rats. We assessed the effect of mechanical ventilation or exosome transfer on brain inflammation and activation of the pyroptosis pathway by western blot and histology. RESULTS Injurious mechanical ventilation induced similar markers of inflammation and pyroptosis, such as increased IL-1β and activated caspase-1/gasdermin D (GSDMD) in both lung and brain, in addition to inducing microglial activation and cell death in the brain. Isolated EVs were enriched for the exosomal markers CD9 and CD81, suggesting enrichment for exosomes. EVs isolated from neonatal rats with VILI had increased caspase-1 but not GSDMD. Adoptive transfer of these EVs led to neuroinflammation with microglial activation and activation of caspase-1 and GSDMD in the brain similar to that observed in neonatal rats that were mechanically ventilated. CONCLUSIONS These findings suggest that circulating EVs can contribute to the brain injury and poor neurodevelopmental outcomes in preterm infants with VILI through activation of GSDMD.
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Affiliation(s)
- Laura Chavez
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Julia Meguro
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Shaoyi Chen
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Vanessa Nunes de Paiva
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Ronald Zambrano
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Julia M Eterno
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Rahul Kumar
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Matthew R Duncan
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Merline Benny
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Karen C Young
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - W Dalton Dietrich
- The Miami Project To Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Roberta Brambilla
- The Miami Project To Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Shu Wu
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA
| | - Augusto F Schmidt
- Department of Pediatrics, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL, 33136, USA.
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18
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Pettinato C, Brambilla R, Campoleoni M. Development of a web-app for dose class estimation in radiological procedures. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00256-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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19
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Desu HL, Illiano P, Choi JS, Ascona MC, Gao H, Lee JK, Brambilla R. TNFR2 Signaling Regulates the Immunomodulatory Function of Oligodendrocyte Precursor Cells. Cells 2021; 10:1785. [PMID: 34359956 PMCID: PMC8306473 DOI: 10.3390/cells10071785] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/14/2022] Open
Abstract
Multiple sclerosis (MS) is a neuroimmune disorder characterized by inflammation, CNS demyelination, and progressive neurodegeneration. Chronic MS patients exhibit impaired remyelination capacity, partly due to the changes that oligodendrocyte precursor cells (OPCs) undergo in response to the MS lesion environment. The cytokine tumor necrosis factor (TNF) is present in the MS-affected CNS and has been implicated in disease pathophysiology. Of the two active forms of TNF, transmembrane (tmTNF) and soluble (solTNF), tmTNF signals via TNFR2 mediating protective and reparative effects, including remyelination, whereas solTNF signals predominantly via TNFR1 promoting neurotoxicity. To better understand the mechanisms underlying repair failure in MS, we investigated the cellular responses of OPCs to inflammatory exposure and the specific role of TNFR2 signaling in their modulation. Following treatment of cultured OPCs with IFNγ, IL1β, and TNF, we observed, by RNA sequencing, marked inflammatory and immune activation of OPCs, accompanied by metabolic changes and dysregulation of their proliferation and differentiation programming. We also established the high likelihood of cell-cell interaction between OPCs and microglia in neuroinflammatory conditions, with OPCs able to produce chemokines that can recruit and activate microglia. Importantly, we showed that these functions are exacerbated when TNFR2 is ablated. Together, our data indicate that neuroinflammation leads OPCs to shift towards an immunomodulatory phenotype while diminishing their capacity to proliferate and differentiate, thus impairing their repair function. Furthermore, we demonstrated that TNFR2 plays a key role in this process, suggesting that boosting TNFR2 activation or its downstream signals could be an effective strategy to restore OPC reparative capacity in demyelinating disease.
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Affiliation(s)
- Haritha L. Desu
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.L.D.); (P.I.); (J.S.C.); (M.C.A.); (H.G.); (J.K.L.)
| | - Placido Illiano
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.L.D.); (P.I.); (J.S.C.); (M.C.A.); (H.G.); (J.K.L.)
| | - James S. Choi
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.L.D.); (P.I.); (J.S.C.); (M.C.A.); (H.G.); (J.K.L.)
| | - Maureen C. Ascona
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.L.D.); (P.I.); (J.S.C.); (M.C.A.); (H.G.); (J.K.L.)
| | - Han Gao
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.L.D.); (P.I.); (J.S.C.); (M.C.A.); (H.G.); (J.K.L.)
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Jae K. Lee
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.L.D.); (P.I.); (J.S.C.); (M.C.A.); (H.G.); (J.K.L.)
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.L.D.); (P.I.); (J.S.C.); (M.C.A.); (H.G.); (J.K.L.)
- Department of Neurobiology Research, Institute of Molecular Medicine, and BRIDGE—Brain Research Inter Disciplinary Guided Excellence, 5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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20
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Madsen PM, Desu HL, de Rivero Vaccari JP, Florimon Y, Ellman DG, Keane RW, Clausen BH, Lambertsen KL, Brambilla R. Corrigendum to: Oligodendrocytes modulate the immune-inflammatory response in EAE via TNFR2 signaling. Brain Behav Immun 2021; 95:520. [PMID: 33933332 PMCID: PMC8219028 DOI: 10.1016/j.bbi.2021.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Pernille M. Madsen
- The Miami Project to Cure Paralysis, Dept. Neurological
Surgery, University of Miami Miller School of Medicine, FL 33136, USA; Dept.
Neurobiology Research, Institute of Molecular Medicine, University of Southern
Denmark, Odense, Denmark
| | - Haritha L. Desu
- The Miami Project to Cure Paralysis, Dept. Neurological
Surgery, University of Miami Miller School of Medicine, FL 33136, USA; The
Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL
33136, USA
| | - Juan Pablo de Rivero Vaccari
- The Miami Project to Cure Paralysis, Dept. Neurological
Surgery, University of Miami Miller School of Medicine, FL 33136, USA
| | - Yoleinny Florimon
- The Miami Project to Cure Paralysis, Dept. Neurological
Surgery, University of Miami Miller School of Medicine, FL 33136, USA
| | - Ditte G. Ellman
- Dept. Neurobiology Research, Institute of Molecular
Medicine, University of Southern Denmark, Odense, Denmark
| | - Robert W. Keane
- The Miami Project to Cure Paralysis, Dept. Neurological
Surgery, University of Miami Miller School of Medicine, FL 33136, USA; The
Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL
33136, USA; Dept. Physiology and Biophysics, University of Miami Miller School of
Medicine, FL 33136, USA
| | - Bettina H Clausen
- Dept. Neurobiology Research, Institute of Molecular
Medicine, University of Southern Denmark, Odense, Denmark; BRIDGE – Brain
Research Inter Disciplinary Guided Excellence, Department of Clinical Research,
University of Southern Denmark, Odense, Denmark
| | - Kate L. Lambertsen
- Dept. Neurobiology Research, Institute of Molecular
Medicine, University of Southern Denmark, Odense, Denmark; Department of Neurology,
Odense University Hospital, Odense, Denmark; BRIDGE – Brain Research Inter
Disciplinary Guided Excellence, Department of Clinical Research, University of
Southern Denmark, Odense, Denmark
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, FL 33136, USA; Dept. Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA; BRIDGE - Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
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21
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Pallesen JS, Narayanan D, Tran KT, Solbak SMØ, Marseglia G, Sørensen LME, Høj LJ, Munafò F, Carmona RMC, Garcia AD, Desu HL, Brambilla R, Johansen TN, Popowicz GM, Sattler M, Gajhede M, Bach A. Deconstructing Noncovalent Kelch-like ECH-Associated Protein 1 (Keap1) Inhibitors into Fragments to Reconstruct New Potent Compounds. J Med Chem 2021; 64:4623-4661. [PMID: 33818106 DOI: 10.1021/acs.jmedchem.0c02094] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Targeting the protein-protein interaction (PPI) between nuclear factor erythroid 2-related factor 2 (Nrf2) and Kelch-like ECH-associated protein 1 (Keap1) is a potential therapeutic strategy to control diseases involving oxidative stress. Here, six classes of known small-molecule Keap1-Nrf2 PPI inhibitors were dissected into 77 fragments in a fragment-based deconstruction reconstruction (FBDR) study and tested in four orthogonal assays. This gave 17 fragment hits of which six were shown by X-ray crystallography to bind in the Keap1 Kelch binding pocket. Two hits were merged into compound 8 with a 220-380-fold stronger affinity (Ki = 16 μM) relative to the parent fragments. Systematic optimization resulted in several novel analogues with Ki values of 0.04-0.5 μM, binding modes determined by X-ray crystallography, and enhanced microsomal stability. This demonstrates how FBDR can be used to find new fragment hits, elucidate important ligand-protein interactions, and identify new potent inhibitors of the Keap1-Nrf2 PPI.
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Affiliation(s)
- Jakob S Pallesen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Dilip Narayanan
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Kim T Tran
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Sara M Ø Solbak
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Giuseppe Marseglia
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark.,Food and Drug Department, University of Parma, Parco Area delle Scienze 27/a, 43124 Parma, Italy
| | - Louis M E Sørensen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Lars J Høj
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Federico Munafò
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Rosa M C Carmona
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Anthony D Garcia
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark.,École Nationale Supérieure de Chimie de Rennes, 11 Allée de Beaulieu, CS 50837, Rennes Cedex 7 35708, France
| | - Haritha L Desu
- The Miami Project to Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, United States
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, United States.,Department of Neurobiology Research, Institute of Molecular Medicine, and BRIDGE-Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, DK-5000 Odense, Denmark
| | - Tommy N Johansen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Grzegorz M Popowicz
- Institute of Structural Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany.,Biomolecular NMR and Center for Integrated Protein Science Munich at Department of Chemistry, Technical University of Munich, 85747 Garching, Germany
| | - Michael Sattler
- Institute of Structural Biology, Helmholtz Zentrum München, 85764 Neuherberg, Germany.,Biomolecular NMR and Center for Integrated Protein Science Munich at Department of Chemistry, Technical University of Munich, 85747 Garching, Germany
| | - Michael Gajhede
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Anders Bach
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
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22
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Caputo F, Pavarin RM, Lungaro L, Minarini A, Vigna-Taglianti F, Brambilla R, Sanchini S, Zoli E, Noventa A, Domenicali M, Vignoli T, Patussi V, Testino G, Scafato E, De Giorgio R, Zoli G. Identification of harmful drinking in subjects who have had their driving license suspended due to alcohol use: a retrospective Italian study. Eur Rev Med Pharmacol Sci 2020; 24:10720-10728. [PMID: 33155232 DOI: 10.26355/eurrev_202010_23432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Early identification of Harmful Drinking (HD) is difficult, and underestimated. The aim of our retrospective study was to investigate the presence of HD in a population of subjects who had their driving license suspended due to driving under the influence of alcohol. MATERIALS AND METHODS We retrospectively recruited 979 subjects. During the first appointment (T0), clinical and laboratory characteristics of patients were evaluated, and the AUDIT questionnaire was administered. Two groups were then defined: Harmful Drinking (HD) and non-HD, and all subjects underwent a brief interview for 5-10 minutes before being assigned to a group. RESULTS 95.9% of our sample were identified as non-HD, whereas 4.1% of them were HD; twenty-one (2.1%) of the HD underwent a control appointment (T1), and 17 (1.7%) of them were diagnosed with alcohol use disorder (AUD); there was a statistically significant reduction in mean daily alcohol intake (p<0.009), and in the mean values of the blood markers of HD between T0 and T1 in HD. CONCLUSIONS The present study shows that 4.1%, and 1.7% of subjects presented a diagnosis of HD and AUD, respectively, and their entry in a protocol of drinking monitoring proved beneficial in reducing alcohol intake. Thus, the implementation of strict surveillance of subjects found driving under the influence of alcohol involving a network of professional figures (from police forces to specialists in alcohol addiction treatment) may help to detect and to treat subjects with HD and AUD, and to monitor their alcohol use over time.
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Affiliation(s)
- F Caputo
- Department of Internal Medicine, SS Annunziata Hospital, Cento (Ferrara), University of Ferrara, Ferrara, Italy.
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23
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Ellman DG, Lund MC, Nissen M, Nielsen PS, Sørensen C, Lester EB, Thougaard E, Jørgensen LH, Nedospasov SA, Andersen DC, Stubbe J, Brambilla R, Degn M, Lambertsen KL. Conditional Ablation of Myeloid TNF Improves Functional Outcome and Decreases Lesion Size after Spinal Cord Injury in Mice. Cells 2020; 9:E2407. [PMID: 33153044 PMCID: PMC7692197 DOI: 10.3390/cells9112407] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/27/2020] [Accepted: 11/01/2020] [Indexed: 12/17/2022] Open
Abstract
Spinal cord injury (SCI) is a devastating condition consisting of an instant primary mechanical injury followed by a secondary injury that progresses for weeks to months. The cytokine tumor necrosis factor (TNF) plays an important role in the pathophysiology of SCI. We investigated the effect of myeloid TNF ablation (peripheral myeloid cells (macrophages and neutrophils) and microglia) versus central myeloid TNF ablation (microglia) in a SCI contusion model. We show that TNF ablation in macrophages and neutrophils leads to reduced lesion volume and improved functional outcome after SCI. In contrast, TNF ablation in microglia only or TNF deficiency in all cells had no effect. TNF levels tended to be decreased 3 h post-SCI in mice with peripheral myeloid TNF ablation and was significantly decreased 3 days after SCI. Leukocyte and microglia populations and all other cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, and IFNγ) and chemokines (CCL2, CCL5, and CXCL1) investigated, in addition to TNFR1 and TNFR2, were comparable between genotypes. Analysis of post-SCI signaling cascades demonstrated that the MAPK kinase SAPK/JNK decreased and neuronal Bcl-XL levels increased post-SCI in mice with ablation of TNF in peripheral myeloid cells. These findings demonstrate that peripheral myeloid cell-derived TNF is pathogenic in SCI.
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Affiliation(s)
- Ditte Gry Ellman
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
| | - Minna Christiansen Lund
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
| | - Maiken Nissen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
| | - Pernille Sveistrup Nielsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
| | - Charlotte Sørensen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
| | - Emilie Boye Lester
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
| | - Estrid Thougaard
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
| | - Louise Helskov Jørgensen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark; (L.H.J.); (D.C.A.)
| | - Sergei A. Nedospasov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences and Lomonosov Moscow State University, 119991 Moscow, Russia;
| | - Ditte Caroline Andersen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark; (L.H.J.); (D.C.A.)
- Laboratory of Molecular and Cellular Cardiology, Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 5000 Odense, Denmark
- Danish Center for Regenerative Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Jane Stubbe
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark;
| | - Roberta Brambilla
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Matilda Degn
- Pediatric Oncology Laboratory, Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Kate Lykke Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark; (D.G.E.); (M.C.L.); (M.N.); (P.S.N.); (C.S.); (E.B.L.); (E.T.); (R.B.)
- Department of Neurology, Odense University Hospital, 5000 Odense, Denmark
- BRIGDE—Brain Research—Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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Plastini MJ, Desu HL, Brambilla R. Dynamic Responses of Microglia in Animal Models of Multiple Sclerosis. Front Cell Neurosci 2020; 14:269. [PMID: 32973458 PMCID: PMC7468479 DOI: 10.3389/fncel.2020.00269] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 06/11/2020] [Accepted: 07/31/2020] [Indexed: 12/20/2022] Open
Abstract
Microglia play an essential role in maintaining central nervous system (CNS) homeostasis, as well as responding to injury and disease. Most neurological disorders feature microglial activation, a process whereby microglia undergo profound morphological and transcriptional changes aimed at containing CNS damage and promoting repair, but often resulting in overt inflammation that sustains and propagates the neurodegenerative process. This is especially evident in multiple sclerosis (MS), were microglial activation and microglia-driven neuroinflammation are considered key events in the onset, progression, and resolution of the disease. Our understanding of microglial functions in MS has widened exponentially in the last decade by way of new tools and markers to discriminate microglia from other myeloid populations. Consequently, the complex functional and phenotypical diversity of microglia can now be appreciated. This, in combination with a variety of animal models that mimic specific features and processes of MS, has contributed to filling the gap of knowledge in the cascade of events underlying MS pathophysiology. The purpose of this review is to present the most up to date knowledge of the dynamic responses of microglia in the commonly used animal models of MS, specifically the immune-mediated experimental autoimmune encephalomyelitis (EAE) model, and the chemically-induced cuprizone and lysolecithin models. Elucidating the spectrum of microglial functions in these models, from detrimental to protective, is essential to identify emerging targets for therapy and guide drug discovery efforts.
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Affiliation(s)
- Melanie J Plastini
- The Miami Project To Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States.,The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Haritha L Desu
- The Miami Project To Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States.,The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Roberta Brambilla
- The Miami Project To Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, United States.,The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, United States.,Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,BRIDGE-Brain Research Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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25
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Russo V, Molini S, De Bonis S, Ziacchi M, Ricciardi G, Migliore F, Viani S, Lavalle C, Pangallo A, La Greca C, Brambilla R, Tordini A, Ospizio R, Lovecchio M, Rago A. P1149Subcutaneous implantable cardioverter-defibrillator when Transvenous ICD is not a viable option. Europace 2020. [DOI: 10.1093/europace/euaa162.210] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
NO FUNDING
OnBehalf
RHYTHM DETECT Registry
Background
The class of recommendation for S-ICD implantation in patients who have inadequate vascular access is I according to AHA-ACC-HRS Guidelines and IIb according to ESC Guidelines. Data are lacking about the use of S-ICD for patients in which a transvenous ICD is not a viable option because of the inability to deploy a transvenous lead.
Purpose
To describe current practice and to measure outcomes associated with S-ICD use in patients in which a transvenous ICD is not a viable option.
Methods
942 consecutive patients underwent S-ICD implantation at 22 Italian centers from 2014 to 2019. We identified 101 (11%) patients who received S-ICD because of the reported impossibility of deploying a transvenous lead.
Results
21 patients presented with inadequate vascular access but no previous device in place. One patient had a mechanical prosthesis in tricuspid position. The remaining 79 patients received the S-ICD after removal of a prior system implanted, and venous occlusion was diagnosed after lead extraction, or partially or completely failed lead removal. In 24 of these patients a functional transvenous pacing system was left in place for persisting pacing needs. Patients were 60 ± 15 years old, 85% were male, 77% had ischemic or non-ischemic dilated cardiomyopathy, ejection fraction was 36 ± 13%. At implantation, acute conversion test was performed in 64 patients and shock energy of ≤65J was successful in 62 (96.9%) patients. During a median follow-up of 18 months, 6 patients died for non-device related reasons and 1 patient underwent heart transplantation. One patient underwent device replacement for battery depletion and one patient underwent leadless pacemaker implantation. Minor complications (hematomas not requiring system revision) were reported in 2 patients. Appropriate therapies were delivered in 4 patients and 8 patients experienced inappropriate therapies (in 3 patients due to double counting during pacing); all resolved with device reprogramming. Conclusions: In current clinical practice, a minority of S-ICD patients receive the device because of inadequate vascular access. The profile of these patients is similar to that of the typical ICD population in the context of primary sudden death prevention, but many of them present with pacing indications. Acute and mid-term efficacy of S-ICD seemed high. Few complications occurred during follow-up. Particular attention must be paid to device programming for those patients with concomitant pacing systems, in order to prevent inappropriate therapies.
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Affiliation(s)
- V Russo
- Second University of Naples, Naples, Italy
| | - S Molini
- Università Politecnica delle Marche , Torrette di Ancona (AN), Italy
| | | | - M Ziacchi
- Azienda Ospedaliero, Universitaria di Bologna, Policlinico S.Orsola-Malpigh, Bologna, Italy
| | - G Ricciardi
- Careggi University Hospital, Florence, Italy
| | | | - S Viani
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - C Lavalle
- Umberto I Polyclinic of Rome, Rome, Italy
| | - A Pangallo
- Bianchi Melacrino Morelli Hospital (BMM), Reggio Calabria, Italy
| | - C La Greca
- Poliambulanza Foundation Hospital Institute of Brescia, Brescia, Italy
| | | | | | | | | | - A Rago
- Second University of Naples, Naples, Italy
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26
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Desu HL, Plastini M, Illiano P, Bramlett HM, Dietrich WD, de Rivero Vaccari JP, Brambilla R, Keane RW. IC100: a novel anti-ASC monoclonal antibody improves functional outcomes in an animal model of multiple sclerosis. J Neuroinflammation 2020; 17:143. [PMID: 32366256 PMCID: PMC7199312 DOI: 10.1186/s12974-020-01826-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/24/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The inflammasome adaptor apoptosis-associated speck-like protein containing a CARD (ASC) is involved in immune signaling by bridging the interactions between inflammasome sensors and caspase-1. Strong experimental evidence has shown that ASC-/- mice are protected from disease progression in animal models of multiple sclerosis (MS), suggesting that targeting inflammasome activation via ASC inhibition may be a promising therapeutic strategy in MS. Thus, the goal of our study is to test the efficacy of IC100, a novel humanized antibody targeting ASC, in preventing and/or suppressing disease in the experimental autoimmune encephalomyelitis (EAE) model of MS. METHODS We employed the EAE model of MS where disease was induced by immunization of C57BL/6 mice with myelin oligodendrocyte glycoprotein peptide 35-55 (MOG35-55). Mice were treated with vehicle or increasing doses of IC100 (10, 30, and 45 mg/kg) and clinical disease course was evaluated up to 35 days post EAE induction. Immune cell infiltration into the spinal cord and microglia responses were assessed. RESULTS We show that IC100 treatment reduced the severity of EAE when compared to vehicle-treated controls. At a dose of 30 mg/kg, IC100 significantly reduced the number of CD4+ and CD8+ T cells and CD11b+MHCII+ activated myeloid cells entering the spinal cord from the periphery, and reduced the number of total and activated microglia. CONCLUSIONS These data indicate that IC100 suppresses the immune-inflammatory response that drives EAE development and progression, thereby identifying ASC as a promising target for the treatment of MS as well as other neurological diseases with a neuroinflammatory component.
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Affiliation(s)
- Haritha L Desu
- University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Melanie Plastini
- University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Placido Illiano
- University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Helen M Bramlett
- University of Miami Miller School of Medicine, Miami, FL, 33136, USA
- InflamaCORE, LLC, Miami, FL, 33156, USA
- Bruce W. Carter, Department of Veterans Affairs Medical Center, Miami, FL, 33136, USA
| | - W Dalton Dietrich
- University of Miami Miller School of Medicine, Miami, FL, 33136, USA
- InflamaCORE, LLC, Miami, FL, 33156, USA
| | | | - Roberta Brambilla
- University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
- Deparment of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
- BRIDGE Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Robert W Keane
- University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
- InflamaCORE, LLC, Miami, FL, 33156, USA.
- Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
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27
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Illiano P, Brambilla R, Parolini C. The mutual interplay of gut microbiota, diet and human disease. FEBS J 2020; 287:833-855. [DOI: 10.1111/febs.15217] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/21/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Placido Illiano
- The Miami Project to Cure Paralysis Department of Neurological Surgery University of Miami Miller School of Medicine FL USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis Department of Neurological Surgery University of Miami Miller School of Medicine FL USA
- Department of Neurobiology Research Institute of Molecular Medicine University of Southern Denmark Odense Denmark
- Department of Clinical Research BRIDGE‐Brain Research‐Inter‐Disciplinary Guided Excellence University of Southern Denmark Odense C Denmark
| | - Cinzia Parolini
- Department of Pharmacological and Biomolecular Sciences Università degli Studi di Milano Italy
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28
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Madsen PM, Desu HL, Vaccari JPDR, Florimon Y, Ellman DG, Keane RW, Clausen BH, Lambertsen KL, Brambilla R. Oligodendrocytes modulate the immune-inflammatory response in EAE via TNFR2 signaling. Brain Behav Immun 2020; 84:132-146. [PMID: 31785393 PMCID: PMC7010565 DOI: 10.1016/j.bbi.2019.11.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/08/2019] [Accepted: 11/23/2019] [Indexed: 01/02/2023] Open
Abstract
The pleotropic cytokine tumor necrosis factor (TNF) is involved in the pathophysiology of multiple sclerosis (MS). In various models of MS, including experimental autoimmune encephalomyelitis (EAE), the membrane-bound form of TNF (tmTNF), which signals primarily via TNFR2, mediates protective and reparative effects, whereas the soluble form (solTNF), which signals primarily via TNFR1, promotes pro-inflammatory and detrimental functions. In this study, we investigated the role of TNFR2 expressed in oligodendrocytes in the early phase of EAE pathogenesis. We demonstrated that mice with specific ablation of oligodendroglial TNFR2 displayed early onset and higher peak of motor dysfunction when subjected to EAE, in advance of which accelerated infiltration of immune cells was observed as early as 10 days post EAE induction. The immune cell influx was preceded by microglial activation and increased blood brain barrier permeability. Lack of oligodendroglial TNFR2 accelerated the expression of inflammatory cytokines as well as expression and activation of the inflammasome. Gene expression profiling of oligodendrocytes sorted from the spinal cord 14 days post EAE induction showed robust upregulation of inflammatory genes, some of which were elevated in cells lacking TNFR2 compared to controls. Together, our data demonstrate that oligodendrocytes are directly involved in inflammation and immune modulation in CNS disease and this function is regulated, at least in part, by TNFR2.
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Affiliation(s)
- Pernille M. Madsen
- The Miami Project To Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, FL 33136, USA,Dept. Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Haritha L. Desu
- The Miami Project To Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, FL 33136, USA,The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Juan Pablo de Rivero Vaccari
- The Miami Project To Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, FL 33136, USA
| | - Yoleinny Florimon
- The Miami Project To Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, FL 33136, USA
| | - Ditte G. Ellman
- Dept. Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Robert W. Keane
- The Miami Project To Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, FL 33136, USA,The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA,Dept. Physiology and Biophysics University of Miami Miller School of Medicine, FL 33136, USA
| | - Bettina H. Clausen
- Dept. Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark,BRIDGE - Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kate L. Lambertsen
- Dept. Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark,Department of Neurology, Odense University Hospital, Odense, Denmark,BRIDGE - Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Dept. Neurological Surgery, University of Miami Miller School of Medicine, FL 33136, USA; Dept. Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; The Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA; BRIDGE - Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
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29
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Yahn SL, Li J, Goo I, Gao H, Brambilla R, Lee JK. Fibrotic scar after experimental autoimmune encephalomyelitis inhibits oligodendrocyte differentiation. Neurobiol Dis 2019; 134:104674. [PMID: 31731043 PMCID: PMC7547849 DOI: 10.1016/j.nbd.2019.104674] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 08/21/2019] [Revised: 10/25/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023] Open
Abstract
Remyelination failure is a crucial component of disease progression in the autoimmune demyelinating disease Multiple Sclerosis (MS). The regenerative capacity of oligodendrocyte progenitor cells (OPCs) to replace myelinating oligodendrocytes is likely influenced by many aspects of the lesion environment including inflammatory signaling and extracellular matrix (ECM) deposition. These features of MS lesions are typically attributed to infiltrating leukocytes and reactive astrocytes. Here we demonstrate that fibroblasts also contribute to the inhibitory environment in the animal model of MS, experimental autoimmune encephalomyelitis (EAE). Using Col1α1GFP transgenic mice, we show that perivascular fibroblasts are activated in the spinal cord at EAE onset, and infiltrate the parenchyma by the peak of behavioral deficits where they are closely associated with areas of demyelination, myeloid cell accumulation, and ECM deposition. We further show that both fibroblast conditioned media and fibroblast ECM inhibit the differentiation of OPCs into mature oligodendrocytes. Taken together, our results indicate that the fibrotic scar is a major component of EAE pathology that leads to an inhibitory environment for remyelination, thus raising the possibility that anti-fibrotic mechanisms may serve as novel therapeutic targets for MS.
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Affiliation(s)
- Stephanie L Yahn
- Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, United States of America
| | - Jiajun Li
- Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, United States of America
| | - Irene Goo
- Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, United States of America
| | - Han Gao
- Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, United States of America
| | - Roberta Brambilla
- Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, United States of America
| | - Jae K Lee
- Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, United States of America.
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30
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Yli-Karjanmaa M, Larsen KS, Fenger CD, Kristensen LK, Martin NA, Jensen PT, Breton A, Nathanson L, Nielsen PV, Lund MC, Carlsen SL, Gramsbergen JB, Finsen B, Stubbe J, Frich LH, Stolp H, Brambilla R, Anthony DC, Meyer M, Lambertsen KL. TNF deficiency causes alterations in the spatial organization of neurogenic zones and alters the number of microglia and neurons in the cerebral cortex. Brain Behav Immun 2019; 82:279-297. [PMID: 31505254 DOI: 10.1016/j.bbi.2019.08.195] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/21/2019] [Accepted: 08/29/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Although tumor necrosis factor (TNF) inhibitors are used to treat chronic inflammatory diseases, there is little information about how long-term inhibition of TNF affects the homeostatic functions that TNF maintains in the intact CNS. MATERIALS AND METHODS To assess whether developmental TNF deficiency causes alterations in the naïve CNS, we estimated the number of proliferating cells, microglia, and neurons in the developing neocortex of E13.5, P7 and adult TNF knock out (TNF-/-) mice and wildtype (WT) littermates. We also measured changes in gene and protein expression and monoamine levels in adult WT and TNF-/- mice. To evaluate long-term effects of TNF inhibitors, we treated healthy adult C57BL/6 mice with either saline, the selective soluble TNF inhibitor XPro1595, or the nonselective TNF inhibitor etanercept. We estimated changes in cell number and protein expression after two months of treatment. We assessed the effects of TNF deficiency on cognition by testing adult WT and TNF-/- mice and mice treated with saline, XPro1595, or etanercept with specific behavioral tasks. RESULTS TNF deficiency decreased the number of proliferating cells and microglia and increased the number of neurons. At the same time, TNF deficiency decreased the expression of WNT signaling-related proteins, specifically Collagen Triple Helix Repeat Containing 1 (CTHRC1) and Frizzled receptor 6 (FZD6). In contrast to XPro1595, long-term inhibition of TNF with etanercept in adult C57BL/6 mice decreased the number of BrdU+ cells in the granule cell layer of the dentate gyrus. Etanercept, but not XPro1595, also impaired spatial learning and memory in the Barnes maze memory test. CONCLUSION TNF deficiency impacts the organization of neurogenic zones and alters the cell composition in brain. Long-term inhibition of TNF with the nonselective TNF inhibitor etanercept, but not the soluble TNF inhibitor XPro1595, decreases neurogenesis in the adult mouse hippocampus and impairs learning and memory after two months of treatment.
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Affiliation(s)
- Minna Yli-Karjanmaa
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Kathrine Solevad Larsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Christina Dühring Fenger
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Lotte Kellemann Kristensen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Nellie Anne Martin
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Peter Toft Jensen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | | | - Lubov Nathanson
- Institute for Neuro Immune Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Pernille Vinther Nielsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Minna Christiansen Lund
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Stephanie Lindeman Carlsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Jan Bert Gramsbergen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Bente Finsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jane Stubbe
- Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Lars Henrik Frich
- Orthopedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Helen Stolp
- Department of Pharmacology, University of Oxford, Oxford, UK; Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - Roberta Brambilla
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Daniel Clive Anthony
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; Department of Pharmacology, University of Oxford, Oxford, UK; BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Morten Meyer
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kate Lykke Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark; BRIDGE - Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Neurology, Odense University Hospital, Odense, Denmark.
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31
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Yli-Karjanmaa M, Clausen BH, Degn M, Novrup HG, Ellman DG, Toft-Jensen P, Szymkowski DE, Stensballe A, Meyer M, Brambilla R, Lambertsen KL. Topical Administration of a Soluble TNF Inhibitor Reduces Infarct Volume After Focal Cerebral Ischemia in Mice. Front Neurosci 2019; 13:781. [PMID: 31440125 PMCID: PMC6692878 DOI: 10.3389/fnins.2019.00781] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 03/28/2019] [Accepted: 07/11/2019] [Indexed: 01/05/2023] Open
Abstract
Background Tumor necrosis factor, which exists both as a soluble (solTNF) and a transmembrane (tmTNF) protein, plays an important role in post-stroke inflammation. The objective of the present study was to test the effect of topical versus intracerebroventricular administration of XPro1595 (a solTNF inhibitor) and etanercept (a solTNF and tmTNF inhibitor) compared to saline on output measures such as infarct volume and post-stroke inflammation in mice. Methods Adult male C57BL/6 mice were treated topically (2.5 mg/ml/1μl/h for 3 consecutive days) or intracerebroventricularly (1.25 mg/kg/0.5 ml, once) with saline, XPro1595, or etanercept immediately after permanent middle cerebral artery occlusion (pMCAO). Mice were allowed to survive 1 or 3 days. Infarct volume, microglial and leukocyte profiles, and inflammatory markers were evaluated. Results We found that topical, and not intracerebroventricular, administration of XPro1595 reduced infarct volume at both 1 and 3 days after pMCAO. Etanercept showed no effect. We observed no changes in microglial or leukocyte populations. XPro1595 increased gene expression of P2ry12 at 1 day and Trem2 at 1 and 3 days, while decreasing Cx3cr1 expression at 1 and 3 days after pMCAO, suggesting a change in microglial activation toward a phagocytic phenotype. Conclusion Our data demonstrate that topical administration of XPro1595 for 3 consecutive days decreases infarct volumes after ischemic stroke, while modifying microglial activation and the inflammatory response post-stroke. This suggests that inhibitors of solTNF hold great promise for future neuroprotective treatment in ischemic stroke.
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Affiliation(s)
- Minna Yli-Karjanmaa
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Bettina Hjelm Clausen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,BRIDGE - Brain Research Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Matilda Degn
- Pediatric Oncology Laboratory, Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hans Gram Novrup
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Ditte Gry Ellman
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Peter Toft-Jensen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | | | - Allan Stensballe
- Department of Health Science and Technology, University of Aalborg, Aalborg, Denmark
| | - Morten Meyer
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,BRIDGE - Brain Research Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Roberta Brambilla
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,BRIDGE - Brain Research Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Kate Lykke Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,BRIDGE - Brain Research Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Neurology, Odense University Hospital, Odense, Denmark
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32
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Pani A, Giuseppina B, Bonanno C, Grazia Bongiorni M, Bottoni N, Brambilla R, Ceglia SD, Della Bella P, Vito GD, Malaspina D, Menardi E, Napoli V, Negroni MS, Ocello S, Orsida D, Pandozi C, Pedretti S, Penela D, Pepi P, Rossi L, Rovaris G, Scopinaro A, Vincenti A, Viola G, Zacà V, Zoppo F, Vergara P. Predictors of Zero X-Ray Ablation for Supraventricular Tachycardias in a Nationwide Multicenter Experience. Circ Arrhythm Electrophysiol 2019; 11:e005592. [PMID: 29874166 DOI: 10.1161/circep.117.005592] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 01/16/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND This multicenter, prospective study evaluated the determinants of zero-fluoroscopy (ZFL) ablation of supraventricular tachycardias. METHODS AND RESULTS Four hundred thirty patients (215 male, 55.4±22.1 years) with indication to electrophysiological study or ablation of supraventricular tachycardias were enrolled. All participating physicians agreed to follow the as low as reasonably achievable policy. A procedure was defined as ZFL when no fluoroscopy was used. The total fluoroscopy time inversely correlated to the number of procedures previously performed by each operator since study start (r=-0.112; P=0.02). Two hundred eighty-nine procedures (67.2%) were ZFL; multivariable analysis identified as predictors of ZFL: procedure after the 30th for each operator, compared with procedures up to the ninth (P=0.011; hazard ratio, 3.49; 95% confidence interval [CI], 1.79-6.80); the type of arrhythmia (P=0.031; electrophysiological study and atrioventricular nodal reentry tachycardia ablation having the highest probability of ZFL; hazard ratio, 6.87; 95% CI, 2.08-22.7 and hazard ratio, 2.02; 95% CI, 1.04-3.91, respectively); the operator's (P=0.002) and patient's age (P=0.009). Among operators, achievement of ZFL varied from 0% to 100%; 8 (22.8%) operators achieved ZFL in <25% of their procedures; 17 (48.6%) operators achieved ZFL in >75% of their procedures. The probability of ZFL increased by 2.8% (hazard ratio, 0.98; 95% CI, 0.97-0.99) as patient's age decreased by 1 year. Acute procedural success was obtained in all cases. CONCLUSIONS The use of 3-dimensional mapping system completely avoided the use of fluoroscopy in most cases, with very low fluoroscopy time in the remaining and high safety and effectiveness profiles. Achievement of ZFL was predicted by the type of arrhythmia, operator's experience, and patient's age.
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Affiliation(s)
- Antonio Pani
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Belotti Giuseppina
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Carlo Bonanno
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Maria Grazia Bongiorni
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Nicola Bottoni
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Roberta Brambilla
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Sergio de Ceglia
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Paolo Della Bella
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Giovanni de Vito
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Daniele Malaspina
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Endrj Menardi
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Velia Napoli
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Maria Silvia Negroni
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Salvatore Ocello
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Daniela Orsida
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Claudio Pandozi
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Stefano Pedretti
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Diego Penela
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Patrizia Pepi
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Luca Rossi
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Giovanni Rovaris
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Alice Scopinaro
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Antonello Vincenti
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Graziana Viola
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Valerio Zacà
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Franco Zoppo
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
| | - Pasquale Vergara
- From the Cardiology Department, Ospedale Alessandro Manzoni, Lecco, Italy (A.P., R.B., G.d.V.); Cardiology Department, Ospedale Treviglio e Caravaggio, Italy (G.B.); Cardiology Department, Ospedale San Bortolo, Vicenza, Italy (C.B.); Cardiology Department, Ospedale Cisanello, Azienda Ospedalieria Universitaria, Pisa, Italy (M.G.B.); Cardiology Department, Ospedale Santa Maria Nuova, Reggio Emilia, Italy (N.B.); Cardiology Department, Ospedale San Gerardo, Monza, Italy (S.d.C., G.R.); Arrhythmology Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milano, Italy (P.D.B., P.V.); Cardiology Department, Ospedale San Carlo Borromeo, Milano, Italy (D.M.); Cardiology Department, Ospedale ASO S. Croce e Carle, Cuneo, Italy (E.M.); Johnson & Johnson Med, Biosense Webster Italy, Milano (V.N.); Cardiology Department, Ospedale San Paolo, Milano, Italy (M.S.N.); Cardiology Department, Ospedale Santissima Trinità, Cagliari, Italy (S.O.); Cardiology Department, Ospedale S. Antonio Abate, Gallarate, Italy (D.O.); Cardiology Department, Ospedale San Filippo Neri, Roma, Italy (C.P.); Cardiology Department, A.S.S.T Grande Ospedale Metropolitano Niguarda, Milano, Italy (S.P.); Cardiology Department, Ospedale Guglielmo da Saliceto, Piacenza, Italy (D.P., L.R.); Cardiology Department, Ospedale San Carlo Poma, Mantova, Italy (P.P.); Cardiology Department, Azienda Ospedaliera SS. Antonio e Biagio, Alessandria, Italy (A.S.); Cardiology Department, Ospedale Multimedica, Sesto San Giovanni, Italy (A.V.); Cardiology Department, Ospedale San Francesco, Nuoro, Italy (G.V.); Cardiology Department, Ospedale Santa Maria alle Scotte, Siena, Italy (V.Z.); and Cardiology Department, Ospedale Civile, Mirano, Italy (F.Z.)
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Tse BC, Dvoriantchikova G, Tao W, Gallo RA, Lee JY, Pappas S, Brambilla R, Ivanov D, Tse DT, Pelaez D. Tumor Necrosis Factor Inhibition in the Acute Management of Traumatic Optic Neuropathy. Invest Ophthalmol Vis Sci 2019; 59:2905-2912. [PMID: 30025145 PMCID: PMC5989875 DOI: 10.1167/iovs.18-24431] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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] [Indexed: 12/22/2022] Open
Abstract
Purpose To determine the effectiveness of etanercept, a tumor necrosis factor (TNF) inhibitor, in conferring neuroprotection to retinal ganglion cells (RGCs) and improving visual outcomes after optic nerve trauma with either optic nerve crush (ONC) or sonication-induced traumatic optic neuropathy (SI-TON) in mice. Methods Mouse optic nerves were unilaterally subjected to ONC (n = 20) or SI-TON (n = 20). TNF expression was evaluated by using immunohistochemistry and quantitative RT-PCR (qRT-PCR) in optic nerves harvested 6 and 24 hours post ONC (n = 10) and SI-TON (n = 10). Mice in each injury group received daily subcutaneous injections of either etanercept (10 mg/kg of body weight; five mice) or vehicle (five mice) for 7 days. Pattern electroretinograms were performed on all mice at 1 and 2 weeks after injury. ONC mice were killed at 2 weeks after injury, while SI-TON mice were euthanized at 4 weeks after injury. Whole retina flat-mounts were used for RGC quantification. Results Immunohistochemistry and qRT-PCR showed upregulation of TNF protein and gene expression within 24 hours after injury. In both models, etanercept use immediately following optic nerve injury led to higher RGC survival when compared to controls, which was comparable between the two models (24.23% in ONC versus 20.42% in SI-TON). In both models, 1 and 2 weeks post injury, mice treated with etanercept had significantly higher a-wave amplitudes than untreated injured controls. Conclusions Treatment with etanercept significantly reduced retinal damage and improved visual function in both animal models of TON. These findings suggest that reducing TNF activity in injured optic nerves constitutes an effective therapeutic approach in an acute setting.
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Affiliation(s)
- Brian C Tse
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States
| | - Galina Dvoriantchikova
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States
| | - Wensi Tao
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States
| | - Ryan A Gallo
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States
| | - John Y Lee
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States
| | - Steven Pappas
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States
| | - Roberta Brambilla
- Department of Neurological Surgery, Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Dmitry Ivanov
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States.,Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - David T Tse
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States
| | - Daniel Pelaez
- Department of Ophthalmology, Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Miami, Florida, United States.,Department of Biomedical Engineering, University of Miami, Coral Gables, Florida, United States
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Giannattasio C, Vincenti A, Failla M, Capra A, Cirò A, De Ceglia S, Gentile G, Brambilla R, Mancia G. Response. Hypertension 2019. [DOI: 10.1161/01.hyp.0000116290.71516.0b] [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: 11/16/2022]
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Gao H, Danzi MC, Choi CS, Taherian M, Dalby-Hansen C, Ellman DG, Madsen PM, Bixby JL, Lemmon VP, Lambertsen KL, Brambilla R. Opposing Functions of Microglial and Macrophagic TNFR2 in the Pathogenesis of Experimental Autoimmune Encephalomyelitis. Cell Rep 2017; 18:198-212. [PMID: 28052249 DOI: 10.1016/j.celrep.2016.11.083] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [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: 06/10/2016] [Revised: 09/30/2016] [Accepted: 11/30/2016] [Indexed: 12/15/2022] Open
Abstract
In multiple sclerosis (MS), soluble tumor necrosis factor (TNF) is detrimental via activation of TNF receptor 1 (TNFR1), whereas transmembrane TNF is beneficial primarily by activating TNF receptor 2 (TNFR2). Here, we investigate the role of TNFR2 in microglia and monocytes/macrophages in experimental autoimmune encephalomyelitis (EAE), a model of MS, by cell-specific gene targeting. We show that TNFR2 ablation in microglia leads to early onset of EAE with increased leukocyte infiltration, T cell activation, and demyelination in the central nervous system (CNS). Conversely, TNFR2 ablation in monocytes/macrophages results in EAE suppression with impaired peripheral T cell activation and reduced CNS T cell infiltration and demyelination. Our work uncovers a dichotomy of function for TNFR2 in myeloid cells, with microglial TNFR2 providing protective signals to contain disease and monocyte/macrophagic TNFR2 driving immune activation and EAE initiation. This must be taken into account when targeting TNFR2 for therapeutic purposes in neuroinflammatory diseases.
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Affiliation(s)
- Han Gao
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Matt C Danzi
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Center for Computational Science, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | | | - Mehran Taherian
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Camilla Dalby-Hansen
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense C 5000, Denmark
| | - Ditte G Ellman
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense C 5000, Denmark
| | - Pernille M Madsen
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense C 5000, Denmark
| | - John L Bixby
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Center for Computational Science, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Cellular and Molecular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Vance P Lemmon
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Center for Computational Science, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Kate L Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense C 5000, Denmark; Brain Research - Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense C 5000, Denmark; Department of Neurology, Odense University Hospital, Odense C 5000, Denmark
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Ellman DG, Novrup HG, Jørgensen LH, Lund MC, Yli-Karjanmaa M, Madsen PM, Vienhues JH, Dursun S, Bethea JR, Lykke-Hartmann K, Brambilla R, Lambertsen KL. Neuronal Ablation of IKK2 Decreases Lesion Size and Improves Functional Outcome after Spinal Cord Injury in Mice. JSM Neurosurg Spine 2017; 5:1090. [PMID: 30035210 PMCID: PMC6051723] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Nuclear factor-kappa B (NF-κB) is a key modulator of inflammation and secondary injury responses in neurodegenerative disease, including spinal cord injury (SCI). Inhibition of astroglial NF-κB reduces inflammation, enhances oligodendrogenesis and improves functional recovery after SCI, however the contribution of neuronal NF-κB to secondary inflammatory responses following SCI has yet to be investigated. We demonstrate that conditional ablation of IKK2 in Synapsin 1-expressing neurons in mice (Syn1creIKK2fl/fl) reduces activation of the classical NF-κB signaling pathway, resulting in impaired motor function and altered memory retention under naïve conditions. Following induction of a moderate SCI phosphorylated NF-κB levels decreased in the spinal cord of Syn1creIKK2fl/fl mice compared to controls, resulting in improvement in functional recovery. Histologically, Syn1creIKK2fl/fl mice exhibited reduced lesion volume but comparable microglial/leukocyte responses after SCI. In parallel, interleukin (IL)-1β expression was significantly decreased within the lesioned spinal cord, whereas IL-5, IL-6, IL-10, tumor necrosis factor (TNF) and chemokine (C-X-C motif) ligand 1 were unchanged compared to control mice. We conclude that conditional ablation of IKK2 in neurons, resulting in reduced neuronal NF-B signaling, and lead to protective effects after SCI and propose the neuronal classical NF-κB pathway as a potential target for the development of new therapeutic, neuroprotective strategies for SCI.
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Affiliation(s)
| | | | | | | | | | - Pernille Marie Madsen
- Neurobiology Research, University of Southern Denmark, Denmark
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, USA
| | | | - Safinaz Dursun
- Neurobiology Research, University of Southern Denmark, Denmark
| | - John R. Bethea
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, USA
- Department of Biology, Drexel University, USA
| | | | - Roberta Brambilla
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, USA
| | - Kate Lykke Lambertsen
- Neurobiology Research, University of Southern Denmark, Denmark
- Department of Neurology, Odense University Hospital, Denmark
- Department of Clinical Research, University of Southern Denmark, Denmark
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Al-Ali H, Gao H, Dalby-Hansen C, Peters VA, Shi Y, Brambilla R. High content analysis of phagocytic activity and cell morphology with PuntoMorph. J Neurosci Methods 2017; 291:43-50. [PMID: 28789994 DOI: 10.1016/j.jneumeth.2017.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 06/16/2017] [Revised: 08/02/2017] [Accepted: 08/03/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Phagocytosis is essential for maintenance of normal homeostasis and healthy tissue. As such, it is a therapeutic target for a wide range of clinical applications. The development of phenotypic screens targeting phagocytosis has lagged behind, however, due to the difficulties associated with image-based quantification of phagocytic activity. NEW METHOD We present a robust algorithm and cell-based assay system for high content analysis of phagocytic activity. The method utilizes fluorescently labeled beads as a phagocytic substrate with defined physical properties. The algorithm employs statistical modeling to determine the mean fluorescence of individual beads within each image, and uses the information to conduct an accurate count of phagocytosed beads. In addition, the algorithm conducts detailed and sophisticated analysis of cellular morphology, making it a standalone tool for high content screening. RESULTS We tested our assay system using microglial cultures. Our results recapitulated previous findings on the effects of microglial stimulation on cell morphology and phagocytic activity. Moreover, our cell-level analysis revealed that the two phenotypes associated with microglial activation, specifically cell body hypertrophy and increased phagocytic activity, are not highly correlated. This novel finding suggests the two phenotypes may be under the control of distinct signaling pathways. COMPARISON WITH EXISTING METHODS We demonstrate that our assay system outperforms preexisting methods for quantifying phagocytic activity in multiple dimensions including speed, accuracy, and resolution. CONCLUSIONS We provide a framework to facilitate the development of high content assays suitable for drug screening. For convenience, we implemented our algorithm in a standalone software package, PuntoMorph.
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Affiliation(s)
- Hassan Al-Ali
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; Peggy and Harold Katz Family Drug Discovery Center, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
| | - Han Gao
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Camilla Dalby-Hansen
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Vanessa Ann Peters
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Yan Shi
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, 33136, USA; Neuroscience Program, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
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Conte G, Scola E, Calloni S, Brambilla R, Campoleoni M, Lombardi L, Di Berardino F, Zanetti D, Gaini LM, Triulzi F, Sina C. Flat Panel Angiography in the Cross-Sectional Imaging of the Temporal Bone: Assessment of Image Quality and Radiation Dose Compared with a 64-Section Multisection CT Scanner. AJNR Am J Neuroradiol 2017; 38:1998-2002. [PMID: 28751512 DOI: 10.3174/ajnr.a5302] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/22/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cross-sectional imaging of the temporal bone is challenging because of the complexity and small dimensions of the anatomic structures. We evaluated the role of flat panel angiography in the cross-sectional imaging of the temporal bone by comparing its image quality and radiation dose with a 64-section multisection CT scanner. MATERIALS AND METHODS We retrospectively collected 29 multisection CT and 29 flat panel angiography images of normal whole-head temporal bones. Image quality was assessed by 2 neuroradiologists, who rated the visualization of 30 anatomic structures with a 3-point ordinal scale. The radiation dose was assessed with an anthropomorphic phantom. RESULTS Flat panel angiography showed better image quality than multisection CT in depicting the anterior and posterior crura of the stapes, the footplate of the stapes, the stapedius muscle, and the anterior ligament of the malleus (P < .05). In contrast, multisection CT showed better image quality than flat panel angiography in assessing the tympanic membrane, the bone marrow of the malleus and incus, the tendon of the tensor tympani, the interscalar septum, and the modiolus of the cochlea (P < .05). Flat panel angiography had a significantly higher overall image quality rating than multisection CT (P = .035). A reduction of the effective dose of approximately 40% was demonstrated for flat panel angiography compared with multisection CT. CONCLUSIONS Flat panel angiography shows strengths and weaknesses compared with multisection CT. It is more susceptible to artifacts, but due to the higher spatial resolution, it shows equal or higher image quality in assessing some bony structures of diagnostic interest. The lower radiation dose is an additional advantage of flat panel angiography.
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Affiliation(s)
- G Conte
- From the Postgraduation School of Radiodiagnostics (G.C., S.C.)
| | - E Scola
- Neuroradiology Unit (E.S., L.L., F.T., C.S.)
| | - S Calloni
- From the Postgraduation School of Radiodiagnostics (G.C., S.C.)
| | - R Brambilla
- Health Physics Unit (R.B., M.C.), Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Campoleoni
- Health Physics Unit (R.B., M.C.), Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - L Lombardi
- Neuroradiology Unit (E.S., L.L., F.T., C.S.)
| | | | | | - L M Gaini
- Otolaryngology Unit (L.M.G.), Department of Clinical Sciences and Community Health, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca'Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - F Triulzi
- Department of Pathophysiology and Transplantation (F.T.), Università degli Studi di Milano, Milan, Italy.,Neuroradiology Unit (E.S., L.L., F.T., C.S.)
| | - C Sina
- Neuroradiology Unit (E.S., L.L., F.T., C.S.)
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Madsen PM, Sloley SS, Vitores AA, Carballosa-Gautam MM, Brambilla R, Hentall ID. Prolonged stimulation of a brainstem raphe region attenuates experimental autoimmune encephalomyelitis. Neuroscience 2017; 346:395-402. [PMID: 28147248 PMCID: PMC5337132 DOI: 10.1016/j.neuroscience.2017.01.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 10/31/2016] [Revised: 01/17/2017] [Accepted: 01/23/2017] [Indexed: 12/22/2022]
Abstract
Multiple sclerosis (MS), a neuroinflammatory disease, has few treatment options, none entirely adequate. We studied whether prolonged electrical microstimulation of a hindbrain region (the nucleus raphe magnus) can attenuate experimental autoimmune encephalomyelitis, a murine model of MS induced by MOG35-55 injection. Eight days after symptoms emerged, a wireless electrical stimulator with an attached microelectrode was implanted cranially, and daily intermittent stimulation was begun in awake, unrestrained mice. The thoracic spinal cord was analyzed for changes in histology (on day 29) and gene expression (on day 37), with a focus on myelination and cytokine production. Controls, with inactive implants, showed a phase of disease exacerbation on days 19-25 that stimulation for >16days eliminated. Prolonged stimulation also reduced numbers of infiltrating immune cells and increased numbers of myelinated axons. It additionally lowered genetic expression of some pro-inflammatory cytokines (interferon gamma and tumor necrosis factor) and platelet-derived growth factor receptor alpha, a marker of oligodendrocyte precursors, while raising expression of myelin basic protein. Studies of restorative treatments for MS might profitably consider ways to stimulate the raphe magnus, directly or via its inputs, or to emulate its serotonergic and peptidergic output.
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Affiliation(s)
- Pernille M Madsen
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, USA; Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Stephanie S Sloley
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, USA
| | - Alberto A Vitores
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, USA
| | | | - Roberta Brambilla
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, USA.
| | - Ian D Hentall
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, USA.
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Madsen PM, Clausen BH, Degn M, Thyssen S, Kristensen LK, Svensson M, Ditzel N, Finsen B, Deierborg T, Brambilla R, Lambertsen KL. Genetic ablation of soluble tumor necrosis factor with preservation of membrane tumor necrosis factor is associated with neuroprotection after focal cerebral ischemia. J Cereb Blood Flow Metab 2016; 36:1553-69. [PMID: 26661199 PMCID: PMC5012516 DOI: 10.1177/0271678x15610339] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/07/2015] [Indexed: 11/16/2022]
Abstract
Microglia respond to focal cerebral ischemia by increasing their production of the neuromodulatory cytokine tumor necrosis factor, which exists both as membrane-anchored tumor necrosis factor and as cleaved soluble tumor necrosis factor forms. We previously demonstrated that tumor necrosis factor knockout mice display increased lesion volume after focal cerebral ischemia, suggesting that tumor necrosis factor is neuroprotective in experimental stroke. Here, we extend our studies to show that mice with intact membrane-anchored tumor necrosis factor, but no soluble tumor necrosis factor, display reduced infarct volumes at one and five days after stroke. This was associated with improved functional outcome after experimental stroke. No changes were found in the mRNA levels of tumor necrosis factor and tumor necrosis factor-related genes (TNFR1, TNFR2, TACE), pro-inflammatory cytokines (IL-1β, IL-6) or chemokines (CXCL1, CXCL10, CCL2); however, protein expression of TNF, IL-1β, IL-6 and CXCL1 was reduced in membrane-anchored tumor necrosis factor(Δ/Δ) compared to membrane-anchored tumor necrosis factor(wt/wt) mice one day after experimental stroke. This was paralleled by reduced MHCII expression and a reduction in macrophage infiltration in the ipsilateral cortex of membrane-anchored tumor necrosis factor(Δ/Δ) mice. Collectively, these findings indicate that membrane-anchored tumor necrosis factor mediates the protective effects of tumor necrosis factor signaling in experimental stroke, and therapeutic strategies specifically targeting soluble tumor necrosis factor could be beneficial in clinical stroke therapy.
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Affiliation(s)
- Pernille M Madsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, USA
| | - Bettina H Clausen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Matilda Degn
- Molecular Sleep Lab, Department of Diagnostics, Glostrup Hospital, Glostrup, Denmark
| | - Stine Thyssen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Lotte K Kristensen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Martina Svensson
- Department of Experimental Medical Sciences, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Nicholas Ditzel
- KMEB, Molecular Endocrinology, Odense University Hospital, Odense, Denmark
| | - Bente Finsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Tomas Deierborg
- Department of Experimental Medical Sciences, Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Roberta Brambilla
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, USA
| | - Kate L Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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Clausen BH, Degn M, Sivasaravanaparan M, Fogtmann T, Andersen MG, Trojanowsky MD, Gao H, Hvidsten S, Baun C, Deierborg T, Finsen B, Kristensen BW, Bak ST, Meyer M, Lee J, Nedospasov SA, Brambilla R, Lambertsen KL. Conditional ablation of myeloid TNF increases lesion volume after experimental stroke in mice, possibly via altered ERK1/2 signaling. Sci Rep 2016; 6:29291. [PMID: 27384243 PMCID: PMC4935869 DOI: 10.1038/srep29291] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 10/28/2015] [Accepted: 06/17/2016] [Indexed: 01/08/2023] Open
Abstract
Microglia are activated following cerebral ischemia and increase their production of the neuro- and immunomodulatory cytokine tumor necrosis factor (TNF). To address the function of TNF from this cellular source in focal cerebral ischemia we used TNF conditional knock out mice (LysMcreTNFfl/fl) in which the TNF gene was deleted in cells of the myeloid lineage, including microglia. The deletion reduced secreted TNF levels in lipopolysaccharide-stimulated cultured primary microglia by ~93%. Furthermore, phosphorylated-ERK/ERK ratios were significantly decreased in naïve LysMcreTNFfl/fl mice demonstrating altered ERK signal transduction. Micro-PET using 18[F]-fluorodeoxyglucose immediately after focal cerebral ischemia showed increased glucose uptake in LysMcreTNFfl/fl mice, representing significant metabolic changes, that translated into increased infarct volumes at 24 hours and 5 days compared to littermates (TNFfl/fl). In naïve LysMcreTNFfl/fl mice cytokine levels were low and comparable to littermates. At 6 hours, TNF producing microglia were reduced by 56% in the ischemic cortex in LysMcreTNFfl/fl mice compared to littermate mice, whereas no TNF+ leukocytes were detected. At 24 hours, pro-inflammatory cytokine (TNF, IL-1β, IL-6, IL-5 and CXCL1) levels were significantly lower in LysMcreTNFfl/fl mice, despite comparable infiltrating leukocyte populations. Our results identify microglial TNF as beneficial and neuroprotective in the acute phase and as a modulator of neuroinflammation at later time points after experimental ischemia, which may contribute to regenerative recovery.
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Affiliation(s)
- Bettina Hjelm Clausen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21st, DK-5000 Odense C, Denmark
| | - Matilda Degn
- Rigshospitalet, Department of Diagnostics, Molecular Sleep Lab, Nordre Ringvej 69, DK-2600 Glostrup, Denmark
| | - Mithula Sivasaravanaparan
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21st, DK-5000 Odense C, Denmark
| | - Torben Fogtmann
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21st, DK-5000 Odense C, Denmark
| | - Maria Gammelstrup Andersen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21st, DK-5000 Odense C, Denmark
| | - Michelle D Trojanowsky
- Miami Project to Cure Paralysis, University os Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL 33136, USA
| | - Han Gao
- Miami Project to Cure Paralysis, University os Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL 33136, USA
| | - Svend Hvidsten
- Department of Nulcear Medicine, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
| | - Christina Baun
- Department of Nulcear Medicine, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
| | - Tomas Deierborg
- Department of Experimental Medical Sciences, Experimental Neuroinflammation Laboratory, Lund University, Sölveg 19, 22100 Lund, Sweden
| | - Bente Finsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21st, DK-5000 Odense C, Denmark
| | - Bjarne Winther Kristensen
- Institute of Clinical Research, University of Southern Denmark, J.B. Winsloewsvej 19, DK-5000 Odense C, Denmark.,Department of Pathology, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
| | - Sara Thornby Bak
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21st, DK-5000 Odense C, Denmark
| | - Morten Meyer
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21st, DK-5000 Odense C, Denmark
| | - Jae Lee
- Miami Project to Cure Paralysis, University os Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL 33136, USA
| | - Sergei A Nedospasov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences and Lomonosov Moscow State University, Vavilova Str 32, Moscow, 119991, Russia
| | - Roberta Brambilla
- Miami Project to Cure Paralysis, University os Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL 33136, USA
| | - Kate Lykke Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsloewsvej 21st, DK-5000 Odense C, Denmark.,Department of Neurology, Odense University Hospital, Sdr. Boulevard 29, DK-5000 Odense C, Denmark
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Pinto M, Nissanka N, Peralta S, Brambilla R, Diaz F, Moraes CT. Pioglitazone ameliorates the phenotype of a novel Parkinson's disease mouse model by reducing neuroinflammation. Mol Neurodegener 2016; 11:25. [PMID: 27038906 PMCID: PMC4818913 DOI: 10.1186/s13024-016-0090-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 03/23/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms. The cause of the motor symptoms is the loss of dopaminergic neurons in the substantia nigra with consequent depletion of dopamine in the striatum. Although the etiology of PD is unknown, mitochondrial dysfunctions, including cytochrome c oxidase (Complex IV) impairment in dopaminergic neurons, have been associated with the disease's pathophysiology. In order to analyze the role of Complex IV in PD, we knocked out Cox10 (essential for the maturation of COXI, a catalytic subunit of Complex IV) in dopaminergic neurons. We also tested whether the resulting phenotype was improved by stimulating the PPAR-γ pathway. RESULTS Cox10/DAT-cre mice showed decreased numbers of TH+ and DAT+ cells in the substantia nigra, early striatal dopamine depletion, motor defects reversible with L-DOPA treatment and hypersensitivity to L-DOPA with hyperkinetic behavior. We found that chronic pioglitazone (PPAR-γ agonist) treatment ameliorated the motor phenotype in Cox10/DAT-cre mice. Although neither mitochondrial function nor the number of dopaminergic neurons was improved, neuroinflammation in the midbrain and the striatum was decreased. CONCLUSIONS By triggering a mitochondrial Complex IV defect in dopaminergic neurons, we created a new mouse model resembling the late stages of PD with massive degeneration of dopaminergic neurons and striatal dopamine depletion. The motor phenotypes were improved by Pioglitazone treatment, suggesting that targetable secondary pathways can influence the development of certain forms of PD.
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Affiliation(s)
- Milena Pinto
- />Department of Neurology, University of Miami Miller School of Medicine, 1420 NW 9th Avenue, Rm.229, Miami, FL 33136 USA
| | - Nadee Nissanka
- />Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL 33136 USA
| | - Susana Peralta
- />Department of Neurology, University of Miami Miller School of Medicine, 1420 NW 9th Avenue, Rm.229, Miami, FL 33136 USA
| | - Roberta Brambilla
- />Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL 33136 USA
- />The Miami Project To Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136 USA
| | - Francisca Diaz
- />Department of Neurology, University of Miami Miller School of Medicine, 1420 NW 9th Avenue, Rm.229, Miami, FL 33136 USA
| | - Carlos T. Moraes
- />Department of Neurology, University of Miami Miller School of Medicine, 1420 NW 9th Avenue, Rm.229, Miami, FL 33136 USA
- />Department of Cell Biology, University of Miami Miller School of Medicine, Miami, FL 33136 USA
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43
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Ardito A, Massaglia C, Pelosi E, Zaggia B, Basile V, Brambilla R, Vigna-Taglianti F, Duregon E, Arena V, Perotti P, Penna D, Terzolo M. 18F-FDG PET/CT in the post-operative monitoring of patients with adrenocortical carcinoma. Eur J Endocrinol 2015; 173:749-56. [PMID: 26346137 DOI: 10.1530/eje-15-0707] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/07/2015] [Indexed: 12/21/2022]
Abstract
CONTEXT The role of (18)F-labeled 2-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the post-operative monitoring of patients with adrenocortical carcinoma (ACC) is still unclear. OBJECTIVE To assess the accuracy of FDG PET/CT to diagnose ACC recurrence in a real world setting. DESIGN AND METHODS Retrospective evaluation of data of 57 patients with presumed ACC recurrence at CT scan who underwent FDG PET/CT within a median time of 20 days. We compared the results of either FDG PET/CT or CT with a gold standard confirmation of recurrence (positive histopathology report of removed/biopsied lesions or radiological progression of target lesions at follow-up) to assess their diagnostic performance at different body sites to correctly categorize target lesions. We also assessed whether FDG PET/CT findings may be useful to inform the management strategy. RESULTS In 48 patients with confirmed ACC recurrence, we found that FDG PET/CT had lower sensitivity than CT in diagnosing liver and lung recurrences of ACC. FDG PET/CT had higher specificity than CT in categorizing liver lesions. FDG PET/CT had a greater positive likelihood ratio than CT to identify liver and abdominal ACC recurrences. The management strategy was changed based on FDG PET/CT findings in 12 patients (21.1%). CONCLUSIONS The greater sensitivity of CT may be partly expected due the specific inclusion criteria of the study; however, the greater specificity of FDG PET/CT was particularly useful in ruling out suspected ACC recurrences found by CT. Thus, use of FDG PET/CT as a second-line test in the post-operative surveillance of ACC patients following CT finding of a potential recurrence may have a significant impact on patient management.
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Affiliation(s)
| | | | - E Pelosi
- Internal Medicine IDepartment of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, ItalyIRMETPET-CT Diagnostic Imaging Center, Turin, ItalyPublic HealthDepartment of Clinical and Biological SciencesPathologyDepartment of Oncology, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy
| | | | | | - R Brambilla
- Internal Medicine IDepartment of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, ItalyIRMETPET-CT Diagnostic Imaging Center, Turin, ItalyPublic HealthDepartment of Clinical and Biological SciencesPathologyDepartment of Oncology, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy
| | - F Vigna-Taglianti
- Internal Medicine IDepartment of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, ItalyIRMETPET-CT Diagnostic Imaging Center, Turin, ItalyPublic HealthDepartment of Clinical and Biological SciencesPathologyDepartment of Oncology, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy
| | - E Duregon
- Internal Medicine IDepartment of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, ItalyIRMETPET-CT Diagnostic Imaging Center, Turin, ItalyPublic HealthDepartment of Clinical and Biological SciencesPathologyDepartment of Oncology, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy
| | - V Arena
- Internal Medicine IDepartment of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, ItalyIRMETPET-CT Diagnostic Imaging Center, Turin, ItalyPublic HealthDepartment of Clinical and Biological SciencesPathologyDepartment of Oncology, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy
| | | | - D Penna
- Internal Medicine IDepartment of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, ItalyIRMETPET-CT Diagnostic Imaging Center, Turin, ItalyPublic HealthDepartment of Clinical and Biological SciencesPathologyDepartment of Oncology, San Luigi Hospital, University of Turin, Regione Gonzole, 10, 10043 Orbassano, Italy
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44
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Bernardes D, Brambilla R, Bracchi-Ricard V, Karmally S, Dellarole A, Carvalho-Tavares J, Bethea JR. Prior regular exercise improves clinical outcome and reduces demyelination and axonal injury in experimental autoimmune encephalomyelitis. J Neurochem 2015; 136 Suppl 1:63-73. [PMID: 26364732 DOI: 10.1111/jnc.13354] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [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: 01/31/2015] [Revised: 08/18/2015] [Accepted: 08/21/2015] [Indexed: 12/22/2022]
Abstract
Although previous studies have shown that forced exercise modulates inflammation and is therapeutic acutely for experimental autoimmune encephalomyelitis (EAE), the long-term benefits have not been evaluated. In this study, we investigated the effects of preconditioning exercise on the clinical and pathological progression of EAE. Female C57BL/6 mice were randomly assigned to either an exercised (Ex) or unexercised (UEx) group and all of them were induced for EAE. Mice in the Ex group had an attenuated clinical score relative to UEx mice throughout the study. At 42 dpi, flow cytometry analysis showed a significant reduction in B cells, CD4(+) T cells, and CD8(+) T cells infiltrating into the spinal cord in the Ex group compared to UEx. Ex mice also had a significant reduction in myelin damage with a corresponding increase in proteolipid protein expression. Finally, Ex mice had a significant reduction in axonal damage. Collectively, our study demonstrates for the first time that a prolonged and forced preconditioning protocol of exercise improves clinical outcome and attenuates pathological hallmarks of EAE at chronic disease. In this study, we show that a program of 6 weeks of preconditioning exercise promoted a significant reduction of cells infiltrating into the spinal cord, a significant reduction in myelin damage and a significant reduction in axonal damage in experimental autoimmune encephalomyelitis (EAE) mice at 42 dpi. Collectively, our study demonstrates for the first time that a preconditioning protocol of exercise improves clinical outcome and attenuates pathological hallmarks of EAE at chronic disease.
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Affiliation(s)
- Danielle Bernardes
- Departamento de Fisiologia e Biofísica, Núcleo de Neurociências, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, Brazil.,The Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Roberta Brambilla
- The Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Valerie Bracchi-Ricard
- The Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida, USA.,Department of Biology, Drexel University, Philadelphia, Philadelphia, USA
| | - Shaffiat Karmally
- The Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Anna Dellarole
- The Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Juliana Carvalho-Tavares
- Departamento de Fisiologia e Biofísica, Núcleo de Neurociências, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - John R Bethea
- Department of Biology, Drexel University, Philadelphia, Philadelphia, USA
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45
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Esposito A, Zilocchi M, Fasani P, Giannitto C, Maccagnoni S, Maniglio M, Campoleoni M, Brambilla R, Casiraghi E, Biondetti P. The value of precontrast thoraco-abdominopelvic CT in polytrauma patients. Eur J Radiol 2015; 84:1212-8. [DOI: 10.1016/j.ejrad.2015.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 02/15/2015] [Accepted: 02/20/2015] [Indexed: 10/24/2022]
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46
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Fossati G, Morini R, Corradini I, Antonucci F, Trepte P, Edry E, Sharma V, Papale A, Pozzi D, Defilippi P, Meier JC, Brambilla R, Turco E, Rosenblum K, Wanker EE, Ziv NE, Menna E, Matteoli M. Reduced SNAP-25 increases PSD-95 mobility and impairs spine morphogenesis. Cell Death Differ 2015; 22:1425-36. [PMID: 25678324 DOI: 10.1038/cdd.2014.227] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 10/22/2014] [Accepted: 11/26/2014] [Indexed: 12/24/2022] Open
Abstract
Impairment of synaptic function can lead to neuropsychiatric disorders collectively referred to as synaptopathies. The SNARE protein SNAP-25 is implicated in several brain pathologies and, indeed, brain areas of psychiatric patients often display reduced SNAP-25 expression. It has been recently found that acute downregulation of SNAP-25 in brain slices impairs long-term potentiation; however, the processes through which this occurs are still poorly defined. We show that in vivo acute downregulation of SNAP-25 in CA1 hippocampal region affects spine number. Consistently, hippocampal neurons from SNAP-25 heterozygous mice show reduced densities of dendritic spines and defective PSD-95 dynamics. Finally, we show that, in brain, SNAP-25 is part of a molecular complex including PSD-95 and p140Cap, with p140Cap being capable to bind to both SNAP-25 and PSD-95. These data demonstrate an unexpected role of SNAP-25 in controlling PSD-95 clustering and open the possibility that genetic reductions of the protein levels - as occurring in schizophrenia - may contribute to the pathology through an effect on postsynaptic function and plasticity.
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Affiliation(s)
- G Fossati
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy
| | - R Morini
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy
| | - I Corradini
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Istituto di Neuroscienze del CNR, Milano 20129, Italy
| | - F Antonucci
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Istituto di Neuroscienze del CNR, Milano 20129, Italy
| | - P Trepte
- Neuroproteomics, Max Delbrueck Center for Molecular Medicine (MDC), Berlin 13125, Germany
| | - E Edry
- Sagol Department of Neurobiology, Center for Gene Manipulation in the Adult Brain (CGMB), Haifa University, Haifa, Israel
| | - V Sharma
- Sagol Department of Neurobiology, Center for Gene Manipulation in the Adult Brain (CGMB), Haifa University, Haifa, Israel
| | - A Papale
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute and University, Milano 20132, Italy
| | - D Pozzi
- Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy
| | - P Defilippi
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino 10124, Italy
| | - J C Meier
- 1] RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany [2] TU Braunschweig, Zoological Institute, Division of Cell Biology and Cell Physiology, Braunschweig, Germany
| | - R Brambilla
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute and University, Milano 20132, Italy
| | - E Turco
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino 10124, Italy
| | - K Rosenblum
- Sagol Department of Neurobiology, Center for Gene Manipulation in the Adult Brain (CGMB), Haifa University, Haifa, Israel
| | - E E Wanker
- Neuroproteomics, Max Delbrueck Center for Molecular Medicine (MDC), Berlin 13125, Germany
| | - N E Ziv
- Network Biology Labs and Faculty of Medicine, Technion, 33000 Haifa, Israel
| | - E Menna
- 1] Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy [2] Istituto di Neuroscienze del CNR, Milano 20129, Italy
| | - M Matteoli
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy
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47
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Corrêa GG, Morais EC, Brambilla R, Bernardes AA, Radtke C, Dezen D, Júnior AV, Fronza N, Santos JHZD. Effects of the sol-gel route on the structural characteristics and antibacterial activity of silica-encapsulated gentamicin. Colloids Surf B Biointerfaces 2014; 116:510-7. [PMID: 24572495 DOI: 10.1016/j.colsurfb.2014.01.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 08/13/2013] [Revised: 12/23/2013] [Accepted: 01/21/2014] [Indexed: 10/25/2022]
Abstract
The effects of sol-gel processes, i.e., acid-catalyzed gelation, base-catalyzed gelation and base-catalyzed precipitation routes, on the encapsulation of gentamicin were investigated. The resulting xerogels were characterized using a series of complementary instrumental techniques, i.e., the adsorption/desorption of nitrogen, small-angle X-ray scattering, Fourier transform infrared spectroscopy, diffuse reflectance spectroscopy, X-ray photoelectron spectroscopy, atomic force microscopy and scanning electron microscopy. The encapsulated gentamicin samples were tested against a series of Gram-positive and Gram-negative bacterial strains. The best antimicrobial activity was observed with the encapsulated gentamicin that was prepared via the precipitation route, even in comparison with the neat antibiotic, especially in the case of the Gram-positive strain Staphylococcus aureus. The gentamicin concentration on the outermost surface and the zeta potential were identified as factors that affected the highest efficiency, as observed in the case of encapsulation via the base-catalyzed process.
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Affiliation(s)
- G G Corrêa
- Universidade Federal do Rio Grande do Sul, Instituto de Química, Av. Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil
| | - E C Morais
- Universidade Federal do Rio Grande do Sul, Instituto de Química, Av. Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil
| | - R Brambilla
- Universidade Federal do Rio Grande do Sul, Instituto de Química, Av. Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil
| | - A A Bernardes
- Universidade Federal do Rio Grande do Sul, Instituto de Química, Av. Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil
| | - C Radtke
- Universidade Federal do Rio Grande do Sul, Instituto de Química, Av. Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil
| | - D Dezen
- Instituto Federal de Educação, Ciência e Tecnologia Catarinense, Campus Concórdia, SC, Brazil
| | - A V Júnior
- Instituto Federal de Educação, Ciência e Tecnologia Catarinense, Campus Concórdia, SC, Brazil
| | - N Fronza
- Instituto Federal de Educação, Ciência e Tecnologia Catarinense, Campus Concórdia, SC, Brazil
| | - J H Z Dos Santos
- Universidade Federal do Rio Grande do Sul, Instituto de Química, Av. Bento Gonçalves, 9500, Porto Alegre 91501-970, RS, Brazil.
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Brambilla R, Morton PD, Ashbaugh JJ, Karmally S, Lambertsen KL, Bethea JR. Astrocytes play a key role in EAE pathophysiology by orchestrating in the CNS the inflammatory response of resident and peripheral immune cells and by suppressing remyelination. Glia 2013; 62:452-67. [DOI: 10.1002/glia.22616] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 11/21/2013] [Accepted: 11/21/2013] [Indexed: 12/19/2022]
Affiliation(s)
- Roberta Brambilla
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, Miller School of Medicine; University of Miami; Miami Florida
- The Neuroscience Program, Miller School of Medicine; University of Miami; Miami Florida
| | - Paul D. Morton
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, Miller School of Medicine; University of Miami; Miami Florida
- The Neuroscience Program, Miller School of Medicine; University of Miami; Miami Florida
| | - Jessica Jopek Ashbaugh
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, Miller School of Medicine; University of Miami; Miami Florida
- Department of Microbiology and Immunology, Miller School of Medicine; University of Miami; Miami Florida
| | - Shaffiat Karmally
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, Miller School of Medicine; University of Miami; Miami Florida
| | - Kate Lykke Lambertsen
- Department of Neurobiology Research, Institute of Molecular Medicine; University of Southern Denmark; Odense Denmark
| | - John R. Bethea
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, Miller School of Medicine; University of Miami; Miami Florida
- The Neuroscience Program, Miller School of Medicine; University of Miami; Miami Florida
- Department of Microbiology and Immunology, Miller School of Medicine; University of Miami; Miami Florida
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Bernardes D, Oliveira-Lima OC, da Silva TV, Faraco CCF, Leite HR, Juliano MA, dos Santos DM, Bethea JR, Brambilla R, Orian JM, Arantes RME, Carvalho-Tavares J. Differential brain and spinal cord cytokine and BDNF levels in experimental autoimmune encephalomyelitis are modulated by prior and regular exercise. J Neuroimmunol 2013; 264:24-34. [DOI: 10.1016/j.jneuroim.2013.08.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 08/14/2013] [Accepted: 08/26/2013] [Indexed: 12/17/2022]
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Ashbaugh JJ, Brambilla R, Karmally SA, Cabello C, Malek TR, Bethea JR. IL7Rα contributes to experimental autoimmune encephalomyelitis through altered T cell responses and nonhematopoietic cell lineages. J Immunol 2013; 190:4525-34. [PMID: 23530149 DOI: 10.4049/jimmunol.1203214] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A mutation in the IL7Rα locus has been identified as a risk factor for multiple sclerosis (MS), a neurodegenerative autoimmune disease characterized by inflammation, demyelination, and axonal damage. IL7Rα has well documented roles in lymphocyte development and homeostasis, but its involvement in disease is largely understudied. In this study, we use the experimental autoimmune encephalomyelitis (EAE) model of MS to show that a less severe form of the disease results when IL7Rα expression is largely restricted to thymic tissue in IL7RTg(IL7R-/-) mice. Compared with wild-type (WT) mice, IL7RTg(IL7R-/-) mice exhibited reduced paralysis and myelin damage that correlated with dampened effector responses, namely decreased TNF production. Furthermore, treatment of diseased WT mice with neutralizing anti-IL7Rα Ab also resulted in significant improvement of EAE. In addition, chimeric mice were generated by bone marrow transplant to limit expression of IL7Rα to cells of either hematopoietic or nonhematopoietic origin. Mice lacking IL7Rα only on hematopoietic cells develop severe EAE, suggesting that IL7Rα expression in the nonhematopoietic compartment contributes to disease. Moreover, novel IL7Rα expression was identified on astrocytes and oligodendrocytes endogenous to the CNS. Chimeric mice that lack IL7Rα only on nonhematopoietic cells also develop severe EAE, which further supports the role of IL7Rα in T cell effector function. Conversely, mice that lack IL7Rα throughout both compartments are dramatically protected from disease. Taken together, these data indicate that multiple cell types use IL7Rα signaling in the development of EAE, and inhibition of this pathway should be considered as a new therapeutic avenue for MS.
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Affiliation(s)
- Jessica J Ashbaugh
- Department of Microbiology and Immunology, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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