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Qiang X, Chen W, Zhu CS, Li J, Qi T, Lou L, Wang P, Tracey KJ, Wang H. Therapeutic potential of procathepsin L-inhibiting and progesterone-entrapping dimethyl-β-cyclodextrin nanoparticles in treating experimental sepsis. Front Immunol 2024; 15:1368448. [PMID: 38550581 PMCID: PMC10972846 DOI: 10.3389/fimmu.2024.1368448] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/04/2024] [Indexed: 04/02/2024] Open
Abstract
The pathogenic mechanisms of bacterial infections and resultant sepsis are partly attributed to dysregulated inflammatory responses sustained by some late-acting mediators including the procathepsin-L (pCTS-L). It was entirely unknown whether any compounds of the U.S. Drug Collection could suppress pCTS-L-induced inflammation, and pharmacologically be exploited into possible therapies. Here, we demonstrated that a macrophage cell-based screening of a U.S. Drug Collection of 1360 compounds resulted in the identification of progesterone (PRO) as an inhibitor of pCTS-L-mediated production of several chemokines [e.g., Epithelial Neutrophil-Activating Peptide (ENA-78), Monocyte Chemoattractant Protein-1 (MCP-1) or MCP-3] and cytokines [e.g., Interleukin-10 (IL-10) or Tumor Necrosis Factor (TNF)] in primary human peripheral blood mononuclear cells (PBMCs). In vivo, these PRO-entrapping 2,6-dimethal-β-cyclodextrin (DM-β-CD) nanoparticles (containing 1.35 mg/kg PRO and 14.65 mg/kg DM-β-CD) significantly increased animal survival in both male (from 30% to 70%, n = 20, P = 0.041) and female (from 50% to 80%, n = 30, P = 0.026) mice even when they were initially administered at 24 h post the onset of sepsis. This protective effect was associated with a reduction of sepsis-triggered accumulation of three surrogate biomarkers [e.g., Granulocyte Colony Stimulating Factor (G-CSF) by 40%; Macrophage Inflammatory Protein-2 (MIP-2) by 45%; and Soluble Tumor Necrosis Factor Receptor I (sTNFRI) by 80%]. Surface Plasmon Resonance (SPR) analysis revealed a strong interaction between PRO and pCTS-L (KD = 78.2 ± 33.7 nM), which was paralleled with a positive correlation between serum PRO concentration and serum pCTS-L level (ρ = 0.56, P = 0.0009) or disease severity (Sequential Organ Failure Assessment, SOFA; ρ = 0.64, P = 0.0001) score in septic patients. Our observations support a promising opportunity to explore DM-β-CD nanoparticles entrapping lipophilic drugs as possible therapies for clinical sepsis.
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Affiliation(s)
- Xiaoling Qiang
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Weiqiang Chen
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Cassie Shu Zhu
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Jianhua Li
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Timothy Qi
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Li Lou
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Ping Wang
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Kevin J. Tracey
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - Haichao Wang
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
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Morain SR, Bollinger J, Weinfurt K, Sugarman J. Stakeholder perspectives on data sharing from pragmatic clinical trials: Unanticipated challenges for meeting emerging requirements. Learn Health Syst 2024; 8:e10366. [PMID: 38249837 PMCID: PMC10797577 DOI: 10.1002/lrh2.10366] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/24/2023] [Accepted: 03/29/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Numerous arguments have been advanced for broadly sharing de-identified, participant-level clinical trial data. However, data sharing in pragmatic clinical trials (PCTs) presents ethical challenges. While prior scholarship has described aspects of PCTs that raise distinct considerations for data sharing, there have been no reports of the experiences of those at the leading edge of data-sharing efforts for PCTs, including how these particular challenges have been navigated. To address this gap, we conducted interviews with key stakeholders, with a focus on the ethical issues presented by sharing data from PCTs. Methods We recruited respondents using purposive sampling to reflect the range of stakeholder groups affected by efforts to expand PCT data sharing. Through semi-structured interviews, we explored respondents' experiences and perceptions about sharing de-identified, individual-level data from PCTs. An integrated approach was used to identify and describe key themes. Results We conducted 40 interviews between April and September 2022. Five overarching themes emerged through analysis: (1) challenges in sharing data collected under a waiver or alteration of consent; (2) conflicting views regarding PCT patient-subject preferences for data sharing; (3) identification of respect-promoting practices beyond consent; (4) concerns about elevated risks or burdens from sharing PCT data; and (5) diverse views about the likely benefits resulting from sharing PCT data. Conclusion Our data indicate unresolved tensions in how to fulfill the expectation to broadly share de-identified, individual-level data from PCTs, and suggest that those promulgating and implementing data-sharing policies must be sensitive to PCT-specific considerations. Future work could inform efforts to tailor data-sharing policy and practice to reflect the challenges presented by PCTs, including sharing experiences from trials that have successfully navigated these tensions.
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Affiliation(s)
- Stephanie R. Morain
- Berman Insitute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of Health Policy & ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Juli Bollinger
- Berman Insitute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Kevin Weinfurt
- Department of Population Health SciencesDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Jeremy Sugarman
- Berman Insitute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of Health Policy & ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of MedicineSchool of Medicine, Johns HopkinsBaltimoreMarylandUSA
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Ma Y, Gow BJ, Song R, Rist PM, Hausdorff JM, Lipsitz LA, Manor B, Wayne PM. Long-term Tai Chi practice in older adults is associated with "younger" functional abilities. Aging Cell 2024; 23:e14023. [PMID: 37905388 PMCID: PMC10776109 DOI: 10.1111/acel.14023] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
Age-related alterations in physiology lead to declines in physical function that are associated with numerous adverse outcomes among older adults. Utilizing a hybrid design, we aimed to understand whether both long-term and short-term Tai Chi (TC) training are associated with age-related decline in physical function in healthy older adults. We first conducted cross-sectional comparisons among TC-naïve older adults (n = 60, 64.2 ± 7.7 years), TC-expert older adults (n = 27, 62.8 ± 7.6 years, 24.5 ± 12 years experience), and TC-naïve younger adults (n = 15, 28.7 ± 3.2 years) to inform long-term effects of TC training on physical function, including single leg stance time with eyes closed, grip strength, Timed Up and Go, maximum walking speed, functional reach, and vertical jump for lower-extremity power. There were significant differences among the three groups on all the six tests. For most functional tests, TC-experts performed better than age-matched TC-naïve controls and were statistically indistinguishable from young healthy adult controls. Long-term TC training was associated with higher levels of physical function in older adults, suggesting a potential preventative healthy aging effect. In the randomized longitudinal trial, TC-naïve subjects were randomized (n = 31 to Tai Chi group, n = 29 to usual care control group) to evaluate the short-term effects of TC over 6 months on all outcomes. TC's short-term impacts on physical function were small and not statistically significant. The impact of short-term training in healthy adults is less clear. Both potential longer-term preventive effects and shorter-term restorative effects warrant further research with rigorous, adequately powered controlled clinical trials.
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Affiliation(s)
- Yan Ma
- Osher Center for Integrative Health, Division of Preventive MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Brian J. Gow
- Osher Center for Integrative Health, Division of Preventive MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Laboratory for Computational Physiology (LCP)Massachusetts Institute of TechnologyCambridgeMassachusettsUSA
| | - Rhayun Song
- College of NursingChungnam National UniversityDaejeonKorea
| | - Pamela M. Rist
- Division of Preventive MedicineBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center; Sagol School of Neuroscience and Department of Physical Therapy, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Department of Orthopedic Surgery and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Lewis A. Lipsitz
- Hinda and Arthur Marcus Institute for Aging ResearchHebrew SeniorLifeBostonMassachusettsUSA
- Division of Gerontology, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging ResearchHebrew SeniorLifeBostonMassachusettsUSA
- Division of Gerontology, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | - Peter M. Wayne
- Osher Center for Integrative Health, Division of Preventive MedicineBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
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Chargo NJ, Schepper JD, Rios‐Arce N, Kang HJ, Gardinier JD, Parameswaran N, McCabe LR. Lactobacillus Reuteri 6475 Prevents Bone Loss in a Clinically Relevant Oral Model of Glucocorticoid-Induced Osteoporosis in Male CD-1 Mice. JBMR Plus 2023; 7:e10805. [PMID: 38130770 PMCID: PMC10731127 DOI: 10.1002/jbm4.10805] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/06/2023] [Accepted: 07/28/2023] [Indexed: 12/23/2023] Open
Abstract
Glucocorticoids (GCs) are commonly used anti-inflammatory medications with significant side effects, including glucocorticoid-induced osteoporosis (GIO). We have previously demonstrated that chronic subcutaneous GC treatment in mice leads to gut barrier dysfunction and trabecular bone loss. We further showed that treating with probiotics or barrier enhancers improves gut barrier function and prevents GIO. The overall goal of this study was to test if probiotics could prevent GC-induced gut barrier dysfunction and bone loss in a clinically relevant oral-GC model of GIO. Eight-week-old male CD-1 mice were treated with vehicle or corticosterone in the drinking water for 4 weeks and administered probiotics Lactobacillus reuteri ATCC 6475 (LR 6475) or VSL#3 thrice weekly via oral gavage. As expected, GC treatment led to significant gut barrier dysfunction (assessed by measuring serum endotoxin levels) and bone loss after 4 weeks. Serum endotoxin levels significantly and negatively correlated with bone volume. Importantly, LR 6475 treatment effectively prevented both GC-induced increase in serum endotoxin and trabecular bone loss. VSL#3 had intermediate results, not differing from either control or GC-treated animals. GC-induced reductions in femur length, cortical thickness, and cortical area were not affected by probiotic treatment. Taken together, these results are the first to demonstrate that LR 6475 effectively prevents the detrimental effects of GC treatment on gut barrier, which correlates with enhanced trabecular bone health in an oral mouse model of GIO. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Nicholas J Chargo
- Department of PhysiologyMichigan State UniversityEast LansingMIUSA
- College of Osteopathic MedicineMichigan State UniversityEast LansingMIUSA
| | | | - Naoimy Rios‐Arce
- Department of PhysiologyMichigan State UniversityEast LansingMIUSA
| | - Ho Jun Kang
- Department of PhysiologyMichigan State UniversityEast LansingMIUSA
| | | | - Narayanan Parameswaran
- Department of PhysiologyMichigan State UniversityEast LansingMIUSA
- College of Human MedicineMichigan State UniversityEast LansingMIUSA
| | - Laura R McCabe
- Department of PhysiologyMichigan State UniversityEast LansingMIUSA
- College of Osteopathic MedicineMichigan State UniversityEast LansingMIUSA
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Rogers ER, Mirzakhalili E, Lempka SF. Model-based analysis of subthreshold mechanisms of spinal cord stimulation for pain. J Neural Eng 2023; 20:066003. [PMID: 37906966 PMCID: PMC10632558 DOI: 10.1088/1741-2552/ad0858] [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: 08/07/2023] [Revised: 10/11/2023] [Accepted: 10/31/2023] [Indexed: 11/02/2023]
Abstract
Objective.Spinal cord stimulation (SCS) is a common treatment for chronic pain. For decades, SCS maximized overlap between stimulation-induced paresthesias and the patient's painful areas. Recently developed SCS paradigms relieve pain at sub-perceptible amplitudes, yet little is known about the neural response to these new waveforms or their analgesic mechanisms of action. Therefore, in this study, we investigated the neural response to multiple forms of paresthesia-free SCS.Approach.We used computational modeling to investigate the neurophysiological effects and the plausibility of commonly proposed mechanisms of three paresthesia-free SCS paradigms: burst, 1 kHz, and 10 kHz SCS. Specifically, in C- and Aβ-fibers, we investigated the effects of different SCS waveforms on spike timing and activation thresholds, as well as how stochastic ion channel gating affects the response of dorsal column axons. Finally, we characterized membrane polarization of superficial dorsal horn neurons.Main results.We found that none of the SCS waveforms activate nor modulate spike timing in C-fibers. Spike timing was modulated in Aβ-fibers only at suprathreshold amplitudes. Ion channel stochasticity had little effect on Aβ-fiber activation thresholds but produced heterogeneous spike timings at suprathreshold amplitudes. Finally, local cells were preferentially polarized in their axon terminals, and the magnitude of this polarization was dependent on cellular morphology and position relative to the stimulation electrodes.Significance.Overall, the mechanisms of action of subparesthetic SCS remain unclear. Our results suggest that no SCS waveforms directly activate C-fibers, and modulation of spike timing is unlikely at subthreshold amplitudes. We conclude that potential subthreshold neuromodulatory effects of SCS on local cells are likely to be presynaptic in nature, as axons are preferentially depolarized during SCS.
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Affiliation(s)
- Evan R Rogers
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States of America
| | - Ehsan Mirzakhalili
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States of America
| | - Scott F Lempka
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States of America
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States of America
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States of America
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Fuqua JD, Lawrence MM, Hettinger ZR, Borowik AK, Brecheen PL, Szczygiel MM, Abbott CB, Peelor FF, Confides AL, Kinter M, Bodine SC, Dupont‐Versteegden EE, Miller BF. Impaired proteostatic mechanisms other than decreased protein synthesis limit old skeletal muscle recovery after disuse atrophy. J Cachexia Sarcopenia Muscle 2023; 14:2076-2089. [PMID: 37448295 PMCID: PMC10570113 DOI: 10.1002/jcsm.13285] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 02/03/2023] [Revised: 04/10/2023] [Accepted: 05/22/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Skeletal muscle mass and strength diminish during periods of disuse but recover upon return to weight bearing in healthy adults but are incomplete in old muscle. Efforts to improve muscle recovery in older individuals commonly aim at increasing myofibrillar protein synthesis via mammalian target of rapamycin (mTOR) stimulation despite evidence demonstrating that old muscle has chronically elevated levels of mammalian target of rapamycin complex 1 (mTORC1) activity. We hypothesized that protein synthesis is higher in old muscle than adult muscle, which contributes to a proteostatic stress that impairs recovery. METHODS We unloaded hindlimbs of adult (10-month) and old (28-month) F344BN rats for 14 days to induce atrophy, followed by reloading up to 60 days with deuterium oxide (D2 O) labelling to study muscle regrowth and proteostasis. RESULTS We found that old muscle has limited recovery of muscle mass during reloading despite having higher translational capacity and myofibrillar protein synthesis (0.029 k/day ± 0.002 vs. 0.039 k/day ± 0.002, P < 0.0001) than adult muscle. We showed that collagen protein synthesis was not different (0.005 k (1/day) ± 0.0005 vs. 0.004 k (1/day) ± 0.0005, P = 0.15) in old compared to adult, but old muscle had higher collagen concentration (4.5 μg/mg ± 1.2 vs. 9.8 μg/mg ± 0.96, P < 0.01), implying that collagen breakdown was slower in old muscle than adult muscle. This finding was supported by old muscle having more insoluble collagen (4.0 ± 1.1 vs. 9.2 ± 0.9, P < 0.01) and an accumulation of advanced glycation end products (1.0 ± 0.06 vs. 1.5 ± 0.08, P < 0.001) than adult muscle during reloading. Limited recovery of muscle mass during reloading is in part due to higher protein degradation (0.017 1/t ± 0.002 vs. 0.028 1/t ± 0.004, P < 0.05) and/or compromised proteostasis as evidenced by accumulation of ubiquitinated insoluble proteins (1.02 ± 0.06 vs. 1.22 ± 0.06, P < 0.05). Last, we showed that synthesis of individual proteins related to protein folding/refolding, protein degradation and neural-related biological processes was higher in old muscle during reloading than adult muscle. CONCLUSIONS Our data suggest that the failure of old muscle to recover after disuse is not due to limitations in the ability to synthesize myofibrillar proteins but because of other impaired proteostatic mechanisms (e.g., protein folding and degradation). These data provide novel information on individual proteins that accumulate in protein aggregates after disuse and certain biological processes such as protein folding and degradation that likely play a role in impaired recovery. Therefore, interventions to enhance regrowth of old muscle after disuse should be directed towards the identified impaired proteostatic mechanisms and not aimed at increasing protein synthesis.
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Affiliation(s)
- Jordan D. Fuqua
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
| | - Marcus M. Lawrence
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
- Department of Kinesiology and Outdoor RecreationSouthern Utah UniversityCedar CityUTUSA
| | - Zachary R. Hettinger
- Department of Physical Therapy, College of Health SciencesUniversity of KentuckyLexingtonKYUSA
- Center for Muscle BiologyUniversity of KentuckyLexingtonKYUSA
| | - Agnieszka K. Borowik
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
| | - Parker L. Brecheen
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
| | - Marcelina M. Szczygiel
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
| | - Claire B. Abbott
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
| | - Frederick F. Peelor
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
| | - Amy L. Confides
- Department of Physical Therapy, College of Health SciencesUniversity of KentuckyLexingtonKYUSA
- Center for Muscle BiologyUniversity of KentuckyLexingtonKYUSA
| | - Michael Kinter
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
| | - Sue C. Bodine
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
- Department of Internal MedicineUniversity of IowaIowa CityIAUSA
- Fraternal Order of Eagles Diabetes Research CenterUniversity of IowaIowa CityIAUSA
- Iowa City Veterans Affairs Medical CenterIowa CityIAUSA
| | - Esther E. Dupont‐Versteegden
- Department of Physical Therapy, College of Health SciencesUniversity of KentuckyLexingtonKYUSA
- Center for Muscle BiologyUniversity of KentuckyLexingtonKYUSA
| | - Benjamin F. Miller
- Aging & Metabolism Research ProgramOklahoma Medical Research FoundationOklahoma CityOKUSA
- Oklahoma City Veterans Affairs Medical CenterOklahoma CityOKUSA
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Nikpasand M, Abbott RE, Kage CC, Singh S, Winkelstein BA, Barocas VH, Ellingson AM. Cervical facet capsular ligament mechanics: Estimations based on subject-specific anatomy and kinematics. JOR Spine 2023; 6:e1269. [PMID: 37780821 PMCID: PMC10540825 DOI: 10.1002/jsp2.1269] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 10/03/2023] Open
Abstract
Background To understand the facet capsular ligament's (FCL) role in cervical spine mechanics, the interactions between the FCL and other spinal components must be examined. One approach is to develop a subject-specific finite element (FE) model of the lower cervical spine, simulating the motion segments and their components' behaviors under physiological loading conditions. This approach can be particularly attractive when a patient's anatomical and kinematic data are available. Methods We developed and demonstrated methodology to create 3D subject-specific models of the lower cervical spine, with a focus on facet capsular ligament biomechanics. Displacement-controlled boundary conditions were applied to the vertebrae using kinematics extracted from biplane videoradiography during planar head motions, including axial rotation, lateral bending, and flexion-extension. The FCL geometries were generated by fitting a surface over the estimated ligament-bone attachment regions. The fiber structure and material characteristics of the ligament tissue were extracted from available human cervical FCL data. The method was demonstrated by application to the cervical geometry and kinematics of a healthy 23-year-old female subject. Results FCL strain within the resulting subject-specific model were subsequently compared to models with generic: (1) geometry, (2) kinematics, and (3) material properties to assess the effect of model specificity. Asymmetry in both the kinematics and the anatomy led to asymmetry in strain fields, highlighting the importance of patient-specific models. We also found that the calculated strain field was largely independent of constitutive model and driven by vertebrae morphology and motion, but the stress field showed more constitutive-equation-dependence, as would be expected given the highly constrained motion of cervical FCLs. Conclusions The current study provides a methodology to create a subject-specific model of the cervical spine that can be used to investigate various clinical questions by coupling experimental kinematics with multiscale computational models.
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Affiliation(s)
- Maryam Nikpasand
- Department of Mechanical EngineeringUniversity of Minnesota—Twin CitiesMinneapolisMinnesotaUSA
| | - Rebecca E. Abbott
- Department of Rehabilitation MedicineUniversity of Minnesota—Twin CitiesMinneapolisMinnesotaUSA
| | - Craig C. Kage
- Department of Rehabilitation MedicineUniversity of Minnesota—Twin CitiesMinneapolisMinnesotaUSA
| | - Sagar Singh
- Department of BioengineeringUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Beth A. Winkelstein
- Department of BioengineeringUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Victor H. Barocas
- Department of Mechanical EngineeringUniversity of Minnesota—Twin CitiesMinneapolisMinnesotaUSA
- Department of Biomedical EngineeringUniversity of Minnesota—Twin CitiesMinneapolisMinnesotaUSA
| | - Arin M. Ellingson
- Department of Rehabilitation MedicineUniversity of Minnesota—Twin CitiesMinneapolisMinnesotaUSA
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Youssef A, Mohammed BK, Prasad A, del Aguila A, Bassi G, Yang W, Ulloa L. Splenic SUMO1 controls systemic inflammation in experimental sepsis. Front Immunol 2023; 14:1200939. [PMID: 37520526 PMCID: PMC10374847 DOI: 10.3389/fimmu.2023.1200939] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction The recent discovery of TAK981(Subasumstat), the first-in-class selective inhibitor of SUMOylation, enables new immune treatments. TAK981 is already in clinical trials to potentiate immunotherapy in metastatic tumors and hematologic malignancies. Cancer patients have more than ten times higher risk of infections, but the effects of TAK981 in sepsis are unknown and previous studies on SUMO in infections are conflicting. Methods We used TAK981 in two sepsis models; polymicrobial peritonitis (CLP) and LPS endotoxemia. Splenectomy was done in both models to study the role of spleen. Western blotting of SUMO-conjugated proteins in spleen lysates was done. Global SUMO1 and SUMO3 knockout mice were used to study the specific SUMO regulation of inflammation in LPS endotoxemia. Splenocytes adoptive transfer was done from SUMO knockouts to wild type mice to study the role of spleen SUMOylation in experimental sepsis. Results and discussion Here, we report that inhibition of SUMOylation with TAK981 improved survival in mild polymicrobial peritonitis by enhancing innate immune responses and peritoneal bacterial clearance. Thus, we focused on the effects of TAK981 on the immune responses to bacterial endotoxin, showing that TAK981 enhanced early TNFα production but did not affect the resolution of inflammation. Splenectomy decreased serum TNFα levels by nearly 60% and TAK981-induced TNFα responses. In the spleen, endotoxemia induced a distinct temporal and substrate specificity for SUMO1 and SUMO2/3, and both were inhibited by TAK981. Global genetic depletion of SUMO1, but not SUMO3, enhanced TNFα production and metabolic acidosis. The transfer of SUMO1-null, but not wild-type, splenocytes into splenectomized wild-type mice exacerbated TNFα production and metabolic acidosis in endotoxemia. Conclusion These results suggest that specific regulation of splenic SUMO1 can modulate immune and metabolic responses to bacterial infection.
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Braun TD, Olson K, Panza E, Lillis J, Schumacher L, Abrantes AM, Kunicki Z, Unick JL. Internalized weight stigma in women with class III obesity: A randomized controlled trial of a virtual lifestyle modification intervention followed by a mindful self-compassion intervention. Obes Sci Pract 2022; 8:816-827. [PMID: 36483124 PMCID: PMC9722463 DOI: 10.1002/osp4.616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/11/2022] Open
Abstract
Background Internalized weight stigma (Internalized-WS) is prevalent among individuals with severe obesity, particularly women, and is associated with shame, disordered eating, and weight gain. Effective, accessible interventions that address both severe (Class-III) obesity and Internalized-WS are needed. This randomized pilot trial evaluated the feasibility, acceptability, and preliminary efficacy of a fully-remote lifestyle modification intervention (LM) followed by mindful self-compassion training (MSC) or control. Methods Twenty-eight women with Class-III obesity (46.6 ± 3.7 kg/m2) and elevated Internalized-WS were randomized to a virtually-delivered 4-month LM followed by a 2-month MSC or cooking/dietary education (CON). Psychosocial measures/weight were assessed at baseline, 4-(post-LM), 6-(post-MSC/CON), and 9-month (follow-up). Results Improvements in Internalized-WS, shame, and self-compassion were observed with LM. Mean 4-month weight loss was 6.3 ± 3.7%. MSC had lower attendance and usefulness ratings versus CON. Post-MSC/CON, MSC yielded significant and/or meaningful improvements in Internalized-WS, self-compassion, and intuitive eating relative to CON. Weight loss did not differ by group at 6-month, and at 9-month trended lower in MSC versus CON. Conclusion Virtual LM is feasible, acceptable, and leads to significant weight loss among women with severe obesity; MSC led to further improved Internalized-WS, self-compassion, and intuitive eating. Continued work is needed to elucidate effects of self-compassion training on Internalized-WS, its mechanisms, and linkages to cardiometabolic health and long-term weight loss.
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Affiliation(s)
- Tosca D. Braun
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Centers for Behavioral and Preventive MedicineThe Miriam HospitalProvidenceRIUSA
- Butler HospitalProvidenceRIUSA
| | - Kayloni Olson
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
| | - Emily Panza
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
| | - Jason Lillis
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
| | - Leah Schumacher
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
| | - Ana M. Abrantes
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Butler HospitalProvidenceRIUSA
| | - Zachary Kunicki
- Quantitative Sciences ProgramBrown UniversityProvidenceRIUSA
| | - Jessica L. Unick
- Alpert Medical School of Brown UniversityProvidenceRIUSA
- Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRIUSA
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10
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Sprick JD, Jones T, Jeong J, DaCosta D, Park J. Dynamic cerebral autoregulation is intact in chronic kidney disease. Physiol Rep 2022; 10:e15495. [PMID: 36325592 PMCID: PMC9630754 DOI: 10.14814/phy2.15495] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 05/09/2023] Open
Abstract
Chronic Kidney Disease (CKD) patients experience an elevated risk for cerebrovascular disease. One factor that may contribute to this heightened risk is an impairment in dynamic cerebral autoregulation, the mechanism by which cerebral vessels modulate cerebral blood flow during fluctuations in arterial pressure. We hypothesized that dynamic cerebral autoregulation would be impaired in CKD. To test this hypothesis, we compared dynamic cerebral autoregulation between CKD patients stages III-IV and matched controls (CON) without CKD. Fifteen patients with CKD and 20 CON participants performed 2, 5-minute bouts of repeated sit-to-stand maneuvers at 0.05 Hz and 0.10 Hz while mean arterial pressure (MAP, via finger photoplethysmography) and middle cerebral artery blood velocity (MCAv, via transcranial Doppler ultrasound) were measured continuously. Cerebral autoregulation was characterized by performing a transfer function analysis (TFA) on the MAP-MCAv relationship to derive coherence, phase, gain, and normalized gain (nGain). We observed no group differences in any of the TFA metrics during the repeated sit-to-stand maneuvers. During the 0.05 Hz maneuver, Coherence: CKD = 0.83 ± 0.13, CON = 0.85 ± 0.12, Phase (radians): CKD = 1.39 ± 0.41, CON = 1.25 ± 0.30, Gain (cm/s/mmHg): CKD = 0.69 ± 0.20, CON = 0.71 ± 0.22, nGain (%/mmHg): CKD = 1.26 ± 0.35, CON = 1.20 ± 0.28, p ≥ 0.24. During the 0.10 Hz maneuver (N = 6 CKD and N = 12 CON), Coherence: CKD = 0.61 ± 0.10, CON = 0.67 ± 0.11, Phase (radians): CKD = 1.43 ± 0.26, CON = 1.30 ± 0.23, Gain (cm/s/mmHg): CKD = 0.75 ± 0.15, CON = 0.84 ± 0.26, nGain (%/mmHg): CKD = 1.50 ± 0.28, CON = 1.29 ± 0.24, p ≥ 0.12. Contrary to our hypothesis, dynamic cerebral autoregulation remains intact in CKD stages III-IV. These findings suggest that other mechanisms likely contribute to the increased cerebrovascular disease burden experienced by this population. Future work should determine if other cerebrovascular regulatory mechanisms are impaired and related to cerebrovascular disease risk in CKD.
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Affiliation(s)
- Justin D. Sprick
- Division of Renal Medicine, Department of MedicineEmory University School of MedicineAtlantaGeorgiaUSA
- Department of Veterans Affairs Health Care SystemDecaturGeorgiaUSA
- Department of Kinesiology, Health Promotion and RecreationUniversity of North TexasDentonTexasUSA
| | - Toure Jones
- Division of Renal Medicine, Department of MedicineEmory University School of MedicineAtlantaGeorgiaUSA
- Department of Veterans Affairs Health Care SystemDecaturGeorgiaUSA
| | - Jinhee Jeong
- Division of Renal Medicine, Department of MedicineEmory University School of MedicineAtlantaGeorgiaUSA
- Department of Veterans Affairs Health Care SystemDecaturGeorgiaUSA
| | - Dana DaCosta
- Division of Renal Medicine, Department of MedicineEmory University School of MedicineAtlantaGeorgiaUSA
- Department of Veterans Affairs Health Care SystemDecaturGeorgiaUSA
| | - Jeanie Park
- Division of Renal Medicine, Department of MedicineEmory University School of MedicineAtlantaGeorgiaUSA
- Department of Veterans Affairs Health Care SystemDecaturGeorgiaUSA
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11
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Crawford LC, Kim S, Karelia D, Sepulveda DE, Morgan DJ, Lü J, Henderson-Redmond AN. Decursinol-mediated antinociception and anti-allodynia in acute and neuropathic pain models in male mice: Tolerance and receptor profiling. Front Pharmacol 2022; 13:968976. [PMID: 36249788 PMCID: PMC9558739 DOI: 10.3389/fphar.2022.968976] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
Korean scientists have shown that oral administration of Angelica gigas Nakai (AGN) root alcoholic extract and the metabolite of its pyranocoumarins, decursinol, have antinociceptive properties across various thermal and acute inflammatory pain models. The objectives of this study were 1) to assess whether tolerance develops to the antinociceptive effects of once-daily intraperitoneally administered decursinol (50 mg/kg) in acute thermal pain models, 2) to establish its anti-allodynic efficacy and potential tolerance development in a model of chemotherapy-evoked neuropathic pain (CENP) and 3) to probe the involvement of select receptors in mediating the pain-relieving effects with antagonists. The results show that decursinol induced antinociception in both the hot plate and tail-flick assays and reversed mechanical allodynia in mice with cisplatin-evoked neuropathic pain. Tolerance was detected to the antinociceptive effects of decursinol in the hot plate and tail-flick assays and to the anti-allodynic effects of decursinol in neuropathic mice. Pretreatment with either the 5-HT2 antagonist methysergide, the 5-HT2A antagonist volinanserin, or the 5-HT2C antagonist SB-242084 failed to attenuate decursinol-induced antinociception in the tail-flick assay. While pretreatment with the cannabinoid inverse agonists rimonabant and SR144528 failed to modify decursinol-induced anti-allodynia, pretreatment with the opioid antagonist naloxone partially attenuated the anti-allodynic effects of decursinol. In conclusion, our data support decursinol as an active phytochemical of AGN having both antinociceptive and anti-allodynic properties. Future work warrants a more critical investigation of potential receptor mechanisms as they are likely more complicated than initially reported.
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Affiliation(s)
- LaTaijah C. Crawford
- Biomedical Sciences Graduate Program, Pennsylvania State University College of Medicine, Hershey, PA, United States
- Department of Biomedical Sciences, Marshall University, Huntington, WV, United States
| | - Sangyub Kim
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Deepkamal Karelia
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Diana E. Sepulveda
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Daniel J. Morgan
- Department of Biomedical Sciences, Marshall University, Huntington, WV, United States
| | - Junxuan Lü
- Biomedical Sciences Graduate Program, Pennsylvania State University College of Medicine, Hershey, PA, United States
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, United States
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12
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Ita ME, Singh S, Troche HR, Welch RL, Winkelstein BA. Intra-articular MMP-1 in the spinal facet joint induces sustained pain and neuronal dysregulation in the DRG and spinal cord, and alters ligament kinematics under tensile loading. Front Bioeng Biotechnol 2022; 10:926675. [PMID: 35992346 PMCID: PMC9382200 DOI: 10.3389/fbioe.2022.926675] [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: 04/22/2022] [Accepted: 06/27/2022] [Indexed: 12/03/2022] Open
Abstract
Chronic joint pain is a major healthcare challenge with a staggering socioeconomic burden. Pain from synovial joints is mediated by the innervated collagenous capsular ligament that surrounds the joint and encodes nociceptive signals. The interstitial collagenase MMP-1 is elevated in painful joint pathologies and has many roles in collagen regulation and signal transduction. Yet, the role of MMP-1 in mediating nociception in painful joints remains poorly understood. The goal of this study was to determine whether exogenous intra-articular MMP-1 induces pain in the spinal facet joint and to investigate effects of MMP-1 on mediating the capsular ligament’s collagen network, biomechanical response, and neuronal regulation. Intra-articular MMP-1 was administered into the cervical C6/C7 facet joints of rats. Mechanical hyperalgesia quantified behavioral sensitivity before, and for 28 days after, injection. On day 28, joint tissue structure was assessed using histology. Multiscale ligament kinematics were defined under tensile loading along with microstructural changes in the collagen network. The amount of degraded collagen in ligaments was quantified and substance P expression assayed in neural tissue since it is a regulatory of nociceptive signaling. Intra-articular MMP-1 induces behavioral sensitivity that is sustained for 28 days (p < 0.01), absent any significant effects on the structure of joint tissues. Yet, there are changes in the ligament’s biomechanical and microstructural behavior under load. Ligaments from joints injected with MMP-1 exhibit greater displacement at yield (p = 0.04) and a step-like increase in the number of anomalous reorganization events of the collagen fibers during loading (p ≤ 0.02). Collagen hybridizing peptide, a metric of damaged collagen, is positively correlated with the spread of collagen fibers in the unloaded state after MMP-1 (p = 0.01) and that correlation is maintained throughout the sub-failure regime (p ≤ 0.03). MMP-1 injection increases substance P expression in dorsal root ganglia (p < 0.01) and spinal cord (p < 0.01) neurons. These findings suggest that MMP-1 is a likely mediator of neuronal signaling in joint pain and that MMP-1 presence in the joint space may predispose the capsular ligament to altered responses to loading. MMP-1-mediated pathways may be relevant targets for treating degenerative joint pain in cases with subtle or no evidence of structural degeneration.
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Affiliation(s)
- Meagan E. Ita
- Spine Pain Research Laboratory, Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Sagar Singh
- Spine Pain Research Laboratory, Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Harrison R. Troche
- Spine Pain Research Laboratory, Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Rachel L. Welch
- Spine Pain Research Laboratory, Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
| | - Beth A. Winkelstein
- Spine Pain Research Laboratory, Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States
- *Correspondence: Beth A. Winkelstein,
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13
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Jiang H, Kokkinos V, Ye S, Urban A, Bagić A, Richardson M, He B. Interictal SEEG Resting-State Connectivity Localizes the Seizure Onset Zone and Predicts Seizure Outcome. Adv Sci (Weinh) 2022; 9:e2200887. [PMID: 35545899 PMCID: PMC9218648 DOI: 10.1002/advs.202200887] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Indexed: 05/23/2023]
Abstract
Localization of epileptogenic zone currently requires prolonged intracranial recordings to capture seizure, which may take days to weeks. The authors developed a novel method to identify the seizure onset zone (SOZ) and predict seizure outcome using short-time resting-state stereotacticelectroencephalography (SEEG) data. In a cohort of 27 drug-resistant epilepsy patients, the authors estimated the information flow via directional connectivity and inferred the excitation-inhibition ratio from the 1/f power slope. They hypothesized that the antagonism of information flow at multiple frequencies between SOZ and non-SOZ underlying the relatively stable epilepsy resting state could be related to the disrupted excitation-inhibition balance. They found flatter 1/f power slope in non-SOZ regions compared to the SOZ, with dominant information flow from non-SOZ to SOZ regions. Greater differences in resting-state information flow between SOZ and non-SOZ regions are associated with favorable seizure outcome. By integrating a balanced random forest model with resting-state connectivity, their method localized the SOZ with an accuracy of 88% and predicted the seizure outcome with an accuracy of 92% using clinically determined SOZ. Overall, this study suggests that brief resting-state SEEG data can significantly facilitate the identification of SOZ and may eventually predict seizure outcomes without requiring long-term ictal recordings.
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Affiliation(s)
- Haiteng Jiang
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
- Department of NeurobiologyAffiliated Mental Health Center & Hangzhou Seventh People's HospitalZhejiang University School of MedicineHangzhou310013P. R. China
- NHC and CAMS Key Laboratory of Medical NeurobiologyMOE Frontier Science Center for Brain Science and Brain‐machine IntegrationSchool of Brain Science and Brain MedicineZhejiang UniversityHangzhou310058P. R. China
| | - Vasileios Kokkinos
- University of Pittsburgh Comprehensive Epilepsy CenterDepartment of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPA15232USA
- Massachusetts General HospitalBostonMA02114USA
| | - Shuai Ye
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
| | - Alexandra Urban
- University of Pittsburgh Comprehensive Epilepsy CenterDepartment of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPA15232USA
| | - Anto Bagić
- University of Pittsburgh Comprehensive Epilepsy CenterDepartment of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPA15232USA
| | - Mark Richardson
- University of Pittsburgh Comprehensive Epilepsy CenterDepartment of NeurologyUniversity of Pittsburgh School of MedicinePittsburghPA15232USA
- Massachusetts General HospitalBostonMA02114USA
| | - Bin He
- Department of Biomedical EngineeringCarnegie Mellon UniversityPittsburghPA15213USA
- Neuroscience InstituteCarnegie Mellon UniversityPittsburghPA15213USA
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14
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Creswell KG, Sayette MA. How laboratory studies of cigarette craving can inform the experimental alcohol craving literature. Alcohol Clin Exp Res 2022; 46:344-358. [PMID: 35037262 PMCID: PMC8920775 DOI: 10.1111/acer.14773] [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: 08/27/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 11/28/2022]
Abstract
Interest in alcohol and other drug craving has flourished over the past two decades, and evidence has accumulated showing that craving can be meaningfully linked to both drug use and relapse. Considerable human experimental alcohol craving research since 2000 has focused on craving as a clinical phenomenon. Self-reported craving to drink typically has served as a catch-all for the craving construct in these studies, whereas few studies have considered craving as a process (or hypothetical construct) that interacts with other phenomena to affect use. In contrast to alcohol, we believe that recently there has been more mechanistic work targeting cigarette craving-related processes. Here, we briefly present a narrative review of studies of acute alcohol craving in humans that have been conducted during the past two decades. We then specify important ways in which alcohol and tobacco differ (e.g., the role of withdrawal), and we note the unique challenges in inducing robust alcohol craving states in the laboratory. Finally, we offer recommendations for how the alcohol field might advance its conceptual understanding of craving by adopting ideas and methods drawn from the smoking research literature. Specifically, we suggest that researchers extend their studies to not only examine the link between alcohol craving and relapse but also to focus on why and, in some instances, how alcohol cravings matter clinically, and the circumstances under which craving especially matters. We propose research to investigate the shifts in alcohol-related cognitive and affective processing that occur during alcohol craving states. Furthermore, we highlight the value of research examining the level of insight that individuals with varying levels of alcohol involvement possess about their own craving-related processing shifts. We believe that laboratory studies can provide rich opportunities to examine conceptual questions about alcohol craving that are central to addiction.
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Affiliation(s)
- Kasey G. Creswell
- Department of PsychologyCarnegie Mellon UniversityPittsburghPennsylvaniaUSA
| | - Michael A. Sayette
- Department of PsychologyUniversity of PittsburghPittsburghPennsylvaniaUSA
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15
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Cheng BR, Wu RY, Gao QY, Jiang KX, Li SS, Qi SH, Yuan MY, Liu JP. Chinese Proprietary Medicine Xianling Gubao Capsule for Osteoporosis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Front Endocrinol (Lausanne) 2022; 13:870277. [PMID: 35464071 PMCID: PMC9022208 DOI: 10.3389/fendo.2022.870277] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/11/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess the benefit and harm of Chinese medicine Xianling Gubao (XLGB) capsule compared to conventional medication or placebo to inform clinical practice. METHODS We included randomized controlled trials (RCTs) with Jadad score ≥3 of XLGB capsule compared to pharmaceutical medication, placebo, or no treatment for primary osteoporosis. We conducted searches in EMBASE, Cochrane CENTRAL, MEDLINE, China National Knowledge Infrastructure, VIP, Wanfang, and Chinese Biomedical Literature Database (Sino-Med) from their inception till November 13th, 2021. Study selection and data extraction were done by two authors independently. The methodological quality of the RCTs was assessed using Cochrane's risk of bias tool. The effect size was presented as risk ratio (RR) or mean difference (MD) with their 95% confidence interval (CI). RESULTS Our searches identified 2292 records and after exclusions, eight trials involving 846 participants were included. There was no statistically significant difference between conventional medications with or without XLGB on new fracture (RR: 0.50, 95% CI: [0.13, 1.87]). Quality of life by SF-36 questionnaire of XLGB plus calcium carbonate, vitamin D3, and calcitriol was improved than that of without XLGB (MD: 6.72 scores, 95% CI: [2.82, 10.62]). XLGB increased bone mineral density similarly as calcium carbonate plus vitamin D3 (MD: 0.21, 95% CI: [-0.16, 0.58]) or as alendronate sodium, calcium carbonate plus vitamin D3 (MD: 0.00, 95% CI: [-0.10, 0.10]), but it had no additional effect as an add-on treatment to conventional medications (MD: 0.13, 95% CI: [-0.12, 0.37]). XLGB relieved pain via visual analog scale more effectively when combined with medications (MD: -1.55 score, 95% CI: [-2.47, -0.63]). XLGB as monotherapy did not increase adverse events (RR: 0.63, 95% CI: [0.28, 1.41]), or as an add-on treatment (RR: 0.25, 95% CI: [0.03, 2.16]). CONCLUSION This systematic review shows that XLGB capsule appears to be safe and has a beneficial effect on the quality of life and pain relief when used alone or in combination with conventional medications in osteoporosis patients. Further large, rigorous trials are warranted to test its long-term benefit.
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Affiliation(s)
- Bai-Ru Cheng
- The First School of Clinical Medicine (Dongzhimen Hospital), Beijing University of Chinese Medicine, Beijing, China
| | - Rou-Yan Wu
- The First School of Clinical Medicine (Dongzhimen Hospital), Beijing University of Chinese Medicine, Beijing, China
| | - Qin-Yang Gao
- The First School of Clinical Medicine (Dongzhimen Hospital), Beijing University of Chinese Medicine, Beijing, China
| | - Kai-Xin Jiang
- The Second School of Clinical Medicine (Dongfang Hospital), Beijing University of Chinese Medicine, Beijing, China
| | - Shuang-Sang Li
- The Second School of Clinical Medicine (Dongfang Hospital), Beijing University of Chinese Medicine, Beijing, China
| | - Shi-Hao Qi
- The Second School of Clinical Medicine (Dongfang Hospital), Beijing University of Chinese Medicine, Beijing, China
| | - Ming-Yi Yuan
- The Second School of Clinical Medicine (Dongfang Hospital), Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Jian-Ping Liu,
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16
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Morain SR, Mathews DJH, Weinfurt K, May E, Bollinger JM, Geller G, Sugarman J. Stakeholder perspectives regarding pragmatic clinical trial collateral findings. Learn Health Syst 2021; 5:e10245. [PMID: 34667872 PMCID: PMC8512737 DOI: 10.1002/lrh2.10245] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/03/2020] [Accepted: 08/16/2020] [Indexed: 12/14/2022] Open
Abstract
CONTEXT Pragmatic clinical trials (PCTs), which are becoming widespread since they are relatively inexpensive and offer important benefits for healthcare decision-making, can also present practical, ethical, and legal challenges. One such challenge involves managing "pragmatic clinical trial collateral findings" (PCT-CFs), or information emerging in a PCT that is unrelated to the primary research question(s), yet may have implications for individual patients, clinicians, or health care systems from whom or within which data were collected. The expansion of PCTs makes it likely healthcare systems will increasingly encounter PCT-CFs, yet little guidance exists regarding their appropriate management. METHODS We conducted semi-structured interviews with key stakeholders experienced in the conduct or oversight of PCTs and those in health system leadership. Interviews explored respondents' experience with PCTs and PCT-CFs, and actual or hypothetical reactions to PCT-CF management. We used standard methods of qualitative analysis to identify key themes. FINDINGS Forty-one stakeholders participated. Four key themes emerged. First, discussions of PCT-CFs are complicated by layers of ambiguity related to both the nature of PCTs themselves, and unanticipated results that emanate from them. Second, management of PCT-CFs is context-specific, and not amenable to a "one-size-fits-all" approach. Third, there was a wide diversity of attitudes regarding the scope of researcher responsibilities in PCTs. Fourth, PCT-CFs had generally not been previously considered by respondents, but there was widespread belief in the importance of prospective planning to anticipate such issues in future PCTs. CONCLUSIONS PCT-CFs are likely to increase, yet those charged with PCT-CF decision-making and their disclosure are unlikely to have experience with these issues. Further deliberation about the ethical obligations and implementation processes regarding PCT-CFs is needed. To enhance the likelihood of developing sound policies and practices, such deliberations should include the input and perspectives of key stakeholders in PCTs, including professionals, policy makers, and patients.
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Affiliation(s)
- Stephanie R. Morain
- Center for Medical Ethics and Health PolicyBaylor College of MedicineHoustonTexasUSA
| | - Debra J. H. Mathews
- Berman Institute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of PediatricsJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Kevin Weinfurt
- Department of Population Health SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
| | - Elizabeth May
- Berman Institute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Juli M. Bollinger
- Berman Institute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Gail Geller
- Berman Institute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jeremy Sugarman
- Berman Institute of BioethicsJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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17
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Boudreau A, Richard AJ, Harvey I, Stephens JM. Artemisia scoparia and Metabolic Health: Untapped Potential of an Ancient Remedy for Modern Use. Front Endocrinol (Lausanne) 2021; 12:727061. [PMID: 35211087 PMCID: PMC8861327 DOI: 10.3389/fendo.2021.727061] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
Botanicals have a long history of medicinal use for a multitude of ailments, and many modern pharmaceuticals were originally isolated from plants or derived from phytochemicals. Among these, artemisinin, first isolated from Artemisia annua, is the foundation for standard anti-malarial therapies. Plants of the genus Artemisia are among the most common herbal remedies across Asia and Central Europe. The species Artemisia scoparia (SCOPA) is widely used in traditional folk medicine for various liver diseases and inflammatory conditions, as well as for infections, fever, pain, cancer, and diabetes. Modern in vivo and in vitro studies have now investigated SCOPA's effects on these pathologies and its ability to mitigate hepatotoxicity, oxidative stress, obesity, diabetes, and other disease states. This review focuses on the effects of SCOPA that are particularly relevant to metabolic health. Indeed, in recent years, an ethanolic extract of SCOPA has been shown to enhance differentiation of cultured adipocytes and to share some properties of thiazolidinediones (TZDs), a class of insulin-sensitizing agonists of the adipogenic transcription factor PPARγ. In a mouse model of diet-induced obesity, SCOPA diet supplementation lowered fasting insulin and glucose levels, while inducing metabolically favorable changes in adipose tissue and liver. These observations are consistent with many lines of evidence from various tissues and cell types known to contribute to metabolic homeostasis, including immune cells, hepatocytes, and pancreatic beta-cells. Compounds belonging to several classes of phytochemicals have been implicated in these effects, and we provide an overview of these bioactives. The ongoing global epidemics of obesity and metabolic disease clearly require novel therapeutic approaches. While the mechanisms involved in SCOPA's effects on metabolic, anti-inflammatory, and oxidative stress pathways are not fully characterized, current data support further investigation of this plant and its bioactives as potential therapeutic agents in obesity-related metabolic dysfunction and many other conditions.
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Affiliation(s)
- Anik Boudreau
- Adipocyte Biology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Allison J. Richard
- Adipocyte Biology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Innocence Harvey
- Adipocyte Biology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Jacqueline M. Stephens
- Adipocyte Biology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United States
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA, United States
- *Correspondence: Jacqueline M. Stephens,
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