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Schill C, Panich S, Barbe MF, Gusic ME, Litvin J. Teaching the tutors: use of an OSTE to train medical students to be peer tutors. Adv Physiol Educ 2024; 48:368-377. [PMID: 38656164 DOI: 10.1152/advan.00007.2024] [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] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 04/26/2024]
Abstract
First-year medical students are often challenged by the rapid pace and large volume of content that must be learned. Peer teaching has emerged as a supportive educational strategy. However, the most effective strategies for training peer tutors (PTs) for their role are not known. This paper examines the use of an Objective Structured Teaching Exercise (OSTE) to augment PT training sessions. Applying deliberate practice as a conceptual framework, an OSTE was used to provide tutors with an opportunity to practice their skills and receive feedback about their performance when meeting with a student presenting with a challenge. The newly trained PTs were required to assess a standardized student, determine challenge(s) being experienced, and present options to address the challenge(s). Standardized students evaluated the tutors' performance and a pre- and post-OSTE questionnaire was used to determine whether the OSTE was effective in increasing the confidence level of PTs to effectively assess and support students seeking help. Participants reported an increase in confidence in their ability to assess areas requiring improvement, understand the active learning strategies, and suggest appropriate active learning study strategies. Evaluations completed by standardized students documented that newly trained PTs accurately diagnosed the challenge presented in the OSTE and in most cases PTs asked all relevant questions to assess. Increased self-efficacy promotes PT's capacity to perform their work and feedback during an OSTE can further advance required skills. Aggregate OSTE results can also inform efforts to enhance the PT training program.NEW & NOTEWORTHY This novel application of the Objective Structured Teaching Exercise (OSTE) was done to enhance tutors' skills as valued members of our integrated academic support program. The OSTE provided feedback to the tutors and enabled us to identify a need for enhanced tutor training in active learning strategies. The OSTE can be adapted for use in other health science educational programs to enhance their training programs and to assess tutor's skills in preparation for their role.
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Affiliation(s)
- Christian Schill
- Lewis Katz School of Medicine, Temple University-St. Luke's University Health Network Regional Campus, Bethlehem, Pennsylvania, United States
| | - Samantha Panich
- Department of Biomedical Education, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Mary F Barbe
- Department of Cardiovascular Sciences and Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Maryellen E Gusic
- Department of Biomedical Education, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Judith Litvin
- Department of Biomedical Education, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
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Kobylianskii A, Thiel P, McGrattan M, Barbe MF, Lemos N. Key Anatomical Concepts, Landmarks and Proposed Terminology for Nerve-sparing Gynecologic Surgery: a Narrative Review. J Minim Invasive Gynecol 2024:S1553-4650(24)00218-8. [PMID: 38761917 DOI: 10.1016/j.jmig.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/27/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE To synthesize the terminology utilized in nerve-sparing surgical literature and propose standardized and non-conflicting terms to allow for consistent vocabulary. DESIGN We performed a literature search on PubMed using the search terms "pelvis" and "nerve-sparing". Non-gynecologic surgery and animal studies were excluded. A narrative review was performed, focusing on nerves, fasciae, ligaments, and retroperitoneal spaces. Terms from included papers were discussed by all authors, who are surgeons versed in nerve-sparing procedures and one anatomist, and recommendations were made regarding the most appropriate terms based on the frequency of occurrence in the literature and the possibility of overlapping names with other structures. SETTING N/A PARTICIPANTS: : N/A INTERVENTIONS: : N/A RESULTS: : 224 articles were identified, with 81 included in the full text review. 48% of articles focused on cervical cancer and 26% on deeply infiltrating endometriosis. Findings were synthesized both narratively and visually. Inconsistencies in pelvic anatomical nomenclature were prevalent across publications. The structure with the most varied terminology was the rectal branch of the inferior hypogastric plexus (IHP) with 14 names. A standardized terminology for pelvic autonomic nerve structures, fasciae, ligaments, and retroperitoneal spaces was proposed to avoid conflicting terms. CONCLUSION Surgeons and anatomists should use consistent terminology to facilitate an increased uptake of nerve-sparing techniques in gynecologic surgery through better understanding of surgical technique description. We have proposed a standardized terminology believed to facilitate this goal.
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Affiliation(s)
- Anna Kobylianskii
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada
| | - Peter Thiel
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada
| | - Meghan McGrattan
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada
| | - Mary F Barbe
- Department of Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine of Temple University, Philadelphia, Pennsylvania, USA
| | - Nucelio Lemos
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada; Department of Gynecology, Federal University of Sao Paolo, Sao Paolo, Brazil; Department of Neuropelveology and Advanced Pelvic Surgery, Institute for Care and Rehabilitation in Neuropelveology and Gynecology (INCREASING), Sao Paolo, Brazil.
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3
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Barbe MF, Chen FL, Loomis RH, Harris MY, Kim BM, Xie K, Hilliard BA, McGonagle ER, Bailey TD, Gares RP, Van Der Bas M, Kalicharan BA, Holt-Bright L, Stone LS, Hodges PW, Klyne DM. Characterization of pain-related behaviors in a rat model of acute-to-chronic low back pain: single vs. multi-level disc injury. Front Pain Res (Lausanne) 2024; 5:1394017. [PMID: 38770243 PMCID: PMC11102983 DOI: 10.3389/fpain.2024.1394017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Low back pain is the most common type of chronic pain. We examined pain-related behaviors across 18 weeks in rats that received injury to one or two lumbar intervertebral discs (IVD) to determine if multi-level disc injuries enhance/prolong pain. Methods Twenty-three Sprague-Dawley adult female rats were used: 8 received disc puncture (DP) of one lumbar IVD (L5/6, DP-1); 8 received DP of two lumbar IVDs (L4/5 & L5/6, DP-2); 8 underwent sham surgery. Results DP-2 rats showed local (low back) sensitivity to pressure at 6- and 12-weeks post-injury, and remote sensitivity to pressure (upper thighs) at 12- and 18-weeks and touch (hind paws) at 6, 12 and 18-weeks. DP-1 rats showed local and remote pressure sensitivity at 12-weeks only (and no tactile sensitivity), relative to Sham DP rats. Both DP groups showed reduced distance traveled during gait testing over multiple weeks, compared to pre-injury; only DP-2 rats showed reduced distance relative to Sham DP rats at 12-weeks. DP-2 rats displayed reduced positive interactions with a novel adult female rat at 3-weeks and hesitation and freezing during gait assays from 6-weeks onwards. At study end (18-weeks), radiological and histological analyses revealed reduced disc height and degeneration of punctured IVDs. Serum BDNF and TNFα levels were higher at 18-weeks in DP-2 rats, relative to Sham DP rats, and levels correlated positively with remote sensitivity in hind paws (tactile) and thighs (pressure). Discussion Thus, multi-level disc injuries resulted in earlier, prolonged and greater discomfort locally and remotely, than single-level disc injury. BDNF and TNFα may have contributing roles.
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Affiliation(s)
- Mary F. Barbe
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Frank Liu Chen
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Regina H. Loomis
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Michele Y. Harris
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Brandon M. Kim
- Medical Doctor Program, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Kevin Xie
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Brendan A. Hilliard
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Elizabeth R. McGonagle
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Taylor D. Bailey
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Ryan P. Gares
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Megan Van Der Bas
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Betsy A. Kalicharan
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Lewis Holt-Bright
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Laura S. Stone
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN, United States
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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Day EP, Johnston BR, Bazarek SF, Brown JM, Lemos N, Gibson EI, Hurban HN, Fecho SB, Holt-Bright L, Eun DD, Pontari MA, De EJ, McGovern FJ, Ruggieri MR, Barbe MF. Anatomical Location of the Vesical Branches of the Inferior Hypogastric Plexus in Human Cadavers. Diagnostics (Basel) 2024; 14:794. [PMID: 38667441 PMCID: PMC11049538 DOI: 10.3390/diagnostics14080794] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
We have demonstrated in canines that somatic nerve transfer to vesical branches of the inferior hypogastric plexus (IHP) can be used for bladder reinnervation after spinal root injury. Yet, the complex anatomy of the IHP hinders the clinical application of this repair strategy. Here, using human cadavers, we clarify the spatial relationships of the vesical branches of the IHP and nearby pelvic ganglia, with the ureteral orifice of the bladder. Forty-four pelvic regions were examined in 30 human cadavers. Gross post-mortem and intra-operative approaches (open anterior abdominal, manual laparoscopic, and robot-assisted) were used. Nerve branch distances and diameters were measured after thorough visual inspection and gentle dissection, so as to not distort tissue. The IHP had between 1 to 4 vesical branches (2.33 ± 0.72, mean ± SD) with average diameters of 0.51 ± 0.06 mm. Vesical branches from the IHP arose from a grossly visible pelvic ganglion in 93% of cases (confirmed histologically). The pelvic ganglion was typically located 7.11 ± 6.11 mm posterolateral to the ureteral orifice in 69% of specimens. With this in-depth characterization, vesical branches from the IHP can be safely located both posterolateral to the ureteral orifice and emanating from a more proximal ganglionic enlargement during surgical procedures.
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Affiliation(s)
- Emily P. Day
- MD Program, Drexel University College of Medicine, Philadelphia, PA 19129, USA;
- Center for Translational Medicine, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA; (E.I.G.); or (M.R.R.)
| | - Benjamin R. Johnston
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA; (B.R.J.); (S.F.B.)
| | - Stanley F. Bazarek
- Department of Neurosurgery, Brigham and Women’s Hospital, Boston, MA 02115, USA; (B.R.J.); (S.F.B.)
| | - Justin M. Brown
- Neurosurgery Paralysis Center, Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02115, USA;
| | - Nucelio Lemos
- Department of Obstetrics and Gynecology, University of Toronto Temerty Faculty of Medicine, Toronto, ON M5S 1A8, Canada;
| | - Eve I. Gibson
- Center for Translational Medicine, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA; (E.I.G.); or (M.R.R.)
| | - Helaina N. Hurban
- MD Program, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA;
| | - Susan B. Fecho
- School of Visual, Performing and Communication Arts, Barton College, Wilson, NC 27893, USA;
| | - Lewis Holt-Bright
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA;
| | - Daniel D. Eun
- Robotic Surgical Services, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA;
- Department of Urology, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA;
| | - Michel A. Pontari
- Department of Urology, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA;
| | - Elise J. De
- Department of Urology, Albany Medical Center, Albany, NY 12208, USA;
| | - Francis J. McGovern
- Department of Urology, Massachusetts General Hospital, Boston, MA 02115, USA;
| | - Michael R. Ruggieri
- Center for Translational Medicine, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA; (E.I.G.); or (M.R.R.)
- Neurosurgery Paralysis Center, Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02115, USA;
| | - Mary F. Barbe
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA;
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA
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Tiwari E, Porreca DS, Braverman AS, Holt-Bright L, Frara NA, Brown JM, Johnston BR, Bazarek SF, Hilliard BA, Mazzei M, Pontari MA, Yu D, Ruggieri MR, Barbe MF. Nerve transfer for restoration of lower motor neuron-lesioned bladder, urethral and anal sphincter function. Part 4: Effectiveness of the motor reinnervation. Am J Physiol Regul Integr Comp Physiol 2024. [PMID: 38497126 DOI: 10.1152/ajpregu.00248.2023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
In pilot work we showed that somatic nerve transfers can restore motor function in long-term decentralized dogs. We continue to explore the effectiveness of motor reinnervation in 30 female dogs. After anesthesia, 12 underwent bilateral transection of coccygeal and sacral (S) spinal roots, dorsal roots of lumbar (L)7, and hypogastric nerves. Twelve months post-decentralization, 8 underwent transfer of obturator nerve branches to pelvic nerve vesical branches, and sciatic nerve branches to pudendal nerves, followed by 10 months recovery (ObNT-ScNT Reinn). The remaining 4 were euthanized 18 months post-decentralization (Decentralized). Results were compared to 18 Controls. Squat-and-void postures were tracked during awake cystometry. None showed squat-and-void postures during the decentralization phase. Seven of 8 ObNT-ScNT Reinn began showing such postures by 6 months post-reinnervation; one showed a return of defecation postures. Retrograde dyes were injected into the bladder and urethra 3 weeks prior to euthanasia, at which point, roots and transferred nerves were electrically stimulated to evaluate motor function. Upon L2-L6 root stimulation, 5 of 8 ObNT-ScNT Reinn showed elevated detrusor pressure and 4 showed elevated urethral pressure, compared to L7-S3 root stimulation. After stimulation of sciatic-to-pudendal transferred nerves, 3 of 8 ObNT-ScNT Reinn showed elevated urethral pressure; all showed elevated anal sphincter pressure. Retrogradely labeled neurons were observed in L2-L6 ventral horns (in laminae VI, VIII and IX) of ObNT-ScNT Reinn, versus Controls in which labeled neurons were observed in L7-S3 ventral horns (in lamina VII). This data supports the use of nerve transfer techniques for restoration of bladder function.
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Affiliation(s)
- Ekta Tiwari
- School of Engineering, Brown University, Brown University, Providence, RI, United States
| | - Danielle S Porreca
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA, United States
| | - Alan S Braverman
- Anatomy and Cell Biology, Temple University, Philadelphia, PA, United States
| | - Lewis Holt-Bright
- Aging + Cardiovascular Discovery Center, Temple University, Philadelphia, Pennsylvania, United States
| | - Nagat A Frara
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Temple University, Philadelphia, PA, United States
| | - Justin M Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States
| | | | | | - Brendan A Hilliard
- Aging + Cardiovascular Discovery Center, Temple University, Philadelphia, United States
| | - Michael Mazzei
- Trauma/Surgical Critical Care, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | | | - Daohai Yu
- Department of Biomedical Education and Data Science, Temple University, Philadelphia, PA, United States
| | - Michael R Ruggieri
- Anatomy and Cell Biology, Temple University, Philadelphia, Pennsylvania, United States
| | - Mary F Barbe
- Aging + Cardiovascular Discovery Center, Temple University, Philadelphia, PA, United States
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6
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Lutke Schipholt IJ, Coppieters MW, Diepens M, Hoekstra T, Ostelo RWJG, Barbe MF, Meijer OG, Bontkes HJ, Scholten-Peeters GGM. Systemic Inflammation, Sleep, and Psychological Factors Determine Recovery Trajectories for People With Neck Pain: An Exploratory Study. J Pain 2024:S1526-5900(24)00377-8. [PMID: 38342190 DOI: 10.1016/j.jpain.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/13/2024]
Abstract
We conducted an explorative prospective cohort study with 6 months follow-up to 1) identify different pain and disability trajectories following an episode of acute neck pain, and 2) assess whether neuroimmune/endocrine, psychological, behavioral, nociceptive processing, clinical outcome, demographic and management-related factors differ between these trajectories. Fifty people with acute neck pain (ie, within 2 weeks of onset) were included. At baseline, and at 2, 4, 6, 12, and 26 weeks follow-up, various neuroimmune/endocrine (eg, inflammatory cytokines and endocrine factors), psychological (eg, stress symptoms), behavioral (eg, sleep disturbances), nociceptive processing (eg, condition pain modulation), clinical outcome (eg, trauma), demographic factors (eg, age), and management-related factors (eg, treatment received) were assessed. Latent class models were performed to identify outcome trajectories for neck pain and disability. Linear mixed models or the Pearson chi-square test were used to evaluate differences in these factors between the trajectories at baseline and at each follow-up assessment and over the entire 6 months period. For pain, 3 trajectories were identified. The majority of patients were assigned to the "Moderate pain - Favourable recovery" trajectory (n = 25; 50%) with smaller proportions assigned to the "Severe pain - Favourable recovery" (n = 16; 32%) and the "Severe pain - Unfavourable recovery" (n = 9; 18%) trajectories. For disability, 2 trajectories were identified: "Mild disability - Favourable recovery" (n = 43; 82%) and "Severe disability - Unfavourable recovery" (n = 7; 18%). Ongoing systemic inflammation (increased high-sensitive C-reactive protein), sleep disturbances, and elevated psychological factors (such as depression, stress and anxiety symptoms) were mainly present in the unfavorable outcome trajectories compared to the favorable outcome trajectories. PERSPECTIVE: Using exploratory analyses, different recovery trajectories for acute neck pain were identified based on disability and pain intensity. These trajectories were influenced by systemic inflammation, sleep disturbances, and psychological factors.
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Affiliation(s)
- Ivo J Lutke Schipholt
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam University Medical Centre, Location Vrije Universiteit, Amsterdam, Noord Holland, The Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; School of Health Sciences and Social Work, and Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Queensland, Australia
| | - Maaike Diepens
- Department Family Medicine, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences and the Amsterdam Public Health Research Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, Noord Holland, The Netherlands
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute Amsterdam, Amsterdam, Noord Holland, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit, Amsterdam Movement Sciences Research Institute, Amsterdam, Noord Holland, The Netherlands
| | - Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Onno G Meijer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands; Orthopaedic Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, PR China
| | - Hetty J Bontkes
- Department of Clinical Chemistry, Laboratory Medical Immunology, Amsterdam University Medical Centre, Location Vrije Universiteit, Amsterdam, Noord Holland, The Netherlands
| | - Gwendolyne G M Scholten-Peeters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences - Program Musculoskeletal Health, Amsterdam, Noord Holland, The Netherlands
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Hilliard BA, Amin M, Popoff SN, Barbe MF. Potentiation of Collagen Deposition by the Combination of Substance P with Transforming Growth Factor Beta in Rat Skin Fibroblasts. Int J Mol Sci 2024; 25:1862. [PMID: 38339140 PMCID: PMC10855312 DOI: 10.3390/ijms25031862] [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: 01/11/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
A role for substance P has been proposed in musculoskeletal fibrosis, with effects mediated through transforming growth factor beta (TGFβ). We examined the in vitro effects of substance P on proliferation, collagen secretion, and collagen deposition in rat primary dermal fibroblasts cultured in medium containing 10% fetal bovine serum, with or without TGFβ. In six-day cultures, substance P increased cell proliferation at concentrations from 0.0002 to 100 nM. TGFβ increased proliferation at concentrations from 0.0002 to 2 pg/mL, although higher concentrations inhibited proliferation. Substance P treatment alone at concentrations of 100, 0.2, and 0.00002 nM did not increase collagen deposition per cell, yet when combined with TGFβ (5 ng/mL), increased collagen deposition compared to TGFβ treatment alone. Substance P treatment (100 nM) also increased smooth muscle actin (SMA) expression at 72 h of culture at a level similar to 5 ng/mL of TGFβ; only TGFβ increased SMA at 48 h of culture. Thus, substance P may play a role in potentiating matrix deposition in vivo when combined with TGFβ, although this potentiation may be dependent on the concentration of each factor. Treatments targeting substance P may be a viable strategy for treating fibrosis where both substance P and TGFβ play roles.
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Affiliation(s)
- Brendan A. Hilliard
- Aging and Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (M.A.); (M.F.B.)
| | - Mamta Amin
- Aging and Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (M.A.); (M.F.B.)
| | - Steven N. Popoff
- Department of Biomedical Education, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA;
| | - Mary F. Barbe
- Aging and Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (M.A.); (M.F.B.)
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Klyne DM, Hilliard BA, Harris MY, Amin M, Hall M, Besomi M, Mustafa S, Farrell SF, Rawashdeh O, Han FY, Hodges PW, Frara N, Barbe MF. Poor sleep versus exercise: A duel to decide whether pain resolves or persists after injury. Brain Behav Immun Health 2024; 35:100714. [PMID: 38111687 PMCID: PMC10727927 DOI: 10.1016/j.bbih.2023.100714] [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: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023] Open
Abstract
Poor sleep is thought to enhance pain via increasing peripheral and/or central sensitization. Aerobic exercise, conversely, relives pain via reducing sensitization, among other mechanisms. This raises two clinical questions: (1) does poor sleep contribute to the transition from acute-to-persistent pain, and (2) can exercise protect against this transition? This study tested these questions and explored underlying mechanisms in a controlled injury model. Twenty-nine adult female Sprague-Dawley rats performed an intensive lever-pulling task for 4 weeks to induce symptoms consistent with clinical acute-onset overuse injury. Rats were then divided into three groups and exposed for 4 weeks to either: voluntary exercise via access to a running wheel, sleep disturbance, or both. Pain-related behaviours (forepaw mechanical sensitivity, reflexive grip strength), systemic levels of brain derived neurotrophic factor (BDNF), estradiol and corticosterone, and white blood cells (WBC) were assessed pre-injury, post-injury and post-intervention. Mechanical sensitivity increased post-injury and remained elevated with sleep disturbance alone, but decreased to pre-injury levels with exercise both with and without sleep disturbance. Reflexive grip strength decreased post-injury but recovered post-intervention-more with exercise than sleep disturbance. BDNF increased with sleep disturbance alone, remained at pre-injury levels with exercise regardless of sleep, and correlated with mechanical sensitivity. WBCs and estradiol increased with exercise alone and together with sleep disturbance, respectively. Corticosterone was not impacted by injury/intervention. Findings provide preliminary evidence for a role of poor sleep in the transition from acute-to-persistent pain, and the potential for aerobic exercise to counter these effects. BDNF might have a role in these relationships.
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Affiliation(s)
- David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia
| | - Brendan A. Hilliard
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine of Temple University, Philadelphia, 19140, USA
| | - Michele Y. Harris
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine of Temple University, Philadelphia, 19140, USA
| | - Mamta Amin
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine of Temple University, Philadelphia, 19140, USA
| | - Michelle Hall
- Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, 3010, Australia
| | - Manuela Besomi
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia
| | - Sanam Mustafa
- School of Biomedicine, The University of Adelaide, Adelaide, 5005, Australia
| | - Scott F. Farrell
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Better Health Outcomes for Compensable Injury, The University of Queensland, Brisbane, 4029, Australia
| | - Oliver Rawashdeh
- School of Biomedical Sciences, The University of Queensland, Brisbane, 4072, Australia
| | - Felicity Y. Han
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, 4072, Australia
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia
| | - Nagat Frara
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine of Temple University, Philadelphia, 19140, USA
| | - Mary F. Barbe
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine of Temple University, Philadelphia, 19140, USA
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9
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Ward RJ, Driban JB, MacKay JW, McAlindon TE, Lu B, Eaton CB, Lo GH, Barbe MF, Harkey MS. Meniscal degeneration is prognostic of destabilzing meniscal tear and accelerated knee osteoarthritis: Data from the Osteoarthritis Initiative. J Orthop Res 2023; 41:2418-2423. [PMID: 37094976 PMCID: PMC10592659 DOI: 10.1002/jor.25575] [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: 01/10/2023] [Revised: 04/03/2023] [Accepted: 04/17/2023] [Indexed: 04/26/2023]
Abstract
The objective of this study was to assess the prognostic potential of magnetic resonance (MR)-detected meniscal degeneration in relation to incident destabilizing meniscal tears (radial, complex, root, or macerated) or accelerated knee osteoarthritis (AKOA). We used existing MR data from a case-control study of three groups from the Osteoarthritis Initiative without radiographic KOA at baseline: AKOA, typical KOA, and no KOA. From these groups, we included people without medial and lateral meniscal tear at baseline (n = 226) and 48-month meniscal data (n = 221). Intermediate-weighted fat-suppressed MR images annually from baseline to the 48-month visit were graded using a semiquantitative meniscal tear classification criterion. Incident destabilizing meniscal tear was defined as progressing from an intact meniscus to a destabilizing tear by the 48-month visit. We used two logistic regression models to assess whether: (1) presence of medial meniscal degeneration was associated with an incident medial destabilizing meniscal tear, and (2) presence of meniscal degeneration in either meniscus was associated with incident AKOA over the next 4 years. People with the presence of a medial meniscal degeneration had three times the odds of developing an incident destabilizing medial meniscal tear within 4 years compared with a person without medial meniscus degeneration (odds ratio [OR]: 3.03; 95% confidence interval [CI]: 1.40-6.59). People with meniscal degeneration had five times the odds of developing incident AKOA within 4 years compared with a person without meniscal degeneration in either meniscus (OR: 5.04; 95% CI: 2.57-9.89). Meniscal degeneration on MR is clinically meaningful as it relates to future poor outcomes.
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Affiliation(s)
- Robert J. Ward
- Department of Radiology, Saint Georges University, Grenada
WI, USA; Sullivan’s Island Imaging, Sullivan’s Island SC, USA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts
Medical Center, Boston MA, USA
| | - James W. MacKay
- Norwich Medical School, University of East Anglia, Norwich,
UK & Department of Radiology, University of Cambridge, Cambridge, UK
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts
Medical Center, Boston MA, USA
| | - Bing Lu
- Division of Rheumatology, Immunology & Allergy, Brigham
& Women’s Hospital and Harvard Medical School, Boston MA, USA
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Alpert Medical
School of Brown University, Pawtucket RI, USA
| | - Grace H. Lo
- Medical Care Line and Research Care Line, Houston VA
HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E.
DeBakey Medical Center, Houston TX, USA
- Section of Immunology, Allergy, and Rheumatology, Baylor
College of Medicine, Houston TX, USA
| | - Mary F. Barbe
- Center for Translational Medicine, Temple University School
of Medicine, Philadelphia PA, USA
| | - Matthew S. Harkey
- Department of Kinesiology, Michigan State University, East
Lansing MI, USA
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10
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Frara N, Barbe MF, Giaddui D, Porreca DS, Braverman AS, Tiwari E, Ahmad A, Brown JM, Johnston BR, Bazarek SF, Ruggieri MR. Nerve transfer for restoration of lower motor neuron-lesioned bladder, urethral, and anal sphincter function in a dog model. Part 3. nicotinic receptor characterization. Am J Physiol Regul Integr Comp Physiol 2023; 325:R344-R358. [PMID: 37458380 PMCID: PMC10642361 DOI: 10.1152/ajpregu.00273.2022] [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: 10/27/2022] [Revised: 06/09/2023] [Accepted: 07/05/2023] [Indexed: 09/05/2023]
Abstract
Very little is known about the physiological role of nicotinic receptors in canine bladders, although functional nicotinic receptors have been reported in bladders of many species. Utilizing in vitro methods, we evaluated nicotinic receptors mediating bladder function in dogs: control (9 female and 11 male normal controls, 5 sham operated), Decentralized (9 females, decentralized 6-21 mo), and obturator-to-pelvic nerve transfer reinnervated (ObNT-Reinn; 9 females; decentralized 9-13 mo, then reinnervated with 8-12 mo recovery). Muscle strips were collected, mucosa-denuded, and mounted in muscle baths before incubation with neurotransmitter antagonists, and contractions to the nicotinic receptor agonist epibatidine were determined. Strip response to epibatidine, expressed as percent potassium chloride, was similar (∼35% in controls, 30% in Decentralized, and 24% in ObNT-Reinn). Differentially, epibatidine responses in Decentralized and ObNT-Reinn bladder strips were lower than controls after tetrodotoxin (TTX, a sodium channel blocker that inhibits axonal action potentials). Yet, in all groups, epibatidine-induced strip contractions were similarly inhibited by mecamylamine and hexamethonium (ganglionic nicotinic receptor antagonists), SR 16584 (α3β4 neuronal nicotinic receptor antagonist), atracurium and tubocurarine (neuromuscular nicotinic receptor antagonists), and atropine (muscarinic receptor antagonist), indicating that nicotinic receptors (particularly α3β4 subtypes), neuromuscular and muscarinic receptors play roles in bladder contractility. In control bladder strips, since tetrodotoxin did not inhibit epibatidine contractions, nicotinic receptors are likely located on nerve terminals. The tetrodotoxin inhibition of epibatidine-induced contractions in Decentralized and ObNT-Reinn suggests a relocation of nicotinic receptors from nerve terminals to more distant axonal sites, perhaps as a compensatory mechanism to recover bladder function.
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Affiliation(s)
- Nagat Frara
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Mary F Barbe
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Dania Giaddui
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Danielle S Porreca
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
| | - Alan S Braverman
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Ekta Tiwari
- School of Engineering, Brown University, Providence, Rhode Island, United States
| | - Attia Ahmad
- Cooper Medical School of Rowan University, Camden, New Jersey, United States
| | - Justin M Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Benjamin R Johnston
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, Massachusetts, United States
| | - Stanley F Bazarek
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, Massachusetts, United States
| | - Michael R Ruggieri
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States
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11
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Lambi AG, DeSante RJ, Patel PR, Hilliard BA, Popoff SN, Barbe MF. Blocking CCN2 Reduces Established Palmar Neuromuscular Fibrosis and Improves Function Following Repetitive Overuse Injury. Int J Mol Sci 2023; 24:13866. [PMID: 37762168 PMCID: PMC10531056 DOI: 10.3390/ijms241813866] [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: 06/30/2023] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 09/29/2023] Open
Abstract
The matricellular protein cell communication factor 2/connective tissue growth factor (CCN2/CTGF) is critical to development of neuromuscular fibrosis. Here, we tested whether anti-CCN2 antibody treatment will reduce established forepaw fibro-degenerative changes and improve function in a rat model of overuse injury. Adult female rats performed a high repetition high force (HRHF) task for 18 weeks. Tissues were collected from one subset after 18 wks (HRHF-Untreated). Two subsets were provided 6 wks of rest with concurrent treatment with anti-CCN2 (HRHF-Rest/anti-CCN2) or IgG (HRHF-Rest/IgG). Results were compared to IgG-treated Controls. Forepaw muscle fibrosis, neural fibrosis and entheseal damage were increased in HRHF-Untreated rats, compared to Controls, and changes were ameliorated in HRHF-Rest/anti-CCN2 rats. Anti-CCN2 treatment also reduced phosphorylated-β-catenin (pro-fibrotic protein) in muscles and distal bone/entheses complex, and increased CCN3 (anti-fibrotic) in the same tissues, compared to HRHF-Untreated rats. Grip strength declines and mechanical sensitivity observed in HRHF-Untreated improved with rest; grip strength improved further in HRHF-Rest/anti-CCN2. Grip strength declines correlated with muscle fibrosis, entheseal damage, extraneural fibrosis, and decreased nerve conduction velocity, while enhanced mechanical sensitivity (a pain-related behavior) correlated with extraneural fibrosis. These studies demonstrate that blocking CCN2 signaling reduces established forepaw neuromuscular fibrosis and entheseal damage, which improves forepaw function, following overuse injury.
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Affiliation(s)
- Alex G. Lambi
- Department of Surgery, Plastic Surgery Section, New Mexico Veterans Administration Health Care System, Albuquerque, NM 87108, USA;
- Division of Plastic Surgery, University of New Mexico School of Medicine, Albuquerque, NM 87106, USA
| | - Robert J. DeSante
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (R.J.D.); (P.R.P.); (B.A.H.)
| | - Parth R. Patel
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (R.J.D.); (P.R.P.); (B.A.H.)
| | - Brendan A. Hilliard
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (R.J.D.); (P.R.P.); (B.A.H.)
| | - Steven N. Popoff
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA;
| | - Mary F. Barbe
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (R.J.D.); (P.R.P.); (B.A.H.)
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA;
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12
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Lambi AG, Morrell NT, Popoff SN, Benhaim P, Barbe MF. Let's Focus on the Fibrosis in Dupuytren Disease: Cell Communication Network Factor 2 as a Novel Target. J Hand Surg Glob Online 2023; 5:682-688. [PMID: 37790821 PMCID: PMC10543811 DOI: 10.1016/j.jhsg.2023.06.017] [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: 06/21/2023] [Accepted: 06/24/2023] [Indexed: 10/05/2023] Open
Abstract
Dupuytren disease is a progressive, benign fibroproliferative disorder of the hands that can lead to debilitating hand contractures. Once symptomatic, treatment involves either surgical intervention, specifically fasciectomy or percutaneous needle aponeurotomy, or enzymatic degradation with clostridial collagenase. Currently, collagenase is the only pharmacotherapy that has been approved for the treatment of Dupuytren contracture. There is a need for a pharmacotherapeutic that can be administered to limit disease progression and prevent recurrence after treatment. Targeting the underlying fibrotic pathophysiology is critical. We propose a novel target to be considered in Dupuytren disease-cell communication network factor 2/connective tissue growth factor-an established mediator of musculoskeletal tissue fibrosis.
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Affiliation(s)
- Alex G. Lambi
- Department of Orthopedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque, NM
- Department of Surgery Division of Plastic Surgery, University of New Mexico School of Medicine, Albuquerque, NM
- Department of Surgery Plastic Surgery Section, New Mexico Veterans Affairs Health Science Center, Albuquerque, NM
| | - Nathan T. Morrell
- Department of Orthopedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque, NM
| | - Steven N. Popoff
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
- Department of Orthopaedic Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Prosper Benhaim
- Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA
| | - Mary F. Barbe
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
- Center for Translational Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
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13
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Lambi AG, Harris MY, Amin M, Joiner PG, Hilliard BA, Assari S, Popoff SN, Barbe MF. Blocking CCN2 Reduces Established Bone Loss Induced by Prolonged Intense Loading by Increasing Osteoblast Activity in Rats. JBMR Plus 2023; 7:e10783. [PMID: 37701153 PMCID: PMC10494513 DOI: 10.1002/jbm4.10783] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 09/14/2023] Open
Abstract
We have an operant model of reaching and grasping in which detrimental bone remodeling is observed rather than beneficial adaptation when rats perform a high-repetition, high-force (HRHF) task long term. Here, adult female Sprague-Dawley rats performed an intense HRHF task for 18 weeks, which we have shown induces radial trabecular bone osteopenia. One cohort was euthanized at this point (to assay the bone changes post task; HRHF-Untreated). Two other cohorts were placed on 6 weeks of rest while being simultaneously treated with either an anti-CCN2 (FG-3019, 40 mg/kg body weight, ip; twice per week; HRHF-Rest/anti-CCN2), or a control IgG (HRHF-Rest/IgG), with the purpose of determining which might improve the trabecular bone decline. Results were compared with food-restricted control rats (FRC). MicroCT analysis of distal metaphysis of radii showed decreased trabecular bone volume fraction (BV/TV) and thickness in HRHF-Untreated rats compared with FRCs; responses improved with HRHF-Rest/anti-CCN2. Rest/IgG also improved trabecular thickness but not BV/TV. Histomorphometry showed that rest with either treatment improved osteoid volume and task-induced increases in osteoclasts. Only the HRHF-Rest/anti-CCN2 treatment improved osteoblast numbers, osteoid width, mineralization, and bone formation rate compared with HRHF-Untreated rats (as well as the latter three attributes compared with HRHF-Rest/IgG rats). Serum ELISA results were in support, showing increased osteocalcin and decreased CTX-1 in HRHF-Rest/anti-CCN2 rats compared with both HRHF-Untreated and HRHF-Rest/IgG rats. These results are highly encouraging for use of anti-CCN2 for therapeutic treatment of bone loss, such as that induced by chronic overuse. © 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)
- Alex G Lambi
- Department of Orthopedics and RehabilitationUniversity of New MexicoAlbuquerqueNMUSA
| | - Michele Y Harris
- Center for Translational Medicine, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA
| | - Mamta Amin
- Center for Translational Medicine, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA
| | - Patrice G Joiner
- Center for Translational Medicine, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA
| | - Brendan A Hilliard
- Center for Translational Medicine, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA
| | | | - Steven N Popoff
- Department of Biomedical Education and Data Science, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA
| | - Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA
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14
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Rico MC, Perez-Leal O, Barbe MF, Amin M, Colussi DJ, Florez ML, Olusajo V, Rios DS, Barrero CA. Extracellular Acetylated Histone 3.3 Induces Inflammation and Lung Tissue Damage. Biomolecules 2023; 13:1334. [PMID: 37759735 PMCID: PMC10527259 DOI: 10.3390/biom13091334] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/18/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Extracellular histones, part of the protein group known as damage-associated molecular patterns (DAMPs), are released from damaged or dying cells and can instigate cellular toxicity. Within the context of chronic obstructive pulmonary disease (COPD), there is an observed abundance of extracellular histone H3.3, indicating potential pathogenic implications. Notably, histone H3.3 is often found hyperacetylated (AcH3.3) in the lungs of COPD patients. Despite these observations, the specific role of these acetylated histones in inducing pulmonary tissue damage in COPD remains unclear. To investigate AcH3.3's impact on lung tissue, we administered recombinant histones (rH2A, rH3.3, and rAcH3.3) or vehicle solution to mice via intratracheal instillation. After 48 h, we evaluated the lung toxicity damage and found that the rAcH3.3 treated animals exhibited more severe lung tissue damage compared to those treated with non-acetylated H3.3 and controls. The rAcH3.3 instillation resulted in significant histological changes, including alveolar wall rupture, epithelial cell damage, and immune cell infiltration. Micro-CT analysis confirmed macroscopic structural changes. The rAcH3.3 instillation also increased apoptotic activity (cleavage of caspase 3 and 9) and triggered acute systemic inflammatory marker activation (TNF-α, IL-6, MCP-3, or CXCL-1) in plasma, accompanied by leukocytosis and lymphocytosis. Confocal imaging analysis confirmed lymphocytic and monocytic/macrophage lung infiltration in response to H3.3 and AcH3.3 administration. Taken together, our findings implicate extracellular AcH3.3 in inducing cytotoxicity and acute inflammatory responses, suggesting its potential role in promoting COPD-related lung damage progression.
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Affiliation(s)
- Mario C. Rico
- Pharmaceutical Sciences Department, Temple University School of Pharmacy, Philadelphia, PA 19140, USA; (M.C.R.); (O.P.-L.); (D.J.C.); (M.L.F.); (V.O.)
| | - Oscar Perez-Leal
- Pharmaceutical Sciences Department, Temple University School of Pharmacy, Philadelphia, PA 19140, USA; (M.C.R.); (O.P.-L.); (D.J.C.); (M.L.F.); (V.O.)
| | - Mary F. Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (M.F.B.); (M.A.)
| | - Mamta Amin
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA; (M.F.B.); (M.A.)
| | - Dennis J. Colussi
- Pharmaceutical Sciences Department, Temple University School of Pharmacy, Philadelphia, PA 19140, USA; (M.C.R.); (O.P.-L.); (D.J.C.); (M.L.F.); (V.O.)
| | - Magda L. Florez
- Pharmaceutical Sciences Department, Temple University School of Pharmacy, Philadelphia, PA 19140, USA; (M.C.R.); (O.P.-L.); (D.J.C.); (M.L.F.); (V.O.)
| | - Victor Olusajo
- Pharmaceutical Sciences Department, Temple University School of Pharmacy, Philadelphia, PA 19140, USA; (M.C.R.); (O.P.-L.); (D.J.C.); (M.L.F.); (V.O.)
| | | | - Carlos A. Barrero
- Pharmaceutical Sciences Department, Temple University School of Pharmacy, Philadelphia, PA 19140, USA; (M.C.R.); (O.P.-L.); (D.J.C.); (M.L.F.); (V.O.)
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15
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Lambi AG, Popoff SN, Benhaim P, Barbe MF. Pharmacotherapies in Dupuytren Disease: Current and Novel Strategies. J Hand Surg Am 2023; 48:810-821. [PMID: 36935324 PMCID: PMC10440226 DOI: 10.1016/j.jhsa.2023.02.003] [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: 09/28/2022] [Revised: 12/27/2022] [Accepted: 02/06/2023] [Indexed: 03/21/2023]
Abstract
Dupuytren disease is a benign, progressive fibroproliferative disorder of the hands. To date, only one pharmacotherapy (clostridial collagenase) has been approved for use in Dupuytren disease. There is a great need for additional nonsurgical methods that can be used to either avoid the risks of invasive treatments or help minimize recurrence rates following treatment. A number of nonsurgical modalities have been discussed in the past and continue to appear in discussions among hand surgeons, despite highly variable and often poor or no long-term clinical data. This article reviews many of the pharmacotherapies discussed in the treatment of Dupuytren disease and novel therapies used in inflammation and fibrosis that offer potential treatment options.
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Affiliation(s)
- Alex G Lambi
- Department of Orthopedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque, NM.
| | - Steven N Popoff
- Department of Orthopaedic Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA; Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Prosper Benhaim
- Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA
| | - Mary F Barbe
- Department of Biomedical Education and Data Science, Lewis Katz School of Medicine at Temple University, Philadelphia, PA; Center for Translational Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
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16
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Frara N, Giaddui D, Braverman AS, Jawawdeh K, Wu C, Ruggieri, Sr MR, Barbe MF. Mechanisms involved in nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox)-derived reactive oxygen species (ROS) modulation of muscle function in human and dog bladders. PLoS One 2023; 18:e0287212. [PMID: 37352265 PMCID: PMC10289437 DOI: 10.1371/journal.pone.0287212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/01/2023] [Indexed: 06/25/2023] Open
Abstract
Roles of redox signaling in bladder function is still under investigation. We explored the physiological role of reactive oxygen species (ROS) and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox) in regulating bladder function in humans and dogs. Mucosa-denuded bladder smooth muscle strips obtained from 7 human organ donors and 4 normal dogs were mounted in muscle baths, and trains of electrical field stimulation (EFS) applied for 20 minutes at 90-second intervals. Subsets of strips were incubated with hydrogen peroxide (H2O2), angiotensin II (Ang II; Nox activator), apocynin (inhibitor of Noxs and ROS scavenger), or ZD7155 (specific inhibitor of angiotensin type 1 (AT1) receptor) for 20 minutes in continued EFS trains. Subsets treated with inhibitors were then treated with H2O2 or Ang II. In human and dog bladders, the ROS, H2O2 (100μM), caused contractions and enhanced EFS-induced contractions. Apocynin (100μM) attenuated EFS-induced strip contractions in both species; subsequent treatment with H2O2 restored strip activity. In human bladders, Ang II (1μM) did not enhance EFS-induced contractions yet caused direct strip contractions. In dog bladders, Ang II enhanced both EFS-induced and direct contractions. Ang II also partially restored EFS-induced contractions attenuated by prior apocynin treatment. In both species, treatment with ZD7155 (10μM) inhibited EFS-induced activity; subsequent treatment with Ang II did not restore strip activity. Collectively, these data provide evidence that ROS can modulate bladder function without exogenous stimuli. Since inflammation is associated with oxidative damage, the effects of Ang II on bladder smooth muscle function may have pathologic implications.
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Affiliation(s)
- Nagat Frara
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Dania Giaddui
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Alan S. Braverman
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Kais Jawawdeh
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Changhao Wu
- Department of Biochemistry and Physiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Michael R. Ruggieri, Sr
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Mary F. Barbe
- Center for Translational Medicine at the Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
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17
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Hu M, Bodnar B, Zhang Y, Xie F, Li F, Li S, Zhao J, Zhao R, Gedupoori N, Mo Y, Lin L, Li X, Meng W, Yang X, Wang H, Barbe MF, Srinivasan S, Bethea JR, Mo X, Xu H, Hu W. Defective neurite elongation and branching in Nibp/Trappc9 deficient zebrafish and mice. Int J Biol Sci 2023; 19:3226-3248. [PMID: 37416774 PMCID: PMC10321293 DOI: 10.7150/ijbs.78489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
Loss of function in transport protein particles (TRAPP) links a new set of emerging genetic disorders called "TRAPPopathies". One such disorder is NIBP syndrome, characterized by microcephaly and intellectual disability, and caused by mutations of NIBP/TRAPPC9, a crucial and unique member of TRAPPII. To investigate the neural cellular/molecular mechanisms underlying microcephaly, we developed Nibp/Trappc9-deficient animal models using different techniques, including morpholino knockdown and CRISPR/Cas mutation in zebrafish and Cre/LoxP-mediated gene targeting in mice. Nibp/Trappc9 deficiency impaired the stability of the TRAPPII complex at actin filaments and microtubules of neurites and growth cones. This deficiency also impaired elongation and branching of neuronal dendrites and axons, without significant effects on neurite initiation or neural cell number/types in embryonic and adult brains. The positive correlation of TRAPPII stability and neurite elongation/branching suggests a potential role for TRAPPII in regulating neurite morphology. These results provide novel genetic/molecular evidence to define patients with a type of non-syndromic autosomal recessive intellectual disability and highlight the importance of developing therapeutic approaches targeting the TRAPPII complex to cure TRAPPopathies.
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Affiliation(s)
- Min Hu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Brittany Bodnar
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Yonggang Zhang
- Center for Stem Cell Research and Application, Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Chengdu 610052, China
| | - Fangxin Xie
- Center for Stem Cell Research and Application, Institute of Blood Transfusion, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Chengdu 610052, China
- Department of Clinical Laboratory, Xi'an NO. 3 Hospital, Xi'an, Shaanxi, 710018, China
| | - Fang Li
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Siying Li
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Jin Zhao
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Ruotong Zhao
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Naveen Gedupoori
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Yifan Mo
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Lanyi Lin
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Xue Li
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Wentong Meng
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Xiaofeng Yang
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Hong Wang
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Mary F. Barbe
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Shanthi Srinivasan
- Division of Digestive Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John R. Bethea
- Department of Biology, Drexel University, Philadelphia, PA, USA
| | - Xianming Mo
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Hong Xu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Wenhui Hu
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
- Center for Metabolic Disease Research, Department of Pathalogy and Laboratory Medicine, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA
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Jayaprakash N, Song W, Toth V, Vardhan A, Levy T, Tomaio J, Qanud K, Mughrabi I, Chang YC, Rob M, Daytz A, Abbas A, Nassrallah Z, Volpe BT, Tracey KJ, Al-Abed Y, Datta-Chaudhuri T, Miller L, Barbe MF, Lee SC, Zanos TP, Zanos S. Organ- and function-specific anatomical organization of vagal fibers supports fascicular vagus nerve stimulation. Brain Stimul 2023; 16:484-506. [PMID: 36773779 DOI: 10.1016/j.brs.2023.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/03/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Vagal fibers travel inside fascicles and form branches to innervate organs and regulate organ functions. Existing vagus nerve stimulation (VNS) therapies activate vagal fibers non-selectively, often resulting in reduced efficacy and side effects from non-targeted organs. The transverse and longitudinal arrangement of fibers inside the vagal trunk with respect to the functions they mediate and organs they innervate is unknown, however it is crucial for selective VNS. Using micro-computed tomography imaging, we tracked fascicular trajectories and found that, in swine, sensory and motor fascicles are spatially separated cephalad, close to the nodose ganglion, and merge caudad, towards the lower cervical and upper thoracic region; larynx-, heart- and lung-specific fascicles are separated caudad and progressively merge cephalad. Using quantified immunohistochemistry at single fiber level, we identified and characterized all vagal fibers and found that fibers of different morphological types are differentially distributed in fascicles: myelinated afferents and efferents occupy separate fascicles, myelinated and unmyelinated efferents also occupy separate fascicles, and small unmyelinated afferents are widely distributed within most fascicles. We developed a multi-contact cuff electrode to accommodate the fascicular structure of the vagal trunk and used it to deliver fascicle-selective cervical VNS in anesthetized and awake swine. Compound action potentials from distinct fiber types, and physiological responses from different organs, including laryngeal muscle, cough, breathing, and heart rate responses are elicited in a radially asymmetric manner, with consistent angular separations that agree with the documented fascicular organization. These results indicate that fibers in the trunk of the vagus nerve are anatomically organized according to functions they mediate and organs they innervate and can be asymmetrically activated by fascicular cervical VNS.
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Affiliation(s)
| | - Weiguo Song
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Viktor Toth
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | - Todd Levy
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | - Khaled Qanud
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | - Yao-Chuan Chang
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Moontahinaz Rob
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Anna Daytz
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Adam Abbas
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Zeinab Nassrallah
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Bruce T Volpe
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Kevin J Tracey
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Yousef Al-Abed
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | - Larry Miller
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | - Sunhee C Lee
- Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | - Stavros Zanos
- Feinstein Institutes for Medical Research, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, USA.
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19
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Batson T, Lee J, Kindler JM, Pollock NK, Barbe MF, Modlesky CM. Cardiometabolic Risk and Its Relationship With Visceral Adiposity in Children With Cerebral Palsy. J Endocr Soc 2023; 7:bvad014. [PMID: 36819461 PMCID: PMC9936959 DOI: 10.1210/jendso/bvad014] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Indexed: 02/05/2023] Open
Abstract
Context Adults with cerebral palsy (CP) display a higher prevalence of cardiometabolic disease compared with the general population. Studies examining cardiometabolic disease risk in children with CP are limited. Objective The purpose of this study was to determine if children with CP exhibit higher cardiometabolic risk than typically developing children, and to examine its relationship with visceral adiposity and physical activity. Methods Thirty ambulatory children with CP and 30 age-, sex-, and race-matched typically developing control children were tested for blood lipids, glucose, and the homeostatic model assessment of insulin resistance (HOMA-IR). Visceral fat was assessed using dual-energy x-ray absorptiometry. Physical activity was assessed using accelerometer-based monitors. Results Children with CP had higher total cholesterol, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol (non-HDL-C), glucose, prevalence of dyslipidemia, prevalence of prediabetes, and visceral fat mass index (VFMI) and lower physical activity than controls (all P < .05). In the groups combined, non-HDL-C and glucose were positively related to VFMI (r = 0.337 and 0.313, respectively, P < .05), and non-HDL-C and HOMA-IR were negatively related to physical activity (r = -0.411 and -0.368, respectively, P < .05). HOMA-IR was positively related to VFMI in children with CP (r = 0.698, P < .05), but not in controls. Glucose was not related to physical activity in children with CP, but it was negatively related in controls (r = -0.454, P < .05). Conclusion Children with CP demonstrate early signs of cardiometabolic disease, which are more closely related to increased visceral adiposity than decreased physical activity.
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Affiliation(s)
- Trevor Batson
- Department of Kinesiology, University of Georgia, Athens, GA 30602, USA
| | - Junsoo Lee
- Department of Kinesiology, University of Georgia, Athens, GA 30602, USA
| | - Joseph M Kindler
- Department of Nutritional Sciences, University of Georgia, Athens, GA 30602, USA
| | - Norman K Pollock
- Department of Pediatrics, Boston Medical Center, Boston, MA 02119, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA 19140, USA
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20
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Johnston BR, Bazarek S, Sten M, McIntyre BS, Fine N, De EJB, McGovern F, Lemos N, Ruggieri MR, Barbe MF, Brown JM. Restoring bladder function using motor and sensory nerve transfers: a cadaveric feasibility study. J Neurosurg Spine 2023; 38:258-264. [PMID: 36208430 PMCID: PMC9898215 DOI: 10.3171/2022.8.spine22291] [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: 03/14/2022] [Accepted: 08/04/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Bladder dysfunction after nerve injury has a variable presentation, and extent of injury determines whether the bladder is spastic or atonic. The authors have proposed a series of 3 nerve transfers for functional innervation of the detrusor muscle and external urethral sphincter, along with sensory innervation to the genital dermatome. These transfers are applicable to only cases with low spinal segment injuries (sacral nerve root function is lost) and largely preserved lumbar function. Transfer of the posterior branch of the obturator nerve to the vesical branch of the pelvic nerve provides a feasible mechanism for patients to initiate detrusor contraction by thigh adduction. External urethra innervation (motor and sensory) may be accomplished by transfer of the vastus medialis nerve to the pudendal nerve. The sensory component of the pudendal nerve to the genitalia may be further enhanced by transfer of the saphenous nerve (sensory) to the pudendal nerve. The main limitations of coapting the nerve donors to their intrapelvic targets are the bifurcation or arborization points of the parent nerve. To ensure that the donor nerves had sufficient length and diameter, the authors sought to measure these parameters. METHODS Twenty-six pelvic and anterior thigh regions were dissected in 13 female cadavers. After the graft and donor sites were clearly exposed and the branches identified, the donor nerves were cut at suitable distal sites and then moved into the pelvis for tensionless anastomosis. Diameters were measured with calipers. RESULTS The obturator nerve was bifurcated a mean ± SD (range) of 5.5 ± 1.7 (2.0-9.0) cm proximal to the entrance of the obturator foramen. In every cadaver, the authors were able to bring the posterior division of the obturator nerve to the vesical branch of the pelvic nerve (located internal to the ischial spine) in a tensionless manner with an excess obturator nerve length of 2.0 ± 1.2 (0.0-5.0) cm. The distance between the femoral nerve arborization and the anterior superior iliac spine was 9.3 ± 1.8 (6.5-15.0) cm, and the distance from the femoral arborization to the ischial spine was 12.9 ± 1.4 (10.0-16.0) cm. Diameters were similar between donor and recipient nerves. CONCLUSIONS The chosen donor nerves were long enough and of sufficient caliber for the proposed nerve transfers and tensionless anastomosis.
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Affiliation(s)
| | - Stanley Bazarek
- 1Department of Neurosurgery, Brigham and Women's Hospital, Boston
| | - Margaret Sten
- 2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Brian S McIntyre
- 3Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Noam Fine
- 4Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Elise J B De
- 4Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Francis McGovern
- 4Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Nucelio Lemos
- 5Department of Obstetrics & Gynaecology, University of Toronto, Ontario, Canada; and
| | - Michael R Ruggieri
- 6Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Mary F Barbe
- 6Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Justin M Brown
- 2Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
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Frara N, Barbe MF, Giaddui D, Braverman AS, Amin M, Yu D, Ruggieri MR. Dog and human bladders have different neurogenic and nicotinic responses in inner versus outer detrusor muscle layers. Am J Physiol Regul Integr Comp Physiol 2022; 323:R589-R600. [PMID: 36062901 PMCID: PMC9722258 DOI: 10.1152/ajpregu.00084.2022] [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: 04/19/2022] [Revised: 07/15/2022] [Accepted: 08/29/2022] [Indexed: 01/02/2023]
Abstract
The aim of this study was to investigate layer and species variations in detrusor muscle strip responses to myogenic, neurogenic, and nicotinic, and muscarinic receptor stimulations. Strips from bladders of 9 dogs and 6 human organ transplant donors were dissected from inner and outer longitudinal muscle layers, at least 1 cm above urethral orifices. Strips were mounted in muscle baths and maximal responses to neurogenic stimulation using electrical field stimulation (EFS) and myogenic stimulation using potassium chloride (KCl, 120 mM) determined. After washing and re-equilibration was completed, responses to nicotinic receptor agonist epibatidine (10 μM) were determined followed by responses to EFS and muscarinic receptor agonist bethanechol (30 μM) in continued presence of epibatidine. Thereafter, strips and full-thickness bladder sections from four additional dogs and three human donors were examined for axonal density and intramural ganglia. In dog bladders, contractions to KCl, epibatidine, and bethanechol were 1.5- to 2-fold higher in the inner longitudinal muscle layer, whereas contractions to EFS were 1.5-fold higher in the outer (both pre- and post-epibatidine). Human bladders showed 1.2-fold greater contractions to epibatidine in the inner layer and to EFS in the outer, yet no layer differences to KCl or bethanechol were noted. In both species, axonal density was 2- to 2.5-fold greater in the outer layer. Dogs had more intramural ganglia in the adventitia/serosa layer, compared with more internal layers and to humans. These findings indicate several layer-dependent differences in receptor expression or distribution, and neurogenic responses in dog and human detrusor muscles, and myogenic/muscarinic differences between dog versus humans.
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Affiliation(s)
- Nagat Frara
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Dania Giaddui
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Alan S Braverman
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Mamta Amin
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Daohai Yu
- Center for Biostatistics and Epidemiology, Department of Biomedical Education and Data Science, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Michael R Ruggieri
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
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22
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Dilley A, Harris M, Barbe MF, Bove GM. Aberrant Neuronal Activity in a Model of Work-Related Upper Limb Pain and Dysfunction. J Pain 2022; 23:852-863. [PMID: 34958943 PMCID: PMC9086086 DOI: 10.1016/j.jpain.2021.12.004] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/26/2021] [Accepted: 12/03/2021] [Indexed: 05/03/2023]
Abstract
Work-related musculoskeletal disorders associated with intense repetitive tasks are highly prevalent. Painful symptoms associated with such disorders can be attributed to neuropathy. In this study, we characterized the neuronal discharge from the median nerve in rats trained to perform an operant repetitive task. After 3-weeks of the task, rats developed pain behaviors and a decline in grip strength. Ongoing activity developed in 17.7% of slowly conducting neurons at 3-weeks, similar to neuritis. At 12-weeks, an irregular high frequency neuronal discharge was prevalent in >88.4% of slow and fast conducting neurons. At this time point, 8.3% of slow and 21.2% of fast conducting neurons developed a bursting discharge, which, combined with a reduction in fast-conducting neurons with receptive fields (38.4%), is consistent with marked neuropathology. Taken together, we have shown that an operant repetitive task leads to an active and progressive neuropathy that is characterized by marked neuropathology following 12-weeks task that mainly affects fast conducting neurons. Such aberrant neuronal activity may underlie painful symptoms in patients with work-related musculoskeletal disorders. PERSPECTIVE: Aberrant neuronal activity, similar to that reported in this study, may contribute to upper limb pain and dysfunction in patients with work-related musculoskeletal disorders. In addition, profiles of instantaneous frequencies may provide an effective way of stratifying patients with painful neuropathies.
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Affiliation(s)
- Andrew Dilley
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, England
| | - Michele Harris
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Geoffrey M Bove
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania; Bove Consulting, Kennebunkport, Maine.
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Abstract
While the effects of physical risk factors on MSD development have been a primary focus of musculoskeletal research, psychological stressors, and certain personal characteristics (e.g. ageing, sex, and obesity) are also associated with increased MSD risk. The psychological and personal characteristics listed above share a common characteristic: all are associated with disruption of the body's neuroendocrine and immune responses resulting in an impaired healing process. An impaired healing response may result in reduced fatigue life of musculoskeletal tissues due to a diminished ability to keep pace with accumulating damage (perhaps reparable under normal circumstances), and an increased vulnerability of damaged tissue to further trauma owing to the prolonged healing process. Research in engineered self-healing materials suggests that decreased healing kinetics in the presence of mechanical loading can substantially reduce the fatigue life of materials. A model of factors influencing damage accrual and healing will be presented. Practitioner summary: This article provides a potential reason why musculoskeletal disorder risk is affected by psychosocial stress, age, sex, and obesity. The reason is that these factors are all associated with a slower than normal healing response. This may lead to faster damage development in musculoskeletal tissues resulting in higher MSD risk.
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Affiliation(s)
- Sean Gallagher
- Industrial and Systems Engineering Department, Auburn University, Auburn, AL, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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24
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Giaddui D, Porreca DS, Tiwari E, Frara NA, Hobson LJ, Barbe MF, Braverman AS, Brown JM, Pontari MA, Ruggieri Sr. MR. Lateralization of bladder function in normal female canines. PLoS One 2022; 17:e0264382. [PMID: 35231045 PMCID: PMC8887770 DOI: 10.1371/journal.pone.0264382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 02/10/2022] [Indexed: 11/19/2022] Open
Abstract
This study aimed to identify potential lateralization of bladder function. Electrical stimulation of spinal roots or the pelvic nerve’s anterior vesical branch was performed bilaterally in female dogs. The percent difference between the left and right stimulation-induced increased detrusor pressure was determined. Bladders were considered left or right-sided if differences were greater or less than 25% or 10%. Based on differences of 25%, upon stimulation of spinal roots, bladders were left-sided in 17/44 (38.6%), right-sided in 12/44 (27.2%) and bilateral in 15/44 (34.2%). Using ± 10%, 48% had left side dominance (n = 21/44), 39% had right side dominance (n = 17/44), and 14% were bilateral (n = 6/44). With stimulation of the pelvic nerve’s anterior vesical branch in 19 dogs, bladders were left-sided in 8 (42.1%), right-sided in 6 (31.6%) and bilateral in 5 (26.3%) using 25% differences and left side dominance in 8 (43%), right sided in 7 (37%) and bilateral in 4 (21%) using 10% differences. These data suggest lateralization of innervation of the female dog bladder with left- and right-sided lateralization occurring at similar rates. Lateralization often varied at different spinal cord levels within the same animal.
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Affiliation(s)
- Dania Giaddui
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Danielle S. Porreca
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Ekta Tiwari
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Nagat A. Frara
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Lucas J. Hobson
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Mary F. Barbe
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Alan S. Braverman
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Justin M. Brown
- Department of Neurosurgery, Neurosurgery Paralysis Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Michel A. Pontari
- Department of Urology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Michael R. Ruggieri Sr.
- Department of Cardiovascular Sciences and Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
- Shriners Hospitals for Children of Philadelphia, Pennsylvania, Philadelphia, United States of America
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25
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Klyne DM, Barbe MF, Hodges PW. Relationship between systemic inflammation and recovery over 12 months after an acute episode of low back pain. Spine J 2022; 22:214-225. [PMID: 34547387 DOI: 10.1016/j.spinee.2021.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 05/11/2021] [Revised: 08/02/2021] [Accepted: 09/14/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Individual characteristics can influence outcomes after injury. Our previous work in individuals with early-acute low back pain (LBP) identified subgroups (clusters) with specific biopsychosocial features that recovered poorly or well by 6 months. PURPOSE This study extends on that work by revealing the short- and long-term trajectories of recovery and systemic inflammation of these participant clusters: (1) "inflammatory & poor sleep" (Cluster 1), "high TNF & depression" (Cluster 2), "high pain & high pain-related fear" (Cluster 3), and "low pain & low pain-related fear" (Cluster 4). STUDY DESIGN/SETTING Longitudinal cohort study. PATIENT SAMPLE Eighty-three individuals within 2 weeks of an acute episode of LBP - grouped into their a priori-defined cluster. OUTCOME MEASURES General participant characteristics (sex, age, body mass index, smoking history, previous LBP history); self-reported LBP (0-10 numerical rating scale, LBP-related disability (Roland-Morris Disability Questionnaire), depression (Center for Epidemiological Studies Depression Scale, pain catastrophizing (Pain Catastrophizing Scale), fear avoidance (Fear Avoidance Beliefs Questionnaire), pain self-efficacy (Pain Self-Efficacy Questionnaire), and sleep (Pittsburgh Sleep Quality Index); systemic inflammatory biomarkers (C-reactive protein [CRP], interleukin-6 [IL-6], interleukin-1β, tumor necrosis factor [TNF]). METHODS Participants provided blood for the measurement of CRP/cytokines, and completed questionnaires related to their pain/disability, psychological and sleep status. Blood measures were repeated 3-monthly for 9 months, and pain/disability were self-reported fortnightly for 12 months. Recovery (change in pain) and CRP/cytokines were longitudinally compared between clusters using mixed-models. Associations between baseline factors and follow-up CRP/cytokines levels were assessed with multiple regression. RESULTS Clusters 1 and 2 were associated, but oppositely, with recovery over the 12-months. Cluster 1 reported most recovery at every 3-monthly interval, whereas Cluster 2 reported least recovery. Cluster 1 had elevated CRP (and IL-6) at baseline that continued to decrease from 3 to 9 months. TNF was elevated early and persistently in Cluster 2. Baseline factors other than inflammation generally failed to predict follow-up inflammation. CONCLUSIONS Findings support the early role of CRP (and perhaps IL-6) in control of inflammation and recovery, and a pathological role of persistent TNF overexpression, which may be perpetuated by depressive-like behaviors.
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Affiliation(s)
- David M Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Paul W Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
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Bove GM, Chapelle SL, Barrigar MJS, Barbe MF. Manual Therapy Research Methods in Animal Models, Focusing on Soft Tissues. Front Integr Neurosci 2022; 15:802378. [PMID: 35153688 PMCID: PMC8834537 DOI: 10.3389/fnint.2021.802378] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/29/2021] [Indexed: 02/02/2023] Open
Abstract
Manual therapies have been practiced for centuries, yet little research has been performed to understand their efficacy and almost no animal research has been performed to inform mechanisms of action. The methods of manual therapy practice are quite varied and present a challenge for scientists to model the treatments and perform research using rodents. In this perspective we present a descriptive analysis of the complexity of the treatments, highlighting the role of tissue mechanics and physics. With these complexities in mind, we compare using manual therapy as clinically practiced, to attempts to develop machinery to model or mimic manual therapy. We propose that because of the complexities of manual therapy as practiced, having therapists perform the treatments on research animals just as they would on humans is the most scientific approach. Our results using this approach have supported its practicality.
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Affiliation(s)
- Geoffrey M. Bove
- Bove Consulting, Kennebunkport, ME, United States
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
- *Correspondence: Geoffrey M. Bove
| | | | | | - Mary F. Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
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Barbe MF, Panibatla ST, Harris MY, Amin M, Dorotan JT, Cruz GE, Bove GM. Manual Therapy With Rest as a Treatment for Established Inflammation and Fibrosis in a Rat Model of Repetitive Strain Injury. Front Physiol 2021; 12:755923. [PMID: 34803739 PMCID: PMC8600143 DOI: 10.3389/fphys.2021.755923] [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: 08/09/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Repetitive strain injuries caused by repetitive occupational work are difficult to prevent for multiple reasons. Therefore, we examined the effectiveness of manual therapy (MT) with rest to treat the inflammation and fibrosis that develops through the performance of a repetitive task. We hypothesized that this treatment would reduce task-induced sensorimotor declines and neuromuscular inflammation. Methods: Twenty-nine female Sprague-Dawley rats performed a reaching and lever-pulling task for 14weeks. All ceased performing the task at 14weeks. Ten were euthanized at this timepoint (TASK). Nine received manual therapy to their upper extremities while resting 7weeks (MTR); 10 were assigned to rest alone (REST). Ten additional food restricted rats were included that neither performed the task nor received manual therapy (FRC). Results: Confirming previous experiments, TASK rats showed behavioral changes (forepaw mechanical hypersensitivity, reduced grip strength, lowered forelimb/forepaw agility, and noxious cold temperature sensitivity), reduced median nerve conduction velocity (NCV), and pathological tissue changes (myelin degradation, increased median nerve and muscle inflammation, and collagen production). Manual therapy with rest (MTR) ameliorated cold sensitivity seen in REST rats, enhanced muscle interleukin 10 (IL-10) more than in REST rats, lead to improvement in most other measures, compared to TASK rats. REST rats showed improved grip strength, lowered nerve inflammation and degraded myelin, and lowered muscle tumor necrosis factor alpha (TNFα) and collagen I levels, compared to TASK rats, yet maintained lowered forelimb/forepaw agility and NCV, and increased neural fibrosis. Conclusion: In our model of repetitive motion disorder, manual therapy during rest had modest effects on behavioral, histological, and physiological measures, compared to rest alone. These findings stand in contrast to the robust preventive effects of manual therapy in this same model.
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Affiliation(s)
- Mary F Barbe
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Siva Tejaa Panibatla
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Michele Y Harris
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Mamta Amin
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Jocelynne T Dorotan
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Geneva E Cruz
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Geoffrey M Bove
- Center for Translational Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States.,Bove Consulting, Kennebunkport, ME, United States
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Frara N, Giaddui D, Braverman AS, Porecca DS, Brown JM, Mazzei M, Wagner IJ, Pontari MA, Tiwari E, Testa CL, Yu D, Hobson LJ, Barbe MF, Ruggieri MR. MP08-08 NERVE TRANSFER FOR RESTORATION OF LOWER MOTOR NEURON-LESIONED BLADDER FUNCTION. PART 2: ATTENUATION OF PURINERGIC BLADDER SMOOTH MUSCLE CONTRACTIONS. J Urol 2021. [DOI: 10.1097/ju.0000000000001981.08] [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: 11/25/2022]
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Klyne DM, Barbe MF, James G, Hodges PW. Does the Interaction between Local and Systemic Inflammation Provide a Link from Psychology and Lifestyle to Tissue Health in Musculoskeletal Conditions? Int J Mol Sci 2021; 22:ijms22147299. [PMID: 34298917 PMCID: PMC8304860 DOI: 10.3390/ijms22147299] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 05/31/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 01/02/2023] Open
Abstract
Musculoskeletal conditions are known to involve biological, psychological, social and, often, lifestyle elements. However, these domains are generally considered in isolation from each other. This siloed approach is unlikely to be adequate to understand the complexity of these conditions and likely explains a major component of the disappointing effects of treatment. This paper presents a hypothesis that aims to provide a foundation to understand the interaction and integration between these domains. We propose a hypothesis that provides a plausible link between psychology and lifestyle factors with tissue level effects (such as connective tissue dysregulation/accumulation) in musculoskeletal conditions that is founded on understanding the molecular basis for interaction between systemic and local inflammation. The hypothesis provides plausible and testable links between mind and body, for which empirical evidence can be found for many aspects. We present this hypothesis from the perspective of connective tissue biology and pathology (fibrosis), the role of inflammation locally (tissue level), and how this inflammation is shaped by systemic inflammation through bidirectional pathways, and various psychological and lifestyle factors via their influence on systemic inflammation. This hypothesis provides a foundation for new consideration of the development and refinement of personalized multidimensional treatments for individuals with musculoskeletal conditions.
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Affiliation(s)
- David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (G.J.); (P.W.H.)
- Correspondence: ; Tel.: +61-7-3365-4569
| | - Mary F. Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA;
| | - Greg James
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (G.J.); (P.W.H.)
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (G.J.); (P.W.H.)
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Barbe MF, Harris MY, Cruz GE, Amin M, Billett NM, Dorotan JT, Day EP, Kim SY, Bove GM. Key indicators of repetitive overuse-induced neuromuscular inflammation and fibrosis are prevented by manual therapy in a rat model. BMC Musculoskelet Disord 2021; 22:417. [PMID: 33952219 PMCID: PMC8101118 DOI: 10.1186/s12891-021-04270-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/07/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND We examined the effectiveness of a manual therapy consisting of forearm skin rolling, muscle mobilization, and upper extremity traction as a preventive treatment for rats performing an intensive lever-pulling task. We hypothesized that this treatment would reduce task-induced neuromuscular and tendon inflammation, fibrosis, and sensorimotor declines. METHODS Sprague-Dawley rats performed a reaching and lever pulling task for a food reward, 2 h/day, 3 days/week, for 12 weeks, while simultaneously receiving the manual therapy treatment 3 times per week for 12 weeks to either the task-involved upper extremities (TASK-Tx), or the lower extremities as an active control group (TASK-Ac). Results were compared to similarly treated control rats (C-Tx and C-Ac). RESULTS Median nerves and forearm flexor muscles and tendons of TASK-Ac rats showed higher numbers of inflammatory CD68+ and fibrogenic CD206+ macrophages, particularly in epineurium, endomysium and epitendons than TASK-Tx rats. CD68+ and CD206+ macrophages numbers in TASK-Tx rats were comparable to the non-task control groups. TASK-Ac rats had more extraneural fibrosis in median nerves, pro-collagen type I levels and immunoexpression in flexor digitorum muscles, and fibrogenic changes in flexor digitorum epitendons, than TASK-Tx rats (which showed comparable responses as control groups). TASK-Ac rats showed cold temperature, lower reflexive grip strength, and task avoidance, responses not seen in TASK-Tx rats (which showed comparable responses as the control groups). CONCLUSIONS Manual therapy of forelimbs involved in performing the reaching and grasping task prevented the development of inflammatory and fibrogenic changes in forearm nerves, muscle, and tendons, and sensorimotor declines.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA.
| | - Michele Y Harris
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Geneva E Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Nathan M Billett
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Jocelynne T Dorotan
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Emily P Day
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Seung Y Kim
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Geoffrey M Bove
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA.,Bove Consulting, Kennebunkport, ME, 04046, USA
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Frara N, Giaddui D, Braverman AS, Porreca DS, Brown JM, Mazzei M, Wagner IJ, Pontari MA, Tiwari E, Testa CL, Yu D, Hobson LJ, Barbe MF, Ruggieri MR. Nerve transfer for restoration of lower motor neuron-lesioned bladder function. Part 1: attenuation of purinergic bladder smooth muscle contractions. Am J Physiol Regul Integr Comp Physiol 2021; 320:R885-R896. [PMID: 33759578 PMCID: PMC8285613 DOI: 10.1152/ajpregu.00299.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This study determined the effect of pelvic organ decentralization and reinnervation 1 yr later on the contribution of muscarinic and purinergic receptors to ex vivo, nerve-evoked, bladder smooth muscle contractions. Nineteen canines underwent decentralization by bilateral transection of all coccygeal and sacral (S) spinal roots, dorsal roots of lumbar (L)7, and hypogastric nerves. After exclusions, 8 were reinnervated 12 mo postdecentralization with obturator-to-pelvic and sciatic-to-pudendal nerve transfers then euthanized 8-12 mo later. Four served as long-term decentralized only animals. Controls included six sham-operated and three unoperated animals. Detrusor muscle was assessed for contractile responses to potassium chloride (KCl) and electric field stimulation (EFS) before and after purinergic receptor desensitization with α, β-methylene adenosine triphosphate (α,β-mATP), muscarinic receptor antagonism with atropine, or sodium channel blockade with tetrodotoxin. Atropine inhibition of EFS-induced contractions increased in decentralized and reinnervated animals compared with controls. Maximal contractile responses to α,β-mATP did not differ between groups. In strips from decentralized and reinnervated animals, the contractile response to EFS was enhanced at lower frequencies compared with normal controls. The observation of increased blockade of nerve-evoked contractions by muscarinic antagonist with no change in responsiveness to purinergic agonist suggests either decreased ATP release or increased ecto-ATPase activity in detrusor muscle as a consequence of the long-term decentralization. The reduction in the frequency required to produce maximum contraction following decentralization may be due to enhanced nerve sensitivity to EFS or a change in the effectiveness of the neurotransmission.
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Affiliation(s)
- Nagat Frara
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Dania Giaddui
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Alan S Braverman
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Danielle S Porreca
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Justin M Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael Mazzei
- Department of Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Ida J Wagner
- Department of Surgery, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Michel A Pontari
- Department of Urology, Lewis Katz School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Ekta Tiwari
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Courtney L Testa
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Daohai Yu
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Lucas J Hobson
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Michael R Ruggieri
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.,Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
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Barbe MF, Testa CL, Cruz GE, Frara NA, Tiwari E, Hobson LJ, McIntyre BS, Porreca DS, Giaddui D, Braverman AS, Day EP, Amin M, Brown JM, Mazzei M, Pontari MA, Wagner IJ, Ruggieri MR. Nerve transfer for restoration of lower motor neuron-lesioned bladder function. Part 2: correlation between histological changes and nerve evoked contractions. Am J Physiol Regul Integr Comp Physiol 2021; 320:R897-R915. [PMID: 33759573 PMCID: PMC8285612 DOI: 10.1152/ajpregu.00300.2020] [Citation(s) in RCA: 3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We determined the effect of pelvic organ decentralization and reinnervation 1 yr later on urinary bladder histology and function. Nineteen canines underwent decentralization by bilateral transection of all coccygeal and sacral (S) spinal roots, dorsal roots of lumbar (L)7, and hypogastric nerves. After exclusions, eight were reinnervated 12 mo postdecentralization with obturator-to-pelvic and sciatic-to-pudendal nerve transfers, then euthanized 8-12 mo later. Four served as long-term decentralized only animals. Before euthanasia, pelvic or transferred nerves and L1–S3 spinal roots were stimulated and maximum detrusor pressure (MDP) recorded. Bladder specimens were collected for histological and ex vivo smooth muscle contractility studies. Both reinnervated and decentralized animals showed less or denuded urothelium, fewer intramural ganglia, and more inflammation and collagen, than controls, although percent muscle was maintained. In reinnervated animals, pgp9.5+ axon density was higher compared with decentralized animals. Ex vivo smooth muscle contractions in response to KCl correlated positively with submucosal inflammation, detrusor muscle thickness, and pgp9.5+ axon density. In vivo, reinnervated animals showed higher MDP after stimulation of L1–L6 roots compared with their transected L7–S3 roots, and reinnervated and decentralized animals showed lower MDP than controls after stimulation of nerves (due likely to fibrotic nerve encapsulation). MDP correlated negatively with detrusor collagen and inflammation, and positively with pgp9.5+ axon density and intramural ganglia numbers. These results demonstrate that bladder function can be improved by transfer of obturator nerves to pelvic nerves at 1 yr after decentralization, although the fibrosis and inflammation that developed were associated with decreased contractile function.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Courtney L Testa
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Geneva E Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Nagat A Frara
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Ekta Tiwari
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Lucas J Hobson
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Brian S McIntyre
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Danielle S Porreca
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Dania Giaddui
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Alan S Braverman
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Emily P Day
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Mamta Amin
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
| | - Justin M Brown
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael Mazzei
- Department of Surgery, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Michel A Pontari
- Department of Urology, Lewis Katz School of Medicine, Temple University Health System, Philadelphia, Pennsylvania
| | - Ida J Wagner
- Department of Surgery, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Michael R Ruggieri
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.,Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania
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Abstract
Purpose/Aim: We recently found that blocking CCN2 signaling using a monoclonal antibody (FG-3019) may be a novel therapeutic strategy for reducing overuse-induced tissue fibrosis. Since CCN2 plays roles in osteoclastogenesis, and persistent performance of a high repetition high force (HRHF) lever pulling task results in a loss in trabecular bone volume in the radius, we examined here whether blocking CCN2 signaling would reduce the early catabolic effects of performing a HRHF task for 3 weeks. Materials and Methods: Young adult, female, Sprague-Dawley rats were operantly shaped to learn to pull at high force levels, before performing the HRHF task for 3 weeks. HRHF task rats were then left untreated (HRHF Untreated), treated in task weeks 2 and 3 with a monoclonal antibody that antagonizes CCN2 (HRHF+FG-3019), or treated with an IgG (HRHF+IgG), while continuing to perform the task. Non-task control rats were left untreated. Results: In metaphyseal trabeculae of the distal radius, HRHF Untreated and HRHF-IgG rats showed increased osteoblast numbers and other indices of bone formation, compared to controls, yet decreased trabecular bone volume, increased osteoclast numbers, and increased serum CTX-1 (a serum biomarker of bone resorption). HRHF+FG-3019 rats also showed increased osteoblast numbers and bone formation, but in contrast to HRHF Untreated and HRHF-IgG rats, showed higher trabecular bone volume, and reduced osteoclast numbers and serum CTX-1 levels (and statistically similar to Control levels). Conclusions: HRHF loading increased bone formation in each task group, yet blocking CCN2 dampened trabecular bone catabolism by reducing osteoclast numbers and activity.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy & Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Mamta Amin
- Department of Anatomy & Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Anne Gingery
- Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alex G Lambi
- Division of Plastic & Reconstructive Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
| | - Steven N Popoff
- Department of Anatomy & Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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Abstract
AIM To examine the chronic effect of force on mRNA and protein expression levels of fibrosis-related genes in flexor digitorum muscles in a rat model of repetitive overuse injury that induces muscle fibrosis at high force levels. MATERIALS AND METHODS Two groups of rats were trained to perform a voluntary repetitive lever-pulling task at either a high (HFHR) or a low force (LFHR) for 18 weeks, while a control group (FRC) performed no task. RNA and protein were prepared from forelimb flexor digitorum muscles. Fibrosis-related gene RNA transcripts were evaluated using quantitative PCR (qPCR) and analyzed using the geometric mean of three housekeeping genes or the mean of each individually as reference. Protein levels were quantified using ELISA, western blot, or immunohistofluorescence. RESULTS Of eight fibrosis-related mRNAs examined, only FGF2 demonstrated a consistent significant increase in the HFHR group, compared to the FRC group. However, protein amounts of collagen type 1, collagen type 3, and TGFβ1 were significantly higher in the HFHR, compared to the FRC and LFHR groups, while CCN2 and FGF2 were higher in both HFHR and LFHR, compared to the FRC group. CONCLUSIONS Our results suggest that there is steady-state transcription of fibrogenic genes in muscles with established fibrosis, implying that post-transcriptional processes are responsible for the increased protein levels of fibrotic factors during muscle overuse conditions. We hypothesize that targeting such pathways represents a valid approach to treat overuse injury. Alternatively, FGF2 gene expression may represent a valid target for therapy.
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Affiliation(s)
| | - Mamta Amin
- Temple University, Lewis Katz School of Medicine, Philadelphia, PA
| | - Steven N. Popoff
- Temple University, Lewis Katz School of Medicine, Philadelphia, PA
| | - Mary F. Barbe
- Temple University, Lewis Katz School of Medicine, Philadelphia, PA
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Barbe MF, Loomis R, Lepkowsky AM, Forman S, Zhao H, Gordon J. A longitudinal characterization of sex-specific somatosensory and spatial memory deficits in HIV Tg26 heterozygous mice. PLoS One 2020; 15:e0244725. [PMID: 33382797 PMCID: PMC7775086 DOI: 10.1371/journal.pone.0244725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 12/15/2020] [Indexed: 12/14/2022] Open
Abstract
The pathogenesis of human immunodeficiency virus associated neurological disorders is still not well understood, yet is known to result in neurological declines despite combination anti-retroviral therapy. HIV-1 transgenic (Tg26) mice contain integrated non-infectious HIV-1 proviral DNA. We sought to assess the integrity of neurocognitive function and sensory systems in HIV-1 Tg26 mice using a longitudinal design, in both sexes, to examine both age- and sex-related disease progression. General neurological reflexive testing showed only acclimation to repeated testing by all groups. Yet, at 2.5 months of age, female Tg26 +/- mice showed hyposensitivity to noxious hot temperatures, compared to wild types (both sexes) and male Tg26 +/- mice, that worsened by 10 months of age. Female Tg26 +/- mice had short-term spatial memory losses in novel object location memory testing at 2.5 and 7 months, compared to female wild types; changes not observed in male counterparts. Female Tg26 +/- mice showed mild learning deficits and short- and long-term spatial memory deficits in olfactory and visually cued Barnes Maze testing at 3 months of age, yet greater learning and memory deficits by 8 months. In contrast, male Tg26 +/- mice displayed no learning deficits and fewer spatial memory deficits (mainly heading errors in nontarget holes). Thus, greater sex-specific temperature hyposensitivity and spatial memory declines were observed in female HIV Tg26 +/- mice, than in male Tg26 +/- mice, or their wild type littermates, that increased with aging. Additionally, tibial bones were examined using ex vivo micro-CT after tissue collection at 11 months. Sex-dependent increases in bone volume and trabecular number were seen in males, matching their greater weights at this age. These results indicate that HIV-1 Tg26 mice is a promising model in which to study neuropathic mechanisms underlying peripheral pathology as well as cognitive deficits seen with HIV.
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Affiliation(s)
- Mary F. Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
- Comprehensive NeuroAIDS Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
- * E-mail: ,
| | - Regina Loomis
- Comprehensive NeuroAIDS Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
- Department of Neuroscience and Center for Neurovirology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
| | - Adam M. Lepkowsky
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
| | - Steven Forman
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
| | - Huaqing Zhao
- Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
| | - Jennifer Gordon
- Comprehensive NeuroAIDS Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
- Department of Neuroscience and Center for Neurovirology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
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Barbe MF, Hilliard B, Fisher PW, White AR, Delany SP, Iannarone VJ, Harris MY, Amin M, Cruz GE, Popoff SN. Blocking substance P signaling reduces musculotendinous and dermal fibrosis and sensorimotor declines in a rat model of overuse injury. Connect Tissue Res 2020; 61:604-619. [PMID: 31443618 PMCID: PMC7036028 DOI: 10.1080/03008207.2019.1653289] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose/Aim: Substance P-NK-1R signaling has been implicated in fibrotic tendinopathies and myositis. Blocking this signaling with a neurokinin 1 receptor antagonist (NK1RA) has been proposed as a therapeutic target for their treatment.Materials and Methods: Using a rodent model of overuse injury, we pharmacologically blocked Substance P using a specific NK1RA with the hopes of reducing forelimb tendon, muscle and dermal fibrogenic changes and associated pain-related behaviors. Young adult rats learned to pull at high force levels across a 5-week period, before performing a high repetition high force (HRHF) task for 3 weeks (2 h/day, 3 days/week). HRHF rats were untreated or treated in task weeks 2 and 3 with the NK1RA, i.p. Control rats received vehicle or NK1RA treatments.Results: Grip strength declined in untreated HRHF rats, and mechanical sensitivity and temperature aversion increased compared to controls; these changes were improved by NK1RA treatment (L-732,138). NK1RA treatment also reduced HRHF-induced thickening in flexor digitorum epitendons, and HRHF-induced increases of TGFbeta1, CCN2/CTGF, and collagen type 1 in flexor digitorum muscles. In the forepaw upper dermis, task-induced increases in collagen deposition were reduced by NK1RA treatment.Conclusions: Our findings indicate that Substance P plays a role in the development of fibrogenic responses and subsequent discomfort in forelimb tissues involved in performing a high demand repetitive forceful task.
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Affiliation(s)
- MF Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - B Hilliard
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - PW Fisher
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - AR White
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - SP Delany
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - VJ Iannarone
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - MY Harris
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - M Amin
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - GE Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
| | - SN Popoff
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, United States
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Barbe MF, Hilliard BA, Amin M, Harris MY, Hobson LJ, Cruz GE, Dorotan JT, Paul RW, Klyne DM, Popoff SN. Blocking CTGF/CCN2 reverses neural fibrosis and sensorimotor declines in a rat model of overuse-induced median mononeuropathy. J Orthop Res 2020; 38:2396-2408. [PMID: 32379362 PMCID: PMC7647961 DOI: 10.1002/jor.24709] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/24/2020] [Accepted: 04/29/2020] [Indexed: 02/04/2023]
Abstract
Encapsulation of median nerves is a hallmark of overuse-induced median mononeuropathy and contributes to functional declines. We tested if an antibody against CTGF/CCN2 (termed FG-3019 or Pamrevlumab) reduces established neural fibrosis and sensorimotor declines in a clinically relevant rodent model of overuse in which median mononeuropathy develops. Young adult female rats performed a high repetition high force (HRHF) lever-pulling task for 18 weeks. Rats were then euthanised at 18 weeks (HRHF untreated), or rested and systemically treated for 6 weeks with either an anti-CCN2 monoclonal antibody (HRHF-Rest/FG-3019) or IgG (HRHF-Rest/IgG), with results compared with nontask control rats. Neuropathology was evident in HRHF-untreated and HRHF-Rest/IgG rats as increased perineural collagen deposition and degraded myelin basic protein (dMBP) in median nerves, and increased substance P in lower cervical dorsal root ganglia (DRG), compared with controls. Both groups showed functional declines, specifically, decreased sensory conduction velocity in median nerves, noxious cold temperature hypersensitivity, and grip strength declines, compared with controls. There were also increases of ATF3-immunopositive nuclei in ventral horn neurons in HRHF-untreated rats, compared with controls (which showed none). FG-3019-treated rats showed no increase above control levels of perineural collagen or dMBP in median nerves, Substance P in lower cervical DRGs, or ATF3-immunopositive nuclei in ventral horns, and similar median nerve conduction velocities and thermal sensitivity, compared with controls. We hypothesize that neural fibrotic processes underpin the sensorimotor declines by compressing or impeding median nerves during movement, and that inhibiting fibrosis using an anti-CCN2 treatment reverses these effects.
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Affiliation(s)
- Mary F. Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Brendan A. Hilliard
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Michele Y. Harris
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Lucas J. Hobson
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Geneva E. Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Jocelynne T. Dorotan
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - Ryan W. Paul
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
| | - David M. Klyne
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania,NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - Steven N. Popoff
- Department of Anatomy and Cell Biology, Lewis Katz School of MedicineTemple UniversityPhiladelphiaPennsylvania
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Chen C, Willhouse AH, Huang P, Ko N, Wang Y, Xu B, Huang LHM, Kieffer B, Barbe MF, Liu-Chen LY. Characterization of a Knock-In Mouse Line Expressing a Fusion Protein of κ Opioid Receptor Conjugated with tdTomato: 3-Dimensional Brain Imaging via CLARITY. eNeuro 2020; 7:ENEURO.0028-20.2020. [PMID: 32561573 PMCID: PMC7385665 DOI: 10.1523/eneuro.0028-20.2020] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 01/28/2020] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 11/26/2022] Open
Abstract
Activation of κ opioid receptor (KOR) produces analgesia, antipruritic effect, sedation and dysphoria. To characterize neuroanatomy of KOR at high resolutions and circumvent issues of specificity of KOR antibodies, we generated a knock-in mouse line expressing KOR fused at the C terminus with the fluorescent protein tdTomato (KtdT). The selective KOR agonist U50,488H caused anti-scratch effect and hypolocomotion, indicating intact KOR neuronal circuitries. Clearing of brains with CLARITY revealed three-dimensional (3-D) images of distribution of KOR, and any G-protein-coupled receptors, for the first time. 3-D brain images of KtdT and immunohistochemistry (IHC) on brain sections with antibodies against tdTomato show similar distribution to that of autoradiography of [3H]U69,593 binding to KOR in wild-type mice. KtdT was observed in regions involved in reward and aversion, pain modulation, and neuroendocrine regulation. KOR is present in several areas with unknown roles, including the claustrum (CLA), dorsal endopiriform nucleus, paraventricular nucleus of the thalamus (PVT), lateral habenula (LHb), and substantia nigra pars reticulata (SNr), which are discussed. Prominent KtdT-containing fibers were observed to project from caudate putamen (CP) and nucleus accumbens (ACB) to substantia innominata (SI) and SNr. Double IHC revealed co-localization of KtdT with tyrosine hydroxylase (TH) in brain regions, including CP, ACB, and ventral tegmental area (VTA). KOR was visualized at the cellular level, such as co-localization with TH and agonist-induced KOR translocation into intracellular space in some VTA neurons. These mice thus represent a powerful and heretofore unparalleled tool for neuroanatomy of KOR at both the 3-D and cellular levels.
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Affiliation(s)
- Chongguang Chen
- Center for Substance Abuse Research and Department of Pharmacology
| | - Alex H Willhouse
- Center for Substance Abuse Research and Department of Pharmacology
| | - Peng Huang
- Center for Substance Abuse Research and Department of Pharmacology
| | - Nora Ko
- Center for Substance Abuse Research and Department of Pharmacology
| | - Yujun Wang
- Center for Substance Abuse Research and Department of Pharmacology
| | - Bin Xu
- Cardiovascular Research Center
| | | | - Brigitte Kieffer
- Douglas Hospital, McGill University, Verdun, Quebec H4H 1R3, Canada
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140
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39
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Tiwari E, Salvadeo DM, Braverman AS, Frara NA, Hobson L, Cruz G, Brown JM, Mazzei M, Pontari MA, White AR, Barbe MF, Ruggieri MR. Nerve transfer for restoration of lower motor neuron-lesioned bladder and urethra function: establishment of a canine model and interim pilot study results. J Neurosurg Spine 2020; 32:258-268. [PMID: 31703192 DOI: 10.3171/2019.8.spine19265] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/13/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Previous patient surveys have shown that patients with spinal cord or cauda equina injuries prioritize recovery of bladder function. The authors sought to determine if nerve transfer after long-term decentralization restores bladder and sphincter function in canines. METHODS Twenty-four female canines were included in this study. Transection of sacral roots and hypogastric nerves (S Dec) was performed in 6 animals, and 7 animals underwent this procedure with additional transection of the L7 dorsal roots (L7d+S Dec). Twelve months later, 3 L7d+S Dec animals underwent obturator-to-pelvic nerve and sciatic-to-pudendal nerve transfers (L7d+S Dec+Reinn). Eleven animals served as controls. Squat-and-void behaviors were tracked before and after decentralization, after reinnervation, and following awake bladder-filling procedures. Bladders were cystoscopically injected with Fluoro-Gold 3 weeks before euthanasia. Immediately before euthanasia, transferred nerves were stimulated to evaluate motor function. Dorsal root ganglia were assessed for retrogradely labeled neurons. RESULTS Transection of only sacral roots failed to reduce squat-and-void postures; L7 dorsal root transection was necessary for significant reduction. Three L7d+S Dec animals showing loss of squat-and-void postures post-decentralization were chosen for reinnervation and recovered these postures 4-6 months after reinnervation. Each showed obturator nerve stimulation-induced bladder contractions and sciatic nerve stimulation-induced anal sphincter contractions immediately prior to euthanasia. One showed sciatic nerve stimulation-induced external urethral sphincter contractions and voluntarily voided twice following nonanesthetized bladder filling. Reinnervation was confirmed by increased labeled cells in L2 and the L4-6 dorsal root ganglia (source of obturator nerve in canines) of L7d+S Dec+Reinn animals, compared with controls. CONCLUSIONS New neuronal pathways created by nerve transfer can restore bladder sensation and motor function in lower motor neuron-lesioned canines even 12 months after decentralization.
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Affiliation(s)
- Ekta Tiwari
- 1Department of Computer and Electrical Engineering, College of Engineering
| | | | - Alan S Braverman
- 2Department of Anatomy and Cell Biology, Lewis Katz School of Medicine
| | - Nagat A Frara
- 2Department of Anatomy and Cell Biology, Lewis Katz School of Medicine
| | - Lucas Hobson
- 2Department of Anatomy and Cell Biology, Lewis Katz School of Medicine
| | - Geneva Cruz
- 2Department of Anatomy and Cell Biology, Lewis Katz School of Medicine
| | - Justin M Brown
- 3Department of Neurosurgery, Neurosurgery Paralysis Center, Massachusetts General Hospital, Boston, Massachusetts; and
| | | | - Michel A Pontari
- 5Department of Urology, Temple University, Philadelphia, Pennsylvania
| | - Amanda R White
- 2Department of Anatomy and Cell Biology, Lewis Katz School of Medicine
| | - Mary F Barbe
- 2Department of Anatomy and Cell Biology, Lewis Katz School of Medicine
| | - Michael R Ruggieri
- 1Department of Computer and Electrical Engineering, College of Engineering.,2Department of Anatomy and Cell Biology, Lewis Katz School of Medicine.,6The Shriners Hospital of Philadelphia, Pennsylvania
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Driban JB, Harkey MS, Barbe MF, Ward RJ, MacKay JW, Davis JE, Lu B, Price LL, Eaton CB, Lo GH, McAlindon TE. Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review. BMC Musculoskelet Disord 2020; 21:332. [PMID: 32471412 PMCID: PMC7260785 DOI: 10.1186/s12891-020-03367-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/25/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Osteoarthritis is generally a slowly progressive disorder. However, at least 1 in 7 people with incident knee osteoarthritis develop an abrupt progression to advanced-stage radiographic disease, many within 12 months. We summarize what is known - primarily based on findings from the Osteoarthritis Initiative - about the risk factors and natural history of accelerated knee osteoarthritis (AKOA) - defined as a transition from no radiographic knee osteoarthritis to advanced-stage disease < 4 years - and put these findings in context with typical osteoarthritis (slowly progressing disease), aging, prior case reports/series, and relevant animal models. Risk factors in the 2 to 4 years before radiographic manifestation of AKOA (onset) include older age, higher body mass index, altered joint alignment, contralateral osteoarthritis, greater pre-radiographic disease burden (structural, symptoms, and function), or low fasting glucose. One to 2 years before AKOA onset people often exhibit rapid articular cartilage loss, larger bone marrow lesions and effusion-synovitis, more meniscal pathology, slower chair-stand or walking pace, and increased global impact of arthritis than adults with typical knee osteoarthritis. Increased joint symptoms predispose a person to new joint trauma, which for someone who develops AKOA is often characterized by a destabilizing meniscal tear (e.g., radial or root tear). One in 7 people with AKOA onset subsequently receive a knee replacement during a 9-year period. The median time from any increase in radiographic severity to knee replacement is only 2.3 years. Despite some similarities, AKOA is different than other rapidly progressive arthropathies and collapsing these phenomena together or extracting results from one type of osteoarthritis to another should be avoided until further research comparing these types of osteoarthritis is conducted. Animal models that induce meniscal damage in the presence of other risk factors or create an incongruent distribution of loading on joints create an accelerated form of osteoarthritis compared to other models and may offer insights into AKOA. CONCLUSION Accelerated knee osteoarthritis is unique from typical knee osteoarthritis. The incidence of AKOA in the Osteoarthritis Initiative and Chingford Study is substantial. AKOA needs to be taken into account and studied in epidemiologic studies and clinical trials.
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Affiliation(s)
- Jeffrey B Driban
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.
| | - Matthew S Harkey
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA
| | - James W MacKay
- Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Level 5, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.,Department of Radiology, Norwich Medical School, University of East Anglia, Research Park NR4 7U1, Norwich, UK
| | - Julie E Davis
- Milken Institute of Public Health, The George Washington University, 950 New Hampshire Ave NW, Washington, DC, 20052, USA
| | - Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street PBB-B3, Boston, MA, 02115, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Box #63, Boston, MA, 02111, USA.,Tufts Clinical and Translational Science Institute, Tufts University, 800 Washington Street, Box #63, Boston, MA, 02111, USA
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, 111 Brewster Street, Pawtucket, RI, 02860, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX. 1 Baylor Plaza, BCM-285, Houston, TX, 77030, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA, 02111, USA
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Harkey MS, Davis JE, Price LL, Ward RJ, MacKay JW, Eaton CB, Lo GH, Barbe MF, Zhang M, Pang J, Stout AC, Lu B, McAlindon TE, Driban JB. Composite quantitative knee structure metrics predict the development of accelerated knee osteoarthritis: data from the osteoarthritis initiative. BMC Musculoskelet Disord 2020; 21:299. [PMID: 32404099 PMCID: PMC7222452 DOI: 10.1186/s12891-020-03338-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/08/2020] [Indexed: 11/24/2022] Open
Abstract
Background We aimed to determine if composite structural measures of knee osteoarthritis (KOA) progression on magnetic resonance (MR) imaging can predict the radiographic onset of accelerated knee osteoarthritis. Methods We used data from a nested case-control study among participants from the Osteoarthritis Initiative without radiographic KOA at baseline. Participants were separated into three groups based on radiographic disease progression over 4 years: 1) accelerated (Kellgren-Lawrence grades [KL] 0/1 to 3/4), 2) typical (increase in KL, excluding accelerated osteoarthritis), or 3) no KOA (no change in KL). We assessed tibiofemoral cartilage damage (four regions: medial/lateral tibia/femur), bone marrow lesion (BML) volume (four regions: medial/lateral tibia/femur), and whole knee effusion-synovitis volume on 3 T MR images with semi-automated programs. We calculated two MR-based composite scores. Cumulative damage was the sum of standardized cartilage damage. Disease activity was the sum of standardized volumes of effusion-synovitis and BMLs. We focused on annual images from 2 years before to 2 years after radiographic onset (or a matched time for those without knee osteoarthritis). To determine between group differences in the composite metrics at all time points, we used generalized linear mixed models with group (3 levels) and time (up to 5 levels). For our prognostic analysis, we used multinomial logistic regression models to determine if one-year worsening in each composite metric change associated with future accelerated knee osteoarthritis (odds ratios [OR] based on units of 1 standard deviation of change). Results Prior to disease onset, the accelerated KOA group had greater average disease activity compared to the typical and no KOA groups and this persisted up to 2 years after disease onset. During a pre-radiographic disease period, the odds of developing accelerated KOA were greater in people with worsening disease activity [versus typical KOA OR (95% confidence interval [CI]): 1.58 (1.08 to 2.33); versus no KOA: 2.39 (1.55 to 3.71)] or cumulative damage [versus typical KOA: 1.69 (1.14 to 2.51); versus no KOA: 2.11 (1.41 to 3.16)]. Conclusions MR-based disease activity and cumulative damage metrics may be prognostic markers to help identify people at risk for accelerated onset and progression of knee osteoarthritis.
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Affiliation(s)
- Matthew S Harkey
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA. .,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Julie E Davis
- Department of Global Health in the Milken Institute of Public Health, George Washington University, Washington, DC, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, Boston, MA, USA
| | - James W MacKay
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Ming Zhang
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA.,Department of Computer Science & Networking, Wentworth Institute of Technology, Boston, MA, USA
| | | | - Alina C Stout
- Public Health Institute, Northeastern University, Boston, MA, USA
| | - Bing Lu
- Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, 800 Washington Street, Box 406, Boston, MA, 02111, USA
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Shanas N, Querido W, Dumont A, Yonko E, Carter E, Ok J, Karchner JP, Barbe MF, Ali S, Patil C, Raggio C, Pleshko N. Clinical application of near infrared fiber optic spectroscopy for noninvasive bone assessment. J Biophotonics 2020; 13:e201960172. [PMID: 31957205 DOI: 10.1002/jbio.201960172] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/27/2019] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
Approaches for noninvasive bone quality assessment are of great clinical need, particularly in individuals that require close monitoring of disease progression. X-ray measurements are standard approaches to assess bone quality; however, they have several disadvantages. Here, a nonionizing approach for noninvasive assessment of the second metacarpal bone based on near infrared (NIR) spectroscopy was investigated. Transcutaneous bone signal detection was experimentally confirmed with cadaveric hand data, and Monte Carlo modeling further indicated that 50% of the measured signals arise from bone. Spectral data were collected via a NIR fiber optic from the bone of individuals with osteogenesis imperfecta, a disease marked by frequent bone fractures and fragility. Multiple significant correlations were found between spectral parameters related to water, protein and fat, and standard bone quality parameters obtained by X-ray measurements. The results from this preliminary study highlight the potential application of NIR spectroscopy for the noninvasive assessment of bone quality.
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Affiliation(s)
- No'ad Shanas
- Department for Bioengineering, Temple University, Philadelphia, Pennsylvania
| | - William Querido
- Department for Bioengineering, Temple University, Philadelphia, Pennsylvania
| | - Alexander Dumont
- Department for Bioengineering, Temple University, Philadelphia, Pennsylvania
| | - Elizabeth Yonko
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Erin Carter
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Jina Ok
- Department for Bioengineering, Temple University, Philadelphia, Pennsylvania
| | - James P Karchner
- Department for Bioengineering, Temple University, Philadelphia, Pennsylvania
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Sayed Ali
- Department of Radiology, Temple University Hospital, Philadelphia, Pennsylvania
| | - Chetan Patil
- Department for Bioengineering, Temple University, Philadelphia, Pennsylvania
| | - Cathleen Raggio
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York
| | - Nancy Pleshko
- Department for Bioengineering, Temple University, Philadelphia, Pennsylvania
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43
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Barbe MF, Hilliard BA, Amin M, Harris MY, Hobson LJ, Cruz GE, Popoff SN. Blocking CTGF/CCN2 reduces established skeletal muscle fibrosis in a rat model of overuse injury. FASEB J 2020; 34:6554-6569. [PMID: 32227398 PMCID: PMC7200299 DOI: 10.1096/fj.202000240rr] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/12/2022]
Abstract
Tissue fibrosis is a hallmark of overuse musculoskeletal injuries and contributes to functional declines. We tested whether inhibition of CCN2 (cellular communication network factor 2, previously known as connective tissue growth factor, CTGF) using a specific antibody (termed FG‐3019 or pamrevlumab) reduces established overuse‐induced muscle fibrosis in a clinically relevant rodent model of upper extremity overuse injury. Young adult rats performed a high repetition high force (HRHF) reaching and lever‐pulling task for 18 weeks, after first being shaped for 6 weeks to learn this operant task. Rats were then euthanized (HRHF‐Untreated), or rested and treated for 6 weeks with FG‐3019 (HRHF‐Rest/FG‐3019) or a human IgG as a vehicle control (HRHF‐Rest/IgG). HRHF‐Untreated and HRHF‐Rest/IgG rats had higher muscle levels of several fibrosis‐related proteins (TGFβ1, CCN2, collagen types I and III, and FGF2), and higher muscle numbers of alpha SMA and pERK immunopositive cells, compared to control rats. Each of these fibrogenic changes was restored to control levels by the blocking of CCN2 signaling in HRHF‐Rest/FG‐3019 rats, as were HRHF task‐induced increases in serum CCN2 and pro‐collagen I intact N‐terminal protein. Levels of cleaved CCN3, an antifibrotic protein, were lowered in HRHF‐Untreated and HRHF‐Rest/IgG rats, compared to control rats, yet elevated back to control levels in HRHF‐Rest/FG‐3019 rats. Significant grip strength declines observed in HRHF‐Untreated and HRHF‐Rest/IgG rats, were restored to control levels in HRHF‐Rest/FG‐3019 rats. These results are highly encouraging for use of FG‐3019 for therapeutic treatment of persistent skeletal muscle fibrosis, such as those induced with chronic overuse.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Brendan A Hilliard
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Michele Y Harris
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Lucas J Hobson
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Geneva E Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Steven N Popoff
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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Abstract
Bone adaptation to persistent overloading can be counteracted by superimposed inflammatory and loading-induced damage that can tip the balance from bone accrual to loss. Supplemental digital content is available in the text. It is commonly assumed that beneficial adaptations in bone occur with vigorous exercise, yet any adaptive re/modeling in bone undergoing persistent overloading can be counteracted by superimposed inflammatory, compressive, and tensile loading–induced damage responses above thresholds of tissue fatigue failure and repair. This leads to a tenuous balance between achieving bone accrual and loss.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
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45
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Smith TTG, Barr-Gillespie AE, Klyne DM, Harris MY, Amin M, Paul RW, Cruz GE, Zhao H, Gallagher S, Barbe MF. Forced treadmill running reduces systemic inflammation yet worsens upper limb discomfort in a rat model of work-related musculoskeletal disorders. BMC Musculoskelet Disord 2020; 21:57. [PMID: 32000751 PMCID: PMC6993343 DOI: 10.1186/s12891-020-3085-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/29/2019] [Accepted: 01/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Musculoskeletal disorders can result from prolonged repetitive and/or forceful movements. Performance of an upper extremity high repetition high force task increases serum pro-inflammatory cytokines and upper extremity sensorimotor declines in a rat model of work-related musculoskeletal disorders. Since one of the most efficacious treatments for musculoskeletal pain is exercise, this study investigated the effectiveness of treadmill running in preventing these responses. METHODS Twenty-nine young adult female Sprague-Dawley rats were used. Nineteen were trained for 5 weeks to pull a lever bar at high force (15 min/day). Thirteen went on to perform a high repetition high force reaching and lever-pulling task for 10 weeks (10-wk HRHF; 2 h/day, 3 days/wk). From this group, five were randomly selected to undergo forced treadmill running exercise (TM) during the last 6 weeks of task performance (10-wk HRHF+TM, 1 h/day, 5 days/wk). Results were compared to 10 control rats and 6 rats that underwent 6 weeks of treadmill running following training only (TR-then-TM). Voluntary task and reflexive sensorimotor behavioral outcomes were assessed. Serum was assayed for inflammatory cytokines and corticosterone, reach limb median nerves for CD68+ macrophages and extraneural thickening, and reach limb flexor digitorum muscles and tendons for pathological changes. RESULTS 10-wk HRHF rats had higher serum levels of IL-1α, IL-1β and TNFα, than control rats. In the 10-wk HRHF+TM group, IL-1β and TNFα were lower, whereas IL-10 and corticosterone were higher, compared to 10-wk HRHF only rats. Unexpectedly, several voluntary task performance outcomes (grasp force, reach success, and participation) worsened in rats that underwent treadmill running, compared to untreated 10-wk HRHF rats. Examination of forelimb tissues revealed lower cellularity within the flexor digitorum epitendon but higher numbers of CD68+ macrophages within and extraneural fibrosis around median nerves in 10-wk HRHF+TM than 10-wk HRHF rats. CONCLUSIONS Treadmill running was associated with lower systemic inflammation and moderate tendinosis, yet higher median nerve inflammation/fibrosis and worse task performance and sensorimotor behaviors. Continued loading of the injured tissues in addition to stress-related factors associated with forced running/exercise likely contributed to our findings.
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Affiliation(s)
- Tianqi Tenchi Gao Smith
- Department of Industrial and Systems Engineering, Auburn University, 3323 Shelby Engineering Center, Auburn, AL 36849 USA
- Department of Systems Science and Industrial Engineering, SUNY – Binghamton, Vestal, NY USA
| | - Ann E. Barr-Gillespie
- College of Health Professions, Pacific University, 190 S.E. 8th Avenue, Suite 230, Hillsboro, OR 97123 USA
| | - David M. Klyne
- Department of Anatomy and Cell Biology, Temple University Medical School, 3500 North Broad Street, Philadelphia, PA 19140 USA
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4072 Australia
| | - Michelle Y. Harris
- Department of Anatomy and Cell Biology, Temple University Medical School, 3500 North Broad Street, Philadelphia, PA 19140 USA
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Temple University Medical School, 3500 North Broad Street, Philadelphia, PA 19140 USA
| | | | - Geneva E. Cruz
- Department of Anatomy and Cell Biology, Temple University Medical School, 3500 North Broad Street, Philadelphia, PA 19140 USA
| | - Huaqing Zhao
- Department of Clinical Sciences, Temple University Medical School, 3440 North Broad Street, Philadelphia, PA 19140 USA
| | - Sean Gallagher
- Department of Industrial and Systems Engineering, Auburn University, 3323 Shelby Engineering Center, Auburn, AL 36849 USA
| | - Mary F. Barbe
- Department of Anatomy and Cell Biology, Temple University Medical School, 3500 North Broad Street, Philadelphia, PA 19140 USA
- Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, Philadelphia, PA 19140 USA
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Davis JE, Ward RJ, MacKay JW, Lu B, Price LL, McAlindon TE, Eaton CB, Barbe MF, Lo GH, Harkey MS, Driban JB. Effusion-synovitis and infrapatellar fat pad signal intensity alteration differentiate accelerated knee osteoarthritis. Rheumatology (Oxford) 2020; 58:418-426. [PMID: 30346594 DOI: 10.1093/rheumatology/key305] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/04/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To determine whether greater effusion-synovitis volume and infrapatellar fat pad (IFP) signal intensity alteration differentiate incident accelerated knee OA (KOA) from a gradual onset of KOA or no KOA. METHODS We classified three sex-matched groups of participants in the Osteoarthritis Initiative who had a knee with no radiographic KOA at baseline (recruited 2004-06; Kellgren-Lawrence <2; n = 125/group): accelerated KOA: ⩾1 knee progressed to Kellgren-Lawrence grade ⩾3 within 48 months; common KOA: ⩾1 knee increased in radiographic scoring within 48 months; and no KOA: both knees had the same Kellgren-Lawrence grade at baseline and 48 months. The observation period included up to 2 years before and after when the group criteria were met. Two musculoskeletal radiologists reported presence of IFP signal intensity alteration and independent readers used a semi-automated method to segment effusion-synovitis volume. We used generalized linear mixed models with group and time as independent variables, as well as testing a group-by-time interaction. RESULTS Starting at 2 years before disease onset, adults who developed accelerated KOA had greater effusion-synovitis volume than their peers (accelerated KOA: 11.94 ± 0.90 cm3, KOA: 8.29 ± 1.19 cm3, no KOA: 8.14 ± 0.90 cm3) and have greater odds of having IFP signal intensity alteration than those with no KOA (odds ratio = 2.07, 95% CI = 1.14-3.78). Starting at 1 year prior to disease onset, those with accelerated KOA have greater than twice the odds of having IFP signal intensity alteration than those with common KOA. CONCLUSION People with IFP signal intensity alteration and/or greater effusion-synovitis volume in the absence of radiographic KOA may be at high risk for accelerated KOA, which may be characterized by local inflammation.
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Affiliation(s)
- Julie E Davis
- Division of Rheumatology, Tufts Medical Center, Boston, MA, USA
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, Boston, MA, USA
| | - James W MacKay
- Department of Radiology, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - Bing Lu
- Brigham & Women's Hospital and Harvard Medical School, Tufts University, Boston, MA, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University, Boston, MA, USA.,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | | | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, TX, USA.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
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47
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Deshmukh A, Brown L, Barbe MF, Braverman AS, Tiwari E, Hobson L, Shunmugam S, Armitage O, Hewage E, Ruggieri MR, Morizio J. Fully implantable neural recording and stimulation interfaces: Peripheral nerve interface applications. J Neurosci Methods 2019; 333:108562. [PMID: 31862376 DOI: 10.1016/j.jneumeth.2019.108562] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 04/29/2019] [Revised: 12/15/2019] [Accepted: 12/16/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Peripheral nerve interfacing has many applications ranging from investigation of neural signals to therapeutic intervention for varied diseases. This need has driven technological advancements in the field of electrode arrays and wireless systems for in-vivo electrophysiological experiments. Hence we present our fully implantable, programmable miniaturized wireless stimulation and recording devices. NEW METHOD The method consists of technological advancements enabling implantable wireless recording up to 128 channels with a sampling rate of 50Khz and stimulation up to ±4 mA from 15 independent channels. The novelty of the technique consists of induction charging cages which enables freely moving small animals to undergo continuous electrophysiological and behavioral studies without any impediments. The biocompatible hermetic packaging technology for implantable capsules ensures stability for long-term chronic studies. RESULTS Electromyographs wirelessly recorded from leg muscles of a macaque and a rat using implantable technology are presented during different behavioral task studies. The device's simultaneous stimulation and recording capabilities are reported when interfaced with the vagus and pelvic nerves. COMPARISON WITH EXISTING METHOD(S) The wireless interfacing technology has a large number of recording and stimulating channels without compromising on the signal quality due to sampling rates or stimulating current output capabilities. The induction charging technology along with transceiver and software interface allows experiments on multiple animals to be carried out simultaneously. CONCLUSIONS This customizable technology using wireless power transmission, reduced battery size, and miniaturized electronics has paved way for a robust, fully implantable, hermetic neural interface system enabling the study of bioelectronic medical therapies.
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Affiliation(s)
| | - Logan Brown
- Duke University, Viral Vector Core, Department of Neurobiology, Durham, NC, United States
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States
| | - Alan S Braverman
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States
| | - Ekta Tiwari
- Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, PA, United States
| | - Lucas Hobson
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States
| | | | | | | | - Michael R Ruggieri
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, United States
| | - James Morizio
- Triangle Biosystems, International, Durham, NC, United States.
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Barbe MF, Braverman AS, Salvadeo DM, Gomez-Amaya SM, Lamarre NS, Brown JM, De EJ, McIntyre BS, Day EP, Cruz GE, Frara N, Ruggieri MR. Bladder reinnervation by somatic nerve transfer to pelvic nerve vesical branches does not reinnervate the urethra. Neurourol Urodyn 2019; 39:181-189. [PMID: 31724210 PMCID: PMC6980288 DOI: 10.1002/nau.24217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 08/14/2019] [Accepted: 10/26/2019] [Indexed: 11/09/2022]
Abstract
AIMS We sought to determine whether somatic lumbar nerve transfer to the pelvic nerve's anterior vesical branch after sacral decentralization for detrusor muscle reinnervation also leads to aberrant innervation of the bladder outlet. METHODS Twenty-six female mongrel hound dogs underwent transection of sacral dorsal and ventral spinal roots (ie, sacral decentralization). Immediately afterward, 12 received genitofemoral nerve transfer and 9 received femoral nerve branch transfer. Five were left sacrally decentralized. Controls included 3 sham-operated and 6 unoperated. Eight months postsurgery, the bladder and urethra were injected with retrograde tracing dyes cystoscopically. After 3 weeks, detrusor and urethral pressures were assayed electrophysiologically immediately before euthanasia and characterization of neural reinnervation. RESULTS Electrical stimulation of spinal cords or roots did not lead to increased urethral sphincter pressure in nerve transfer animals, compared with decentralized animals, confirming a lack of functional reinnervation of the bladder outlet. In contrast, mean detrusor pressure increased after lumbar cord/root stimulation. In sham/unoperated animals, urethral and bladder dye injections resulted in labeled neurons in sacral level neural structures (dorsal root ganglia [DRG], sympathetic trunk ganglia [STG], and spinal cord ventral horns); labeling absent in decentralized animals. Urethral dye injections did not result in labeling in lumbar or sacral level neural structures in either nerve transfer group while bladder dye injections lead to increased labeled neurons in lumbar level DRG, STG, and ventral horns, compared to sacrally decentralized animals. CONCLUSION Pelvic nerve transfer for bladder reinnervation does not impact urethral sphincter innervation.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Alan S Braverman
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Danielle M Salvadeo
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Sandra M Gomez-Amaya
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Neil S Lamarre
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Justin M Brown
- Department of Neurosurgery, Neurosurgery Paralysis Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Elise J De
- Department of Urology, Massachusetts General Hospital, Boston, Massachusetts
| | - Brian S McIntyre
- Drexel University College of Medicine, Drexel University, Philadelphia, Pennsylvania
| | - Emily P Day
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Geneva E Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Nagat Frara
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Michael R Ruggieri
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Shriners Hospitals for Children, Philadelphia, Pennsylvania
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49
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Price LL, Harkey MS, Ward RJ, MacKay JW, Zhang M, Pang J, Davis JE, McAlindon TE, Lo GH, Amin M, Eaton CB, Lu B, Duryea J, Barbe MF, Driban JB. Role of Magnetic Resonance Imaging in Classifying Individuals Who Will Develop Accelerated Radiographic Knee Osteoarthritis. J Orthop Res 2019; 37:2420-2428. [PMID: 31297900 PMCID: PMC6778707 DOI: 10.1002/jor.24413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 03/19/2019] [Accepted: 07/05/2019] [Indexed: 02/04/2023]
Abstract
We assessed whether adding magnetic resonance (MR)-based features to a base model of clinically accessible participant characteristics (i.e., serological, radiographic, demographic, symptoms, and physical function) improved classification of adults who developed accelerated radiographic knee osteoarthritis (AKOA) or not over the subsequent 4 years. We conducted a case-control study using radiographs from baseline and the first four annual visits of the osteoarthritis initiative to define groups. Eligible individuals had no radiographic KOA in either knee at baseline (Kellgren-Lawrence [KL] grade <2). We classified two groups matched on sex (i) AKOA: at least one knee developed advanced-stage KOA (KL = 3 or 4) within 48 months and (ii) did not develop AKOA within 48 months. The MR-based features were assessments of bone, effusion/synovitis, tendons, ligaments, cartilage, and menisci. All characteristics and MR-based features were from the baseline visit. Classification and regression tree analyses were performed to determine classification rules and identify statistically important variables. The CART models with and without MR features each explained approximately 40% of the variability. Adding MR-based features to the model yielded modest improvements in specificity (0.90 vs. 0.82) but lower sensitivity (0.62 vs. 0.70) than the base model. There was consistent evidence that serum glucose, effusion-synovitis volume, and cruciate ligament degeneration are statistically important variables in classifying individuals who will develop AKOA. We found common MR-based measures failed to dramatically improve classification. These findings also show a complex interplay among participant characteristics and a need to identify novel characteristics to improve classification. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2420-2428, 2019.
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Affiliation(s)
- Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | - Matthew S. Harkey
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School,
Worcester, MA, USA
| | - Robert J. Ward
- Department of Radiology, Tufts Medical Center, Boston, MA, USA
| | - James W. MacKay
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ming Zhang
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Jincheng Pang
- Internal Medicine Research Unit, Pfizer, Cambridge, MA, USA
| | - Julie E. Davis
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Grace H. Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development Center of
Excellence Michael E. DeBakey VAMC, Houston, TX, USA,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Mamta Amin
- Temple University School of Medicine, Philadelphia, PA, USA
| | | | - Bing Lu
- Brigham & Women’s Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey Duryea
- Department of Radiology, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA,
USA
| | - Mary F. Barbe
- Temple University School of Medicine, Philadelphia, PA, USA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
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Harkey MS, Price LL, McAlindon TE, Davis JE, Stout AC, Lu B, Zhang M, Eaton CB, Barbe MF, Lo GH, Driban JB. Association Between Declining Walking Speed and Increasing Bone Marrow Lesion and Effusion Volume in Individuals with Accelerated Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2019; 71:259-270. [PMID: 29882630 DOI: 10.1002/acr.23613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/05/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To determine whether a decline in walking speed during the year prior to disease onset is associated with concurrent changes in cartilage, bone marrow lesions (BMLs), or effusion in adults who develop common knee osteoarthritis (OA), accelerated knee OA, or no knee OA. METHODS We identified 3 groups from the Osteoarthritis Initiative based on annual radiographs from baseline to 48 months: accelerated knee OA, common knee OA, and no knee OA. We used the cartilage damage index (CDI) to assess tibiofemoral cartilage damage and used a semiautomated program to measure BML and effusion volume. Walking speed was assessed as an individual's habitual walking speed over 20 meters. One-year change in walking speed and structural measures were calculated as index visit measurements minus measurements from the year prior visit. Logistic regression models were used to determine whether change in walking speed (exposure) was associated with change in each structural measure (outcome) for the overall group and then separately for the accelerated knee OA, common knee OA, and no knee OA groups. RESULTS Adults who slowed their walking speed were almost twice as likely to present with increased BML volume, with a significant association (odds ratio 3.04 [95% confidence interval (95% CI) 1.03-8.95]) among adults with accelerated knee OA. Adults with accelerated knee OA who slowed their walking speed were approximately 3.4 times (95% CI 1.10-10.49) more likely to present with increased effusion volume. Walking speed change was not significantly associated with CDI change. CONCLUSION A change in an easily assessable clinical examination (i.e., 20-meter walk test) was associated with concurrent worsening in BML and effusion volume in adults who developed accelerated knee OA.
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Affiliation(s)
| | - Lori Lyn Price
- Tufts Medical Center and Tufts University, Boston, Massachusetts
| | | | | | | | - Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ming Zhang
- Tufts Medical Center, Boston, Massachusetts
| | - Charles B Eaton
- Alpert Medical School of Brown University, Pawtucket, Rhode Island
| | - Mary F Barbe
- Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Grace H Lo
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston Texas
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