Profiling the neurovascular unit unveils detrimental effects of osteopontin on the blood-brain barrier in acute ischemic stroke

Blood-brain barrier (BBB) dysfunction, characterized by degradation of BBB junctional proteins and increased permeability, is a crucial pathophysiological feature of acute ischemic stroke. Dysregulation of multiple neurovascular unit (NVU) cell types is involved in BBB breakdown in ischemic stroke that may be further aggravated by reperfusion therapy. Therefore, therapeutic co-targeting of dysregulated NVU cell types in acute ischemic stroke constitutes a promising strategy to preserve BBB function and improve clinical outcome. However, methods for simultaneous isolation of multiple NVU cell types from the same diseased central nervous system (CNS) tissue, crucial for the identification of therapeutic targets in dysregulated NVU cells, are lacking. Here, we present the EPAM-ia method, that facilitates simultaneous isolation and analysis of the major NVU cell types (endothelial cells, pericytes, astrocytes and microglia) for the identification of therapeutic targets in dysregulated NVU cells to improve the BBB function. Applying this method, we obtained a high yield of pure NVU cells from murine ischemic brain tissue, and generated a valuable NVU transcriptome database ( https://bioinformatics.mpi-bn.mpg.de/SGD_Stroke ). Dissection of the NVU transcriptome revealed Spp1, encoding for osteopontin, to be highly upregulated in all NVU cells 24 h after ischemic stroke. Upregulation of osteopontin was confirmed in stroke patients by immunostaining, which was comparable with that in mice. Therapeutic targeting by subcutaneous injection of an anti-osteopontin antibody post-ischemic stroke in mice resulted in neutralization of osteopontin expression in the NVU cell types investigated. Apart from attenuated glial activation, osteopontin neutralization was associated with BBB preservation along with decreased brain edema and reduced risk for hemorrhagic transformation, resulting in improved neurological outcome and survival. This was supported by BBB-impairing effects of osteopontin in vitro. The clinical significance of these findings is that anti-osteopontin antibody therapy might augment current approved reperfusion therapies in acute ischemic stroke by minimizing deleterious effects of ischemia-induced BBB disruption.

Effect of Caffeine on Leg Muscle Pain during Cycling Exercise among Females

PURPOSE

This double-blind, within-subjects experiment examined the effects of ingesting two doses of caffeine on perceptions of leg muscle pain during moderate-intensity cycling exercise among females.

METHODS

Low-caffeine-consuming college-aged females (N = 11) ingested one of two doses of caffeine (5 or 10 mg x kg(-1) body weight) or a placebo and 1 h later completed 30 min of cycling on an ergometer at approximately 60% VO2peak. The conditions were completed in a counterbalanced order. Perceptions of leg muscle pain as well as power output, heart rate, systolic blood pressure, and oxygen consumption (VO2) were recorded during exercise.

RESULTS

Caffeine had a significant effect on leg muscle pain ratings [F (2,20) = 10.63, P = 0.001, n2 = 0.52]. The mean pain intensity scores during exercise after ingesting 10 mg x kg(-1) body weight caffeine, 5 mg x kg(-1) body weight caffeine, and placebo were 1.6 +/- 1.1, 1.3 +/- 0.7, and 2.4 +/- 1.1, respectively.

CONCLUSION

The results support that caffeine ingestion has a large effect on reducing leg muscle pain during exercise among females, but this effect does not appear to be dose-dependent between 5 and 10 mg.kg body weight caffeine.

The Pyloritek test and the CLO test: accuracy and incremental cost analysis

OBJECTIVE

The aim of this study was to compare the Pyloritek test (a 1-h rapid urease test) to the widely used CLO test.

METHODS

Seventy-one patients undergoing upper endoscopy were studied. All patients gave informed consent. A single antral biopsy specimen was obtained for the CLO test, and another was obtained for the Pyloritek test. Additional specimens were obtained for culture and processed in the event of a discordant result. The Pyloritek assay was read at 1 h by one observer. The CLO test was read at 24 h by an observer blinded to the results of the Pyloritek assay.

RESULTS

There were 18 males and 53 females, and the mean age (+/- SEM) was 53 +/- 17 yr. Thirty-two patients had a positive result on the CLO test, and 39 had a negative test result. Of the 32 patients with a positive CLO test result at 24 h, 31 were positive by the Pyloritek test at 1 h. All 39 patients with negative CLO test results had negative Pyloritek test results as well. There was one discordant result, a negative Pyloritek test result and a positive CLO test result. Culture demonstrated growth of Helicobacter pylori. The kappa value, a measure of the reliability of the Pyloritek test compared with the CLO test, was 0.972 (SE, 0.0284; 95% confidence interval, 0.925-1). Marginal cost-effectiveness analysis favored the Pyloritek test.

CONCLUSIONS

Results of the Pyloritek test at 1 h and the CLO test at 24 h are comparable in terms of detection of urease activity.