Microfilariae of Brugia malayi Inhibit the mTOR Pathway and Induce Autophagy in Human Dendritic Cells.

Immune modulation is a hallmark of patent filarial infection, including suppression of antigen-presenting cell function and downmodulation of filarial antigen-specific T cell responses. The mammalian target of rapamycin (mTOR) signaling pathway has been implicated in immune regulation, not only by suppressing T cell responses but also by regulating autophagy (through mTOR sensing amino acid availability). Global proteomic analysis (liquid chromatography-tandem mass spectrometry) of microfilaria (mf)-exposed monocyte-derived dendritic cells (DC) indicated that multiple components of the mTOR signaling pathway, including mTOR, eIF4A, and eIF4E, are downregulated by mf, suggesting that mf target this pathway for immune modulation in DC. Utilizing Western blot analysis, we demonstrate that similar to rapamycin (a known mTOR inhibitor), mf downregulate the phosphorylation of mTOR and its regulatory proteins, p70S6K1 and 4E-BP1, a process essential for DC protein synthesis. As active mTOR signaling regulates autophagy, we examined whether mf exposure alters autophagy-associated processes. mf-induced autophagy was reflected in marked upregulation of phosphorylated Beclin 1, known to play an important role in both autophagosome formation and autolysosome fusion, in induction of LC3II, a marker of autophagosome formation, and in induced degradation of p62, a ubiquitin-binding protein that aggregates protein in autophagosomes and is degraded upon autophagy that was reduced significantly by mf exposure and by rapamycin. Together, these results suggest that Brugia malayi mf employ mechanisms of metabolic modulation in DC to influence the regulation of the host immune response by downregulating mTOR signaling, resulting in increased autophagy. Whether this is a result of the parasite-secreted rapamycin homolog is currently under study.

Human monocyte subsets at homeostasis and their perturbation in numbers and function in filarial infection.

To characterize the function and plasticity of the major human circulating monocyte populations and to explore their role in systemic helminth infection, highly purified (by flow-based sorting) human monocyte subsets (CD14(hi)/CD16(neg) [classical], CD14(+ or hi)/CD16(med) [intermediate], and CD14(neg)/CD16(hi) [nonclassical]) were examined at homeostasis and after activation. Among these three subsets the classical and intermediate subsets were found to be the major sources of inflammatory and regulatory cytokines, as well as cytokines/chemokines associated with alternative activation, whereas the nonclassical and classical populations demonstrated an ability to transmigrate through endothelial monolayers. Moreover, it was primarily the classical subset that was the most efficient in promoting autologous T cell proliferation. The distribution of these subsets changed in the context of a systemic helminth (Wuchereria bancrofti) infection such that patent infection altered the frequency and distribution of these monocyte subsets with the nonclassical monocytes being expanded (almost 2-fold) in filarial infection. To understand further the filarial/monocyte interface, in vitro modeling demonstrated that the classical subset internalized filarial antigens more efficiently than the other two subsets but that the parasite-driven regulatory cytokine interleukin-10 was exclusively coming from the intermediate subset. Our data suggest that monocyte subsets have a differential function at homeostasis and in response to helminth parasites.

Orchestrating a New Path for Multiple Sclerosis: Achieving Physical, Cognitive, and Emotional Rehabilitation Goals Through Physical and Music Therapy.

BACKGROUND: Interdisciplinary therapies for the management of people with multiple sclerosis (MS) are underappreciated. There is an urgent need to introduce music therapy (MT), either alone or in combination with physical therapy (PT), into clinical practice to achieve synergy with disease-modifying therapies. A holistic approach to rehabilitation for people with MS may mitigate symptoms and reduce polypharmacy, potentially lowering health care costs. RESULTS: As MS progresses, patients experience a range of worsening symptoms, and many develop psychosocial comorbidities. As disease-modifying therapies delay disability progression, nonpharmacologic treatments become increasingly important. The main aim of PT is to improve or maintain patients' functional mobility, strength, and flexibility. Because it targets multiple functions, MT can help improve functional and psychosocial domains and may be a valuable intervention to help patients achieve the physical, cognitive, and emotional goals of PT. Exploratory studies showed that MT, alone or in combination with PT, can lead to functional improvements in mobility, balance, gait, and fatigue. Similar to PT, MT also has benefits in improving fine motor skills, cognition, learning, and memory and in providing emotional support. CONCLUSIONS: Both MT and PT have the potential to improve overall well-being and health-related quality of life in physically active patients with MS, and MT can provide added emotional support for those who are less able to engage in physical activity. However, MT is not typically a part of standard of care, and PT visits are limited. Nevertheless, interdisciplinary therapies should be incorporated into clinical practice.

NIH Music-Based Intervention Toolkit: Music-Based Interventions for Brain Disorders of Aging.

Music-based interventions (MBIs) show promise for managing symptoms of various brain disorders. To fully realize the potential of MBIs and dispel the outdated misconception that MBIs are rooted in soft science, the NIH is promoting rigorously designed, well-powered MBI clinical trials. The pressing need of guidelines for scientifically rigorous studies with enhanced data collection brought together the Renée Fleming Foundation, the Foundation for the NIH, the Trans-NIH Music and Health Working Group, and an interdisciplinary scientific expert panel to create the NIH MBI Toolkit for research on music and health across the lifespan. The Toolkit defines the building blocks of MBIs, including a consolidated set of common data elements for MBI protocols, and core datasets of outcome measures and biomarkers for brain disorders of aging that researchers may select for their studies. Utilization of the guiding principles in this Toolkit will be strongly recommended for NIH-funded studies of MBIs.

NIH/Kennedy Center Workshop on Music and the Brain: Finding Harmony.

The National Institutes of Health and John F. Kennedy Center for the Performing Arts convened a panel of experts to discuss the current state of research on music and the brain. The panel generated research recommendations to accelerate the study of music's effects on the brain and the implications for human health.

The use of therapeutic interchange for biologic therapies.

Therapeutic interchange is the practice of switching or dispensing drugs that are chemically distinct but therapeutically similar in terms of their efficacy, safety, and tolerability profiles. The stated goal of therapeutic interchange is to achieve an improved or neutral outcome with the new agent while reducing overall treatment costs. Until recently, most interchange programs have been limited to switches within drug classes, such as angiotensin-converting enzyme (ACE) inhibitors, proton pump inhibitors (PPIs), HMG-CoA reductase inhibitors (statins), and selective serotonin reuptake inhibitors (SSRIs), and generally to drugs that use the same routes of administration. Therapeutic interchange now is being applied to some biologic agents, such as those used to treat psoriasis and rheumatoid arthritis (RA). In some cases, these agents differ in structure and mode of administration. Patients who require a biologic agent are often difficult to manage, and the comorbidities that are prevalent in these patients further complicate management and agent selection. Population-based outcomes among various agents may not appear notably different, but because there is no a priori means to determine the effects of a given biologic agent on any individual patient, therapeutic interchange is inadvisable once a patient receiving RA or psoriasis therapy has been stabilized. However, if a biologic agent has been designated as preferred on a formulary, it is reasonable to initiate treatment with that agent in a patient who is naive to biologic therapy if that agent is not contraindicated. Respectful, two-way communication between health care professionals and managed care organizations (MCOs) will help ensure that a patient receives the appropriate therapy at the right time.

Influences of type of high school attended and current relationship status on life goal ratings of college women.

Scores on the Goals in Life Scale of 183 college women were compared based on type of high school attended, single-sex versus co-educational, and current relationship status, dating versus nondating. Type of high school alone did not influence any life goal, and those in dating relationships gave priority to relationships over life goals. Several significant interaction effects were present, however, as single-sex school attendees in dating relationships gave lower ratings to several life goals than did women in the other groups.

Identification of dopamine D2 receptors in gill of Crassostrea virginica.

The lateral epithelial cells of gill of Crassostrea virginica are innervated by dopamine and serotonin nerves that regulate the beating rate of their lateral cilia. Terminal release of dopamine slows down the beating rate of the cilia, while serotonin release increases the beating rate. Previously, we showed that the dopaminergic, but not the serotonergic, mechanism regulating the beating rate of the lateral cilia was disrupted by manganese treatments and that this disruption was occurring postsynaptically, at the level of the dopamine receptor or further downstream in the signal transduction pathway. In humans manganese toxicity causes Manganism, a neurological disorder with clinical symptoms similar to Parkinson s disease. In this study we utilized pharmacological agents and an immunohistofluorescence technique to characterize the dopamine receptor type present on the lateral ciliated cells of C. virginica gill. Agonists and antagonists to dopamine D1 or dopamine D2 receptors were applied to gill sections and beating rates of the lateral cilia were measured by stroboscopic microscopy. The D2 agonists and D2 antagonists were effective in mimicking or blocking, respectively, the inhibitory actions of dopamine on lateral cilia beating, while application of either D1 agonists or D1 antagonists had no significant effect. In other experiments we used an epilume fluorescence microscopic fitted with FITC filters to view gill sections treated with a primary antibody against D2 receptors and a FITC-linked secondary antibody. Control gill sections without primary antibody exposure were similarly treated and viewed. The D2 antibody treated sections showed bright fluorescent receptor-antibody complexes present at the lateral ciliated cells and other areas of gill, when compared to controls. The results of our immunofluorescence study identify the presence of D2-like receptors on the lateral ciliated cells of C. virginica gill and our pharmacological results indicate that D2-like receptors are the postsynaptic dopamine receptors involved in the cilio-inhibitory response of the lateral cilia. The results of this study, when combined with our previous work, further suggest that the mechanism of action that underlies the dopaminergic neurotoxicity of manganese in gill of C. virginica involves disruption of D2-like receptors. C. virginica continues to provide a simple yet good model with which to study the physiology of dopaminergic systems as well as the pharmacology of drugs affecting biogenic amines.