ABSTRACT
Astrocytes participate in the development and resolution of neuroinflammation in numerous ways, including the release of cytokines and growth factors. Among many, astrocytes release transforming growth factors beta (TGF-ß) TGF-ß1, TGF-ß2 and TGF-ß3. TGF-ß1 is the most studied isoform, while production and release of TGF-ß2 and TGF-ß3 by astrocytes have been poorly characterized. Here, we report that purified cultures of hippocampal astrocytes produce mainly TGF-ß3 followed by TGF-ß2 and TGF-ß1. Furthermore, astrocytes release principally the active form of TGF-ß3 over the other two. Changes in release of TGF-ß were sensitive to the calcineurin (CaN) inhibitor FK506. Starvation had no effect on TGF-ß1 and TGF-ß3 while TGF-ß2 mRNA was significantly up-regulated in a CaN-dependent manner. We further investigated production and release of astroglial TGF-ß in Alzheimer's disease-related conditions. Oligomeric ß-amyloid (Aß) down-regulated TGF-ß1, while up-regulating TGF-ß2 and TGF-ß3, in a CaN-dependent manner. In cultured hippocampal astrocytes from 3xTg-AD mice, TGF-ß2 and TGF-ß3, but not TGF-ß1, were up-regulated, and this was CaN-independent. In hippocampal tissues from symptomatic 3xTg-AD mice, TGF-ß2 was up-regulated with respect to control mice. Finally, treatment with recombinant TGF-ßs showed that TGF-ß2 and TGF-ß3 significantly reduced PSD95 protein in cultured hippocampal neurons, and this effect was paralleled by conditioned media from Aß-treated astrocytes or from astrocytes from 3xTg-AD mice. Taken together, our data suggest that TGF-ß2 and TGF-ß3 are produced by astrocytes in a CaN-dependent manner and should be investigated further in the context of astrocyte-mediated neurodegeneration.
Subject(s)
Astrocytes/metabolism , Neurons/metabolism , Transforming Growth Factor beta2/metabolism , Transforming Growth Factor beta3/metabolism , Alzheimer Disease/metabolism , Animals , Cells, Cultured , Culture Media, Conditioned/metabolism , Mice , Protein Isoforms/metabolism , RNA, Messenger/metabolismABSTRACT
We herein conducted a systematic review and meta-analysis of published studies to estimate diagnostic accuracy of NUDT15 gene polymorphisms for detection of thiopurine-induced leukopenia. Eligible studies were identified through a comprehensive search on PubMed, Web of Knowledge, Cochrane and OpenGrey datasets up to April 2018. The methodological quality of eligible studies was assessed using the QUADAS-2 criteria. The diagnostic odds ratio (DOR) was used as a single measure of diagnostic performance. Sixteen studies including a total of 3538 thiopurine-treated patients fulfilled inclusion criteria for the systematic review. Among these, 16 studies were available for the meta-analysis of rs116855232, 6 studies for rs186364861 and 5 studies for rs554405994 of NUDT15. A higher DOR was found for rs116855232 (8.44, 95% CI: 5.46-13.03), as compared to rs554405994 (4.336, 95% CI 2.924-6.429) or rs186364861 (2.742, 95% CI 1.453-5.175). Results of meta-regression analysis showed that incidence of leukopenia (relative DOR: 0.96; 95%CI: 0.93-1.00, p = 0.037) and leukopenia onset (late vs early leukopenia, relative DOR: 0.41, 95% CI 0.20-0.85, p = 0.0189) significantly influenced diagnostic accuracy of rs116855232. Subgroup analysis for rs186364861 and rs554405994 revealed a significant DOR for early-onset leukopenia (rs186364861: 4.04, 95% CI 1.78-9.20; rs554405994: 2.94, 95% CI 1.74-4.95), but not for late-onset leukopenia (rs186364861: 1.52, 95% CI 0.52-4.43; rs554405994: 2.02, 95% CI 0.93-4.40). The present meta-analysis points to rs116855232, rs554405994 and rs186364861 of NUDT15 as clinically relevant predictors of thiopurine-induced leukopenia. Nevertheless, prospective studies of genotype-guided dosing of thiopurines are warranted to prove clinical benefit and cost-effectiveness of pretreatment NUDT15 gene testing across different populations.
Subject(s)
Antineoplastic Agents/adverse effects , Azathioprine/adverse effects , Leukopenia/chemically induced , Leukopenia/genetics , Mercaptopurine/adverse effects , Pyrophosphatases/genetics , Thioguanine/adverse effects , Humans , Leukopenia/diagnosis , Polymorphism, GeneticABSTRACT
Astrocytes respond to neuronal activity by generating calcium signals which are implicated in the regulation of astroglial housekeeping functions and/or in modulation of synaptic transmission. We hypothesized that activity-induced calcium signals in astrocytes may activate calcineurin (CaN), a calcium/calmodulin-regulated protein phosphatase, implicated in neuropathology, but whose role in astroglial physiology remains unclear. We used a lentiviral vector expressing NFAT-EYFP (NY) fluorescent calcineurin sensor and a chemical protocol of LTP induction (cLTP) to show that, in mixed neuron-astrocytic hippocampal cultures, cLTP induced robust NY translocation into astrocyte nuclei and, hence, CaN activation. NY translocation was abolished by the CaN inhibitor FK506, and was not observed in pure astroglial cultures. Using Fura-2 single cell calcium imaging, we found sustained Ca2+ elevations in juxtaneuronal, but not distal, astrocytes. Pharmacological analysis revealed that both the Ca2+ signals and the nuclear NY translocation in astrocytes required NMDA and mGluR5 receptors and depended on extracellular Ca2+ entry via a store-operated mechanism. Our results provide a proof of principle that calcineurin in astrocytes may be activated in response to neuronal activity, thereby delineating a framework for investigating the role of astroglial CaN in the physiology of central nervous system.
Subject(s)
Astrocytes/metabolism , Calcineurin/metabolism , Hippocampus/cytology , Neuroglia/metabolism , Neurons/metabolism , Animals , Astrocytes/drug effects , Calcium/metabolism , Cell Nucleus/drug effects , Cell Nucleus/metabolism , Cells, Cultured , Cytosol/metabolism , Genetic Vectors/metabolism , Glycine/analogs & derivatives , Glycine/pharmacology , Long-Term Potentiation/drug effects , Mice, Inbred C57BL , Models, Biological , N-Methylaspartate/metabolism , Neuroglia/drug effects , Neurons/drug effects , Receptor, Metabotropic Glutamate 5/metabolism , Reproducibility of Results , Resorcinols/pharmacologyABSTRACT
In previous work, we demonstrated that NF-κB p50 acts as crucial regulator of adult hippocampal neural progenitor cells (ahNPC). Indeed, NF-κB p50 knockout (KO) mice are characterized by remarkably reduced hippocampal neurogenesis. As a follow up to that work, herein we show that when cultured in vitro, ahNPC from wild type (WT) and p50KO mice are not significantly different in their neurogenic potential. This observation prompted us to investigate cell-autonomous and noncell-autonomous consequences of p50 absence on neuronal fate specification of ahNPC. In particular, we focused our attention on astrocytes, known to provide soluble proneurogenic signals, and investigated the influence of WT and p50KO astrocyte conditioned media (ACM) on WT and p50KO ahNPC differentiation. Interestingly, while WT ACM promoted both neuronal and astroglial differentiations, p50KO ACM only supported astroglial differentiation of WT ahNPC. By using a LC-MS/MS approach, we identified some proteins, which are significantly upregulated in p50KO compared with WT astrocytes. Among them, lipocalin-2 (LCN-2) was recognized as a novel astroglial-derived signal regulating neuronal fate specification of ahNPC. Interestingly, LCN-2 proneurogenic effect was greatly reduced in p50KO NPC, where LCN-2 receptor gene expression appeared downregulated. In addition to that, we demonstrated p50KO NPC unresponsiveness to both neuronal and astroglial fate specification signals from WT and p50KO ACM, and we identified a reduced expression of α2δ1, a thrombospondin-1 receptor, as another phenotypic change occurring in ahNPC in the absence of p50. Altogether, our data suggest that dysregulated NPC-astrocyte communication may contribute to a reduced hippocampal neurogenesis in p50KO mice in vivo. GLIA 2016 GLIA 2017;65:169-181.
Subject(s)
Adult Stem Cells/metabolism , Astrocytes/metabolism , NF-kappa B p50 Subunit/genetics , Neural Stem Cells/metabolism , Animals , Cell Differentiation/physiology , Cell Proliferation/physiology , Hippocampus/metabolism , Mice, Inbred C57BL , Mice, Knockout , Neurogenesis/physiology , Neurons/metabolismABSTRACT
Current therapy of mood disorders has several limitations. Although a high number of drugs are clinically available, as of today, nearly two-thirds of individuals do not achieve full symptomatic remission after treatment with conventional antidepressants. Moreover, several weeks of drug treatment are usually required to obtain clinical effects, a limitation that has considerable clinical implications, ranging from high suicide risk to reduced compliance. The characteristic lag time in classical antidepressant effectiveness has given great impulse to the search for novel therapeutics with more rapid effects. l-acetylcarnitine (LAC), a small molecule of growing interest for its pharmacological properties, is currently marketed for treatment of neuropathic pain. Recent preclinical and clinical data suggested that LAC may exert antidepressant effects with a more rapid onset than conventional drugs. Herein, we review data supporting LAC antidepressant activity and its distinctive mechanisms of action compared with monoaminergic antidepressants. Furthermore, we discuss the unique pharmacological properties of LAC that allow us to look at this molecule as representative of next generation antidepressants with a safe profile.
Subject(s)
Acetylcarnitine/therapeutic use , Antidepressive Agents/therapeutic use , Mood Disorders/drug therapy , Acetylcarnitine/pharmacology , Analgesics/pharmacology , Analgesics/therapeutic use , Animals , Antidepressive Agents/pharmacology , Chronic Pain/drug therapy , Disease Models, Animal , Humans , Mice , RatsABSTRACT
We aimed at validating the role of genetic variants identified by a recent genome-wide association study (GWAS) as determinants of chronic oxaliplatin-induced peripheral neurotoxicity (OXAIPN). Eight polymorphisms (rs10486003, rs2338, rs843748, rs797519, rs4936453, rs12023000, rs17140129, and rs6924717) were genotyped in a total of 150 colorectal cancer patients of Caucasian origin receiving oxaliplatin-based chemotherapy. The severity grade of chronic OXAIPN was assessed by NCI-CTC criteria and the clinical version of the Total Neuropathy Score(©) (TNSc(©) ). None of the polymorphisms investigated was found associated with grade ≥ 2 chronic OXAIPN (NCI-CTC criteria), while a nominal association emerged for ACYP2 rs843748 when using the TNSc(©) scale (dominant model: odds ratio [OR]: 0.27, 95% confidence interval [CI]: 0.10-0.75, P = 0.008). In the combined analysis of this results with data of the two previously published studies which assessed chronic OXAIPN by NCI-CTC criteria, evidence suggestive of association with chronic OXAIPN (NCI-CTC criteria) was found for ACYP2 rs843748 (dominant model: OR: 2.40, 95%CI: 1.40-5.24, P = 0.027), which, however, did not remain significant after correction for multiple testing (threshold P-value <0.00625). These findings suggest a minor role of the single nucleotide polymorphisms (SNPs) investigated as genetic determinants of chronic OXAIPN. These results also highlight the importance of replication studies with meta-analysis for validation of GWAS findings.
Subject(s)
Acid Anhydride Hydrolases/genetics , Antineoplastic Agents/adverse effects , Organoplatinum Compounds/adverse effects , Peripheral Nervous System Diseases/chemically induced , Peripheral Nervous System Diseases/genetics , Polymorphism, Single Nucleotide/genetics , Adult , Aged , Aged, 80 and over , Colorectal Neoplasms/drug therapy , Female , Genome-Wide Association Study , Genotype , Humans , Male , Middle Aged , Oxaliplatin , AcylphosphataseABSTRACT
Opiates were the first drugs shown to negatively impact neurogenesis in the adult mammalian hippocampus. Literature data also suggest that norepinephrine is a positive modulator of hippocampal neurogenesis in vitro and in vivo. On the basis of these observations, we investigated whether tapentadol, a novel central analgesic combining µ-opioid receptor (MOR) agonism with norepinephrine reuptake inhibition (NRI), may produce less inhibition of hippocampal neurogenesis compared with morphine. When tested in vitro, morphine inhibited neuronal differentiation, neurite outgrowth, and survival of adult mouse hippocampal neural progenitors and their progeny, via MOR interaction. By contrast, tapentadol was devoid of these adverse effects on cell survival and reduced neurite outgrowth and the number of newly generated neurons only at nanomolar concentrations where the MOR component is predominant. On the contrary, at higher (micromolar) concentrations, tapentadol elicited proneurogenic and antiapoptotic effects via activation of ß2 and α2 adrenergic receptors, respectively. Altogether, these data suggest that the noradrenergic component in tapentadol has the potential to counteract the adverse MOR-mediated effects on hippocampal neurogenesis. As a proof of concept, we showed that reboxetine, an NRI antidepressant, counteracted both antineurogenic and apoptotic effects of morphine in vitro. In line with these observations, chronic tapentadol treatment did not negatively affect hippocampal neurogenesis in vivo. In light of the increasing long-term use of opiates in chronic pain, in principle, the tapentadol combined mechanism of action may result in less or no reduction in adult neurogenesis compared with classic opiates.
Subject(s)
Adult Stem Cells/drug effects , Neurogenesis/drug effects , Norepinephrine/antagonists & inhibitors , Phenols/pharmacology , Receptors, Opioid, mu/agonists , Adult Stem Cells/physiology , Animals , Cell Differentiation/drug effects , Cell Differentiation/physiology , Cells, Cultured , Dose-Response Relationship, Drug , Hippocampus/cytology , Hippocampus/drug effects , Hippocampus/physiology , Male , Mice , Neurogenesis/physiology , Norepinephrine/physiology , Random Allocation , Receptors, Opioid, mu/physiology , TapentadolABSTRACT
PURPOSE: No information is currently available on genetic determinants of short-term response to drug withdrawal in medication overuse headache (MOH). In the present study, we aimed to evaluate the role of 14 polymorphisms in 8 candidate genes potentially relevant for drug addiction (OPRM1, DRD2, DBH, COMT, BDNF, SLC6A4, 5HT2A, and SLC1A2) as predictors for detoxification outcome of MOH patients at 2 months of follow-up. METHODS: Genotyping was conducted by PCR, PCR-RFLP analysis, or real-time PCR allelic discrimination assay on genomic DNA extracted from peripheral blood. The association between gene variants and risk of unsuccessful detoxification was evaluated by univariate and multivariate logistic regression analyses. RESULTS: One hundred and eight MOH patients with effective drug withdrawal therapy and 65 MOH patients with unsuccessful detoxification were available for the analysis. In the multivariable logistic regression analysis, triptan overuse (odds ratio (OR) 0.271, 95% confidence interval (CI) 0.083-0.890, P = 0.031) and TT genotype carriage of DRD2 NcoI (OR 0.115, 95% CI 0.014-0.982, P = 0.048) emerged as independent predictors for unsuccessful detoxification. In addition, carriers of at least four of the six top-ranked gene variants (P < 0.10) were found at higher odds for unsuccessful detoxification than patients with ≤3 high-risk genotypes (OR 3.40, 95% CI 1.65-7.01, P = 0.001). CONCLUSION: This exploratory study suggests that DRD2 NcoI may be a genetic determinant of detoxification outcome in MOH patients. Our findings also show that an approach based on the combination of multiple genetic markers could be clinically useful for identification of MOH patients at higher risk for unsuccessful detoxification.
Subject(s)
Analgesics/adverse effects , Headache Disorders, Secondary/genetics , Receptors, Dopamine D2/genetics , Substance Withdrawal Syndrome/genetics , Adult , Analgesics/administration & dosage , Female , Follow-Up Studies , Genetic Variation , Genotype , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Polymerase Chain Reaction , Polymorphism, Genetic , Polymorphism, Restriction Fragment Length , Real-Time Polymerase Chain Reaction , Retrospective StudiesABSTRACT
The present study was designed to replicate previous findings reporting a significant association between the rs548294 polymorphism at the glutamate receptor subunit GluR1 gene (GRIA1) and migraine without aura, either as a single marker or in haplotype combination with rs2195450. In addition, the role of GRIA1 polymorphisms and haplotypes was evaluated in migraine patients without aura as predictive factors for consistency in headache response to triptans. Analysis of rs548294 and rs2195450 polymorphisms of GRIA1 was conducted by Real-time PCR allelic discrimination assay in 186 migraine patients without aura and 312 healthy controls, respectively. In the logistic regression analysis adjusted for gender and age, genotype and haplotype frequencies for the two polymorphisms did not significantly differ between migraine patients without aura and controls. In addition, no evidence of association was found between GRIA1 polymorphisms/haplotypes and consistent response to triptans. This study failed to replicate previously reported association between GRIA1 rs548294 and migraine without aura, either as single marker or when analyzed in haplotype combination with rs2195450. In addition, no evidence was found for a relevant role of GRIA1 polymorphisms and haplotypes as modulating factors of headache response to triptans.
Subject(s)
Migraine without Aura/drug therapy , Migraine without Aura/genetics , Polymorphism, Single Nucleotide/genetics , Receptors, AMPA/genetics , Tryptamines/therapeutic use , Adult , Aged , Female , Gene Frequency , Genetic Association Studies , Genetic Predisposition to Disease , Genotype , Humans , Logistic Models , Male , Middle AgedABSTRACT
The amyloid hypothesis of Alzheimer's disease (AD) suggests that soluble amyloid ß (Aß) is an initiator of a cascade of events eventually leading to neurodegeneration. Recently, we reported that Aß deranged Ca(2+) homeostasis specifically in hippocampal astrocytes by targeting key elements of Ca(2+) signaling, such as mGluR5 and IP3 R1. In the present study, we dissect a cascade of signaling events by which Aß deregulates glial Ca(2+) : (i) 100 nM Aß leads to an increase in cytosolic calcium after 4-6 h of treatment; (ii) mGluR5 is increased after 24 h of treatment; (iii) this increase is blocked by inhibitors of calcineurin (CaN) and NF-kB. Furthermore, we show that Aß treatment of glial cells leads to de-phosphorylation of Bcl10 and an increased CaN-Bcl10 interaction. Last, mGluR5 staining is augmented in hippocampal astrocytes of AD patients in proximity of Aß plaques and co-localizes with nuclear accumulation of the p65 NF-kB subunit and increased staining of CaNAα. Taken together our data suggest that nanomolar [Aß] deregulates Ca(2+) homeostasis via CaN and its downstream target NF-kB, possibly via the cross-talk of Bcl10 in hippocampal astrocytes.
Subject(s)
Amyloid beta-Peptides/pharmacology , Astrocytes/drug effects , Calcineurin/metabolism , Calcium Signaling/drug effects , NF-kappa B/metabolism , Peptide Fragments/pharmacology , Receptor, Metabotropic Glutamate 5/metabolism , Adaptor Proteins, Signal Transducing/metabolism , Aged , Aged, 80 and over , Alzheimer Disease/pathology , Animals , Animals, Newborn , B-Cell CLL-Lymphoma 10 Protein , Boron Compounds/pharmacology , Calcium/metabolism , Calcium Signaling/physiology , Cells, Cultured , Chelating Agents/pharmacology , Egtazic Acid/analogs & derivatives , Egtazic Acid/pharmacology , Enzyme Inhibitors/pharmacology , Female , Hippocampus/cytology , Hippocampus/metabolism , Humans , Male , Neoplasm Proteins/metabolism , Nucleocytoplasmic Transport Proteins/metabolism , Rats , Receptor, Metabotropic Glutamate 5/genetics , Up-Regulation/drug effectsABSTRACT
The research of estrogen receptor (ER) ligands has benefited in the last decade from the implementation of combinatorial chemistry. The general pharmacophore has been identified and subsequently a multitude of compounds have been synthesized. Surprisingly, up to now simple amides have not been taken into consideration. Here we show that amides resulting from the condensation of hydroxybenzoic acids with aminophenols result in compounds retaining the pharmacophore structure of an ER ligand with a clear estrogenic activity.
Subject(s)
Benzamides/chemistry , Chemistry Techniques, Synthetic/methods , Receptors, Estrogen/agonists , Aminophenols/chemistry , Cell Line , Drug Evaluation, Preclinical/methods , Humans , Hydroxybenzoates/chemistry , Small Molecule Libraries , Structure-Activity RelationshipABSTRACT
Currently, little is known about the impact of aging on astrocytes in substantia nigra pars compacta (SNpc), where dopaminergic neurons degenerate both in physiological aging and in Parkinson's disease, an age-related neurodegenerative disorder. We performed a morphometric analysis of GFAP+ astrocytes in SNpc and, for comparison, in the pars reticulata (SNpr) of young (4-6 months), middle-aged (14-17 months) and old (20-24 months) C57BL/6J male mice. We demonstrated an age-dependent increase of structural complexity only in astrocytes localized in SNpc, and not in SNpr. Astrocytic structural remodelling was not accompanied by changes in GFAP expression, while GFAP increased in SNpr of old compared to young mice. In parallel, transcript levels of selected astrocyte-enriched genes were evaluated. With aging, decreased GLT1 expression occurred only in SNpc, while xCT transcript increased both in SNpc and SNpr, suggesting a potential loss of homeostatic control of extracellular glutamate only in the subregion where age-dependent neurodegeneration occurs. Altogether, our results support an heterogenous morphological and biomolecular response to aging of GFAP+ astrocytes in SNpc and SNpr.
Subject(s)
Pars Compacta , Pars Reticulata , Mice , Male , Animals , Substantia Nigra/metabolism , Astrocytes/metabolism , Mice, Inbred C57BL , Aging/geneticsABSTRACT
Introduction: CAR T-cell therapy has emerged as a promising new immuno-oncology treatment that engages the patient's immune system to fight certain hematological malignancies, including diffuse large B-cell lymphoma (DLBCL). In the European Union (EU), CAR T-cell therapies have been approved for relapsed/refractory (R/R) DLBCL patients since 2018, but patient access is often still limited or delayed. This paper is aimed at discussing challenges to access and possible solutions in the largest four EU countries. Methods: The analysis relied on literature review, market data collection, since homogeneous data coming from registries were not available, and discussion with experts coming from all four countries. Results: We calculated that in 2020, between 58% and 83% of R/R DLBCL patients (EMA approved label population) or between 29% and 71% of the estimated medically eligible R/R DLBCL patients, were not treated with a licensed CAR T-cell therapy. Common challenges along the patient journey that may result in limited access or delays to CAR T-cell therapy were identified. These include timely identification and referral of eligible patients, pre-treatment funding approval by authorities and payers, and resource needs at CAR T-cell centers. Discussion: These challenges, existing best practices and recommended focus areas for health systems are discussed here, with the aim to inform necessary actions for overcoming patient access challenges for current CAR T-cell therapies as well as for future cell and gene therapies.
ABSTRACT
Although the role of adult hippocampal neurogenesis remains to be fully elucidated, several studies suggested that the process is involved in cognitive and emotional functions and is deregulated in various neuropsychiatric disorders, including major depression. Several psychoactive drugs, including antidepressants, can modulate adult neurogenesis. Here we show for the first time that the α2δ ligands gabapentin [1-(aminomethyl)cyclohexaneacetic acid] and pregabalin (PGB) [(S)-(+)-3-isobutyl-GABA or (S)-3-(aminomethyl)-5-methylhexanoic acid] can produce concentration-dependent increases in the numbers of newborn mature and immature neurons generated in vitro from adult hippocampal neural progenitor cells and, in parallel, a decrease in the number of undifferentiated precursor cells. These effects were confirmed in vivo, because significantly increased numbers of adult cell-generated neurons were observed in the hippocampal region of mice receiving prolonged treatment with PGB (10 mg/kg i.p. for 21 days), compared with vehicle-treated mice. We demonstrated that PGB administration prevented the appearance of depression-like behaviors induced by chronic restraint stress and, in parallel, promoted hippocampal neurogenesis in adult stressed mice. Finally, we provided data suggesting involvement of the α2δ1 subunit and the nuclear factor-κB signaling pathway in drug-mediated proneurogenic effects. The new pharmacological activities of α2δ ligands may help explain their therapeutic activity as supplemental therapy for major depression and depressive symptoms in post-traumatic stress disorder and generalized anxiety disorders. These data contribute to the identification of novel molecular pathways that may represent potential targets for pharmacological modulation in depression.
Subject(s)
Amines/metabolism , Calcium Channels/metabolism , Cell Differentiation/drug effects , Cyclohexanecarboxylic Acids/metabolism , Depression/prevention & control , Hippocampus/drug effects , Neurogenesis/drug effects , Stress, Psychological/drug therapy , gamma-Aminobutyric Acid/analogs & derivatives , Amines/pharmacology , Amines/therapeutic use , Animals , Cell Differentiation/physiology , Cyclohexanecarboxylic Acids/pharmacology , Cyclohexanecarboxylic Acids/therapeutic use , Depression/etiology , Depression/metabolism , Gabapentin , Hippocampus/cytology , Hippocampus/metabolism , Ligands , Male , Mice , Mice, Inbred C57BL , Neurogenesis/physiology , Pregabalin , Random Allocation , Restraint, Physical , Stress, Psychological/complications , Stress, Psychological/metabolism , gamma-Aminobutyric Acid/metabolism , gamma-Aminobutyric Acid/pharmacology , gamma-Aminobutyric Acid/therapeutic useABSTRACT
BACKGROUND: Although manic or hypomanic episodes define bipolar disorder (BD), most patients show a predominance of depressive symptomatology, often associated with delayed or disregarded BD diagnosis. The Hypomania Checklist-32 (HCL-32) has therefore been developed and tested internationally to facilitate BD recognition. SAMPLING AND METHODS: Five hundred seventy-one (563 eligible) patients diagnosed with a major depressive episode according to DSM-IV criteria were consecutively enrolled in a cross-sectional, multicenter, observational study (Come To Me). Lifetime manic or hypomanic features were assessed by the HCL-32, and severity of depressive and anxious symptomatology was assessed using the Zung's self-report questionnaires for depression and anxiety. RESULTS: Among the patients diagnosed with BD (n = 119), either type I or type II, the occurrence of (hypo)manic symptoms was significantly higher compared to major depressive disorder (MDD) symptoms according to HCL-32 total and subscale scores obtained using a score of 14, which ensured an optimal discrimination between BD and MDD with a sensitivity of 0.85 and a specificity of 0.78. CONCLUSIONS: Although some false positives might occur, the HCL-32 was confirmed to be a useful instrument in the detection of past hypomania in MDD patients, finally contributing to proper therapeutic choices.
Subject(s)
Bipolar Disorder/diagnosis , Depressive Disorder, Major/diagnosis , Adult , Aged , Checklist/statistics & numerical data , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Psychometrics/instrumentation , Sensitivity and SpecificityABSTRACT
The aim of this document is to protect public health through the diffusion on the national territory of appropriate pain treatment guidelines and the definition of a practical, diagnostic and therapeutic tool, which contributes to the diffusion of Law no. 38/2010, particularly through information and health professionals training. The lack of systematic pain evaluation and of an appropriate diagnostic-therapeutic approach are the main issues that make patients treatment remains very poor and inadequate. The 41% of patients with chronic pain states they have not received adequate pain control. The pain incidence in the Italian population is 21.7%, which corresponds to approximately 13 million inhabitants. Consequently, becomes significant identifying the tools and methods to help health professionals to recognize the pain nature, providing a global intervention, which includes the evaluation of patient and of the pathology's clinical characteristics, in order to guarantee an adequate therapeutic choice and a minimization of risks associated with therapy. International guidelines for pain management recommend pain evaluation according to its characteristics, in order to recognize the pain nature (nociceptive pain - inflammatory pain and structural mechanical pain -, neuropathic pain) and an adequate therapy, taking into account pain intensity (analgesics or their associations for management of non-inflammatory pain; for management of inflammatory pain, NSAIDs which may be associated with a central analgesic; drugs with action on ion channels and on neurotransmitters reuptake for management of neuropathic pain). The inadequate management of "pain's suffering patient" underlined the need for health professionals to dispose of a practical and effective tool, a "methods-guide". This tool wishes to become a valuable support for pain examination, from first diagnostic approach to appropriate prescription's dispensing. Authors hope to guide health professionals in the right direction to achieve the cultural change awaited from the application of Law no. 38/2010.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Pain Management , Pain/etiology , Humans , Italy , Pain/diagnosis , Pain/drug therapyABSTRACT
Adherence to treatment in psychiatric as in other chronic or recurrent conditions, is often suboptimal. A high proportion of relapses is due to non-adherence to prescribed treatment. Adherence to treatment is a potent predictor of effectiveness, both in clinical trials and cohort studies, therefore is a very relevant area where any improving tool is looked forward. Orally Disintegrating Tablets (ODT) were developed with the aim to improve patient's compliance due to their fast oral absorption. They are particularly useful in psychiatric patients who often simulate drug assumption or experience difficulties in taking pills. ODT formulations have been developed for many antypsychotics including olanzapine. The ODT formulations of olanzapine show to be significantly different one from the other in the dissolution time, thus having a potential impact on compliance. In this review, the results of different studies consistently highlight the positive risk/benefit profile, the contribution to patient's compliance and their preference while using ODT formulation of olanzapine produced throughout the ZYDIS technology (Velotab). Moreover, the differences between olanzapine ODT (Velotab) and the standard formulation of olanzapine and other antipsychotics are described focusing on in efficacy, safety, patient acceptance and health economic impact. The ODT formulation of olanzapine (Velotab) seems to ameliorate patient's adherence thus improving psychiatrist/caregiver/patient alliance.
Subject(s)
Antipsychotic Agents/administration & dosage , Benzodiazepines/administration & dosage , Medication Adherence , Administration, Oral , Antipsychotic Agents/pharmacokinetics , Benzodiazepines/pharmacokinetics , Clinical Trials as Topic , Humans , Olanzapine , Pharmaceutical Preparations , TabletsABSTRACT
Microglia, together with astrocytes and pericytes, cooperate to ensure blood-brain barrier (BBB) stability, modulating endothelial responses to inflammatory insults. Agonists of the sphingosine 1 phosphate (S1P) receptors, such as siponimod (BAF-312), are important pharmacological tools in multiple sclerosis and other inflammatory diseases. Modulation of S1P receptors may result in a reduced inflammatory response and increased BBB stability. An in vitro BBB model was reproduced using human-derived endothelial cells, astrocytes and microglia. Co-cultures were exposed to inflammatory cytokines (TNFα, 10 UI and IFNγ, 5 UI) in the presence of BAF-312 (100 nM), and the BBB properties and microglia role were evaluated. The drug facilitated microglial migration towards endothelial/astrocyte co-cultures, involving the activity of the metalloprotease 2 (MMP2). Microglia actively cooperated with astrocytes in the maintenance of endothelial barrier stability: in the triple co-culture, selective treatment of microglial cells with BAF-312 significantly prevented cytokines' effects on the endothelial barrier. In conclusion, BAF-312, modulating S1P receptors in microglia, may contribute to the reinforcement of the endothelial barrier at the BBB, suggesting an additional effect of the drug in the treatment of multiple sclerosis.
Subject(s)
Blood-Brain Barrier , Multiple Sclerosis , Azetidines , Benzyl Compounds , Cytokines , Endothelial Cells , Humans , Matrix Metalloproteinase 2 , Microglia , Multiple Sclerosis/drug therapy , Phosphates , Sphingosine/pharmacology , Tumor Necrosis Factor-alpha/pharmacologyABSTRACT
Calcium is a universal signal, and its capacity to encode intracellular messages via spatial, temporal and amplitude characteristics allows it to participate in most cellular events. In a specific context, calcium plays a pivotal role in migration, although its role has not been elucidated fully. By using immortalized gonadotropin-releasing hormone-secreting neurons (GN11), we have now investigated the role of TRPV4, a member of the vanilloid family of Ca(2+) channels, in neuronal migration. Our results show that TRPV4 channels are present and functional in GN11 cells and their localization is polarized and enriched in lamellipodial structures. TRPV4 activation leads to a retraction of the lamellipodia and to a decrease in migratory behaviour; moreover cells migrate slower and in a more random manner. We therefore provide evidence for a new regulation of gonadotropin-releasing hormone neurons and a new role for calcium at the leading edge of migratory cells.
Subject(s)
Cell Migration Inhibition/physiology , Neuroendocrine Cells/cytology , Neuroendocrine Cells/metabolism , TRPV Cation Channels/metabolism , Animals , Cell Line, Transformed , Cell Movement/physiology , Down-Regulation/physiology , Female , Mice , Mice, Inbred C57BL , Pregnancy , Rats , Rats, Sprague-DawleyABSTRACT
NAD is an essential coenzyme involved in numerous metabolic pathways. Its principal role is in redox reactions, and as such it is not heavily "consumed" by cells. Yet a number of signaling pathways that bring about its consumption have recently emerged. This has brought about the hypothesis that the enzymes that lead to its biosynthesis may be targets for anticancer therapy. In particular, inhibition of the enzyme nicotinamide phosphoribosyl transferase has been shown to be an effective treatment in a number of preclinical studies, and two lead molecules [N-[4-(1-benzoyl-4-piperidinyl)butyl]-3-(3-pyridinyl)-2E-propenamide (FK866) and (E)-1-[6-(4-chlorophenoxy)hexyl]-2-cyano-3-(pyridin-4-yl)guanidine (CHS 828)] have now entered preclinical trials. Yet, the full potential of these drugs is still unclear. In the present study we have investigated the role of FK866 in neuroblastoma cell lines. We now confirm that FK866 alone in neuroblastoma cells induces autophagy, and its effects are potentiated by chloroquine and antagonized by 3-methyladenine or by down-regulating autophagy-related protein 7. Autophagy, in this model, seems to be crucial for FK866-induced cell death. On the other hand, a striking potentiation of the effects of cisplatin and etoposide is given by cotreatment of cells with ineffective concentrations of FK866 (1 nM). The effect of etoposide on DNA damage is potentiated by FK866 treatment, whereas the effect of FK866 on cytosolic NAD depletion is potentiated by etoposide. Even more strikingly, cotreatment with etoposide/cisplatin and FK866 unmasks an effect on mitochondrial NAD depletion.