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1.
Eur Arch Psychiatry Clin Neurosci ; 273(6): 1209-1223, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36350376

RESUMO

Structural and functional abnormalities of the anterior cingulate cortex (ACC) have frequently been identified in schizophrenia. Alterations of von Economo neurons (VENs), a class of specialized projection neurons, have been found in different neuropsychiatric disorders and are also suspected in schizophrenia. To date, however, no definitive conclusions can be drawn about quantitative histologic changes in the ACC in schizophrenia because of a lack of rigorous, design-based stereologic studies. In the present study, the volume, total neuron number and total number of VENs in layer V of area 24 were determined in both hemispheres of postmortem brains from 12 male patients with schizophrenia and 11 age-matched male controls. To distinguish global from local effects, volume and total neuron number were also determined in the whole area 24 and whole cortical gray matter (CGM). Measurements were adjusted for hemisphere, age, postmortem interval and fixation time using an ANCOVA model. Compared to controls, patients with schizophrenia showed alterations, with lower mean total neuron number in CGM (- 14.9%, P = 0.007) and in layer V of area 24 (- 21.1%, P = 0.002), and lower mean total number of VENs (- 28.3%, P = 0.027). These data provide evidence for ACC involvement in the pathophysiology of schizophrenia, and complement neuroimaging findings of impaired ACC connectivity in schizophrenia. Furthermore, these results support the hypothesis that the clinical presentation of schizophrenia, particularly deficits in social cognition, is associated with pathology of VENs.


Assuntos
Giro do Cíngulo , Esquizofrenia , Humanos , Masculino , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/patologia , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/patologia , Estudos de Casos e Controles , Neurônios/patologia , Encéfalo/patologia
2.
Notf Rett Med ; 26(1): 4-14, 2023.
Artigo em Alemão | MEDLINE | ID: mdl-35287271

RESUMO

In the primary survey of resuscitation room management in critically ill nontrauma patients, the ABCDE (airway, breathing, circulation, disability, exposure) approach is used for immediate recognition and treatment of life-threatening conditions. "B problems" are associated with respiratory failure and require immediate treatment. The pathogenesis is diverse, especially in the nontrauma resuscitation room. Clinical examination, emergency sonography and knowledge of oxygenation techniques and ventilation are important components of diagnosis and therapy. Standardized procedures and regular training in the emergency room are of fundamental importance.

3.
Glia ; 70(6): 1170-1190, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35246882

RESUMO

Microglia are the resident innate immune cells of the central nervous system (CNS) parenchyma. To determine the impact of microglia on disease development and progression in neurodegenerative and neuroinflammatory diseases, it is essential to distinguish microglia from peripheral macrophages/monocytes, which are eventually equally recruited. It has been suggested that transmembrane protein 119 (TMEM119) serves as a reliable microglia marker that discriminates resident microglia from blood-derived macrophages in the human and murine brain. Here, we investigated the validity of TMEM119 as a microglia marker in four in vivo models (cuprizone intoxication, experimental autoimmune encephalomyelitis (EAE), permanent filament middle cerebral artery occlusion (fMCAo), and intracerebral 6-hydroxydopamine (6-OHDA) injections) as well as post mortem multiple sclerosis (MS) brain tissues. In all applied animal models and post mortem MS tissues, we found increased densities of ionized calcium-binding adapter molecule 1+ (IBA1+ ) cells, paralleled by a significant decrease in TMEM119 expression. In addition, other cell types in peripheral tissues (i.e., follicular dendritic cells and brown adipose tissue) were also found to express TMEM119. In summary, this study demonstrates that TMEM119 is not exclusively expressed by microglia nor does it label all microglia, especially under cellular stress conditions. Since novel transgenic lines have been developed to label microglia using the TMEM119 promotor, downregulation of TMEM119 expression might interfere with the results and should, thus, be considered when working with these transgenic mouse models.


Assuntos
Encefalomielite Autoimune Experimental , Microglia , Animais , Sistema Nervoso Central , Modelos Animais de Doenças , Encefalomielite Autoimune Experimental/induzido quimicamente , Encefalomielite Autoimune Experimental/metabolismo , Macrófagos/metabolismo , Camundongos , Camundongos Transgênicos , Microglia/metabolismo
4.
Wound Repair Regen ; 30(5): 595-607, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35691021

RESUMO

The clinical application of shockwave therapy has expanded to the treatment of pathological scars. The objective of this systematic review and meta-analysis is to quantitatively evaluate the efficacy and safety of extracorporeal shockwave therapy combined with comprehensive rehabilitation therapy on post-burn pathological scars compared to comprehensive rehabilitation therapy alone. The randomised controlled trials of extracorporeal shockwave therapy for post-burn pathological scars published in English and Chinese languages before October 2021 were included. The methodological quality and risk of bias of the selected articles were assessed with the Cochrane Collaboration's 'risk of bias' tool. RevMan software was applied for data analysis. This is the first systematic review and meta-analysis considering the effectiveness and safety of extracorporeal shockwave therapy on post-burn pathological scars. And nine randomised controlled trials involving 422 patients were included in this meta-analysis. The meta-analysis results showed that, compared with comprehensive rehabilitation therapy alone, extracorporeal shockwave therapy combined with comprehensive rehabilitation therapy was more effective in relieving pain (standardized mean difference [SMD] = -0.59, 95% confidence interval [CI]: [-0.87 to -0.31], p < 0.0001) and pruritus related to pathological scars (SMD = -0.94; 95% CI: [-1.25 to -0.63], p = 0.004), improving scars' appearance (SMD = -1.78, 95% CI: [-3.37 to -0.19], p = 0.03) and elasticity (SMD = 0.25, 95% CI: [0.29-0.21], p < 0.00001), decreasing scars thickness (SMD = -0.13, 95% CI: [-0.25 to -0.01], p = 0.04) and promoting the maturation status of scars (SMD = -2.86, 95% CI: [-3.96 to -1.76], p < 0.00001). There were no reported serious adverse events during and after extracorporeal shockwave therapy in the included studies. Available data preliminarily suggested that the combination of extracorporeal shockwave therapy and comprehensive rehabilitation therapy had better therapeutic effect on post-burn pathological scars than comprehensive rehabilitation therapy alone, without obvious side effects. However, further clinical well-controlled randomised controlled trials are needed. Systematic review registration ID: PROSPERO CRD42022297573.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Cicatriz/etiologia , Cicatriz/terapia , Tratamento por Ondas de Choque Extracorpóreas/métodos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Cicatrização
5.
Rehabilitation (Stuttg) ; 61(4): 230-239, 2022 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-35995053

RESUMO

The development and course of heart disease can be decisively influenced by psychological comorbidities (especially depression, anxiety disorder or post-traumatic stress disorder). An acute or chronic cardiological disease can in turn trigger or exacerbate mental disorders. These relationships are of considerable importance for cardiac rehabilitation, since psychological comorbidities often limit activity and participation more than organic heart disease. In monodisciplinary rehabilitation procedures (cardiological or psychosomatic), however, in the case of comorbidity, one clinical picture cannot be adequately treated and assessed by socio-medical experts. Interdisciplinary rehabilitation concepts are required here.In the first part of this article, the development and implementation of an interdisciplinary psychocardiological rehabilitation concept from the model phase to the establishment and expansion to other disciplines as well as the first research results are described. After initial positive evaluation data and good acceptance by the rehabilitants, the German Pension Insurance (DRV) is expanding the concept to other specialist areas under the name "dual rehabilitation" in order to promote interdisciplinary cooperation in the case of psychological and somatic comorbidity.In the second part of the work, the concept and first data from the controlled EvaPK study (Evaluation of the effectiveness of psychocardiological rehabilitation) funded by the DRV Bund are presented. These show that the comorbid patients are particularly stressed in terms of activity and participation (recorded in the Mini-ICF-APP-S) and that psychocardiological rehabilitation is also effective in this highly stressed group. However, the evaluations of the catamnesis and the cardiac function parameters are still missing.Both the pilot study and the first data from the EvaPK study show that psychocardiological rehabilitation meets the needs of comorbid patients and is well accepted by them. However, successful psychocardiological rehabilitation according to the concept presented here requires higher personnel costs and intensive, equal cooperation. Further research on this is necessary.


Assuntos
Cardiopatias , Pensões , Doença Crônica , Comorbidade , Alemanha/epidemiologia , Humanos , Projetos Piloto
6.
Medicina (Kaunas) ; 58(4)2022 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-35454318

RESUMO

Background and Objectives: This study tested the hypothesis that treatment of myofascial trigger points (MTrPs) in the upper trapezius muscle (UTM) with repeated injection of 1% lidocaine results in better alleviation of muscular stiffness and soreness as well as improved metabolism in the hypercontracted MTrP area than treatment with radial extracorporeal shock wave therapy (rESWT). Materials and Methods: A single-blinded, prospective, randomized controlled trial was conducted on patients suffering from MTrPs in the UTM. Thirty patients were treated with repeated injection of 2 mL of 1% lidocaine (three injections; one injection per week). Another 30 patients were treated with rESWT (three treatment sessions; one treatment session per week; 2000 radial extracorporeal shock waves per treatment session; positive energy flux density = 0.10 mJ/mm2). The primary outcome measure was pain severity using the VAS score. The secondary outcome measures included muscle elasticity index, pressure pain threshold and neck disability index. Evaluation was performed at baseline (T1), 15−30 min after the first treatment in order to register immediate treatment effects (T2), before the second treatment (i.e., one week after baseline) (T3) and one week after the third treatment (i.e., four weeks after baseline) (T4). Results: There were no statistically significant differences in the primary and secondary outcome measures between the patients in the lidocaine arm and the patients in the rESWT arm at T1 and T4. Within the arms, the mean differences of all outcomes were statistically significant (p < 0.001) when comparing the data obtained at T1 with the data obtained at T3 and the data obtained at T4. Conclusions: The results of this pilot study suggest that the use of rESWT in patients with MTrPs in the UTM is safe and leads to reduced pain and improved muscle elasticity, pressure pain threshold and neck disability index, without adverse effects. Larger trials are necessary to verify this. Clinicians should consider rESWT instead of injections of lidocaine in the treatment of MTrPs in the UTM.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Tratamento por Ondas de Choque Extracorpóreas/métodos , Humanos , Lidocaína/uso terapêutico , Projetos Piloto , Estudos Prospectivos , Resultado do Tratamento , Pontos-Gatilho
7.
Glia ; 69(4): 925-942, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33245604

RESUMO

The loss of myelinating oligodendrocytes is a key characteristic of many neurological diseases, including Multiple Sclerosis (MS). In progressive MS, where effective treatment options are limited, peripheral immune cells can be found at the site of demyelination and are suggested to play a functional role during disease progression. In this study, we hypothesize that metabolic oligodendrocyte injury, caused by feeding the copper chelator cuprizone, is a potent trigger for peripheral immune cell recruitment into the central nervous system (CNS). We used immunohistochemistry and flow cytometry to evaluate the composition, density, and activation status of infiltrating T lymphocytes in cuprizone-intoxicated mice and post-mortem progressive MS tissues. Our results demonstrate a predominance of CD8+ T cells along with high proliferation rates and cytotoxic granule expression, indicating an antigenic and pro-inflammatory milieu in the CNS of cuprizone-intoxicated mice. Numbers of recruited T cells and the composition of lymphocytic infiltrates in cuprizone-intoxicated mice were found to be comparable to those found in progressive MS lesions. Finally, amelioration of the cuprizone-induced pathology by treating mice with laquinimod significantly reduces the number of recruited T cells. Overall, this study provides strong evidence that toxic demyelination is a sufficient trigger for T cells to infiltrate the demyelinated CNS. Further investigation of the mode of action and functional consequence of T cell recruitment might offer promising new therapeutic approaches for progressive MS.


Assuntos
Cuprizona , Doenças Desmielinizantes , Animais , Linfócitos T CD8-Positivos , Cuprizona/toxicidade , Doenças Desmielinizantes/induzido quimicamente , Modelos Animais de Doenças , Camundongos , Camundongos Endogâmicos C57BL , Oligodendroglia
8.
Artif Organs ; 45(1): 68-78, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32750157

RESUMO

Transcatheter aortic valve replacement (TAVR) has emerged as a widely used therapy for aortic valve diseases. With TAVR, flow hemodynamics may change leading to areas of flow stagnation prone to thrombosis risk. The neo-sinus, created by introducing a prosthesis inside the diseased native valve, may prompt leaflet thrombosis due to areas of flow stasis. This study attempted to understand the effect of different prosthesis implant depths on the flow field within the neo- and native sinus and on the coronary perfusion. Experiments were performed inside an in vitro pulse duplicator producing physiological conditions according to ISO 5840-1:2015 standard. Flow fields were obtained for two cardiac outputs (CO) using particle image velocimetry (PIV). Washout was calculated as a measure of flow stasis. The two main results are: a lower implant position and a lower CO/frequency led to better native sinus washout, but worsened neo-sinus washout. In contrast, a higher implant position led to higher coronary flow (for higher CO/frequency). No significant effect of implant depth on coronary flow was observed for lower CO/frequency. In summary, a higher implant position using this self-expanding prosthesis is associated with reduced neo-sinus flow stasis. Hereby, washout of the native sinus, as well as coronary flow, are dependent on cardiac output.


Assuntos
Estenose da Valva Aórtica/cirurgia , Próteses Valvulares Cardíacas/efeitos adversos , Modelos Cardiovasculares , Desenho de Prótese , Substituição da Valva Aórtica Transcateter/efeitos adversos , Valva Aórtica/fisiopatologia , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/fisiopatologia , Velocidade do Fluxo Sanguíneo , Débito Cardíaco , Circulação Coronária , Humanos , Reologia , Substituição da Valva Aórtica Transcateter/métodos , Resultado do Tratamento
9.
Neurobiol Dis ; 134: 104675, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31731041

RESUMO

Accumulating evidence suggests that a degenerative processes within the brain can trigger the formation of new, focal inflammatory lesions in Multiple Sclerosis (MS). Here, we used a novel pre-clinical MS animal model to test whether the amelioration of degenerative brain events reduces the secondary recruitment of peripheral immune cells and, in consequence, inflammatory lesion development. Neural degeneration was induced by a 3 weeks cuprizone intoxication period. To mitigate the cuprizone-induced pathology, animals were treated with Laquinimod (25 mg/kg) during the cuprizone-intoxication period. At the beginning of week 6, encephalitogenic T cell development in peripheral lymphoid organs was induced by the immunization with myelin oligodendrocyte glycoprotein 35-55 peptide (i.e., Cup/EAE). Demyelination, axonal injury and reactive gliosis were determined by immunohistochemistry. Positron emission tomography (PET) imaging was performed to analyze glia activation in vivo. Vehicle-treated cuprizone mice displayed extensive callosal demyelination, glia activation and enhanced TSPO-ligand binding. This cuprizone-induced pathology was profoundly ameliorated in mice treated with Laquinimod. In vehicle-treated Cup/EAE mice, the cuprizone-induced pathology triggered massive peripheral immune cell recruitment into the forebrain, evidenced by multifocal perivascular inflammation, glia activation and neuro-axonal injury. While anti myelin oligodendrocyte glycoprotein 35-55 peptide immune responses were comparable in vehicle- and Laquinimod-treated Cup/EAE mice, the cuprizone-triggered immune cell recruitment was ameliorated by the Laquinimod treatment. This study clearly illustrates that amelioration of a primary brain-intrinsic degenerative process secondary halts peripheral immune cell recruitment and, in consequence, inflammatory lesion development. These findings have important consequences for the interpretation of the results of clinical studies.


Assuntos
Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Encefalite/imunologia , Encefalite/patologia , Esclerose Múltipla/imunologia , Esclerose Múltipla/patologia , Quinolonas/administração & dosagem , Animais , Cuprizona/administração & dosagem , Modelos Animais de Doenças , Encefalite/induzido quimicamente , Feminino , Gliose/induzido quimicamente , Gliose/patologia , Camundongos Endogâmicos C57BL
10.
Eur Arch Psychiatry Clin Neurosci ; 270(4): 413-424, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31552495

RESUMO

In schizophrenia, decreased hippocampal volume, reduced oligodendrocyte numbers in hippocampal cornu ammonis (CA) subregions and reduced neuron number in the dentate gyrus have been reported; reduced oligodendrocyte numbers were significantly related to cognitive deficits. The hippocampus is involved in cognitive functions and connected to the hypothalamus, anterior thalamus, and cingulate cortex, forming the Papez circuit, and to the mediodorsal thalamus. The relationship between the volume of these interconnected regions and oligodendrocyte and neuron numbers in schizophrenia is unknown. Therefore, we used stepwise logistic regression with subsequent multivariate stepwise linear regression and bivariate correlation to analyze oligodendrocyte and neuron numbers in the posterior hippocampal subregions CA1, CA2/3, CA4, dentate gyrus, and subiculum and volumes of the hippocampal CA region, cingulum, anterior and mediodorsal thalamus and hypothalamus in postmortem brains of 10 schizophrenia patients and 11 age- and gender-matched healthy controls. Stepwise logistic regression identified the following predictors for diagnosis, in order of inclusion: (1) oligodendrocyte number in CA4, (2) hypothalamus volume, (3) oligodendrocyte number in CA2/3, and (4) mediodorsal thalamus volume. Subsequent stepwise linear regression analyses identified the following predictors: (1) for oligodendrocyte number in CA4: (a) oligodendrocyte number in CA2/3, (b) diagnostic group, (c) hypothalamus volume, and (d) neurons in posterior subiculum; (2) for hypothalamus volume: (a) mediodorsal thalamus volume; (3) for oligodendrocyte number in CA2/3: oligodendrocyte number (a) in posterior CA4 and (b) in posterior subiculum; (4) for mediodorsal thalamus volume: volumes of (a) anterior thalamus and (b) hippocampal CA. In conclusion, we found a positive relationship between hippocampal oligodendrocyte number and the volume of the hypothalamus, a brain region connected to the hippocampus, which is important for cognition.


Assuntos
Hipocampo/patologia , Hipotálamo/patologia , Rede Nervosa/patologia , Oligodendroglia/citologia , Esquizofrenia/patologia , Tálamo/patologia , Adulto , Autopsia , Feminino , Hipocampo/citologia , Humanos , Hipotálamo/citologia , Masculino , Pessoa de Meia-Idade , Esquizofrenia/diagnóstico
11.
Psychother Psychosom Med Psychol ; 70(5): 190-196, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-31822029

RESUMO

An integrative patient-centered care concept is increasingly demanded for treatment of cardiac patients with concomitant mental disorders. The present study aims to investigate the effect of an integrated concept of psycho-cardiac care (PK) versus a monodisciplinary cardiac (K) or psychosomatic (PSO) care. Patients were examined at baseline (T0), at the time of discharge from the rehabilitation program (T1) and after 6 month (T2). General anxiety, depression (HADS), cardiac anxiety (HAF) and quality of life (SF-12) were evaluated using computer-assisted questionnaires. A total of 93 patients were included (PK: n=37, 55.5 years SD=8.0, 43.2% female; K: n=32, 53.6 years SD=8.2, 34.4% female; PSO: n=24, 55.5 years SD=5.0, 45.8% female). Patients in the PK-group showed a significant reduction of heart-focused anxiety (HAF fear p=0.004) and a significant improvement in quality of life (SF-12 physical p=0.034) during follow-up. In contrast, these parameters remained unchanged in patients in the K- and PSO-groups. The results indicate that cardiac-patients with concomitant mental disorders benefit only from an integrated psycho-cardiac treatment concept. The findings provide first data to psycho-cardiac treatment in stationary rehabilitation and support previous clinical experiences. But further research is required to show the advantage of a psycho-cardiac concept towards monodisciplinary care.


Assuntos
Cardiopatias/psicologia , Cardiopatias/reabilitação , Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Admissão do Paciente , Assistência Centrada no Paciente , Adulto , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/reabilitação , Terapia Combinada , Comorbidade , Transtorno Depressivo/psicologia , Transtorno Depressivo/reabilitação , Feminino , Seguimentos , Humanos , Medicina Integrativa , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Projetos Piloto , Transtornos Psicofisiológicos/psicologia , Transtornos Psicofisiológicos/reabilitação , Qualidade de Vida/psicologia , Resultado do Tratamento
12.
Glia ; 67(2): 263-276, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30511355

RESUMO

Oligodendrocytes are integral to efficient neuronal signaling. Loss of myelinating oligodendrocytes is a central feature of many neurological diseases, including multiple sclerosis (MS). The results of neuropathological studies suggest that oligodendrocytes react with differing sensitivity to toxic insults, with some cells dying early during lesion development and some cells being resistant for weeks. This proposed graded vulnerability has never been demonstrated but provides an attractive window for therapeutic interventions. Furthermore, the biochemical pathways associated with graded oligodendrocyte vulnerability have not been well explored. We used immunohistochemistry and serial block-face scanning electron microscopy (3D-SEM) to show that cuprizone-induced metabolic stress results in an "out of phase" degeneration of oligodendrocytes. Although expression induction of stress response transcription factors in oligodendrocytes occurs within days, subsequent oligodendrocyte apoptosis continues for weeks. In line with the idea of an out of phase degeneration of oligodendrocytes, detailed ultrastructural reconstructions of the axon-myelin unit demonstrate demyelination of single internodes. In parallel, genome wide array analyses revealed an active unfolded protein response early after initiation of the cuprizone intoxication. In addition to the cytoprotective pathways, the pro-apoptotic transcription factor DNA damage-inducible transcript 3 (DDIT3) was induced early in oligodendrocytes. In advanced lesions, DDIT3 was as well expressed by activated astrocytes. Toxin-induced oligodendrocyte apoptosis, demyelination, microgliosis, astrocytosis, and acute axonal damage were less intense in the Ddit3-null mutants. This study identifies DDIT3 as an important regulator of graded oligodendrocyte vulnerability in a MS animal model. Interference with this stress cascade might offer a promising therapeutic approach for demyelinating disorders.


Assuntos
Doenças Desmielinizantes/patologia , Regulação da Expressão Gênica/genética , Oligodendroglia/efeitos dos fármacos , Oligodendroglia/metabolismo , Fator de Transcrição CHOP/metabolismo , Animais , Animais Recém-Nascidos , Astrócitos/metabolismo , Astrócitos/patologia , Proteínas de Ligação ao Cálcio , Células Cultivadas , Corpo Caloso/metabolismo , Corpo Caloso/patologia , Corpo Caloso/ultraestrutura , Cuprizona/toxicidade , Doenças Desmielinizantes/induzido quimicamente , Modelos Animais de Doenças , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Estresse do Retículo Endoplasmático/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Proteínas dos Microfilamentos , Microscopia Eletrônica de Varredura , Inibidores da Monoaminoxidase/toxicidade , Proteínas do Tecido Nervoso/metabolismo , Oligodendroglia/ultraestrutura , Fator de Transcrição CHOP/genética
13.
Histochem Cell Biol ; 152(2): 119-131, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31016368

RESUMO

Oligodendrocyte degeneration is a hallmark of multiple sclerosis pathology, and protecting oligodendrocytes and myelin is likely to be of clinical relevance. Traditionally, oligodendrocyte and myelin degeneration are viewed as a direct consequence of an inflammatory attack, but metabolic defects might be equally important. Appropriate animal models to study the interplay of inflammation and metabolic injury are, therefore, needed. Here, we describe that in spite of its immunosuppressive effects, a continuous intoxication with cuprizone allows the induction of active experimental autoimmune encephalomyelitis (EAE) by myelin oligodendrocyte glycoprotein (MOG35-55) immunization. Although the clinical severity of EAE is ameliorated in cuprizone-intoxicated mice, the recruitment of granulocytes, and especially, CD3+ lymphocytes into the forebrain is triggered by the cuprizone insult. Such combined lesions are further characterized by oligodendrocyte apoptosis and microglia activation, closely mimicking type III multiple sclerosis lesions. In summary, we provide a protocol that allows to study the direct interplay of immune-mediated and metabolic oligodendrocyte injury and its consequences for the cerebral white and grey matters.


Assuntos
Cuprizona/toxicidade , Encefalomielite Autoimune Experimental/induzido quimicamente , Administração Oral , Animais , Apoptose/efeitos dos fármacos , Apoptose/imunologia , Cuprizona/administração & dosagem , Encefalomielite Autoimune Experimental/imunologia , Encefalomielite Autoimune Experimental/patologia , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Glicoproteína Mielina-Oligodendrócito/imunologia , Oligodendroglia/efeitos dos fármacos , Oligodendroglia/imunologia , Oligodendroglia/patologia , Fragmentos de Peptídeos/imunologia
14.
Brain ; 141(2): 535-549, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29253129

RESUMO

Tauopathies are neurodegenerative diseases characterized by the aggregation of tau protein. These pathologies exhibit a wide variety of clinical and anatomo-pathological presentations, which may result from different pathological mechanisms. Although tau inclusions are a common feature in all these diseases, recent evidence instead implicates small oligomeric aggregates as drivers of tau-induced toxicity. Hence in vivo model systems displaying either soluble or fibrillary forms of wild-type or mutant tau are needed to better identify their respective pathological pathways. Here we used adeno-associated viruses to mediate gene transfer of human tau to the rat brain to develop models of pure tauopathies. Two different constructs were used, each giving rise to a specific phenotype developing in less than 3 months. First, hTAUWT overexpression led to a strong hyperphosphorylation of the protein, which was associated with neurotoxicity in the absence of any significant aggregation. In sharp contrast, its co-expression with the pro-aggregation peptide TauRD-ΔK280 in the hTAUProAggr group strongly promoted its aggregation into Gallyas-positive neurofibrillary tangles, while preserving neuronal survival. Our results support the hypothesis that soluble tau species are key players of tau-induced neurodegeneration.


Assuntos
Emaranhados Neurofibrilares/metabolismo , Emaranhados Neurofibrilares/patologia , Tauopatias/metabolismo , Proteínas tau/metabolismo , Animais , Modelos Animais de Doenças , Proteínas de Fluorescência Verde/genética , Proteínas de Fluorescência Verde/metabolismo , Humanos , Masculino , RNA Mensageiro/metabolismo , Ratos , Ratos Wistar , Coloração pela Prata , Tauopatias/diagnóstico por imagem , Transdução Genética , Vimentina/metabolismo , Proteínas tau/genética
15.
Metab Brain Dis ; 34(2): 681-685, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30607821

RESUMO

In multiple sclerosis patients, chronic clinical deficits are known to result from axonal degeneration which is triggered by inadequate remyelination. The underlying molecular mechanisms of remyelination and its failure remain currently unclear. In vivo models, among the cuprizone model, are valuable tools to study underlying mechanisms of remyelination and its failure. Since complete and reproducible demyelination of the analyzed brain region is an indispensable prerequisite for efficient remyelination experiments, in this study we systematically addressed which part of the corpus callosum is reliably and consistently demyelinated after acute cuprizone-induced demyelination. Following a novel evaluation strategy, we can show that at the level of the rostral hippocampus, the most medial sectors of the corpus callosum (spanning 500 µm in the horizontal plane) are consistently demyelinated, whereas more lateral sectors show inconsistent and incomplete demyelination. These results precisely define a part of the corpus callosum which should be used as a region of interest during remyelination experiments.


Assuntos
Cuprizona/farmacologia , Doenças Desmielinizantes/induzido quimicamente , Bainha de Mielina/efeitos dos fármacos , Oligodendroglia/efeitos dos fármacos , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Encéfalo/patologia , Modelos Animais de Doenças , Masculino , Camundongos Endogâmicos C57BL , Proteína Básica da Mielina/metabolismo , Bainha de Mielina/metabolismo , Bainha de Mielina/patologia , Oligodendroglia/metabolismo
16.
Int Wound J ; 15(4): 590-599, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29675986

RESUMO

This study aimed to evaluate and compare the effects of extracorporeal shock wave therapy (ESWT) and conventional wound therapy (CWT) for acute and chronic soft tissue wounds. All English-language articles on ESWT for acute and chronic soft tissue wounds indexed in PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library, Physiotherapy Evidence Database, and HealthSTAR published prior to June 2017 were included, as well as corresponding articles cited in reference lists of related review articles. The methodological quality of the selected studies was assessed with the Cochrane Collaboration's "risk of bias" tool. Study design, subject demographics, wound aetiology, treatment protocols, assessment indexes, and follow-up duration were extracted. The fixed or random-effects model was used to calculate the pooled effect sizes according to studies' heterogeneity. Ten randomised controlled trials (RCTs) involving 473 patients were included in this systematic review and meta-analysis. The meta-analysis showed that ESWT statistically significantly increased the healing rate of acute and chronic soft tissue wounds 2.73-fold (odds ratio, OR = 3.73, 95% confidence interval, CI: 2.30-6.04, P < .001) and improved wound-healing area percentage by 30.45% (Standardized Mean Difference (SMD) = 30.45; 95% CI: 23.79-37.12; P < .001). ESWT reduced wound-healing time by 3 days (SMD = -2.86, 95% CI:-3.78 to -1.95, P < .001) for acute soft tissue wounds and 19 days (SMD = -19.11, 95% CI: -23.74 to -14.47, P < .001) for chronic soft tissue wounds and the risk of wound infection by 53% (OR = 0.47, 95% CI: 0.24-0.92, P = .03) when compared with CWT alone. Serious adverse effects were not reported. ESWT showed better therapeutic effects on acute and chronic soft tissue wounds compared with CWT alone. However, higher-quality and well-controlled RCTs are needed to further assess the role of ESWT for acute and chronic soft tissue wounds.


Assuntos
Doença Aguda/terapia , Doença Crônica/terapia , Tratamento por Ondas de Choque Extracorpóreas/métodos , Lesões dos Tecidos Moles/terapia , Cicatrização/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
17.
Glia ; 65(12): 1900-1913, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28836302

RESUMO

Brain-intrinsic degenerative cascades are a proposed factor driving inflammatory lesion formation in multiple sclerosis (MS) patients. We recently described a model combining noninflammatory cytodegeneration (via cuprizone) with the classic active experimental autoimmune encephalomyelitis (Cup/EAE model), which exhibits inflammatory forebrain lesions. Here, we describe the histopathological characteristics and progression of these Cup/EAE lesions. We show that inflammatory lesions develop at various topographical sites in the forebrain, including white matter tracts and cortical and subcortical grey matter areas. The lesions are characterized by focal demyelination, discontinuation of the perivascular glia limitans, focal axonal damage, and neutrophil granulocyte extravasation. Transgenic mice with enhanced green fluorescent protein-expressing microglia and red fluorescent protein-expressing monocytes reveal that both myeloid cell populations contribute to forebrain inflammatory infiltrates. EAE-triggered inflammatory cerebellar lesions were augmented in mice pre-intoxicated with cuprizone. Gene expression studies suggest roles of the chemokines Cxcl10, Ccl2, and Ccl3 in inflammatory lesion formation. Finally, follow-up experiments in Cup/EAE mice with chronic disease revealed that forebrain, but not spinal cord, lesions undergo spontaneous reorganization and repair. This study underpins the significance of brain-intrinsic degenerative cascades for immune cell recruitment and, in consequence, MS lesion formation.


Assuntos
Progressão da Doença , Encefalite/etiologia , Encefalite/patologia , Encefalomielite Autoimune Experimental/complicações , Sesquiterpenos/toxicidade , Precursor de Proteína beta-Amiloide/metabolismo , Animais , Modelos Animais de Doenças , Encefalite/genética , Encefalomielite Autoimune Experimental/imunologia , Feminino , Adjuvante de Freund/toxicidade , Expressão Gênica/efeitos dos fármacos , Expressão Gênica/genética , Proteína Glial Fibrilar Ácida/metabolismo , Molécula 1 de Adesão Intercelular/genética , Molécula 1 de Adesão Intercelular/metabolismo , Proteínas Luminescentes/genética , Proteínas Luminescentes/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Microglia/patologia , Microglia/ultraestrutura , Monócitos/patologia , Monócitos/ultraestrutura , Glicoproteína Mielina-Oligodendrócito/imunologia , Glicoproteína Mielina-Oligodendrócito/toxicidade , Fragmentos de Peptídeos/imunologia , Fragmentos de Peptídeos/toxicidade , Receptores CCR2/genética , Receptores CCR2/metabolismo , Receptores de Interleucina-8A/genética , Receptores de Interleucina-8A/metabolismo
18.
Biochim Biophys Acta Proteins Proteom ; 1865(6): 703-714, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28377147

RESUMO

BACKGROUND: Human hippocampal area Cornu Ammonis (CA) 1 is one of the first fields in the human telencephalon showing Alzheimer disease (AD)-specific neuropathological changes. In contrast, CA2 and CA3 are far later affected pointing to functional differences, which may be accompanied by differences in proteome endowment and changes. METHODS: Human pyramidal cell layers of hippocampal areas CA1, CA2, and CA3 from neurologically unaffected individuals were excised using laser microdissection. The proteome of each individual sample was analyzed and differentially abundant proteins were validated by immuno-histochemistry. RESULTS: Comparison of CA1 to CA2 revealed 223, CA1 to CA3 197 proteins with differential abundance, among them we found motor proteins MYO5A and DYNC1H1. Extension of the study to human hippocampus slices from AD patients revealed extensive depletion of these proteins in CA1 area compared to unaffected controls. CONCLUSION: High abundance of motor proteins in pyramidal cell layers CA1 compared to CA2 and CA3 points the specific vulnerability of this hippocampal area to transport-associated changes based on microtubule dysfunction and destabilization in AD.


Assuntos
Doença de Alzheimer/metabolismo , Hipocampo/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Proteômica , Idoso , Idoso de 80 Anos ou mais , Cromatografia Líquida , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Espectrometria de Massas em Tandem
19.
Nanomedicine ; 13(3): 1289-1300, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27884636

RESUMO

Targeted delivery of drugs across endothelial barriers remains a formidable challenge, especially in the case of the brain, where the blood-brain barrier severely limits entry of drugs into the central nervous system. Nanoparticle-mediated transport of peptide/protein-based drugs across endothelial barriers shows great potential as a therapeutic strategy in a wide variety of diseases. Functionalizing nanoparticles with peptides allows for more efficient targeting to specific organs. We have evaluated the hemocompatibilty, cytotoxicity, endothelial uptake, efficacy of delivery and safety of liposome, hyperbranched polyester, poly(glycidol) and acrylamide-based nanoparticles functionalized with peptides targeting brain endothelial receptors, in vitro and in vivo. We used an ELISA-based method for the detection of nanoparticles in biological fluids, investigating the blood clearance rate and in vivo biodistribution of labeled nanoparticles in the brain after intravenous injection in Wistar rats. Herein, we provide a detailed report of in vitro and in vivo observations.


Assuntos
Encéfalo/metabolismo , Sistemas de Liberação de Medicamentos , Lipossomos/metabolismo , Nanopartículas/metabolismo , Peptídeos/metabolismo , Sequência de Aminoácidos , Animais , Transporte Biológico , Barreira Hematoencefálica/metabolismo , Linhagem Celular , Portadores de Fármacos , Humanos , Lipossomos/análise , Lipossomos/farmacocinética , Masculino , Nanopartículas/análise , Peptídeos/análise , Peptídeos/farmacocinética , Ratos Wistar , Distribuição Tecidual
20.
Proc Natl Acad Sci U S A ; 111(9): 3274-9, 2014 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-24344285

RESUMO

Agricultural production is sensitive to weather and thus directly affected by climate change. Plausible estimates of these climate change impacts require combined use of climate, crop, and economic models. Results from previous studies vary substantially due to differences in models, scenarios, and data. This paper is part of a collective effort to systematically integrate these three types of models. We focus on the economic component of the assessment, investigating how nine global economic models of agriculture represent endogenous responses to seven standardized climate change scenarios produced by two climate and five crop models. These responses include adjustments in yields, area, consumption, and international trade. We apply biophysical shocks derived from the Intergovernmental Panel on Climate Change's representative concentration pathway with end-of-century radiative forcing of 8.5 W/m(2). The mean biophysical yield effect with no incremental CO2 fertilization is a 17% reduction globally by 2050 relative to a scenario with unchanging climate. Endogenous economic responses reduce yield loss to 11%, increase area of major crops by 11%, and reduce consumption by 3%. Agricultural production, cropland area, trade, and prices show the greatest degree of variability in response to climate change, and consumption the lowest. The sources of these differences include model structure and specification; in particular, model assumptions about ease of land use conversion, intensification, and trade. This study identifies where models disagree on the relative responses to climate shocks and highlights research activities needed to improve the representation of agricultural adaptation responses to climate change.


Assuntos
Agricultura/economia , Mudança Climática , Produtos Agrícolas/crescimento & desenvolvimento , Modelos Econômicos , Dióxido de Carbono/análise , Comércio/estatística & dados numéricos , Simulação por Computador , Previsões , Humanos
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