ABSTRACT
Prior exposure to microenvironmental signals could fundamentally change the response of macrophages to subsequent stimuli. It is believed that T helper-2 (Th2)-cell-type cytokine interleukin-4 (IL-4) and Toll-like receptor (TLR) ligand-activated transcriptional programs mutually antagonize each other, and no remarkable convergence has been identified between them. In contrast, here, we show that IL-4-polarized macrophages established a hyperinflammatory gene expression program upon lipopolysaccharide (LPS) exposure. This phenomenon, which we termed extended synergy, was supported by IL-4-directed epigenomic remodeling, LPS-activated NF-κB-p65 cistrome expansion, and increased enhancer activity. The EGR2 transcription factor contributed to the extended synergy in a macrophage-subtype-specific manner. Consequently, the previously alternatively polarized macrophages produced increased amounts of immune-modulatory factors both in vitro and in vivo in a murine Th2 cell-type airway inflammation model upon LPS exposure. Our findings establish that IL-4-induced epigenetic reprogramming is responsible for the development of inflammatory hyperresponsiveness to TLR activation and contributes to lung pathologies.
Subject(s)
Interleukin-4 , Lipopolysaccharides , Mice , Animals , Interleukin-4/metabolism , Lipopolysaccharides/metabolism , Ligands , Epigenomics , Macrophages/metabolism , Toll-Like Receptors/metabolism , Epigenesis, Genetic , NF-kappa B/metabolismABSTRACT
Cell cycle (CC) facilitates cell division via robust, cyclical gene expression. Protective immunity requires the expansion of pathogen-responsive cell types, but whether CC confers unique gene expression programs that direct the subsequent immunological response remains unclear. Here, we demonstrate that single macrophages (MFs) adopt different plasticity states in CC, which leads to heterogeneous cytokine-induced polarization, priming, and repolarization programs. Specifically, MF plasticity to interferon gamma (IFNG) is substantially reduced during S-G2/M, whereas interleukin 4 (IL-4) induces S-G2/M-biased gene expression, mediated by CC-biased enhancers. Additionally, IL-4 polarization shifts the CC-phase distribution of MFs toward the G2/M phase, providing a subpopulation-specific mechanism for IL-4-induced, dampened IFNG responsiveness. Finally, we demonstrate CC-dependent MF responses in murine and human disease settings in vivo, including Th2-driven airway inflammation and pulmonary fibrosis, where MFs express an S-G2/M-biased tissue remodeling gene program. Therefore, MF inflammatory and regenerative responses are gated by CC in a cyclical, phase-dependent manner.
Subject(s)
Chromatin , Interleukin-4 , Humans , Mice , Animals , Interleukin-4/genetics , Interleukin-4/pharmacology , Chromatin/genetics , Chromatin/metabolism , Macrophages/metabolism , Interferon-gamma/genetics , Interferon-gamma/pharmacology , Cell Cycle/genetics , Cell DivisionABSTRACT
INTRODUCTION/AIMS: Vaccination against coronavirus disease 2019 (COVID-19) is relatively safe in patients with idiopathic inflammatory myopathies (IIM); however, myositis flares following vaccination have been poorly studied. We aimed to evaluate the frequency, features, and outcomes of disease relapses in patients with IIM following COVID-19 vaccination. METHODS: A cohort of 176 IIM patients were interviewed after the third wave of the COVID-19 pandemic and followed prospectively. Relapses were determined using the disease state criteria and the outcome of the flares with myositis response criteria, calculating the total improvement score (TIS). RESULTS: A total of 146 (82.9%) patients received a vaccination, 17/146 (11.6%) patients had a relapse within 3 mo, and 13/146 (8.9%) patients within 1 mo. The relapse rate of unvaccinated patients was 3.3%. Three months after the post-vaccination relapses, 70.6% of the patients (12/17) achieved an improvement of disease activity (average TIS score: 30 ± 15.81; seven minor, five moderate, and zero major improvements). Six months after flares improvement was detected in 15/17(88.2%) of relapsed patients (average TIS score: 43.1 ± 19.53; 3 minimal, 8 moderate, and 4 major). Forward stepwise logistic regression analysis revealed that the active state of myositis at the time of injection (p < .0001; odds ratio, 33; confidence interval, 9-120) was significantly associated with the occurrence of a relapse. DISCUSSION: A minority of the vaccinated IIM patients had a confirmed disease flare after COVID-19 vaccination and the majority of the relapses improved after individualized treatment. An active disease state at the time of vaccination probably contributes to the increased risk of a post vaccination myositis flare.
Subject(s)
COVID-19 , Myositis , Humans , COVID-19 Vaccines/therapeutic use , Incidence , Pandemics , COVID-19/prevention & control , COVID-19/epidemiology , Myositis/epidemiology , Chronic Disease , Recurrence , VaccinationABSTRACT
OBJECTIVES: Pandemic caused by coronavirus disease (COVID-19) determines the life of clinicians and patients since 2 years. We have a lot of information about disease course, treatment and protection against virus, but less on the prognosis of infection in patients with idiopathic inflammatory myopathies (IIM). Also few data are available on triggered humoral response and side effects after vaccination. METHODS: Our goal was to assess by a retrospective cross-sectional study the above data in our cohort (176 IIM patients) by identifying COVID-19 positive patients and follow disease course. Incidence and complications of vaccination were determined by questionnaires. 101 patients volunteered for complex blood test. RESULTS: By June 1st, 2021 significantly higher incidence of COVID 19 infections (34.7%) were identified comparing to the national prevalence (8.2%). A third of these infections occurred asymptomatically or mild. Patients requiring hospitalisation had a significantly longer disease duration and a higher incidence of anti-Jo-1 antibody. All patients infected by COVID-19 became seropositive regardless the immunosuppressive therapy or symptoms severity. 54.3% of the patients received anti-COVID-19 vaccine. 72.3% of patients became seropositive after vaccination. Higher antibody titer against spike protein was detected after Pfizer-BioNTech vaccination compared to others. Patients receiving steroid therapy had decreased post-vaccination antibody response compared to those without steroid treatment. No major post-vaccination infection was observed. CONCLUSIONS: Based on our results, myositis may be associated with an increased risk of COVID-19 infection. Independent risk factor for hospitalisation are longer disease duration and anti-Jo1 positivity. Anti-SARS-CoV2 vaccines seem safe and tolerable and strongly recommended for that population.
Subject(s)
COVID-19 , Pandemics , Humans , Cross-Sectional Studies , Retrospective Studies , Disease Progression , SteroidsABSTRACT
Today, integration into automated systems has become a priority in the development of remote sensing sensors carried on drones. For this purpose, the primary task is to achieve real-time data processing. Increasing sensor resolution, fast data capture and the simultaneous use of multiple sensors is one direction of development. However, this poses challenges on the data processing side due to the increasing amount of data. Our study intends to investigate how the running time and accuracy of commonly used image classification algorithms evolve using Altum Micasense multispectral and thermal acquisition data with GSD = 2 cm spatial resolution. The running times were examined for two PC configurations, with a 4 GB and 8 GB DRAM capacity, respectively, as these parameters are closer to the memory of NRT microcomputers and laptops, which can be applied "out of the lab". During the accuracy assessment, we compared the accuracy %, the Kappa index value and the area ratio of correct pixels. According to our results, in the case of plant cover, the Spectral Angles Mapper (SAM) method achieved the best accuracy among the validated classification solutions. In contrast, the Minimum Distance (MD) method achieved the best accuracy on water surface. In terms of temporality, the best results were obtained with the individually constructed decision tree classification. Thus, it is worth developing these two directions into real-time data processing solutions.
Subject(s)
Algorithms , TelemetryABSTRACT
Controlling the balance of pro-inflammatory M1 versus anti-inflammatory M2 macrophages may have paramount therapeutic benefit in cardiovascular diseases, infections, cancer and chronic inflammation. The targeted depletion of different macrophage populations provides a therapeutic option to regulate macrophage-mediated functions. Macrophages are highly sensitive to necroptosis, a newly described regulated cell death mediated by receptor-interacting serine/threonine-protein kinase 1 (RIPK1), RIPK3 and mixed lineage kinase domain like pseudokinase. Antagonists of inhibitors of apoptosis proteins (SMAC mimetics) block RIPK1 ubiquitination, while TGF-activated kinase 1 (TAK1) inhibitors prevent the phosphorylation of RIPK1, resulting in increased necroptosis. We compared the sensitivity of monocyte-derived human M1 and M2 cells to various apoptotic and necroptotic signals. The two cell types were equally sensitive to all investigated stimuli, but TAK1 inhibitor induced more intense necroptosis in M2 cells. Consequently, the treatment of co-cultured M1 and M2 cells with TAK1 inhibitor shifted the balance of the two populations toward M1 dominance. Blockage of either Aurora Kinase A or glycogen synthase kinase 3ß, two newly described necroptosis inhibitors, increased the sensitivity of M1 cells to TAK1-inhibitor-induced cell death. Finally, we demonstrated that in vitro differentiated tumor-associated macrophages (TAM-like cells) were as highly sensitive to TAK1 inhibitor-induced necroptosis as M2 cells. Our results indicate that at least two different necroptotic pathways operate in macrophages and the targeted elimination of different macrophage populations by TAK1 inhibitor or SMAC mimetic may provide a therapeutic option to regulate the balance of inflammatory/anti-inflammatory macrophage functions.
Subject(s)
Lactones/pharmacology , MAP Kinase Kinase Kinases/antagonists & inhibitors , Macrophages/drug effects , Necroptosis/drug effects , Resorcinols/pharmacology , Humans , Macrophages/metabolismABSTRACT
Polyelectrolyte (PE)/surfactant (S) mixtures play a distinguished role in the efficacy of shampoos and toiletries primarily due to the deposition of PE/S precipitates on the hair surface upon dilution of the formulations. The classical interpretation of this phenomenon is a simple composition change during which the system enters the two-phase region. Recent studies, however, indicated that the phase properties of PE/S mixtures could be strongly affected by the applied solution preparation protocols. In the present work, we aimed at studying the impact of dilution on the nonequilibrium aggregate formation in the sodium poly(styrenesulfonate) (NaPSS)/dodecyltrimethylammonium bromide (DTAB)/NaCl system. Mixtures prepared with hundredfold dilution of concentrated NaPSS/DTAB/NaCl solutions in water were compared with those ones made by rapid mixing of dilute NaPSS/NaCl and DTAB/NaCl solutions. The study revealed that the phase-separation concentration range as well as the composition, morphology, and visual appearance of the precipitates were remarkably different in the two cases. These observations clearly demonstrate that the dilution/deposition process is also related to the nonequilibrium phase properties of PE/S systems, which can be used to modulate the efficiency of various commercial applications.
ABSTRACT
Stress can alter the number and morphology of excitatory synapses in the hippocampus, but nothing is known about the effect of stress on inhibitory synapses. Here, we used an animal model for depression, the chronic mild stress model, and quantified the number of perisomatic inhibitory neurons and their synapses. We found reduced density of parvalbumin-positive (PV+) neurons in response to stress, while the density of cholecystokinin-immunoreactive (CCK+) neurons was unaffected. We did a detailed electron microscopic analysis to quantify the frequency and morphology of perisomatic inhibitory synapses in the hippocampal CA1 area. We analyzed 1100 CA1 pyramidal neurons and 4800 perisomatic terminals in five control and four chronically stressed rats. In the control animals we observed the following parameters: Number of terminals/soma = 57; Number of terminals/100 µm cell perimeter = 10; Synapse/terminal ratio = 32%; Synapse number/100 terminal = 120; Average terminal length = 920nm. None of these parameters were affected by the stress exposure. Overall, these data indicate that despite the depressive-like behavior and the decrease in the number of perisomatic PV+ neurons in the light microscopic preparations, the number of perisomatic inhibitory synapses on CA1 pyramidal cells was not affected by stress. In the electron microscope, PV+ neurons and the axon terminals appeared to be normal and we did not find any apoptotic or necrotic cells. This data is in sharp contrast to the remarkable remodeling of the excitatory synapses on spines that has been reported in response to stress and depressive-like behavior. © 2016 The Authors Hippocampus Published by Wiley Periodicals, Inc.
Subject(s)
Depressive Disorder/pathology , Presynaptic Terminals/ultrastructure , Pyramidal Cells/ultrastructure , Synapses/ultrastructure , Animals , CA1 Region, Hippocampal/metabolism , CA1 Region, Hippocampal/ultrastructure , Cell Count , Cholecystokinin/metabolism , Depressive Disorder/metabolism , Disease Models, Animal , Immunohistochemistry , Male , Microscopy, Electron , Neural Inhibition , Parvalbumins/metabolism , Presynaptic Terminals/metabolism , Pyramidal Cells/metabolism , Rats, Wistar , Stress, Psychological/metabolism , Stress, Psychological/pathology , Synapses/metabolismABSTRACT
For clinical studies in which two coprimary endpoints are necessary for assuring efficacy of the treatment of interest, it is important to determine the minimal sample size needed to attain a certain conjunctive power (i.e., power to reject false null hypothesis for both endpoints). The traditional method of assigning the square root of the targeted overall power to each of the two hypothesis tests is optimal only when the standardized treatment effect sizes of the two endpoints are equal. In spite of this limitation the square root method is applied routinely, resulting in frequent overestimation of the overall sample size. A new, iterative method is presented to find the two individual power values for the two endpoints so that the targeted overall power is attained with the smallest possible overall sample size. The principle is to assign more power to the endpoint for which a larger standardized effect size is likely to occur based on prior information. The main assumption of the new method is the independence of endpoints. However, this is not a serious limitation in case of type II error, thus the method yields a good approximation even if the condition of independence is not fulfilled. The advantages of the new method are (a) a considerable saving (up to 24% in our examples) in the overall sample size, (b) the flexibility as it can be applied to any combination of endpoint types (e.g., normally distributed + binomial, survival + binomial, etc.) and (c) easy to program.
Subject(s)
Biomedical Research/methods , Clinical Trials as Topic , Data Interpretation, Statistical , Humans , Sample SizeABSTRACT
Major depressive disorder is a common and complex mental disorder with unknown etiology. GABAergic dysfunction is likely to contribute to the pathophysiology since disrupted GABAergic systems are well documented in depressed patients. Here we studied structural changes in the hippocampal GABAergic network using the chronic mild stress (CMS) model, as one of the best validated animal models for depression. Rats were subjected to 9 weeks of daily stress and behaviorally characterized using the sucrose consumption test into anhedonic and resilient animals based on their response to stress. Different subtypes of GABAergic interneurons were visualized by immunohistochemistry using antibodies for parvalbumin (PV), calretinin (CR), calbindin (CB), cholecystokinin (CCK), somatostatin (SOM), and neuropeptide Y (NPY). We used an unbiased quantification method to systematically count labeled cells in different subareas of the dorsal and ventral hippocampus. Chronic stress reduced the number of specific interneurons in distinct hippocampal subregions significantly. PV+ and CR+ neurons were reduced in all dorsal subareas, whereas in the ventral part only the CA1 was affected. Stress had the most pronounced effect on the NPY+ and SOM+ cells and reduced their number in almost all dorsal and ventral subareas. Stress had no effect on the CCK+ and CB+ interneurons. In most cases the effect of stress was irrespective to the behavioral phenotype. However, in a few specific areas the number of SOM+, NPY+, and CR+ neurons were significantly reduced in anhedonic animals compared to the resilient group. Overall, these data clearly demonstrate that chronic stress affects the structural integrity of specific GABAergic neuronal subpopulations and this should also affect the functioning of these hippocampal GABAergic networks.
Subject(s)
GABAergic Neurons/pathology , Hippocampus/pathology , Interneurons/pathology , Stress, Psychological/pathology , Analysis of Variance , Animals , Calbindin 1/metabolism , Cell Count , Cholecystokinin/metabolism , Disease Models, Animal , Food Preferences , GABAergic Neurons/metabolism , Interneurons/metabolism , Male , Nerve Tissue Proteins/metabolism , Peptide Fragments/metabolism , Rats , Rats, Wistar , Sucrose/administration & dosage , Sweetening Agents/administration & dosageABSTRACT
Alveolar macrophages (AMs) act as gatekeepers of the lung's immune responses, serving essential roles in recognizing and eliminating pathogens. The transcription factor (TF) early growth response 2 (EGR2) has been recently described as required for mature AMs in mice; however, its mechanisms of action have not been explored. Here, we identified EGR2 as an epigenomic regulator and likely direct proximal transcriptional activator in AMs using epigenomic approaches (RNA sequencing, ATAC sequencing, and CUT&RUN). The predicted direct proximal targets of EGR2 included a subset of AM identity genes and ones related to pathogen recognition, phagosome maturation, and adhesion, such as Clec7a, Atp6v0d2, Itgb2, Rhoc, and Tmsb10. We provided evidence that EGR2 deficiency led to impaired zymosan internalization and reduced the capacity to respond to Aspergillus fumigatus. Mechanistically, the lack of EGR2 altered the transcriptional response, secreted cytokines (i.e., CXCL11), and inflammation-resolving lipid mediators (i.e., RvE1) of AMs during in vivo zymosan-induced inflammation, which manifested in impaired resolution. Our findings demonstrated that EGR2 is a key proximal transcriptional activator and epigenomic bookmark in AMs responsible for select, distinct components of cell identity and a protective transcriptional and epigenomic program against fungi.
Subject(s)
Aspergillus fumigatus , Early Growth Response Protein 2 , Macrophages, Alveolar , Phagocytosis , Animals , Macrophages, Alveolar/immunology , Macrophages, Alveolar/metabolism , Early Growth Response Protein 2/genetics , Early Growth Response Protein 2/metabolism , Early Growth Response Protein 2/immunology , Mice , Phagocytosis/immunology , Phagocytosis/genetics , Aspergillus fumigatus/immunology , Mice, Knockout , Mice, Inbred C57BL , Epigenomics , Epigenesis, Genetic/immunology , ZymosanABSTRACT
AIMS: Studies have demonstrated neuropsychological deficits across a variety of cognitive domains in patients with major depressive disorder (MDD) during acute episode. However, limited data are available concerning whether these abnormalities persist in the remission phase. METHODS: In the present study CANTAB (Cambridge Automated Neuropsychological Test Battery) was used to evaluate the cognitive impairment associated with depression during acute episode and in remission. 25 patients with MDD during an acute episode and 11 patients also during remission were tested with CANTAB. RESULTS: During the acute episode, Delayed matching to sample, Paired associate learning, Spatial recognition memory, Rapid visual processing and Visuospatial planning were impaired. In remission the improvement of visual learning ability, spatial recognition memory, psychomotor speed, and executive function was observed. CONCLUSIONS: The results suggest that MDD is associated with neurocognitive dysfunctions in different domains, the most prominent deficit was found in the Paired associate learning test, which requires both the elaboration of "frontal strategies" and the "mnemonic processes". Cognitive impairment was found to improve partly in remission, suggesting that an individual's current mood interacts with the ability to perform a cognitive task. Besides these state markers, trait deficits are important because cognitive impairments which do not improve in remission might serve as endophenotypes of depression.
Subject(s)
Affect , Cognition , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/psychology , Depression/psychology , Depressive Disorder, Major/psychology , Neuropsychological Tests , Acute Disease , Adult , Depression/complications , Depressive Disorder, Major/complications , Female , Humans , Learning , Male , Mental Recall , Middle Aged , Paired-Associate Learning , Pattern Recognition, Visual , Psychomotor Performance , Recognition, Psychology , Space PerceptionABSTRACT
Introduction: Macrophages significantly contribute to the regulation of vessel formation under physiological and pathological conditions. Although the angiogenesis-regulating role of alternatively polarized macrophages is quite controversial, a growing number of evidence shows that they can participate in the later phases of angiogenesis, including vessel sprouting and remodeling or regression. However, the epigenetic and transcriptional regulatory mechanisms controlling this angiogenesis-modulating program are not fully understood. Results: Here we show that IL-4 can coordinately regulate the VEGFA-VEGFR1 (FLT1) axis via simultaneously inhibiting the proangiogenic Vegfa and inducing the antiangiogenic Flt1 expression in murine bone marrow-derived macrophages, which leads to the attenuated proangiogenic activity of alternatively polarized macrophages. The IL-4-activated STAT6 and IL-4-STAT6 signaling pathway-induced EGR2 transcription factors play a direct role in the transcriptional regulation of the Vegfa-Flt1 axis. We demonstrated that this phenomenon is not restricted to the murine bone marrow-derived macrophages, but can also be observed in different murine tissue-resident macrophages ex vivo and parasites-elicited macrophages in vivo with minor cell type-specific differences. Furthermore, IL-4 exposure can modulate the hypoxic response of genes in both murine and human macrophages leading to a blunted Vegfa/VEGFA and synergistically induced Flt1/FLT1 expression. Discussion: Our findings establish that the IL-4-activated epigenetic and transcriptional program can determine angiogenesis-regulating properties in alternatively polarized macrophages under normoxic and hypoxic conditions.
Subject(s)
Interleukin-4 , Vascular Endothelial Growth Factor A , Humans , Mice , Animals , Interleukin-4/metabolism , Vascular Endothelial Growth Factor A/genetics , Vascular Endothelial Growth Factor A/metabolism , Macrophages/metabolism , Signal Transduction , Gene Expression Regulation , Vascular Endothelial Growth Factor Receptor-1/genetics , Vascular Endothelial Growth Factor Receptor-1/metabolismABSTRACT
BACKGROUND: The aim of our study was to assess psychiatric symptoms in patients with genetically proven primary mutation of the mitochondrial DNA. METHODS: 19 adults with known mitochondrial mutation (MT) have been assessed with the Stanford Health Assessment Questionnaire 20-item Disability Index (HAQ-DI), the Symptom Check List-90-Revised (SCL-90-R), the Beck Depression Inventory-Short Form (BDI-SF), the Hamilton Depression Rating Scale (HDRS) and the clinical version of the Structured Clinical Interview for the the DSM-IV (SCID-I and SCID-II) As control, 10 patients with hereditary sensorimotor neuropathy (HN), harboring the peripheral myelin protein-22 (PMP22) mutation were examined with the same tools. RESULTS: The two groups did not differ significantly in gender, age or education. Mean HAQ-DI score was 0.82 in the MT (range: 0-1.625) and 0.71 in the HN group (range: 0-1.625). Level of disability between the two groups did not differ significantly (p = 0.6076). MT patients scored significantly higher on the BDI-SF and HDRS than HN patients (12.85 versus 4.40, p = 0.031, and 15.62 vs 7.30, p = 0.043, respectively). The Global Severity Index (GSI) of SCL-90-R also showed significant difference (1.44 vs 0.46, p = 0.013) as well as the subscales except for somatization. SCID-I interview yielded a variety of mood disorders in both groups. Eight MT patient (42%) had past, 6 (31%) had current, 5 (26%) had both past and current psychiatric diagnosis, yielding a lifetime prevalence of 9/19 (47%) in the MT group. In the HN group, 3 patients had both past and current diagnosis showing a lifetime prevalence of 3/10 (30%) in this group. SCID-II detected personality disorder in 8 MT cases (42%), yielding 3 avoidant, 2 obsessive-compulsive and 3 personality disorder not otherwise specified (NOS) diagnosis. No personality disorder was identified in the HN group. CONCLUSIONS: Clinicians should be aware of the high prevalence of psychiatric symptoms in patients with mitochondrial mutation which has both etiologic and therapeutic relevance.
Subject(s)
DNA, Mitochondrial/genetics , Mental Disorders/etiology , Mitochondrial Diseases/complications , Adolescent , Adult , Cohort Studies , Data Interpretation, Statistical , Female , Genotype , Hereditary Sensory and Motor Neuropathy/genetics , Hereditary Sensory and Motor Neuropathy/psychology , Humans , Male , Mental Disorders/genetics , Mental Disorders/psychology , Middle Aged , Mitochondrial Diseases/genetics , Mitochondrial Diseases/psychology , Mood Disorders/genetics , Mood Disorders/psychology , Mutation/physiology , Neuropsychological Tests , Personality Disorders/genetics , Personality Disorders/psychology , Polymerase Chain Reaction , Psychiatric Status Rating Scales , Serotonin Plasma Membrane Transport Proteins/genetics , Severity of Illness Index , Young AdultABSTRACT
RATIONALE: There is a shortage of studies analyzing the time course of recurrent episodes and comparing effectiveness of long-term treatments in bipolar disorder. 'Number needed to treat' (NNT) analyses have been proven to be useful for clinically meaningful comparisons, but results vary considerably among studies. The survival curves of different trials also show a great variability preventing reliable conclusions on the time course of maintenance therapies. The variance of survival analyses on long-term medication management can be reduced with increasing the statistical power by combining the life-tables of individual studies. METHODS: In this study the survival tables of 28 studies on maintenance treatment of bipolar disorder were reconstructed from the published diagrams, and the numbers of relapsed patients in the original studies were estimated for plotting composite survival curves of an inactive, mono- and combination therapy arm. The review was finally based on 5231 subjects. RESULTS: The resulting composite diagrams indicate that within the first year 48% of patients on monotherapy, and 35% on combination therapy experienced recurrence of any affective episode ('early relapsers'). The rest of the patient population was affected by recurrences in a smaller rate over a more extended period of time ('late relapsers'). For a favorable outcome at 40 months of episode prevention in bipolar disorder the NNT was 6 for mono- and 3 for combination therapy. Log-rank analyses of the composite data supported the effectiveness of both medication protocols over placebo, and the superiority of drug combination over monotherapy; though there were some indications of decreased efficacy in the two treatment arms after extended maintenance. CONCLUSIONS: Composite analysis offers increased statistical power for studying the time course of survival data. Mood episodes in bipolar disorder are likely to recur early on and relapses in "real-life" can be more frequent than the rates published here. Our results favor combination therapy for the long-term management of bipolar disorder. Concerns are expressed that NNT analyses have significant limitations when applied to recurring events with cumulative deterioration instead of cases where cumulative improvement is expected over time.
Subject(s)
Antipsychotic Agents/therapeutic use , Bipolar Disorder/drug therapy , Bipolar Disorder/psychology , Kaplan-Meier Estimate , Life Tables , Affect , Bipolar Disorder/mortality , Controlled Clinical Trials as Topic , Disease-Free Survival , Drug Therapy, Combination , Humans , Long-Term Care/methods , Recurrence , Time FactorsABSTRACT
Dendritic cells (DCs), as potent phagocytes engulf dead cells and present peptide fragments of tumor antigens or pathogens derived from infected cells to naïve CD8+ T-lymphocytes. Dendritic cells can also induce apoptosis in target cells, thus getting an opportunity to sample their microenvironment. Here, we present that the supernatants of LPS- or CL075-activated DCs induced cell death in different cell lines, but during the differentiation to mature DCs, they lost their cytotoxic potential. Dexamethasone-pre-treated tolerogenic DCs induced less intensive death indicating that the tissue microenvironment can downregulate DC-mediated killing. Exploring the signaling of DC-induced cell death, we observed that the supernatant of activated DCs induced TNF-dependent cell death, since TNF antagonist blocked the cytotoxic activity of DCs, contrary to inhibitors of Fas and TRAIL receptors. We identified that the DC-induced killing is at least partially a RIPK1-dependent process, as RIPK1 positive target cells were more susceptible to DC-induced cell death than their RIPK1 deficient counterparts. Moreover, both the elevated phosphorylation of RIPK1 and the increase in RIPK1-caspase-8 interaction in target cells suggest that RIPK1-mediated signals contribute to DC supernatant-induced cell death. We also proved that the cytotoxic activity of DC-derived supernatant induced apoptosis in the target cells and not necroptosis, as it was completely abrogated with the pan caspase inhibitor (Z-VAD), while the necroptosis inhibitor (Nec-1) had no effect. Our work revealed that the supernatant of activated DCs induces the apoptosis of target cells in a RIPK1-dependent manner. This phenomenon could be relevant for the initiation of cross-presentation and may broaden the plethora of cytotoxic mechanisms acting against tumor cells.
Subject(s)
Dendritic Cells/immunology , Neoplasms/immunology , Receptor-Interacting Protein Serine-Threonine Kinases/metabolism , Apoptosis , Caspase 8/metabolism , Caspase Inhibitors/pharmacology , Cell Death , Cross-Priming , Cytotoxicity, Immunologic , HT29 Cells , Humans , Immune Tolerance , Oligopeptides/pharmacology , Signal Transduction , Tumor Necrosis Factor-alpha/metabolismABSTRACT
Necroptosis is a regulated necrotic-like cell death modality which has come into the focus of attention since it is known to contribute to the pathogenesis of many inflammatory and degenerative diseases as well as to tumor regulation. Based on current data, necroptosis serves as a backup mechanism when death receptor-induced apoptosis is inhibited or absent. However, the necroptotic role of the proteins involved in mitochondrial apoptosis has not been investigated. Here, we demonstrated that the stimulation of several death and pattern recognition receptors induced necroptosis under caspase-compromised conditions in wild-type, but not in caspase-9-negative human Jurkat and murine MEF cells. Cerulein-induced pancreatitis was significantly reduced in mice with acinar cell-restricted caspase-9 gene knockout. The absence of caspase-9 led to impaired association of receptor-interacting serine/threonine-protein kinase 1 (RIPK1) and RIPK3 and resulted in decreased phosphorylation of RIP kinases, but the overexpression of RIPK1 or RIPK3 rescued the effect of caspase-9 deficiency. Inhibition of either Aurora kinase A (AURKA) or its known substrate, glycogen synthase kinase 3ß (GSK3ß) restored necroptosis sensitivity of caspase-9-deficient cells, indicating an interplay between caspase-9 and AURKA-mediated pathways to regulate necroptosis. Our findings suggest that caspase-9 acts as a newly identified regulator of necroptosis, and thus, caspase-9 provides a promising therapeutic target to manipulate the immunological outcome of cell death.
Subject(s)
Caspase 9/metabolism , Necrosis/metabolism , Animals , Cell Death , Cell Line , Disease Models, Animal , Humans , Mice , Mice, Inbred Strains , Pancreatitis/metabolismABSTRACT
Kinetics of hydrolysis induced swelling as well as pure swelling of a novel class of pH responsive biocompatible polymer gels was studied. Poly(aspartic acid) gels were prepared by hydrolysis of chemically cross-linked poly(succinimide) networks. The volume change of spherical gels of different size, measured at constant pH, proceeds in three distinct processes: solvent exchange, hydrolysis and swelling. It turned out that pure swelling as well as the swelling coupled with hydrolysis can be described by the Tanaka-Fillmore-Peters-Candau theory. The relaxation times as well as the cooperative diffusion coefficient of the network chains were determined. It was found that the initial condition of the swelling makes its influence felt neither on the relaxation time, nor on the cooperative diffusion coefficient.
Subject(s)
Aspartic Acid/analogs & derivatives , Gels/chemistry , Peptides/chemistry , Aspartic Acid/chemistry , Biocompatible Materials/chemistry , Hydrogen-Ion Concentration , Hydrolysis , KineticsABSTRACT
Background: Stress-induced cellular changes in limbic brain structures contribute to the development of various psychopathologies. In vivo detection of these microstructural changes may help us to develop objective biomarkers for psychiatric disorders. Diffusion tensor imaging (DTI) is an advanced neuroimaging technique that enables the non-invasive examination of white matter integrity and provides insights into the microstructure of pathways connecting brain areas. Objective: Our aim was to examine the temporal dynamics of stress-induced structural changes with repeated in vivo DTI scans and correlate them with behavioral alterations. Methods: Out of 32 young adult male rats, 16 were exposed to daily immobilization stress for 3 weeks. Four DTI measurements were done: one before the stress exposure (baseline), two scans during the stress (acute and chronic phases), and a last one 2 weeks after the end of the stress protocol (recovery). We used a 4.7T small-animal MRI system and examined 18 gray and white matter structures calculating the following parameters: fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). T2-weighted images were used for volumetry. Cognitive performance and anxiety levels of the animals were assessed in the Morris water maze, novel object recognition, open field, and elevated plus maze tests. Results: Reduced FA and increased MD and RD values were found in the corpus callosum and external capsule of stressed rats. Stress increased RD in the anterior commissure and reduced MD and RD in the amygdala. We observed time-dependent changes in several DTI parameters as the rats matured, but we found no evidence of stress-induced volumetric alterations in the brains. Stressed rats displayed cognitive impairments and we found numerous correlations between the cognitive performance of the animals and between various DTI metrics of the inferior colliculus, corpus callosum, anterior commissure, and amygdala. Conclusions: Our data provide further support to the translational value of DTI studies and suggest that chronic stress exposure results in similar white matter microstructural alterations that have been documented in stress-related psychiatric disorders. These DTI findings imply microstructural abnormalities in the brain, which may underlie the cognitive deficits that are often present in stress-related mental disorders.
ABSTRACT
Marijuana is a widely used recreational drug with increasing legalization worldwide for medical purposes. Most experimental studies use either synthetic or plant-derived cannabinoids to investigate the effect of cannabinoids on anxiety and cognitive functions. The aim of this study was to mimic real life situations where young people smoke cannabis regularly to relax from everyday stress. Therefore, we exposed young adult male NMRI mice to daily stress and concomitant marijuana smoke for 2 months and investigated the consequences on physiology, behavior and adult hippocampal neurogenesis. Animals were restrained for 6-h/day for 5-days a week. During the stress, mice were exposed to cannabis smoke for 2 × 30 min/day. We burned 2 "joints" (2 × 0.8 g marijuana) per occasion in a whole body smoking chamber. Cannabinoid content of the smoke and urine samples was measured by HPLC and SFC-MS/MS. Body weight gain was recorded daily and we did unrestrained, whole body plethysmography to investigate pulmonary functions. The cognitive performance of the animals was evaluated by the novel object recognition and Y maze tests. Anxietyrelated spontaneous locomotor activity and self-grooming were assessed in the open field test (OFT). Adult neurogenesis was quantified post mortem in the hippocampal dentate gyrus. The proliferative activity of the precursor cells was detected by the use of the exogenous marker 5-bromo-20-deoxyuridine. Treatment effects on maturing neurons were studied by the examination of doublecortin-positive neurons. Both stress and cannabis exposure significantly reduced body weight gain. Cannabis smoke had no effect on pulmonary functions, but stress delayed the maturation of several lung functions. Neither stress, nor cannabis smoke affected the cognitive functioning of the animals. Results of the OFT revealed that cannabis had a mild anxiolytic effect and markedly increased self-grooming behavior. Stress blocked cell proliferation in the dentate gyrus, but cannabis had no effect on this parameter. Marijuana smoke however had a pronounced impact on doublecortin-positive neurons influencing their number, morphology and migration. In summary, we report here that long-term stress in combination with cannabis smoke exposure can alter several health-related measures, but the present experimental design could not reveal any interaction between these two treatment factors except for body weight gain.