CytoRADx: A High-Throughput, Standardized Biodosimetry Diagnostic System Based on the Cytokinesis-Block Micronucleus Assay.

In a large-scale catastrophe, such as a nuclear detonation in a major city, it will be crucial to accurately diagnose large numbers of people to direct scarce medical resources to those in greatest need. Currently no FDA-cleared tests are available to diagnose radiation exposures, which can lead to complex, life-threatening injuries. To address this gap, we have achieved substantial advancements in radiation biodosimetry through refinement and adaptation of the cytokinesis-block micronucleus (CBMN) assay as a high throughput, quantitative diagnostic test. The classical CBMN approach, which quantifies micronuclei (MN) resulting from DNA damage, suffers from considerable time and expert labor requirements, in addition to a lack of universal methodology across laboratories. We have developed the CytoRADx™ System to address these drawbacks by implementing a standardized reagent kit, optimized assay protocol, fully automated microscopy and image analysis, and integrated dose prediction. These enhancements allow the CytoRADx System to obtain high-throughput, standardized results without specialized labor or laboratory-specific calibration curves. The CytoRADx System has been optimized for use with both humans and non-human primates (NHP) to quantify radiation dose-dependent formation of micronuclei in lymphocytes, observed using whole blood samples. Cell nuclei and resulting MN are fluorescently stained and preserved on durable microscope slides using materials provided in the kit. Up to 1,000 slides per day are subsequently scanned using the commercially based RADxScan™ Imager with customized software, which automatically quantifies the cellular features and calculates the radiation dose. Using less than 1 mL of blood, irradiated ex vivo, our system has demonstrated accurate and precise measurement of exposures from 0 to 8 Gy (90% of results within 1 Gy of delivered dose). These results were obtained from 636 human samples (24 distinct donors) and 445 NHP samples (30 distinct subjects). The system demonstrated comparable results during in vivo studies, including an investigation of 43 NHPs receiving single-dose total-body irradiation. System performance is repeatable across laboratories, operators, and instruments. Results are also statistically similar across diverse populations, considering various demographics, common medications, medical conditions, and acute injuries associated with radiological disasters. Dose calculations are stable over time as well, providing reproducible results for at least 28 days postirradiation, and for blood specimens collected and stored at room temperature for at least 72 h. The CytoRADx System provides significant advancements in the field of biodosimetry that will enable accurate diagnoses across diverse populations in large-scale emergency scenarios. In addition, our technological enhancements to the well-established CBMN assay provide a pathway for future diagnostic applications, such as toxicology and oncology.

Metabolomic changes in murine serum following inhalation exposure to gasoline and diesel engine emissions.

The adverse health effects of environmental exposure to gaseous and particulate components of vehicular emissions are a major concern among urban populations. A link has been established between respiratory exposure to vehicular emissions and the development of cardiovascular disease (CVD), but the mechanisms driving this interaction remain unknown. Chronic inhalation exposure to mixed vehicle emissions has been linked to CVD in animal models. This study evaluated the temporal effects of acute exposure to mixed vehicle emissions (MVE; mixed gasoline and diesel emissions) on potentially active metabolites in the serum of exposed mice. C57Bl/6 mice were exposed to a single 6-hour exposure to filtered air (FA) or MVE (100 or 300 µg/m(3)) by whole body inhalation. Immediately after and 18 hours after the end of the exposure period, animals were sacrificed for serum and tissue collection. Serum was analyzed for metabolites that were differentially present between treatment groups and time points. Changes in metabolite levels suggestive of increased oxidative stress (oxidized glutathione, cysteine disulfide, taurine), lipid peroxidation (13-HODE, 9-HODE), energy metabolism (lactate, glycerate, branched chain amino acid catabolites, butrylcarnitine, fatty acids), and inflammation (DiHOME, palmitoyl ethanolamide) were observed immediately after the end of exposure in the serum of animals exposed to MVE relative to those exposed to FA. By 18 hours post exposure, serum metabolite differences between animals exposed to MVE versus those exposed to FA were less pronounced. These findings highlight complex metabolomics alterations in the circulation following inhalation exposure to a common source of combustion emissions.

Pleiotropic effect of the proton pump inhibitor esomeprazole leading to suppression of lung inflammation and fibrosis.

BACKGROUND: The beneficial outcome associated with the use of proton pump inhibitors (PPIs) in idiopathic pulmonary fibrosis (IPF) has been reported in retrospective studies. To date, no prospective study has been conducted to confirm these outcomes. In addition, the potential mechanism by which PPIs improve measures of lung function and/or transplant-free survival in IPF has not been elucidated. METHODS: Here, we used biochemical, cell biological and preclinical studies to evaluate regulation of markers associated with inflammation and fibrosis. In our in vitro studies, we exposed primary lung fibroblasts, epithelial and endothelial cells to ionizing radiation or bleomycin; stimuli typically used to induce inflammation and fibrosis. In addition, we cultured lung fibroblasts from IPF patients and studied the effect of esomeprazole on collagen release. Our preclinical study tested efficacy of esomeprazole in a rat model of bleomycin-induced lung injury. Furthermore, we performed retrospective analysis of interstitial lung disease (ILD) databases to examine the effect of PPIs on transplant-free survival. RESULTS: The cell culture studies revealed that esomeprazole controls inflammation by suppressing the expression of pro-inflammatory molecules including vascular cell adhesion molecule-1, inducible nitric oxide synthase, tumor necrosis factor-alpha (TNF-α) and interleukins (IL-1ß and IL-6). The antioxidant effect is associated with strong induction of the stress-inducible cytoprotective protein heme oxygenase-1 (HO1) and the antifibrotic effect is associated with potent inhibition of fibroblast proliferation as well as downregulation of profibrotic proteins including receptors for transforming growth factor ß (TGFß), fibronectin and matrix metalloproteinases (MMPs). Furthermore, esomeprazole showed robust effect in mitigating the inflammatory and fibrotic responses in a murine model of acute lung injury. Finally, retrospective analysis of two ILD databases was performed to assess the effect of PPIs on transplant-free survival in IPF patients. Intriguingly, this data demonstrated that IPF patients on PPIs had prolonged survival over controls (median survival of 3.4 vs 2 years). CONCLUSIONS: Overall, these data indicate the possibility that PPIs may have protective function in IPF by directly modulating the disease process and suggest that they may have other clinical utility in the treatment of extra-intestinal diseases characterized by inflammatory and/or fibrotic phases.

Pyridoxine restores endothelial cell function in high glucose.

OBJECTIVE: Aminoguanidine, which inhibits the formation of advanced glycosylation end products, can restore the ability of endothelial cells to align and elongate in response to shear stress when that ability is lost during culture in high glucose conditions. This study tests whether aminoguanidine can also restore migratory ability of endothelial cells and whether pyridoxine, a stable form of vitamin B6, can restore migratory ability and ability to align and elongate in response to shear. METHODS: Human aortic endothelial cells were cultured in normal glucose (5.5 mM), 17.5 mM glucose, and 30.5 mM glucose in the presence or absence of 5 mM aminoguanidine or varying concentrations of pyridoxine (10-1,000 mg/L). Assay of percent closure of a scrape wound after 24 h quantified migratory ability, and alignment and elongation under flow at 10 dynes/cm(2) quantified response to shear stress. RESULTS: Aminoguanidine (5 mM) fully restores and pyridoxine (100 mg/L, 0.6 µM) partially restores migratory ability of cells cultured in 30.5 mM glucose. Pyridoxine (100 mg/L) fully restores the migratory ability of cells cultured in 17.5 mM glucose. Pyridoxine (100 mg/L) fully restores endothelial cell alignment and elongation and response to shear stress at 30.5 mM glucose. CONCLUSIONS: Pyridoxine, at dosages known to be safe from previous studies (<250 mg/day) can restore migratory ability and shear stress response to endothelial cells cultured in high-glucose conditions. This indicates that pyridoxine is a potential candidate for treatment of diabetic ulcers and atherosclerosis in diabetes due to the link between these pathologies and endothelial dysfunction in diabetes.

High glucose-mediated loss of cell surface heparan sulfate proteoglycan impairs the endothelial shear stress response.

Normal endothelial cells respond to shear stress by elongating and aligning in the direction of fluid flow. Elevated glucose concentrations have been shown to impair this response, though the precise mechanism of damage is not clear. Using an in vitro model of hyperglycemia, we tested the hypothesis that high glucose (HG) impairs the endothelial shear stress response by damaging the glycocalyx. 50 mU/mL heparinase III enzyme removes similar proportions of cell surface heparan sulfate proteoglycan (HSPG) as HG conditions and results in similar impairment of the elongation and alignment response to flow. Doubling the shear stress overcomes the inhibited flow response in HG cells, but not in enzyme treated cells. These findings may be explained by HG leading to decreased expression of full-length HSPG; whereas, heparinase results in a normal density of HSPG of shorter length.

A semi-automated analysis method of small sensory nerve fibers in human skin-biopsies.

Computerized detection method (CDM) software programs have been extensively developed in the field of astronomy to process and analyze images from nearby bright stars to tiny galaxies at the edge of the Universe. These object-recognition algorithms have potentially broader applications, including the detection and quantification of cutaneous small sensory nerve fibers (SSNFs) found in the dermal and epidermal layers, and in the intervening basement membrane of a skin punch biopsy. Here, we report the use of astronomical software adapted as a semi-automated method to perform density measurements of SSNFs in skin-biopsies imaged by Laser Scanning Confocal Microscopy (LSCM). In the first half of the paper, we present a detailed description of how the CDM is applied to analyze the images of skin punch biopsies. We compare the CDM results to the visual classification results in the second half of the paper. Abbreviations used in the paper, description of each astronomical tools, and their basic settings and how-tos are described in the appendices. Comparison between the normalized CDM and the visual classification results on identical images demonstrates that the two density measurements are comparable. The CDM therefore can be used - at a relatively low cost - as a quick (a few hours for entire processing of a single biopsy with 8-10 scans) and reliable (high-repeatability with minimum user-dependence) method to determine the densities of SSNFs.