The impact of public health lockdown measures during the COVID-19 pandemic on the epidemiology of children's orthopedic injuries requiring operative intervention.

BACKGROUND: In March 2020, Ontario instituted a lockdown to reduce spread of the SARS-CoV-2 virus. Schools, recreational facilities, and nonessential businesses were closed. Restrictions were eased through 3 distinct stages over a 6-month period (March to September 2020). We aimed to determine the impact of each stage of the COVID-19 public health lockdown on the epidemiology of operative pediatric orthopedic trauma. METHODS: A retrospective cohort study was performed comparing emergency department (ED) visits for orthopedic injuries and operatively treated orthopedic injuries at a level 1 pediatric trauma centre during each lockdown stage of the pandemic with caseloads during the same date ranges in 2019 (prepandemic). Further analyses were based on patients' demographic characteristics, injury severity, mechanism of injury, and anatomic location of injury. RESULTS: Compared with the prepandemic period, ED visits decreased by 20% (1356 v. 1698, p < 0.001) and operative cases by 29% (262 v. 371, p < 0.001). There was a significant decrease in the number of operative cases per day in stage 1 of the lockdown (1.3 v. 2.0, p < 0.001) and in stage 2 (1.7 v. 3.0; p < 0.001), but there was no significant difference in stage 3 (2.4 v. 2.2, p = 0.35). A significant reduction in the number of playground injuries was seen in stage 1 (1 v. 62, p < 0.001) and stage 2 (6 v. 35, p < 0.001), and there was an increase in the number of self-propelled transit injuries (31 v. 10, p = 0.002) during stage 1. In stage 3, all patient demographic characteristics and all characteristics of operatively treated injuries resumed their prepandemic distributions. CONCLUSION: Provincial lockdown measures designed to limit the spread of SARS-CoV-2 significantly altered the volume and demographic characteristics of pediatric orthopedic injuries that required operative management. The findings from this study will serve to inform health system planning for future emergency lockdowns.

Probing self-assembled micellar topologies via micro-scale diffusive dynamics of surfactants.

HYPOTHESIS: Surfactants spontaneously self-assemble in aqueous solutions and are critical in energy, biotechnology, and the environment. The self-assembled micelles may experience distinct topological transitions beyond a critical counter-ion concentration, yet the associated mechanical signatures are identical. By monitoring self-diffusion dynamics of individual surfactants in micelles via a non-invasive 1H NMR diffusometry, we may distinguish various topological transitions overcoming challenges associated with traditional microstructural probing techniques. EXPERIMENTS: Three micellar systems based on CTAB/5mS, OTAB/NaOA and CPCl/NaClO3 are considered at various counter-ion concentrations, and their rheological properties are assessed. A systematic 1H NMR diffusometry is conducted and the resulting signal attenuation is measured. FINDINGS: With no counter-ion, surfactants self-diffuse freely with a mean squared displacement Z2∼Tdiff in the micelles. As counter-ion concentration increases, self-diffusion becomes restricted with Z2∼Tdiffα, and α→0.5. Beyond the viscosity peak, for the OTAB/NaOA system that shows a linear-shorter linear micelle transition, Z2∼Tdiff0.5. Conversely, for the CTAB/5mS system that experiences a linear wormlike-vesicle transition above the viscosity peak, a free self-diffusion is recovered. The diffusion dynamics in CPCl/NaClO3 are similar to those of OTAB/NaOA. Hence, a similar topological transition is surmised. These results highlight the unique sensitivity of the 1H NMR diffusometry to micelles topological transitions.

The Adjuvant Combination of dmLT and Monophosphoryl Lipid A Activates the Canonical, Nonpyroptotic NLRP3 Inflammasome in Dendritic Cells and Significantly Interacts to Expand Antigen-Specific CD4 T Cells.

Adjuvants are often essential additions to vaccines that enhance the activation of innate immune cells, leading to more potent and protective T and B cell responses. Only a few vaccine adjuvants are currently used in approved vaccine formulations in the United States. Combinations of one or more adjuvants have the potential to increase the efficacy of existing and next-generation vaccines. In this study, we investigated how the nontoxic double mutant Escherichia coli heat-labile toxin R192G/L211A (dmLT), when combined with the TLR4 agonist monophosphoryl lipid A (MPL-A), impacted innate and adaptive immune responses to vaccination in mice. We found that the combination of dmLT and MPL-A induced an expansion of Ag-specific, multifaceted Th1/2/17 CD4 T cells higher than that explained by adding responses to either adjuvant alone. Furthermore, we observed more robust activation of primary mouse bone marrow-derived dendritic cells in the combination adjuvant-treated group via engagement of the canonical NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome complex. This was marked by a multiplicative increase in the secretion of active IL-1ß that was independent of classical gasdermin D-mediated pyroptosis. Moreover, the combination adjuvant increased the production of the secondary messengers cAMP and PGE2 in dendritic cells. These results demonstrate how certain adjuvant combinations could be used to potentiate better vaccine responses to combat a variety of pathogens.

Multinuclear MRI Reveals Early Efficacy of Stem Cell Therapy in Stroke.

Compromised adult human mesenchymal stem cells (hMSC) can impair cell therapy efficacy and further reverse ischemic recovery. However, in vitro assays require extended passage to characterize cells, limiting rapid assessment for therapeutic potency. Multinuclear magnetic resonance imaging and spectroscopy (MRI/S) provides near real-time feedback on disease progression and tissue recovery. Applied to ischemic stroke, 23Na MRI evaluates treatment efficacy within 24 h after middle cerebral artery occlusion, showing recovery of sodium homeostasis and lesion reduction in specimens treated with hMSC while 1H MRS identifies reduction in lactate levels. This combined metric was confirmed by evaluating treatment groups receiving healthy or compromised hMSC versus vehicle (sham saline injection) over 21 days. Behavioral tests to assess functional recovery and cell analysis for immunomodulatory and macrophage activity to detect hMSC potency confirm MR findings. Clinically, these MR metrics may prove critical to early evaluations of therapeutic efficacy and overall stroke recovery.

Human Forebrain Organoid-Derived Extracellular Vesicle Labeling with Iron Oxides for In Vitro Magnetic Resonance Imaging.

The significant roles of extracellular vesicles (EVs) as intracellular mediators, disease biomarkers, and therapeutic agents, make them a scientific hotspot. In particular, EVs secreted by human stem cells show significance in treating neurological disorders, such as Alzheimer's disease and ischemic stroke. However, the clinical applications of EVs are limited due to their poor targeting capabilities and low therapeutic efficacies after intravenous administration. Superparamagnetic iron oxide (SPIO) nanoparticles are biocompatible and have been shown to improve the targeting ability of EVs. In particular, ultrasmall SPIO (USPIO, <50 nm) are more suitable for labeling nanoscale EVs due to their small size. In this study, induced forebrain neural progenitor cortical organoids (iNPCo) were differentiated from human induced pluripotent stem cells (iPSCs), and the iNPCo expressed FOXG1, Nkx2.1, α-catenin, as well as ß-tubulin III. EVs were isolated from iNPCo media, then loaded with USPIOs by sonication. Size and concentration of EV particles were measured by nanoparticle tracking analysis, and no significant changes were observed in size distribution before and after sonication, but the concentration decreased after labeling. miR-21 and miR-133b decreased after sonication. Magnetic resonance imaging (MRI) demonstrated contrast visualized for the USPIO labeled EVs embedded in agarose gel phantoms. Upon calculation, USPIO labeled EVs exhibited considerably shorter relaxation times, quantified as T2 and T2* values, reducing the signal intensity and generating higher MRI contrast compared to unlabeled EVs and gel only. Our study demonstrated that USPIO labeling was a feasible approach for in vitro tracking of brain organoid-derived EVs, which paves the way for further in vivo examination.

Nonparametric 5D D-R2 distribution imaging with single-shot EPI at 21.1 T: Initial results for in vivo rat brain.

In vivo human diffusion MRI is by default performed using single-shot EPI with greater than 50-ms echo times and associated signal loss from transverse relaxation. The individual benefits of the current trends of increasing B0 to boost SNR and employing more advanced signal preparation schemes to improve the specificity for selected microstructural properties eventually may be cancelled by increased relaxation rates at high B0 and echo times with advanced encoding. Here, initial attempts to translate state-of-the-art diffusion-relaxation correlation methods from 3 T to 21.1 T are made to identify hurdles that need to be overcome to fulfill the promises of both high SNR and readily interpretable microstructural information.

Engineering extracellular vesicles by three-dimensional dynamic culture of human mesenchymal stem cells.

Human mesenchymal stem cell (hMSC) derived extracellular vesicles (EVs) have shown therapeutic potential in recent studies. However, the corresponding therapeutic components are largely unknown, and scale-up production of hMSC EVs is a major challenge for translational applications. In the current study, hMSCs were grown as 3D aggregates under wave motion to promote EV secretion. Results demonstrate that 3D hMSC aggregates promote activation of the endosomal sorting complexes required for transport (ESCRT)-dependent and -independent pathways. mRNA sequencing revealed global transcriptome alterations for 3D hMSC aggregates. Compared to 2D-hMSC-EVs, the quantity of 3D-hMSC-EVs was enhanced significantly (by 2-fold), with smaller sizes, higher miR-21 and miR-22 expression, and an altered protein cargo (e.g., upregulation of cytokines and anti-inflammatory factors) uncovered by proteomics analysis, possibly due to altered EV biogenesis. Functionally, 3D-hMSC-EVs rejuvenated senescent stem cells and exhibited enhanced immunomodulatory potentials. In summary, this study provides a promising strategy for scalable production of high-quality EVs from hMSCs with enhanced therapeutic potential.

A Multifunctional Contrast Agent for 19F-Based Magnetic Resonance Imaging.

Magnetic resonance imaging, MRI, relying on 19F nuclei has attracted much attention, because the isotopes exhibit a high gyromagnetic ratio (comparable to that of protons) and have 100% natural abundance. Furthermore, due to the very low traces of intrinsic fluorine in biological tissues, fluorine labeling allows easy visualization in vivo using 19F-based MRI. However, one of the drawbacks of the available fluorine tracers is their very limited solubility in water. Here, we detail the design and preparation of a set of water-compatible fluorine-rich polymers as contrast agents that can enhance the effectiveness of 19F-based MRI. The agents are synthesized using the nucleophilic addition reaction between poly(isobutylene-alt-maleic anhydride) copolymer and a mixture of amine-appended fluorine groups and polyethylene glycol (PEG) blocks. This allows control over the polymer architecture and stoichiometry, resulting in good affinity to water solutions. We further investigate the effects of introducing additional segmental mobility to the fluorine moieties in the polymer, by inserting a PEG linker between the moieties and the polymer backbone. We find that controlling the polymer stoichiometry and introducing additional segmental mobility enhance the NMR signals and narrow the peak profile. In particular, we assess the impact of the PEG linker on T2* and T1 relaxation times, using a series of gradient-recalled echo images with varying echo times, TE, or recovery time, TR, respectively. We find that for equivalent concentrations, the PEG linker greatly increases T2*, while maintaining high T1 values, as compared to polymers without this linker. Phantom images collected from these compounds show bright signals over a background with high intensities.

Extended Ischemic Recovery After Implantation of Human Mesenchymal Stem Cell Aggregates Indicated by Sodium MRI at 21.1 T.

Extended therapeutic application remains a significant issue in the use of stem cell therapies to treat ischemic stroke. Along these lines, neurological recovery in a rodent model of ischemic stroke was evaluated following implantation of human mesenchymal stem cell aggregates (hMSC-agg), labeled with micron-sized particles of iron oxide, directly into the lateral ventricle contralateral to the ischemic lesion hemisphere. Longitudinally, disease progression and response to hMSC-agg therapy were assessed by 1H and 23Na magnetic resonance imaging (MRI) at 21.1 T to investigate cellular localization, migration, and recovery over an extended timeframe. MRI provides quantifiable metrics of tissue status through sodium distributions in addition to traditional proton imaging. Quantitative 23Na MRI revealed a significant decrease of sodium concentrations following hMSC aggregate implantation, indicating recovery of homeostasis. This result correlates positively with extended neurological recovery assessed by behavioral analysis and immunohistochemistry. These findings demonstrate the potential of implanted hMSC aggregate therapy to provide extended treatment for ischemic stroke, as well as the robustness of MRI for monitoring such approaches. This method potentially can be translated to a clinical setting for the assessment of extended cell therapy efficacy.

NODDI highlights recovery mechanisms in white and gray matter in ischemic stroke following human stem cell treatment.

PURPOSE: Diffusion MRI offers insight into ischemic stroke progression in both human and rodent models. However, diffusion MRI to evaluate therapeutic application of mesenchymal stem cells is limited. Robust analytical techniques are required to identify potential physiological changes as a function of cell therapy in stroke. Here, we seek to establish Neurite Orientation Dispersion and Density Imaging (NODDI) as a feasible method in evaluating stroke evolution in response to cell-based therapeutics. METHODS: Diffusion MRI data at 21.1T were acquired from 16 male rats. Rats were grouped randomly: naïve (baseline, N = 5), stroke with injections of phosphate buffered saline (N = 6), stroke with injection of 2D human mesenchymal stem cells (hMSC, N = 5). Data were acquired on days 1, 3, 7, and 21 post-surgery. DTI and NODDI maps were generated, with regions of interest placed in the ischemic hemisphere external capsule and striatum. Diffusion parameters were compared between groups each day, and within groups across hemispheres and longitudinally. Behavioral characterizations were on days 0 (pre-surgery), 3, 7, 14, and 21. RESULTS: The 2D hMSC preserved diffusional restriction in the external capsule compared to saline (day 1: MD, P = .4060; AD, P = .0220). NODDI indicates that hMSC may have preserved intracellular volume fractions (ICVF: day 1, P = .0086; day 3, P = .0021; day 21, P = .0383). Diffusion metrics of hMSC treated animals were comparable to naïve for the external capsule. CONCLUSIONS: NODDI compliments DTI metrics, enhances interpretation of tissue outcome in ischemic stroke following hMSC application, and may be useful in evaluating or predicting therapeutic response.

Mesenchymal stem cell-derived extracellular vesicles ameliorate Alzheimer's disease-like phenotypes in a preclinical mouse model.

Alzheimer's disease (AD) is an irreversible neurodegenerative disorder that affects more than 44 million people worldwide. Despite the high disease burden, there is no effective treatment for people suffering from AD. Mesenchymal stem cells (MSCs) are multipotent stromal cells that have been widely studied due to their therapeutic potential. However, administration of cells has been found to have a multitude of limitations. Recently, extracellular vesicles (EVs) derived from MSCs have been studied as a therapeutic candidate, as they exhibit similar immunoprotective and immunomodulatory abilities as the host human MSCs. Methods: To test the potential therapeutic effects of MSC EVs, human bone-marrow derived MSCs were grown in three-dimensional (3D) cell culture, and small EVs were harvested using differential ultracentrifugation. These small EVs were given to non-transgenic (NT) or 5XFAD (5 familial Alzheimer's disease mutations) mice intranasally (IN) every 4 days for 4 months. The mice were then required to perform a variety of behavioral assays to measure changes in learning and memory. Afterwards, immunohistochemistry was performed on brain slices to measure amyloid beta (Aß) and glial fibrillary acidic protein (GFAP) levels. Results: The data revealed that 5XFAD mice that received hMSC-EV treatment behaved significantly better in cognitive tests than saline treated 5XFAD mice, with no significant change between EV-treated 5XFAD mice and NT mice. Additionally, we found lower Aß plaque load in the hippocampus of the EV-treated mice. Finally, less colocalization between GFAP and Aß plaques was found in the brain of EV-treated mice compared to saline. Conclusions: Taken together, these data suggest that IN administration of MSC-derived EVs can slow down AD pathogenesis.

Nuclear Magnetic Resonance Diffusometry of Linear and Branched Wormlike Micelles.

Diffusion studies using nuclear magnetic resonance (NMR) spectroscopy were conducted on two model surfactant solutions of cetyltrimethylammonium bromide/sodium salicylate (CTAB/NaSal) and cetylpyridinium chloride/sodium salicylate (CPCl/NaSal). By increasing the salt-to-surfactant concentration ratio, these systems display two peaks in the zero-shear viscosity and relaxation time, which are indicative of transitions from linear to branched micellar networks. The goal of this work is to assess the sensitivity of NMR diffusometry to different types of micellar microstructures and identify the mechanism(s) of surfactant self-diffusion in micellar solutions. At low salt-to-surfactant concentration ratios, for which wormlike micelles are linear, the surfactant self-diffusion is best described by a mean squared displacement, Z2, that varies as Z2 ∝ Tdiff0.5, where Tdiff is the diffusion time. As the salt concentration increases to establish branched micelles, Z2 ∝ Tdiff, indicating a Brownian-like self-diffusion of surfactant molecules in branched micelles. This result indicates that NMR diffusometry is capable of differentiating various types of micellar microstructures. In addition, the self-diffusion coefficient of the surfactant molecules in linear and branched micelles are determined, for the first time, by comparing the existing restricted diffusion models and are shown to be much slower than the diffusion of proton molecules in the bulk. Moreover, in linear and moderately branched wormlike micelles, the dominant mechanism of surfactant self-diffusion is through the curvilinear diffusion of the surfactant molecules along the contour length of the micelles, whereas in the branched micelles, before the second viscosity maxima, the surfactant self-diffusion could arise from a combination of micellar breakage, exchange between micelles and/or the bulk.

Biogenesis of Extracellular Vesicles Produced from Human-Stem-Cell-Derived Cortical Spheroids Exposed to Iron Oxides.

Stem-cell-derived extracellular vesicles (EVs) are promising tools for therapeutic delivery and imaging in the medical research fields. EVs that arise from endosomal compartments or plasma membrane budding consist of exosomes and microvesicles, which range between 30 and 200 nm and 100-1000 nm, respectively. Iron oxide nanoparticles can be used to label stem cells or possibly EVs for magnetic resonance imaging. This could be a novel way to visualize areas in the body that are affected by neurological disorders such as stroke. Human induced pluripotent stem cells (iPSK3 cells) were plated on low-attachment plates and treated with SB431542 and LDN193189 during the first week for the induction of cortical spheroid formation and grown with fibroblast growth factor 2 and cyclopamine during the second week for the neural progenitor cell (iNPC) differentiation. iNPCs were then grown on attachment plates and treated with iron oxide (Fe3O4) nanoparticles at different sizes (8, 15, and 30 nm in diameter) and concentrations (0.1, 10, and 100 µM). The spheroids and media collected from these cultures were used for iron oxide detection as well as EV isolation and characterizations, respectively. MTT assay demonstrated that the increased size and concentration of the iron oxide nanoparticles had little effect on the metabolic activity of iNPCs. In addition, the Live/Dead assay showed high viability in all the nanoparticle treated groups and the untreated control. The EVs isolated from these culture groups were analyzed and displayed similar or higher EV counts compared with control. The observed EV size averaged 200-250 nm, and electron microscopy revealed the expected exosome morphology for EVs from all groups. RT-PCR analysis of EV biogenesis markers (CD63, CD81, Alix, TSG101, Syntenin1, ADAM10, RAB27b, and Syndecan) showed differential expression between the iron-oxide-treated cultures and nontreated cultures, as well as between adherent and nonadherent 3D cultures. Iron oxide nanoparticles were detected inside the cortical spheroid cells but not EVs by MRI. The addition of iron oxide nanoparticles does not induce significant cytotoxic effects to cortical spheroids. In addition,, nanoparticles may stimulate the biogenesis of EVs when added to cortical spheroids in vitro.

Accurately constraining velocity information from spectral imaging observations using machine learning techniques.

Determining accurate plasma Doppler (line-of-sight) velocities from spectroscopic measurements is a challenging endeavour, especially when weak chromospheric absorption lines are often rapidly evolving and, hence, contain multiple spectral components in their constituent line profiles. Here, we present a novel method that employs machine learning techniques to identify the underlying components present within observed spectral lines, before subsequently constraining the constituent profiles through single or multiple Voigt fits. Our method allows active and quiescent components present in spectra to be identified and isolated for subsequent study. Lastly, we employ a Ca ɪɪ 8542 Å spectral imaging dataset as a proof-of-concept study to benchmark the suitability of our code for extracting two-component atmospheric profiles that are commonly present in sunspot chromospheres. Minimization tests are employed to validate the reliability of the results, achieving median reduced χ2-values equal to 1.03 between the observed and synthesized umbral line profiles. This article is part of the Theo Murphy meeting issue 'High-resolution wave dynamics in the lower solar atmosphere'.

Characterization of shock wave signatures at millimetre wavelengths from Bifrost simulations.

Observations at millimetre wavelengths provide a valuable tool to study the small-scale dynamics in the solar chromosphere. We evaluate the physical conditions of the atmosphere in the presence of a propagating shock wave and link that to the observable signatures in mm-wavelength radiation, providing valuable insights into the underlying physics of mm-wavelength observations. A realistic numerical simulation from the three-dimensional radiative magnetohydrodynamic code Bifrost is used to interpret changes in the atmosphere caused by shock wave propagation. High-cadence (1 s) time series of brightness temperature (Tb) maps are calculated with the Advanced Radiative Transfer code at the wavelengths 1.309 mm and 1.204 mm, which represents opposite sides of spectral band 6 of the Atacama Large Millimeter/submillimeter Array (ALMA). An example of shock wave propagation is presented. The brightness temperatures show a strong shock wave signature with large variation in formation height between approximately 0.7 and 1.4 Mm. The results demonstrate that millimetre brightness temperatures efficiently track upwardly propagating shock waves in the middle chromosphere. In addition, we show that the gradient of the brightness temperature between wavelengths within ALMA band 6 can potentially be used as a diagnostics tool in understanding the small-scale dynamics at the sampled layers. This article is part of the Theo Murphy meeting issue 'High-resolution wave dynamics in the lower solar atmosphere'.

Magnetoacoustic wave energy dissipation in the atmosphere of solar pores.

The suitability of solar pores as magnetic wave guides has been a key topic of discussion in recent years. Here, we present observational evidence of propagating magnetohydrodynamic wave activity in a group of five photospheric solar pores. Employing data obtained by the Facility Infrared Spectropolarimeter at the Dunn Solar Telescope, oscillations with periods of the order of 5 min were detected at varying atmospheric heights by examining Si ɪ 10827 Å line bisector velocities. Spectropolarimetric inversions, coupled with the spatially resolved root mean square bisector velocities, allowed the wave energy fluxes to be estimated as a function of atmospheric height for each pore. We find propagating magnetoacoustic sausage mode waves with energy fluxes on the order of 30 kW m-2 at an atmospheric height of 100 km, dropping to approximately 2 kW m-2 at an atmospheric height of around 500 km. The cross-sectional structuring of the energy fluxes reveals the presence of both body- and surface-mode sausage waves. Examination of the energy flux decay with atmospheric height provides an estimate of the damping length, found to have an average value across all five pores of Ld ≈ 268 km, similar to the photospheric density scale height. We find the damping lengths are longer for body mode waves, suggesting that surface mode sausage oscillations are able to more readily dissipate their embedded wave energies. This work verifies the suitability of solar pores to act as efficient conduits when guiding magnetoacoustic wave energy upwards into the outer solar atmosphere. This article is part of the Theo Murphy meeting issue 'High-resolution wave dynamics in the lower solar atmosphere'.

Olfactory bulb-targeted quantum dot (QD) bioconjugate and Kv1.3 blocking peptide improve metabolic health in obese male mice.

The olfactory system is a driver of feeding behavior, whereby olfactory acuity is modulated by the metabolic state of the individual. The excitability of the major output neurons of the olfactory bulb (OB) can be modulated through targeting a voltage-dependent potassium channel, Kv1.3, which responds to changes in metabolic factors such as insulin, glucose, and glucagon-like peptide-1. Because gene-targeted deletion or inhibition of Kv1.3 in the periphery has been found to increase energy metabolism and decrease body weight, we hypothesized that inhibition of Kv1.3 selectively in the OB could enhance excitability of the output neurons to evoke changes in energy homeostasis. We thereby employed metal-histidine coordination to self-assemble the Kv1.3 inhibitor margatoxin (MgTx) to fluorescent quantum dots (QDMgTx) as a means to label cells in vivo and test changes in neuronal excitability and metabolism when delivered to the OB. Using patch-clamp electrophysiology to measure Kv1.3 properties in heterologously expressed cells and native mitral cells in OB slices, we found that QDMgTx had a fast rate of inhibition, but with a reduced IC50, and increased action potential firing frequency. QDMgTx was capable of labeling cloned Kv1.3 channels but was not visible when delivered to native Kv1.3 in the OB. Diet-induced obese mice were observed to reduce body weight and clear glucose more quickly following osmotic mini-pump delivery of QDMgTx/MgTx to the OB, and following MgTx delivery, they increased the use of fats as fuels (reduced respiratory exchange ratio). These results suggest that enhanced excitability of bulbar output neurons can drive metabolic responses.

Cyclical aggregation extends in vitro expansion potential of human mesenchymal stem cells.

Mesenchymal stem cell (MSC)-based therapy has shown great promises in various animal disease models. However, this therapeutic potency has not been well claimed when applied to human clinical trials. This is due to both the availability of MSCs at the time of administration and lack of viable expansion strategies. MSCs are very susceptible to in vitro culture environment and tend to adapt the microenvironment which could lead to cellular senescence and aging. Therefore, extended in vitro expansion induces loss of MSC functionality and its clinical relevance. To combat this effect, this work assessed a novel cyclical aggregation as a means of expanding MSCs to maintain stem cell functionality. The cyclical aggregation consists of an aggregation phase and an expansion phase by replating the dissociated MSC aggregates onto planar tissue culture surfaces. The results indicate that cyclical aggregation maintains proliferative capability, stem cell proteins, and clonogenicity, and prevents the acquisition of senescence. To determine why aggregation was responsible for this phenomenon, the integrated stress response pathway was probed with salubrial and GSK-2606414. Treatment with salubrial had no significant effect, while GSK-2606414 mitigated the effects of aggregation leading to in vitro aging. This method holds the potential to increase the clinical relevance of MSC therapeutic effects from small model systems (such as rats and mice) to humans, and may open the potential of patient-derived MSCs for treatment thereby removing the need for immunosuppression.

Aggregation-induced integrated stress response rejuvenates culture-expanded human mesenchymal stem cells.

Protein homeostasis is critical for cellular function, as loss of homeostasis is attributed to aging and the accumulation of unwanted proteins. Human mesenchymal stem cells (MSCs) have shown promising therapeutic potential due to their impressive abilities to secrete inflammatory modulators, angiogenic, and regenerative cytokines. However, there exists the problem of human MSC expansion with compromised therapeutic quality. Duringin vitro expansion, human MSCs are plated on stiff plastics and undergo culture adaptation, which results in aberrant proliferation, shifts in metabolism, and decreased autophagic activity. It has previously been shown that three-dimensional (3D) aggregation can reverse some of these alterations by heightening autophagy and recovering the metabolic state back to a naïve phenotype. To further understand the proteostasis in human MSC culture, this study investigated the effects of 3D aggregation on the human MSC proteome to determine the specific pathways altered by aggregation. The 3D aggregates and 2D cultures of human MSCs derived from bone marrow (bMSC) and adipose tissue (ASC) were analyzed along with differentiated human dermal fibroblasts (FB). The proteomics analysis showed the elevated eukaryotic initiation factor 2 pathway and the upregulated activity of the integrated stress response (ISR) in 3D aggregates. Specific protein quantification further determined that bMSC and ASC responded to ISR, while FB did not. 3D aggregation significantly increased the ischemic survival of bMSCs and ASCs. Perturbation of ISR with small molecules salubrinal and GSK2606414 resulted in differential responses of bMSC, ASC, and FB. This study indicates that aggregation-based preconditioning culture holds the potential for improving the therapeutic efficacy of expanded human MSCs via the establishment of ISR and homeostasis.

Regulation of CSF and Brain Tissue Sodium Levels by the Blood-CSF and Blood-Brain Barriers During Migraine.

Cerebrospinal fluid (CSF) and brain tissue sodium levels increase during migraine. However, little is known regarding the underlying mechanisms of sodium homeostasis disturbance in the brain during the onset and propagation of migraine. Exploring the cause of sodium dysregulation in the brain is important, since correction of the altered sodium homeostasis could potentially treat migraine. Under the hypothesis that disturbances in sodium transport mechanisms at the blood-CSF barrier (BCSFB) and/or the blood-brain barrier (BBB) are the underlying cause of the elevated CSF and brain tissue sodium levels during migraines, we developed a mechanistic, differential equation model of a rat's brain to compare the significance of the BCSFB and the BBB in controlling CSF and brain tissue sodium levels. The model includes the ventricular system, subarachnoid space, brain tissue and blood. Sodium transport from blood to CSF across the BCSFB, and from blood to brain tissue across the BBB were modeled by influx permeability coefficients P BCSFB and P BBB , respectively, while sodium movement from CSF into blood across the BCSFB, and from brain tissue to blood across the BBB were modeled by efflux permeability coefficients P B C S F B ' and P B B B ' , respectively. We then performed a global sensitivity analysis to investigate the sensitivity of the ventricular CSF, subarachnoid CSF and brain tissue sodium concentrations to pathophysiological variations in P BCSFB , P BBB , P B C S F B ' and P B B B ' . Our results show that the ventricular CSF sodium concentration is highly influenced by perturbations of P BCSFB , and to a much lesser extent by perturbations of P B C S F B ' . Brain tissue and subarachnoid CSF sodium concentrations are more sensitive to pathophysiological variations of P BBB and P B B B ' than variations of P BCSFB and P B C S F B ' within 30 min of the onset of the perturbations. However, P BCSFB is the most sensitive model parameter, followed by P BBB and P B B B ' , in controlling brain tissue and subarachnoid CSF sodium levels within 3 h of the perturbation onset.