[Possibilities of complex rehabilitation of young children with epilepsy and movement disorders]. / Vozmozhnosti kompleksnoi reabilitatsii detei rannego vozrasta s epilepsiei i dvigatel'nymi narusheniyami.

Epilepsy is a chronic disease characterized by recurrent, mostly unprovoked seizures with impaired motor, autonomic, mental or mental functions that occur as a result of excessive neuronal discharges in the gray matter of the cerebral cortex. The problem of the activity of medical rehabilitation for epilepsy in the professional community remains debatable, despite the obviousness of the arguments and judgments presented. PURPOSE OF THE STUDY: Development of an effective and safe complex for the rehabilitation of young children with epilepsy, accompanied by impaired movement function. MATERIAL AND METHODS: The study included 123 young children (from 9 to 24 months) with epilepsy accompanied by impaired motor function. By the method of simple randomization, all patients were divided into 4 groups: 3 main groups and a comparison group. All children of the study groups, except for the comparison group, received medical rehabilitation: in the 1st group - classical massage with the exception of the cervical-collar zone; in the 2nd group - kinesitherapy according to the method of V. Voigt; in the 3rd group - a complex effect, including classical massage with the exclusion of the neck-collar zone and kinesitherapy according to the method of V. Voigt. Children of the comparison group received basic therapy. The effectiveness of medical rehabilitation was analyzed using the Gross motor function classification system (GMFCS) and the Griffiths intellectual development scale. RESULTS: Differences in GMFCS scores before and after medical rehabilitation were statistically significant in group 3. In patients with impaired movement function and suffering from epilepsy, the positive dynamics during complex rehabilitation was more pronounced than when using one isolated technique. CONCLUSION: Complexity in planning and prescribing a course of rehabilitation determines the greatest efficiency in reducing the deficit of physical activity. With an increase in the index of epileptiform activity according to electroencephalography data without any clinical manifestations, it is not required to cancel rehabilitation measures, it is necessary to strengthen control over the patient.

A simple method to reduce the background and improve well-to-well reproducibility of staining in ELISPOT assays.

The enzyme-linked immunospot (ELISPOT) assay due to its high sensitivity is widely used for the detection of secreted cytokines at the single-cell level. Quality of staining is the key for accurate detection of spots and their subsequent quantification in ELISPOT assays. A simple technique employing regular aluminum foil has been developed to improve the quality of staining. In plates wrapped with aluminum foil non-specific background staining and artifacts were reduced or abolished. Application of aluminum foil allowed better contrast of specific spots as well as their uniform distribution across the filter membrane. This technique provides an inexpensive and reliable tool for large-volume immune system cells screening by improving well-to-well reproducibility in ELISPOT plates.

Opioid- and GABA(A)-receptors are co-expressed by neurons in rat brain.

Pharmacological data suggest that opioids exert their excitatory action in brain indirectly, by inhibiting release of the inhibitory neurotransmitter GABA. However, it is also possible that single neuron may interact with both opioids and GABA. In the present study, we investigated whether neurons in rat midbrain and medulla express both opioid and GABA(A) receptors. Coronal sections through rat brain were double-stained using antibodies against the alpha 1 subunit of GABA(A) receptor that were combined with antibodies either against the cloned mu-opioid receptor (MOR1) or the cloned kappa-opioid receptor (KOR1). Neurons double-labeled for GABA(A) receptors and either MOR1 or KOR1 were found in many brain regions including inferior colliculus, mesencephalic trigeminal nuclei, pontine reticular nuclei and raphe interpositus nucleus. Neurons double-labeled for GABA(A) and MOR1 were observed less frequently than those labeled for GABA(A) and KOR1. Our findings provide anatomical evidence that GABAergic and opioidergic systems are closely linked and activity of the same neuron may be regulated directly by both GABA and opioids.

Expression of multiple functional chemokine receptors and monocyte chemoattractant protein-1 in human neurons.

Functional chemokine receptors and chemokines are expressed by glial cells within the CNS, though relatively little is known about the patterns of neuronal chemokine receptor expression and function. We developed monoclonal antibodies to the CCR1, CCR2, CCR3, CCR6, CXCR2, CXCR3 and CXCR4 chemokine receptors to study their expression in human fetal neurons cultured from brain tissue as well as the clonally derived NT2.N human neuronal cell line (NTera 2/cl.D1). Specific monoclonal antibody labeling demonstrated expression of CCR2, CXCR2, CXCR3 and CXCR4 on neurons from both sources. Co-labeling studies revealed strong expression of CXCR3 and CXCR4 on both dendritic and axonal processes, with a weaker expression of CXCR2 and CCR2. Reverse transcriptase-polymerase chain reaction analysis of pure NT2.N neurons confirmed RNA expression for CCR2, CXCR2, CXCR3 and CXCR4. No changes in the neuronal labeling pattern of chemokine receptor expression were noted when NT2.N neurons were grown on a supporting layer of astrocytes, again consistent with similar patterns seen in primary human fetal brain cultures. Analysis of single-cell calcium transients revealed a robust response to stromal derived factor-1alpha (CXCR4) and melanocyte growth-stimulating activity (CXCR2), and variable response to monocyte chemoattractant protein-1 (CCR2) or interferon-gamma inducible protein-10 (CXCR3). Finally, we detected the release of monocyte chemoattractant protein-1 from pure cultures of NT2.N neurons, but not undifferentiated NT2 cells. These data indicate that individual neurons may not only co-express multiple functional chemokine receptors, but also that neurons themselves produce chemokines which may influence cellular function within the central nervous system.

Serotonergic and GABAergic neurons in the medial rostral ventral medulla express kappa-opioid receptor immunoreactivity.

Activation of kappa-opioid receptors in the rostral ventral medulla has been reported to attenuate analgesia induced by activation of mu-opioid receptors in the periaqueductal gray matter. Previous studies have suggested that the cells associated with this effect might contain serotonin. In the present study, we investigated the relationship of the cloned kappa-opioid receptor to spinally projecting neurons immunoreactive for serotonin or GABA. This was done by employing two-color immunofluorescence in combination with retrograde tract-tracing using Fluoro-Gold. In the rostral ventral medulla, neurons triple-labeled for the cloned kappa-opioid receptor, serotonin and Fluoro-Gold were observed; neurons double-labeled for the cloned kappa-opioid receptor and serotonin, or single-labeled for the cloned kappa-opioid receptor or for serotonin were also observed. In addition, cloned kappa-opioid receptor immunoreactivity was expressed in some cell profiles immunoreactive for GABA. The expression of the cloned kappa-opioid receptor in the spinal cord dorsal horn was not associated with processes immunoreactive for serotonin. Our findings suggest that kappa-opioid receptors in the rostral ventral medulla are positioned to directly control the activity of at least some serotonergic neurons projecting to the dorsal spinal cord. Thus, it appears possible that the anti-analgesic action resulting from microinjection of kappa-opioid agonists into the rostral ventral medulla is mediated, at least in part, by these neurons.

Relationship of mu- and delta-opioid receptors to GABAergic neurons in the central nervous system, including antinociceptive brainstem circuits.

Inhibition of neurons containing gamma-aminobutyric acid (GABA) may underlie some of the excitatory effects of opioids in the central nervous system (CNS). In the present study, we examined the relationship of the cloned mu- and delta-opioid receptors (MOR1 and DOR1, respectively) to GABAergic neurons in brain and spinal cord. This was done by combining immunofluorescent staining for MOR1 or DOR1 with that for GABA or glutamic acid decarboxylase (GAD); fluorescent retrograde tract-tracing was used in some cases to identify neurons with particular projections. In rats, cells double labeled for GABA and MOR1 were observed in layers II-VI of the parietal cortex and in layers II-IV of the piriform cortex. In the hippocampus, double labeling was observed in the dentate gyrus and in regions CA1 and CA3. Double labeling was very prominent in the striatum and in the reticular nucleus of the thalamus; it was also observed in other portions of the diencephalon. However, double labeling for GABA and MOR1 was never observed in the cerebellar cortex. Cells double labeled for GABA and MOR1 were common in the periaqueductal gray (PAG) and the medial rostral ventral medulla (RVM) of both rats and monkeys, suggesting that involvement of GABAergic neurons with supraspinal opioid antinociception may extend to primates. In the RVM of rats, many of those double-labeled neurons were retrogradely labeled from the dorsal spinal cord. In contrast, double-labeled neurons in the PAG were almost never retrogradely labeled from the RVM. No unequivocal examples of double labeling for DOR1 and GAD were found in any region of the CNS that we examined in either rats or monkeys. However, GABAergic neurons were often apposed by DOR1 immunoreactive varicosities. Our findings suggest that activation of mu-opioid receptors directly modulates the activity of GABAergic neurons throughout the CNS, including neurons involved in the supraspinal component of opioid analgesia. In contrast, delta-opioid receptors appear to be positioned to modulate the activity of GABAergic neurons indirectly.

CNS GABA neurons express the mu-opioid receptor: immunocytochemical studies.

It has been proposed that mu-opioid receptors excite neurons in hippocampus and nucleus raphe dorsalis (NRD) by decreasing GABAergic tone. In the present study, we examined whether immunocytochemical evidence of interaction between GABAergic neurons and the mu-opioid receptor could be found in the CNS. Portions of rat brain were sectioned and stained for GABA and for the cloned mu-opioid receptor (MOR1) using two-color immunofluorescence. Neurons double-labeled for GABA and MOR1 were present in hippocampus and NRD, as well as in olfactory bulb, dorsal lateral periaqueductal gray matter, nucleus raphe medianis, nucleus raphe obscurus, and the spinal trigeminal nucleus and tract. We conclude that expression of the mu-opioid receptor by GABAergic neurons is common in the rat CNS.

Immunocytochemical localization of mu-opioid receptors in follicular cells and preimplantation mouse embryos.

It has been demonstrated that opioid peptides are involved in the regulation of mammalian reproduction. In our previous studies we demonstrated direct effects of opioids on preimplantation mouse embryos, and hypothesized the existence in preimplantation embryos of receptors similar to opioid receptors in the central neuronal system of adult animals. In the present study we addressed this issue by employing immunocytochemical staining for mu-opioid receptors using antisera raised against the C-terminal portion of the cloned mu-opioid receptors (MOR1, NHQLENLEAETAPLP, 384-398) predicted from the cloned receptor. Diffuse MOR1 immunoreactivity of moderate intensity has been revealed in one-cell embryos, while in follicular cells MOR1 staining was of high intensity and appeared to be associated with plasma membrane. No MOR1 immunoreactivity has been observed in two-cell to morula stages of development. However, blastocysts displayed intense MOR1-labeling that was particularly prominent in cells within the inner cell mass. MOR1-staining was most likely specific because preincubation of MOR1 antisera with cognate peptide completely abolished the staining. Our findings suggest the presence of opioid receptors during preimplantation development, long before the formation of the nervous system. Embryonic opioid receptors may play a role in the regulation of preimplantation development and implantation.

mu-Opioid and delta-opioid receptors are expressed in brainstem antinociceptive circuits: studies using immunocytochemistry and retrograde tract-tracing.

Opioid-produced antinociception in mammals seems to be mediated in part by pathways originating in the periaqueductal gray (PAG) and the rostroventral medulla (RVM), and these pathways may include serotonergic neurons. In the present study, we examined the relationship of the cloned mu- and delta-receptors (MOR1 and DOR1, respectively) to PAG neurons projecting to the RVM, and RVM neurons projecting to the dorsal spinal cord. This was carried out by combining immunocytochemical staining for MOR1, DOR1, and serotonin with fluorescent retrograde tract-tracing. Of 133 retrogradely labeled cells in the RVM, 31% were immunoreactive for MOR1. Of the double-labeled cells, 41% also were immunoreactive for 5HT. Fifty-three percent of retrogradely labeled cells were apposed by DOR1-ir varicosities; 29% of the apposed cells were immunoreactive for 5HT. In the mesencephalon, cells retrogradely labeled from the RVM were usually surrounded by MOR1-ir structures; however, retrogradely labeled cells were never observed to be immunoreactive for MOR1. Similarly, retrogradely labeled cells in the caudal midbrain were seldom, if ever, labeled for DOR1; however, they frequently were apposed by DOR1-ir varicosities. Of 156 retrogradely labeled profiles from three rats, 52 (33%) were apposed by DOR1-ir varicosities. We conclude that both mu- and delta-opioid receptors could be involved in the antinociception mediated by the PAG-RVM-spinal cord circuit. In addition, opioids seem likely to have both direct and indirect effects on spinally projecting RVM cells in general, and on serotonergic RVM cells in particular.

An opioid binding protein is specifically down-regulated by chronic morphine treatment in dorsal root and trigeminal ganglia.

Despite the recent cloning of mu, delta and kappa opioid receptors, a role in opioid receptor function for an opioid binding cell adhesion molecule is supported by several lines of evidence, including inhibition of opioid binding by opioid binding cell adhesion molecule antibodies, down-regulation of opioid binding cell adhesion molecule by chronic opioid agonist treatment of cultured NG108-15 cells, and reduction of opioid binding in NG108-15 cells by transfection of opioid binding cell adhesion molecule antisense cDNA. In the present study, we report that chronic in vivo treatment of mice with morphine results in down-regulation of opioid binding cell adhesion molecule immunoreactivity in primary afferent neurons in dorsal root and trigeminal ganglia as well as their axons. This effect was blocked by the opioid antagonist naloxone. Down-regulation of opioid binding cell adhesion molecule immunoreactivity was not observed in other areas of the central nervous system. Taken together, the previous studies which demonstrated the role played by opioid receptors in regulating release of transmitters from primary afferent neurons and the present findings of a specific regulation of opioid binding cell adhesion molecule expression by chronic exposure to morphine, provides evidence from an in vivo perspective which advances the notion that opioid binding cell adhesion molecule plays a role in the action of opioids.