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1.
Proc Natl Acad Sci U S A ; 121(39): e2406308121, 2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-39298485

RESUMO

Huntington's disease (HD) and spinocerebellar ataxia type 3 (SCA3) are the two most prevalent polyglutamine (polyQ) neurodegenerative diseases, caused by CAG (encoding glutamine) repeat expansion in the coding region of the huntingtin (HTT) and ataxin-3 (ATXN3) proteins, respectively. We have earlier reported that the activity, but not the protein level, of an essential DNA repair enzyme, polynucleotide kinase 3'-phosphatase (PNKP), is severely abrogated in both HD and SCA3 resulting in accumulation of double-strand breaks in patients' brain genome. While investigating the mechanistic basis for the loss of PNKP activity and accumulation of DNA double-strand breaks leading to neuronal death, we observed that PNKP interacts with the nuclear isoform of 6-phosphofructo-2-kinase fructose-2,6-bisphosphatase 3 (PFKFB3). Depletion of PFKFB3 markedly abrogates PNKP activity without changing its protein level. Notably, the levels of both PFKFB3 and its product fructose-2,6 bisphosphate (F2,6BP), an allosteric modulator of glycolysis, are significantly lower in the nuclear extracts of postmortem brain tissues of HD and SCA3 patients. Supplementation of F2,6BP restored PNKP activity in the nuclear extracts of patients' brain. Moreover, intracellular delivery of F2,6BP restored both the activity of PNKP and the integrity of transcribed genome in neuronal cells derived from the striatum of the HD mouse. Importantly, supplementing F2,6BP rescued the HD phenotype in Drosophila, suggesting F2,6BP to serve in vivo as a cofactor for the proper functionality of PNKP and thereby, of brain health. Our results thus provide a compelling rationale for exploring the therapeutic use of F2,6BP and structurally related compounds for treating polyQ diseases.


Assuntos
Enzimas Reparadoras do DNA , Reparo do DNA , Frutosedifosfatos , Doença de Huntington , Animais , Humanos , Camundongos , Modelos Animais de Doenças , Quebras de DNA de Cadeia Dupla , Enzimas Reparadoras do DNA/metabolismo , Enzimas Reparadoras do DNA/genética , Drosophila , Drosophila melanogaster , Frutosedifosfatos/metabolismo , Doença de Huntington/metabolismo , Doença de Huntington/genética , Doença de Huntington/tratamento farmacológico , Neurônios/metabolismo , Fosfofrutoquinase-2/metabolismo , Fosfofrutoquinase-2/genética , Fosfotransferases (Aceptor do Grupo Álcool) , Fosfotransferases (Aceptor do Grupo Fosfato)/metabolismo , Fosfotransferases (Aceptor do Grupo Fosfato)/genética
2.
Int J Mol Sci ; 25(16)2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39201779

RESUMO

Alzheimer's disease (AD) is the most common age-associated neurodegenerative disorder, characterized by progressive cognitive decline, memory impairment, and structural brain changes, primarily involving Aß plaques and neurofibrillary tangles of hyperphosphorylated tau protein. Recent research highlights the significance of smaller Aß and Tau oligomeric aggregates (AßO and TauO, respectively) in synaptic dysfunction and disease progression. Calcineurin (CaN), a key calcium/calmodulin-dependent player in regulating synaptic function in the central nervous system (CNS) is implicated in mediating detrimental effects of AßO on synapses and memory function in AD. This study aims to investigate the specific impact of CaN on both exogenous and endogenous TauO through the acute and chronic inhibition of CaN. We previously demonstrated the protective effect against AD of the immunosuppressant CaN inhibitor, FK506, but its influence on TauO remains unclear. In this study, we explored the short-term effects of acute CaN inhibition on TauO phosphorylation and TauO-induced memory deficits and synaptic dysfunction. Mice received FK506 post-TauO intracerebroventricular injection and TauO levels and phosphorylation were assessed, examining their impact on CaN and GSK-3ß. The study investigated FK506 preventive/reversal effects on TauO-induced clustering of CaN and GSK-3ß. Memory and synaptic function in TauO-injected mice were evaluated with/without FK506. Chronic FK506 treatment in 3xTgAD mice explored its influence on CaN, Aß, and Tau levels. This study underscores the significant influence of CaN inhibition on TauO and associated AD pathology, suggesting therapeutic potential in targeting CaN for addressing various aspects of AD onset and progression. These findings provide valuable insights for potential interventions in AD, emphasizing the need for further exploration of CaN-targeted strategies.


Assuntos
Inibidores de Calcineurina , Calcineurina , Modelos Animais de Doenças , Hipocampo , Sinapses , Tacrolimo , Proteínas tau , Animais , Proteínas tau/metabolismo , Tacrolimo/farmacologia , Masculino , Camundongos , Hipocampo/metabolismo , Hipocampo/efeitos dos fármacos , Hipocampo/patologia , Calcineurina/metabolismo , Sinapses/efeitos dos fármacos , Sinapses/metabolismo , Inibidores de Calcineurina/farmacologia , Fosforilação/efeitos dos fármacos , Doença de Alzheimer/metabolismo , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/patologia , Glicogênio Sintase Quinase 3 beta/metabolismo
3.
Cell Mol Life Sci ; 79(4): 222, 2022 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-35377002

RESUMO

BACKGROUND: Alzheimer's disease (AD) is characterized by progressive cognitive decline due to accumulating synaptic insults by toxic oligomers of amyloid beta (AßO) and tau (TauO). There is growing consensus that preventing these oligomers from interacting with synapses might be an effective approach to treat AD. However, recent clinical trial failures suggest low effectiveness of targeting Aß in late-stage AD. Researchers have redirected their attention toward TauO as the levels of this species increase later in disease pathogenesis. Here we show that AßO and TauO differentially target synapses and affect each other's binding dynamics. METHODS: Binding of labeled, pre-formed Aß and tau oligomers onto synaptosomes isolated from the hippocampus and frontal cortex of mouse and postmortem cognitively intact elderly human brains was evaluated using flow-cytometry and western blot analyses. Binding of labeled, pre-formed Aß and tau oligomers onto mouse primary neurons was assessed using immunofluorescence assay. The synaptic dysfunction was measured by fluorescence analysis of single-synapse long-term potentiation (FASS-LTP) assay. RESULTS: We demonstrated that higher TauO concentrations effectively outcompete AßO and become the prevailing synaptic-associated species. Conversely, high concentrations of AßO facilitate synaptic TauO recruitment. Immunofluorescence analyses of mouse primary cortical neurons confirmed differential synaptic binding dynamics of AßO and TauO. Moreover, in vivo experiments using old 3xTgAD mice ICV injected with either AßO or TauO fully supported these findings. Consistent with these observations, FASS-LTP analyses demonstrated that TauO-induced suppression of chemical LTP was exacerbated by AßO. Finally, predigestion with proteinase K abolished the ability of TauO to compete off AßO without affecting the ability of high AßO levels to increase synaptic TauO recruitment. Thus, unlike AßO, TauO effects on synaptosomes are hampered by the absence of protein substrate in the membrane. CONCLUSIONS: These results introduce the concept that TauO become the main synaptotoxic species at late AD, thus supporting the hypothesis that TauO may be the most effective therapeutic target for clinically manifest AD.


Assuntos
Doença de Alzheimer , Idoso , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Hipocampo/metabolismo , Humanos , Sinapses/metabolismo , Sinaptossomos/metabolismo
4.
Int J Mol Sci ; 24(4)2023 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-36834781

RESUMO

Abrogating synaptotoxicity in age-related neurodegenerative disorders is an extremely promising area of research with significant neurotherapeutic implications in tauopathies including Alzheimer's disease (AD). Our studies using human clinical samples and mouse models demonstrated that aberrantly elevated phospholipase D1 (PLD1) is associated with amyloid beta (Aß) and tau-driven synaptic dysfunction and underlying memory deficits. While knocking out the lipolytic PLD1 gene is not detrimental to survival across species, elevated expression is implicated in cancer, cardiovascular conditions and neuropathologies, leading to the successful development of well-tolerated mammalian PLD isoform-specific small molecule inhibitors. Here, we address the importance of PLD1 attenuation, achieved using repeated 1 mg/kg of VU0155069 (VU01) intraperitoneally every alternate day for a month in 3xTg-AD mice beginning only from ~11 months of age (with greater influence of tau-driven insults) compared to age-matched vehicle (0.9% saline)-injected siblings. A multimodal approach involving behavior, electrophysiology and biochemistry corroborate the impact of this pre-clinical therapeutic intervention. VU01 proved efficacious in preventing in later stage AD-like cognitive decline affecting perirhinal cortex-, hippocampal- and amygdala-dependent behaviors. Glutamate-dependent HFS-LTP and LFS-LTD improved. Dendritic spine morphology showed the preservation of mushroom and filamentous spine characteristics. Differential PLD1 immunofluorescence and co-localization with Aß were noted.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Camundongos , Humanos , Animais , Lactente , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Proteínas tau/metabolismo , Camundongos Transgênicos , Disfunção Cognitiva/patologia , Modelos Animais de Doenças , Precursor de Proteína beta-Amiloide/metabolismo , Mamíferos/metabolismo
5.
Int J Mol Sci ; 22(7)2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33915974

RESUMO

The proposed deep space exploration to the moon and later to Mars will result in astronauts receiving significant chronic exposures to space radiation (SR). SR exposure results in multiple neurocognitive impairments. Recently, our cross-species (mouse/rat) studies reported impaired associative memory formation in both species following a chronic 6-month low dose exposure to a mixed field of neutrons (1 mGy/day for a total dose pf 18 cGy). In the present study, we report neutron exposure induced synaptic plasticity in the medial prefrontal cortex, accompanied by microglial activation and significant synaptic loss in the hippocampus. In a parallel study, neutron exposure was also found to alter fluorescence assisted single synaptosome LTP (FASS-LTP) in the hippocampus of rats, that may be related to a reduced ability to insert AMPAR into the post-synaptic membrane, which may arise from increased phosphorylation of the serine 845 residue of the GluA1 subunit. Thus, we demonstrate for the first time, that low dose chronic neutron irradiation impacts homeostatic synaptic plasticity in the hippocampal-cortical circuit in two rodent species, and that the ability to successfully encode associative recognition memory is a dynamic, multicircuit process, possibly involving compensatory changes in AMPAR density on the synaptic surface.


Assuntos
Região CA1 Hipocampal/efeitos da radiação , Radiação Cósmica/efeitos adversos , Plasticidade Neuronal/efeitos da radiação , Nêutrons/efeitos adversos , Córtex Pré-Frontal/efeitos da radiação , Animais , Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Região CA1 Hipocampal/metabolismo , Dendritos/efeitos da radiação , Proteína 4 Homóloga a Disks-Large/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Ratos , Ratos Wistar
6.
J Neurochem ; 153(1): 51-62, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31730234

RESUMO

There is growing evidence that type 2 diabetes or insulin resistance is linked to cognitive impairment. We recently confirmed altered lipid composition, down-regulation of insulin receptor expression and impaired basal synaptic transmission in the hippocampus of our transgenic murine model of adipocyte insulin resistance (AtENPP1-Tg). Here we evaluated whether the correction of adipose tissue dysfunction [via the subcutaneous transplantation of mesenchymal stem cells (MSC)] can improve the hippocampal synaptic transmission in AtENPP1-Tg mice versus their wildtype littermates. Animals were simply randomized to receive MSC, then weighed weekly for 12 weeks. At euthanasia, we assessed leptin in the collected serum and hippocampal synaptic high-frequency stimulation long-term potentiation (HFS-LTP) using brain slices. MSC transplantation normalized AtENPP1-Tg body and epididymal fat weights and was associated with increased leptin levels, a sign of adipocyte maturation. More importantly, transplantation restored the deficiency observed in AtENPP1-Tg HFS-LTP, the cellular readout of memory. Our results further corroborate the role of adipocyte maturation arrest in adipose tissue and highlight a role for the adipose tissue in modulating hippocampal cellular mechanisms. Further studies are warranted to explore the mechanisms for the MSC-induced improvement of hippocampal HFS-LTP.


Assuntos
Tecido Adiposo/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Hipocampo/fisiopatologia , Transplante de Células-Tronco Mesenquimais , Tecido Adiposo/citologia , Animais , Diabetes Mellitus Tipo 2/genética , Dieta Hiperlipídica , Ácidos Graxos não Esterificados , Humanos , Resistência à Insulina/genética , Leptina/sangue , Potenciação de Longa Duração , Células-Tronco Mesenquimais , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Diester Fosfórico Hidrolases/genética , Pirofosfatases/genética , Transmissão Sináptica/fisiologia
7.
Indian Pacing Electrophysiol J ; 20(4): 141-146, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32156639

RESUMO

INTRODUCTION: Epicardial exit sites of ventricular tachycardia (VT) are frequently encountered during VT ablation requiring an epicardial ablation approach for successful elimination of VT. We sought to assess the utility of repolarization markers in identifying individuals requiring an epicardial ablation approach in addition to an endocardial approach. METHODS: 32 patients who underwent successful ablation for scar mediated VT were included in the study. Fourteen patients who required a combined endocardial and epicardial VT ablation were defined as epicardial VT group (Epi) whereas 18 patients who were successfully ablated from the endocardium alone constituted the endocardial VT group (Endo). Repolarization markers during sinus rhythm were compared between the two groups. RESULTS: A higher QTc max and QTc dispersion were seen in the Epi group compared to Endo group (479 ± 34 vs 449 ± 20, p = 0.008 and 63 ± 13 vs 38 ± 8, p = 0.001, respectively). Ts-p and Ts-p/Tp-e were higher in the Epi group (166 ± 23 vs 143 ± 23, p = 0.008 and 1.55 ± 0.26 vs 1.3 ± 0.21, p < 0.005). On multivariate regression, QTc dispersion was an independent predictor of the need for an epicardial approach to ablation. A QTc dispersion more than 51.5 msec identified individuals requiring a combined epicardial and endocardial approach to ablation with a sensitivity of 92.9% and a specificity of 100%. CONCLUSIONS: Patients requiring an epicardial ablation have a higher QTc dispersion. A value greater than 51.5 msec reliably differentiates between the two groups with high sensitivity and specificity.

8.
Neurobiol Learn Mem ; 128: 65-79, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26748024

RESUMO

Long-term memory (LTM) of fear stores activity dependent modifications that include changes in amygdala signaling. Previously, we identified an enhanced probability of release of glutamate mediated signaling to be important in rat fear potentiated startle (FPS), a well-established translational behavioral measure of fear. Here, we investigated short- and long-term synaptic plasticity in FPS involving metabotropic glutamate receptors (mGluRs) and associated downstream proteomic changes in the thalamic-lateral amygdala pathway (Th-LA). Aldolase A, an inhibitor of phospholipase D (PLD), expression was reduced, concurrent with significantly elevated PLD protein expression. Blocking the PLD-mGluR signaling significantly reduced PLD activity. While transmitter release probability increased in FPS, PLD-mGluR agonist and antagonist actions were occluded. In the unpaired group (UNP), blocking the PLD-mGluR increased while activating the receptor decreased transmitter release probability, consistent with decreased synaptic potentials during tetanic stimulation. FPS Post-tetanic potentiation (PTP) immediately following long-term potentiation (LTP) induction was significantly increased. Blocking PLD-mGluR signaling prevented PTP and reduced cumulative PTP probability but not LTP maintenance in both groups. These effects are similar to those mediated through mGluR7, which is co-immunoprecipitated with PLD in FPS. Lastly, blocking mGluR-PLD in the rat amygdala was sufficient to prevent behavioral expression of fear memory. Thus, our study in the Th-LA pathway provides the first evidence for PLD as an important target of mGluR signaling in amygdala fear-associated memory. Importantly, the PLD-mGluR provides a novel therapeutic target for treating maladaptive fear memories in posttraumatic stress and anxiety disorders.


Assuntos
Tonsila do Cerebelo/fisiologia , Medo/fisiologia , Potenciação de Longa Duração , Fosfolipase D/fisiologia , Receptores de Glutamato Metabotrópico/fisiologia , Reflexo de Sobressalto/fisiologia , Tonsila do Cerebelo/enzimologia , Animais , Condicionamento Clássico/efeitos dos fármacos , Condicionamento Clássico/fisiologia , Ciclopropanos/farmacologia , Estimulação Elétrica , Potenciais Pós-Sinápticos Excitadores/efeitos dos fármacos , Medo/efeitos dos fármacos , Frutose-Bifosfato Aldolase/metabolismo , Glicina/análogos & derivados , Glicina/farmacologia , Potenciação de Longa Duração/efeitos dos fármacos , Masculino , Memória de Longo Prazo/efeitos dos fármacos , Memória de Longo Prazo/fisiologia , Vias Neurais/efeitos dos fármacos , Vias Neurais/fisiologia , Fosfolipase D/antagonistas & inibidores , Fosfolipase D/metabolismo , Ratos , Ratos Sprague-Dawley , Receptores de Glutamato Metabotrópico/agonistas , Receptores de Glutamato Metabotrópico/antagonistas & inibidores , Reflexo de Sobressalto/efeitos dos fármacos , Tálamo/fisiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-26802567

RESUMO

BACKGROUND: Drug-environment associative memory mechanisms and the resulting conditioned behaviors are key contributors in relapse to cocaine dependence. Recently, we reported rat amygdala phospholipase D as a key convergent downstream signaling partner in the expression of cocaine-conditioned behaviors mediated by glutamatergic and dopaminergic pathways. In the present study, 1 of the 2 known upstream serotonergic targets of phospholipase D, the serotonin (5-hydroxytryptamine) 2C receptor, was investigated for its role in recruiting phospholipase D signaling in cocaine-conditioned behaviors altered in the rat amygdala and dorsal hippocampus. METHODS: Using Western-blot analysis, amygdala phospholipase D phosphorylation and total expression of phospholipase D/5-hydroxytryptamine 2C receptor were observed in early (Day-1) and late (Day-14) withdrawal (cocaine-free) states among male Sprague-Dawley rats subjected to 7-day cocaine-conditioned hyperactivity training. Functional studies were conducted using Chinese Hamster Ovary cells with stably transfected human unedited isoform of 5-hydroxytryptamine 2C receptor. RESULTS: Phosphorylation of phospholipase D isoforms was altered in the Day-1 group of cocaine-conditioned animals, while increased amygdala and decreased dorsal hippocampus phospholipase D/5-hydroxytryptamine 2C receptor protein expression were observed in the Day-14 cocaine-conditioned rats. Functional cellular studies established that increased p phospholipase D is a mechanistic response to 5-HT2CR activation and provided the first evidence of a biased agonism by specific 5-hydroxytryptamine 2C receptor agonist, WAY163909 in phospholipase D phosphorylation 2, but not phospholipase D phosphorylation 1 activation. CONCLUSIONS: Phospholipase D signaling, activated by dopaminergic, glutamatergic, and serotonergic signaling, can be a common downstream element recruited in associative memory mechanisms altered by cocaine, where increased expression in amygdala and decreased expression in dorsal hippocampus may result in altered anxiety states and increased locomotor responses, respectively.

10.
Clin Transplant ; 30(5): 628-32, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26928633

RESUMO

BACKGROUND: Pre-operative statin use has shown to reduce the incidence of post-operative atrial fibrillation (AF), but not mortality in patients undergoing cardiac surgery. This association, however, has not been examined in a heart transplant (HT) cohort. METHODS: Adults (≥18 yr) who underwent HT between 1997 and 2007 at the University of Minnesota were retrospectively identified. Primary outcome was 30-d mortality after HT. Secondary outcomes were 30-d incidence of AF and time to all-cause mortality. RESULTS: Data from 259 patients (mean age 52.0 ± 11.7 yr, 81% males) were analyzed. Total of 133 (51%) patients were on statin pre-operatively at the time of HT and constituted the statin group. During a mean follow-up of 6.7 ± 3.7 yr, 82 (32%) deaths occurred, 21 (8%) of which occurred within 30 d of HT. The incidence of 30-d mortality was not significantly different between the statin and no-statin groups (9% vs. 7%, p = 0.58). Further, cumulative long-term survival after HT was not significantly different between the study groups (log-rank p = 0.49). Pre-transplant statin use did not impact the 30-d incidence of post-transplant AF (16% vs. 19%, p = 0.59). CONCLUSIONS: Pre-operative statin therapy does not seem to influence the risk of mortality or early post-operative AF after HT. Future large-scale studies are required to validate these preliminary findings.


Assuntos
Fibrilação Atrial/prevenção & controle , Transplante de Coração/mortalidade , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Adolescente , Adulto , Feminino , Seguimentos , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Adulto Jovem
11.
Europace ; 18(12): 1873-1879, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26590379

RESUMO

AIMS: It is generally recommended that individuals aspiring to competitive sports should undergo pre-participation cardiovascular assessment, particularly including arrhythmia risk evaluation. In regard to bradyarrhythmias, the 36th Bethesda Conference suggested that asymptomatic cardiac pauses ≤3 s are 'probably of no significance', whereas longer 'symptomatic' pauses may be abnormal. This study focused on assessing the evidence for the '3 s' threshold. METHODS: A systematic literature search was undertaken including Embase (1980-) and Ovid Medline (1950-). The following MeSH terms were used in the database searches: Cardiac.mp & pause.mp. Additionally, pertinent publications found by review of citation lists of identified publications were examined. Individuals with reversible causes of bradyarrhythmia (e.g. drugs) were excluded. RESULTS: The study population comprised 194 individuals with cardiac pauses of 1.35-30 s. In 120 athletes, specific records for pause durations were provided, but it was not always clear whether pauses occurred at rest. Among these 120 athletes, 106 had pauses ≤3 s, of whom 92 were asymptomatic and 14 were symptomatic. Fourteen athletes had pauses >3 s, of whom nine were asymptomatic and five were symptomatic. There were no deaths during follow-up (7.46 ± 5.1 years). With respect to symptoms, the ≤3 s threshold had a low-positive predictive value (35.7%) and low sensitivity (26.3%), but good negative predictive value (86.7%) and specificity (91%). CONCLUSION: While the evidence is not incontrovertible, the 3 s pause threshold does not adequately discriminate between potentially asymptomatic and symptomatic competitive athletes, and alone should not be used to exclude potential competitors.


Assuntos
Atletas , Bradicardia/complicações , Morte Súbita Cardíaca/prevenção & controle , Coração/fisiopatologia , Esportes , Morte Súbita Cardíaca/etiologia , Humanos , Medição de Risco
12.
Indian Pacing Electrophysiol J ; 15(2): 103-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26937094

RESUMO

Syncope is among the most frequent forms of transient loss of consciousness (TLOC), and is characterized by a relatively brief and self-limited loss of consciousness that by definition is triggered by transient cerebral hypoperfusion. Most often, syncope is caused by a temporary drop of systemic arterial pressure below that required to maintain cerebral function, but brief enough not to cause permanent structural brain injury. Currently, approximately one-third of syncope/collapse patients seen in the emergency department (ED) or urgent care clinic are admitted to hospital for evaluation. The primary objective of developing syncope/TLOC risk stratification schemes is to provide guidance regarding the immediate prognostic risk of syncope patients presenting to the ED or clinic; thereafter, based on that risk assessment physicians may be better equipped to determine which patients can be safely evaluated as outpatients, and which require hospital care. In general, the need for hospitalization is determined by several key issues: i) the patient's immediate (usually considered 1 week to 1 month) mortality risk and risk for physical injury (e.g., falls risk), ii) the patient's ability to care for him/herself, and iii) whether certain treatments inherently require in-hospital initiation (e.g., pacemaker implantation). However, at present no single risk assessment protocol appears to be satisfactory for universal application, and development of a consensus recommendation is an essential next step.

13.
Catheter Cardiovasc Interv ; 84(1): 129-36, 2014 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-24323764

RESUMO

BACKGROUND: The MitraClip® system is a newer percutaneous device that has shown promising results but data on its safety and efficacy in low- and high-surgical risk populations continues to evolve. We performed a systematic review of the published studies reporting the safety and efficacy of MitraClip® implantation for treatment of moderate to severe and severe mitral regurgitation (MR). METHODS: Reviewers independently searched for relevant articles in Medline and abstracted clinical information based on pre-defined criteria and end-points. Patients were classified as low- or high-surgical risk for conventional mitral valve (MV) surgery based on Society of Thoracic Surgeons score, EuroSCORE, or surgeon discretion. Primary safety outcome was 30-day mortality and primary efficacy outcomes were freedom from death, ≥3+ MR, and requirement for MV surgery during follow-up. RESULTS: Immediate and long-term outcomes of 16 studies, including 2980 patients (age 73.7 ± 0.6 years; 63.3% males) receiving the MitraClip®, were analyzed. Acute procedural success rate was 91.4% with a procedural mortality of 0.1%. Mortality at 30 days and long-term (310 days) follow-up was 4.2 and 15.8%, respectively and was significantly higher in the high-risk group (P = 0.003 and 0.019, respectively). Incidence of major procedural adverse outcomes was relatively low with blood transfusion accounting for most events. At follow-up, the number of patients with ≥3+ MR reduced from 96.3% to 14.7% (P < 0.001), and those with NYHA class III/IV reduced from 83.2% to 23.4% (P < 0.001). CONCLUSION: MitraClip® implantation for moderate to severe or severe MR appears to be safe with a very low procedural mortality. There is significant improvement in functional outcomes although long-term mortality is high, especially in high surgical risk patients.


Assuntos
Cateterismo Cardíaco/métodos , Próteses Valvulares Cardíacas , Insuficiência da Valva Mitral/cirurgia , Humanos , Insuficiência da Valva Mitral/diagnóstico , Desenho de Prótese , Índice de Gravidade de Doença
14.
J Electrocardiol ; 47(1): 106-12, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24157188

RESUMO

BACKGROUND AND PURPOSE: Prolonged P-wave dispersion (PWD) and P-wave duration (PWdur) have been found to be associated with common atrial fibrillation (AF), but the association of P-wave indices with lone atrial fibrillation (LAF) is unclear. METHODS: We enrolled 61 paroxysmal LAF cases and 150 controls without AF. P-wave indices were measured from a 12-lead ECG. Multivariable logistic regression was used to assess the association between P-wave indices and LAF. RESULTS: PWD was longer in LAF patients (median, IQR; 54.1 [42.9-63.2] ms) than controls (46.0 [38.5-57.7] ms), P=0.03. MinPWdur was shorter in LAF patients (60.5 [50.7-72.6] ms) than controls (66.0 [55.5-76.4] ms), P=0.03. In multivariable models, only the association between shorter minPWdur and LAF remained statistically significant (OR [95% CI] per tertile increment in minPWdur, 0.64 [0.42-0.95], P=0.03). CONCLUSIONS: Unlike common AF, paroxysmal LAF is independently associated with shorter minPWdur. This finding suggests that both shorter and prolonged PWdur may be associated with increased risk of AF.


Assuntos
Algoritmos , Fibrilação Atrial/diagnóstico , Diagnóstico por Computador/métodos , Eletrocardiografia/métodos , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
15.
J Neurosci Methods ; 409: 110219, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39013526

RESUMO

BACKGROUND: Study of synaptic integrity using conventional electrophysiology is a gold standard for quantitative assessment of neurodegeneration. Fluorescence assisted single-synapse long-term potentiation (FASS-LTP) provides a high throughput method to assess the synaptic integrity of neurotransmission within and between different brain regions as a measure of pharmacological efficacy in translational models. NEW METHOD: We adapted the existing method to our purpose by adding a step during the thawing of frozen samples, by an extra step of placing them on a rocker at room temperature for 30 minutes immediately following thawing with constant mixing on a shaker. This allowed for gradual, uniform thawing, effectively separating the synaptosomes. Our study demonstrates FASS-LTP on four brain regions at 6- and 12-month periods in the 3xTg-AD mouse model, treating sibling cohorts with VU0155069 (a small molecule inhibitor) or vehicle (0.9 % saline). RESULTS: Our findings demonstrate the robust ability of the FASS-LTP technique to characterize the functional synaptic integrity maintained by disease-treatment therapies in multiple brain regions longitudinally using frozen brain tissue. COMPARISON WITH EXISTING METHODS: By providing a detailed, user-friendly protocol for this well-known analysis and including a recovery step improved the ability to robustly replicate the FASS-LTP between different brain regions. This may be extrapolated to a translational use on human clinical samples to improve understanding of the therapeutic impact on synaptic performance related to glutamate neurotransmission. CONCLUSIONS: FASS-LTP method offers a robust analysis of synaptosomes isolated from frozen tissue samples, demonstrating greater reproducibility in rodent and human synapses in physiological and pathological states.


Assuntos
Encéfalo , Potenciação de Longa Duração , Sinapses , Animais , Encéfalo/fisiopatologia , Encéfalo/efeitos dos fármacos , Potenciação de Longa Duração/fisiologia , Potenciação de Longa Duração/efeitos dos fármacos , Sinapses/fisiologia , Sinapses/efeitos dos fármacos , Sinaptossomos/efeitos dos fármacos , Sinaptossomos/metabolismo , Camundongos , Camundongos Transgênicos , Modelos Animais de Doenças , Masculino , Camundongos Endogâmicos C57BL , Feminino
16.
Contemp Clin Dent ; 14(4): 272-276, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38344162

RESUMO

Objective: The objective of this research is to determine whether the thermoplastic polyurethane (TPU) coated with carboxymethylcellulose chitosan has better mechanical and antibacterial action (anti-Streptococcus mutans) when utilized in intraoral simulations with synthetic saliva. Materials and Methods: The TPU sheets (n = 45) were divided into three groups. Control (n = 15) consists of as-received TPU sheets. Test 1 consists of TPU sheets coated with carboxymethyl cellulose (CMC) chitosan (CHI) (n = 15). Test 2 consists of thermoformed nano-coated TPU (n = 15). For the polyurethane sheets, CHI-CMC sheets, and thermoformed CHI-CMC sheets, scanning electron microscopy (SEM) and three-point flexural tests were conducted and assessed. The materials testing software was used to calculate the elastic modulus and tensile strength. To study the bacterial accumulation, the cut circles of the TPU aligner were placed in centrifuge tubes with 2.5 mL of bacterial suspension at a concentration of 104 or 105 CFU/mL. SEM was done to assess the presence of cell growth in all three groups. Results: According to SEM analyses of bacterial buildup, the coated TPU had minimal biofilms compared to the bare TPUs numerous biofilms. The effect of aging on coating thickness reveals that the thickness of thermoformed coated TPU films dramatically decreased over time, while the thickness of coated TPU films was maintained. When TPU is coated with CMC/CHI, the elastic modulus and tensile strength were observed to improve. Conclusion: The development of a super-hydrophilic coating by the CHI CMC coating on TPU sheets improved the coating's biocompatibility while also changing the shape of the multilayer film to prevent bacterial adhesion. The effect on the improvement in the mechanical properties diminished after the material underwent a thermoforming process. It is therefore suggested that the nanofilm be used in therapeutic applications following the thermoforming process.

17.
bioRxiv ; 2023 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-37066187

RESUMO

Background: Blood-brain barrier (BBB) breakdown is a component of the progression and pathology of Alzheimer's disease (AD). BBB dysfunction is primarily caused by reduced or disorganized tight junction or adherens junction proteins of brain microvascular endothelial cell (BMEC). While there is growing evidence of tight junction disruption in BMECs in AD, the functional role of adherens junctions during BBB dysfunction in AD remains unknown. Exosomes secreted from senescent cells have unique characteristics and contribute to modulating the phenotype of recipient cells. However, it remains unknown if and how these exosomes cause BMEC dysfunction in AD. Objectives: This study aimed to investigate the potential roles of AD circulating exosomes and their RNA cargos in brain endothelial dysfunction in AD. Methods: We isolated exosomes from sera of five cases of AD compared with age- and sex-matched cognitively normal controls using size-exclusion chromatography technology. We validated the qualities and particle sizes of isolated exosomes with nanoparticle tracking analysis and atomic force microscopy. We measured the biomechanical natures of the endothelial barrier of BMECs, the lateral binding forces between live BMECs, using fluidic force miscopy. We visualized the paracellular expressions of the key adherens junction protein VE-cadherin in BMEC cultures and a 3D BBB model that employs primary human BMECs and pericytes with immunostaining and evaluated them using confocal microscopy. We also examined the VE-cadherin signal in brain tissues from five cases of AD and five age- and sex-matched cognitively normal controls. Results: We found that circulating exosomes from AD patients suppress the paracellular expression levels of VE-cadherin and impair the barrier function of recipient BMECs. Immunostaining analysis showed that AD circulating exosomes damage VE-cadherin integrity in a 3D model of microvascular tubule formation. We found that circulating exosomes in AD weaken the BBB depending on the RNA cargos. In parallel, we observed that microvascular VE-cadherin expression is diminished in AD brains compared to normal controls. Conclusion: Using in vitro and ex vivo models, our study illustrates that circulating exosomes from AD patients play a significant role in mediating the damage effect on adherens junction of recipient BMEC of the BBB in an exosomal RNA-dependent manner. This suggests a novel mechanism of peripheral senescent exosomes for AD risk.

18.
J Alzheimers Dis ; 95(3): 869-885, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37661885

RESUMO

BACKGROUND: Blood-brain barrier (BBB) breakdown is a crucial aspect of Alzheimer's disease (AD) progression. Dysfunction in BBB is primarily caused by impaired tight junction and adherens junction proteins in brain microvascular endothelial cells (BMECs). The role of adherens junctions in AD-related BBB dysfunction remains unclear. Exosomes from senescent cells have unique characteristics and contribute to modulating the phenotype of recipient cells. However, it remains unknown if and how these exosomes cause BMEC dysfunction in AD. OBJECTIVE: This study aimed to investigate the impact of AD circulating exosomes on brain endothelial dysfunction. METHODS: Exosomes were isolated from sera of AD patients and age- and sex-matched cognitively normal controls using size-exclusion chromatography. The study measured the biomechanical nature of BMECs' endothelial barrier, the lateral binding forces between live BMECs. Paracellular expressions of the key adherens junction protein vascular endothelial (VE)-cadherin were visualized in BMEC cultures and a 3D BBB model using human BMECs and pericytes. VE-cadherin signals were also examined in brain tissues from AD patients and normal controls. RESULTS: Circulating exosomes from AD patients reduced VE-cadherin expression levels and impaired barrier function in recipient BMECs. Immunostaining analysis demonstrated that AD exosomes damaged VE-cadherin integrity in a 3D microvascular tubule formation model. The study found that AD exosomes weakened BBB integrity depending on their RNA content. Additionally, diminished microvascular VE-cadherin expression was observed in AD brains compared to controls. CONCLUSION: These findings highlight the significant role of circulating exosomes from AD patients in damaging adherens junctions of recipient BMECs, dependent on exosomal RNA.


Assuntos
Doença de Alzheimer , Exossomos , Humanos , Células Endoteliais , Encéfalo/irrigação sanguínea , Barreira Hematoencefálica , Caderinas , RNA
19.
Front Immunol ; 13: 904679, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35812423

RESUMO

Spotted fever group rickettsioses caused by Rickettsia (R) are devastating human infections, which mainly target microvascular endothelial cells (ECs) and can induce lethal EC barrier dysfunction in the brain and lungs. Our previous evidence reveals that exosomes (Exos) derived from rickettsial-infected ECs, namely R-ECExos, can induce disruption of the tight junctional (TJ) protein ZO-1 and barrier dysfunction of human normal recipient brain microvascular endothelial cells (BMECs). However, the underlying mechanism remains elusive. Given that we have observed that microRNA23a (miR23a), a negative regulator of endothelial ZO-1 mRNA, is selectively sorted into R-ECExos, the aim of the present study was to characterize the potential functional role of exosomal miR23a delivered by R-ECExos in normal recipient BMECs. We demonstrated that EC-derived Exos (ECExos) have the capacity to deliver oligonucleotide RNAs to normal recipient BMECs in an RNase-abundant environment. miR23a in ECExos impairs normal recipient BMEC barrier function, directly targeting TJ protein ZO-1 mRNAs. In separate studies using a traditional in vitro model and a novel single living-cell biomechanical assay, our group demonstrated that miR23a anti-sense oligonucleotide-enriched ECExos ameliorate R-ECExo-provoked recipient BMEC dysfunction in association with stabilization of ZO-1 in a dose-dependent manner. These results suggest that Exo-based therapy could potentially prove to be a promising strategy to improve vascular barrier function during bacterial infection and concomitant inflammation.


Assuntos
Exossomos , Infecções por Rickettsia , Rickettsia , Doenças Vasculares , Encéfalo/metabolismo , Células Endoteliais/metabolismo , Exossomos/metabolismo , Humanos , MicroRNAs , Doenças Vasculares/metabolismo
20.
Eur J Neurosci ; 34(2): 177-89, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21749491

RESUMO

Cocaine relapse can occur when cocaine-associated environmental cues induce craving. Conditioned place preference (CPP) is a behavioral paradigm modeling the association between cocaine exposure and environmental cues. The amygdala is involved in cocaine cue associations with the basolateral amygdala (BLA) and central amygdala (CeA) acting differentially in cue-induced relapse. Activation of metabotropic glutamate receptors induces synaptic plasticity, the mechanism of which is thought to underlie learning, memory and drug-cue associations. The goal of this study was to examine the neural alterations in responses to group I metabotropic glutamate receptor (mGluR) agonists in the BLA to lateral capsula of CeA (BLA-CeLc) pathway in slices from rats exposed to cocaine-CPP conditioning and withdrawn for 14 days. mGluR1, but not mGluR5, agonist-induced long-term potentiation (mGluR1-LTP) in the BLA-CeLc pathway was reduced in rats withdrawal from cocaine for 2 and 14 days, and exhibited an altered concentration response to picrotoxin. Cocaine withdrawal also reduced γ-aminobutyric acid (GABA)ergic synaptic inhibition in CeLc neurons. Blocking cannabinoid receptor 1 (CB(1) ) reduced mGluR1-LTP in the saline-treated but not cocaine-withdrawn group. Response to CB(1) but not CB(2) agonist was altered after cocaine. Additionally, increasing endocannabinoid (eCB) levels abolished mGluR1-LTP in the saline but not cocaine-withdrawn group. However, CB(1) and CB(2) protein levels were increased in the amygdala of cocaine-withdrawn rats while mGluR1 and mGluR5 remained unchanged. These data suggested that the mechanisms underlying the diminished mGluR1-LTP in cocaine-withdrawn rats involve an altered GABAergic synaptic inhibition mediated by modulation of downstream eCB signaling. These changes may ultimately result in potentiated responses to environmental cues that would bias behavior toward drug-seeking.


Assuntos
Tonsila do Cerebelo/fisiologia , Cocaína/farmacologia , Potenciação de Longa Duração/efeitos dos fármacos , Receptores de Glutamato Metabotrópico/metabolismo , Síndrome de Abstinência a Substâncias/fisiopatologia , Transmissão Sináptica/fisiologia , Ácido gama-Aminobutírico/metabolismo , Tonsila do Cerebelo/efeitos dos fármacos , Animais , Comportamento Animal/efeitos dos fármacos , Condicionamento Psicológico/efeitos dos fármacos , Potenciais Pós-Sinápticos Excitadores/efeitos dos fármacos , Potenciais Pós-Sinápticos Excitadores/fisiologia , Antagonistas GABAérgicos/metabolismo , Potenciação de Longa Duração/fisiologia , Masculino , Técnicas de Patch-Clamp , Picrotoxina/metabolismo , Ratos , Ratos Sprague-Dawley , Receptor CB1 de Canabinoide/agonistas , Receptor CB1 de Canabinoide/análise , Receptor CB1 de Canabinoide/metabolismo , Receptor CB2 de Canabinoide/agonistas , Receptor CB2 de Canabinoide/análise , Receptor CB2 de Canabinoide/metabolismo , Receptor de Glutamato Metabotrópico 5 , Receptores de Glutamato Metabotrópico/agonistas , Receptores de N-Metil-D-Aspartato/metabolismo , Transmissão Sináptica/efeitos dos fármacos
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