IDO-1 inhibition improves outcome after fluid percussion injury in adult male rats.

The enzyme indoleamine 2,3 dioxygenase 1 (IDO1) catalyzes the rate-limiting step in the kynurenine pathway (KP) which produces both neuroprotective and neurotoxic metabolites. Neuroinflammatory signals produced as a result of pathological conditions can increase production of IDO1 and boost its enzymatic capacity. IDO1 and the KP have been implicated in behavioral recovery after human traumatic brain injury (TBI), but their roles in experimental models of TBI are for the most part unknown. We hypothesized there is an increase in KP activity in the fluid percussion injury (FPI) model of TBI, and that administration of an IDO1 inhibitor will improve neurological recovery. In this study, adult male Sprague Dawley rats were subjected to FPI or sham injury and received twice-daily oral administration of the IDO1 inhibitor PF-06840003 (100 mg/kg) or vehicle control. FPI resulted in a significant increase in KP activity, as demonstrated by an increased ratio of kynurenine: tryptophan, in the perilesional neocortex and ipsilateral hippocampus 3 days postinjury (DPI), which normalized by 7 DPI. The increase in KP activity was prevented by PF-06840003. IDO1 inhibition also improved memory performance as assessed in the Barnes maze and anxiety behaviors as assessed in open field testing in the first 28 DPI. These results suggest increased KP activity after FPI may mediate neurological dysfunction, and IDO1 inhibition should be further investigated as a potential therapeutic target to improve recovery.

Endogenous Antimicrobial-Immunomodulatory Molecules: Networking Biomolecules of Innate Immunity.

Endogenous antimicrobial-immunomodulatory molecules (EAIMs) are essential to immune-mediated human health and evolution. Conventionally, antimicrobial peptides (AMPs) have been regarded as the dominant endogenous antimicrobial molecule; however, AMPs are not sufficient to account for the full spectrum of antimicrobial-immunomodulatory duality occurring within the human body. The threat posed by pathogenic microbes is pervasive with the capacity for widespread impact across many organ systems and multiple biochemical pathways; accordingly, the host needs the capacity to react with an equally diverse response. This can be attained by having EAIMs that traverse the full range of molecular size (small to large molecules) and structural diversity (including molecules other than peptides). This review identifies multiple molecules (peptide/protein, lipid, carbohydrate, nucleic acid, small organic molecule, and metallic cation) as EAIMs and discusses the possibility of cooperative, additive effects amongst the various EAIM classes during the host response to a microbial assault. This comprehensive consideration of the full molecular diversity of EAIMs enables the conclusion that EAIMs constitute a previously uncatalogued structurally diverse and collectively underappreciated immuno-active group of integrated molecular responders within the innate immune system's first line of defence.

Alzheimer's Disease and COVID-19 Pathogenic Overlap: Implications for Drug Repurposing.

As COVID-19 continues, a safe, cost-effective treatment strategy demands continued inquiry. Chronic neuroinflammatory disorders may appear to be of little relevance in this regard; often indolent and progressive disorders characterized by neuroinflammation (such as Alzheimer's disease (AD)) are fundamentally dissimilar in etiology and symptomology to COVID-19's rapid infectivity and pathology. However, the two disorders share extensive pathognomonic features, including at membrane, cytoplasmic, and extracellular levels, culminating in analogous immunogenic destruction of their respective organ parenchyma. We hypothesize that these mechanistic similarities may extent to therapeutic targets, namely that it is conceivable an agent against AD's immunopathy may have efficacy against COVID-19 and vice versa. It is notable that while extensively investigated, no agent has yet demonstrated significant therapeutic efficacy against AD's cognitive and memory declines. Yet this very failure has driven the development of numerous agents with strong mechanistic potential and clinical characteristics. Having already approved for clinical trials, these agents may be an expedient starting point in the urgent search for an effective COVID-19 therapy. Herein, we review the overlapping Alzheimer's/ COVID-19 targets and theorize several initial platforms.

Amyloid-ß is a cytokine.

The role of amyloid-ß (Aß) peptide in human physiology and pathology remains an unresolved subject of study; Aß's role in Alzheimer's disease (AD) is particularly controversial. However, before we can more fully appreciate Aß's role in AD, an understanding of its normal physiological role(s) must first be attained. This perspective appraises the current literature and concludes that Aß is a cytokine. This conclusion was arrived at based on a comprehensive listing of 30 characteristic defining structural and functional properties of cytokines followed by a literature precedence-based demonstration that Aß possesses all 30 properties; this categorization of cytokine characteristics enabled an organized comparison of cytokines and Aß, thereby providing systematic justification for classifying Aß as a cytokine. The conclusion that Aß is a cytokine enables the merger of two leading hypotheses of AD (amyloid hypothesis and neuroinflammation) into a single process.

A Stereocontrolled Total Synthesis of Lipoxin B4 and its Biological Activity as a Pro-Resolving Lipid Mediator of Neuroinflammation.

Two stereocontrolled, efficient, and modular syntheses of eicosanoid lipoxin B4 (LXB4 ) are reported. One features a stereoselective reduction followed by an asymmetric epoxidation sequence to set the vicinal diol stereocentres. The dienyne was installed via a one-pot Wittig olefination and base-mediated epoxide ring opening cascade. The other approach installed the diol through an asymmetric dihydroxylation reaction followed by a Horner-Wadsworth-Emmons olefination to afford the common dienyne intermediate. Finally, a Sonogashira coupling and an alkyne hydrosilylation/proto-desilylation protocol furnished LXB4 in 25 % overall yield in just 10 steps. For the first time, LXB4 has been fully characterized spectroscopically with its structure confirmed as previously reported. We have demonstrated that the synthesized LXB4 showed similar biological activity to commercial sources in a cellular neuroprotection model. This synthetic route can be employed to synthesize large quantities of LXB4 , enable synthesis of new analogs, and chemical probes for receptor and pathway characterization.

Alzheimer's disease as an innate autoimmune disease (AD2 ): A new molecular paradigm.

A new model of Alzheimer's disease (AD) is presented: Alzheimer's disease as an autoimmune disease (AD2 ).  In response to pathogen-/damage-associated molecular pattern-stimulating events (e.g., infection, trauma, ischemia, pollution), amyloid beta (Aß) is released as an early responder cytokine triggering an innate immunity cascade in which Aß exhibits immunomodulatory/antimicrobial duality.  However, Aß's antimicrobial properties result in a misdirected attack upon "self" neurons, arising from the electrophysiological similarities between neurons and bacteria in terms of transmembrane potential gradients and anionic charges on outer membrane macromolecules. The subsequent breakdown products of necrotic neurons elicit further release of Aß leading to a chronic, self-perpetuating cycle. In AD2 , amino acid (trp, arg) metabolism is a central control player in modulating AD autoimmunity.  AD2 includes Aß as an important molecular player, but rejects the "amyloid hypothesis," recognizing Aß as a physiologically oligomerizing cytokine and part of a larger immunopathic conceptualization of AD.

Ferulic acid amide derivatives with varying inhibition of amyloid-ß oligomerization and fibrillization.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized, in part, by the misfolding, oligomerization and fibrillization of amyloid-ß (Aß). Evidence suggests that the mechanisms underpinning Aß oligomerization and subsequent fibrillization are distinct, and may therefore require equally distinct therapeutic approaches. Prior studies have suggested that amide derivatives of ferulic acid, a natural polyphenol, may combat multiple AD pathologies, though its impact on Aß aggregation is controversial. We designed and synthesized a systematic library of amide derivatives of ferulic acid and evaluated their anti-oligomeric and anti-fibrillary capacities independently. Azetidine tethered, triphenyl derivatives were the most potent anti-oligomeric agents (compound 2i: IC50 = 1.8 µM ± 0.73 µM); notably these were only modest anti-fibrillary agents (20.57% inhibition of fibrillization), and exemplify the poor correlation between anti-oligomeric/fibrillary activities. These data were subsequently codified in an in silico QSAR model, which yielded a strong predictive model of anti-Aß oligomeric activity (κ = 0.919 for test set; κ = 0.737 for validation set).

Microsecond molecular dynamics studies of cholesterol-mediated myelin sheath degeneration in early Alzheimer's disease.

Cholesterol-mediated perturbations of membrane structural integrity are key early events in the molecular pathogenesis of Alzheimer's disease (AD). In AD, protein misfolding (proteopathy) and pro-inflammatory conditions (immunopathy) culminate in neuronal death, a process enabled by altered membrane biophysical properties which render neurons more susceptible to proteopathic and immunopathic cytotoxicities. Since cholesterol is a principal neuronal membrane lipid, normal cholesterol homeostasis is central to membrane health; also, since increased cholesterol composition is especially present in neuronal myelin sheath (i.e. brain "white matter"), recent studies have not surprisingly revealed that white matter atrophy precedes the conventional biomarkers of AD (amyloid plaques, tau tangles). Employing extensive microsecond all-atom molecular dynamics simulations, we investigated biophysical and mechanical properties of myelin sheath membrane as a function of cholesterol mole fraction (χCHL). Impaired χCHL modulates multiple bilayer properties, including surface area per lipid (APL), chain order, number and mass density profiles, area compressibility and bending moduli, bilayer thickness, lipid tilt angles, H-bonding interactions and tail interdigitation. The increased orientational ordering of both palmitoyl and oleoyl chains in model healthy myelin sheath (HMS) membranes illustrates the condensing effect of cholesterol. With an increase in χCHL, number density profiles of water tend to attain bulk water number density more quickly, indicating shrinkage in the interfacial region with increasing χCHL. The average tilt value is 11.5° for the C10-C13 angle in cholesterol and 64.2° for the P-N angle in POPC lipids in HMS. These calculations provide a molecular-level understanding of myelin sheath susceptibility to pathology as an early event in the pathogenesis of AD.

Inter-individual variability in disease expression: the Tudor-Churchill spectrum.

Henry VIII and Winston Churchill are clinically instructive when appreciating inter-individual variability in disease expression. Both were illustrious English leaders who as young men sustained multiple traumatic brain injuries, which may (or may not) have profoundly influenced their successes and failures of later years. Both men were admired and castigated; both struggled at various times with their bodies and their minds. Ultimately, one was initially a great man who descended as a flawed leader; the other was initially a flawed man who ascended as a great leader. Their similar yet contrasting case histories define the full spectrum ("Tudor-Churchill Spectrum") of inter-individual variability in response to brain disease or injury. The Tudor-Churchill spectrum is the immense variability between individual patients and reminds us that every person is unique, deserving of individualized thought, personalized diagnosis and tailored treatment.

Understanding the effect of nanoconfinement on the structure of water hydrogen bond networks.

Using an integrated approach of network theory and atomistic molecular dynamics simulations, we performed a detailed topological analysis on hydrogen bond networks of water confined between either two graphene sheets or two lipid bilayers to explore the structural perturbation of these networks under nanoscale confinement. The hydrogen bond network structure can be perturbed to a considerable extent when water is confined by such surfaces, yet no small-world behaviour is observed. The presence of ions also reduces the network complexity but its effect may be small depending on the type of confining surfaces. We developed an information flow model to evaluate the fluctuating nature of hydrogen bond networks and to characterise the dynamic, long-distance hydrogen-bonded chains in water. We found that the length and directionality of the hydrogen bond "trails" are highly susceptible to the type of confining surfaces and the degree of confinement. In particular, the endpoints of the hydrogen bond trails are not completely random in confined water, in which inherent distributions are determined by the density of water and the density of hydrogen bonds. This work forms the basis for the study of the pure effect of hydrogen bond network topology on various transport processes, such as proton transfer, that occur along a sequence of hydrogen bonds in a biochemical system. Our results suggest that a combined effect of the structure and lifetime of the hydrogen bond network of interfacial water may contribute to high lateral proton diffusivity at the surface of a lipid membrane.

Nutrients in Alzheimer's Disease: The Interaction of Diet, Drugs and Disease.

In recent decades, clinical trials in Alzheimer's disease (AD) have failed at an unprecedented rate. The etiology of AD has since come under renewed scrutiny, both to elucidate the underlying pathologies and to identify novel therapeutic strategies. Here, diet has emerged as a potential causative/protective agent. A variety of nutrients, including lipids, minerals, vitamins, antioxidants and sugars as well as broader dietary patterns and microbiotal interactions have demonstrated associations with AD. Although clinical trials have yet to definitively implicate any singular dietary element as therapeutic or causative, it is apparent that dietary preferences, likely in complex synergies, may influence the risk, onset and course of AD. This review catalogs the impact of major dietary elements on AD. It further examines an unexplored reciprocal association where AD may modulate diet, as well as how potential therapeutics may complicate these interactions. In doing so, we observe diet may have profound effects on the outcome of a clinical trial, either as a confounder of a drug/disease interaction or as a generally disruptive covariate. We therefore conclude that future clinical trials in AD should endeavor to control for diet, either in study design or subsequent analyses.

Inhibition of Pantothenate Synthetase by Analogs of ß-Alanine Precursor Ineffective as an Antibacterial Strategy.

BACKGROUND: Pantothenate, the fundamental precursor to coenzyme A, is required for optimal growth and virulence of microbial pathogens. It is synthesized by the enzyme-catalyzed condensation of ß-alanine and pantoate, which has shown susceptibility to inhibition by analogs of its molecular constituents. Accordingly, analogs of ß-alanine are gaining inquiry as potential antimicrobial chemotherapeutics. METHODS: We synthesized and evaluated 35 derivatives of ß-alanine, substituted at the α, ß, amine, and carboxyl sites, derived from in silico, dynamic molecular modeling to be potential competitive inhibitors of pantothenate synthetase. Employing the Clinical Laboratory Standards M7-A6 broth microdilution method, we tested these for inhibition of growth in Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa. RESULTS: All compounds proved entirely ineffective in all species tested, with no inhibition of growth being observed up to 200 µM/mL. CONCLUSIONS: Upon revision of the literature, we conclude that high enzyme selectivity or external salvage mechanisms may render this strategy futile against most bacteria.

Concussion, Cagney, Captains of the Clouds.

The case of James Cagney adds interesting details to the history of concussion. It is underappreciated that a movie-star of Cagney's stature incurred multiple concussions over many years. Moreover, the fact that he sustained one of these concussions in Canada while filming Captains of the Clouds, a major Hollywood film, is essentially unknown, and was seldom discussed by Cagney despite his willingness to discuss his many other concussions. The scene showing this concussion was left in the final released version of the movie, making it one of the earliest filmed concussions and the first concussion ever filmed in Technicolor.

Lingua patientis: new words for patient communication and history taking.

The English language sometimes fails in its ability to describe the severity or complexity of medical symptoms and complaints. In frustration, patients (or families) occasionally create new words to convey the subtleties of their medical history. Although medicine has created a comprehensive technical lexicon for physicians, we have failed to develop a corresponding patient-centric vocabulary (lingua patientis) that provides more accurate symptom description. The social networking of lingua patientis words might enhance history taking and afford improved appreciation of disease impact on individual patients. The English language is renowned for its capacity for flexibility and adaptability - we need to exploit this capacity for the benefit of our patients.

Diversification of edaravone via palladium-catalyzed hydrazine cross-coupling: Applications against protein misfolding and oligomerization of beta-amyloid.

N-Aryl derivatives of edaravone were identified as potentially effective small molecule inhibitors of tau and beta-amyloid aggregation in the context of developing disease-modifying therapeutics for Alzheimer's disease (AD). Palladium-catalyzed hydrazine monoarylation protocols were then employed as an expedient means of preparing a focused library of 21 edaravone derivatives featuring varied N-aryl substitution, thereby enabling structure-activity relationship (SAR) studies. On the basis of data obtained from two functional biochemical assays examining the effect of edaravone derivatives on both fibril and oligomer formation, it was determined that derivatives featuring an N-biaryl motif were four-fold more potent than edaravone.

Impact of protecting ligands on surface structure and antibacterial activity of silver nanoparticles.

Silver nanoparticles (Ag NPs) have attracted much attention in the past decade because of their unique physicochemical properties and notable antibacterial activities. In particular, thiol-protected Ag NPs have come to the forefront of metal nanoparticle studies, as they have been shown to possess high stability and interesting structure-property relationships. However, a clear correlation between thiol-protecting ligands, the resulting Ag NP surface structure, and their antibacterial properties has yet to be determined. Here, a multielement (Ag and S), multi-edge (Ag K-edge, Ag L3-edge, S K-edge) X-ray absorption spectroscopy (XAS) methodology was used to identify the structure and composition of Ag NPs protected with cysteine. XAS characterization was carried out on similar-sized Ag NPs protected with poly(vinylpyrrolidone) (PVP), in order to provide a valid comparison of the ligand effect on surface structure. The PVP-Ag NPs showed a metallic Ag surface and composition, consistent with metal NPs protected by weak protecting ligands. On the other hand, the Cys-Ag NPs exhibited a distinct surface shell of silver sulfide, which is remarkably different than previously studied Cys-Ag NPs. The minimum inhibitory concentration (MIC) of both types of Ag NPs against Gram-positive (+) and Gram-negative (-) bacteria were tested, including Staphylococcus aureus (+), Escherichia coli (-), and Pseudomonas aeruginosa (-). It was found that the MICs of the Cys-Ag NPs were significantly lower than the PVP-Ag NPs for each bacteria, implicating the influence of the sulfidized surface structure. Overall, this work shows the effect of ligand on the surface structure of Ag NPs, as well as the importance of surface structure in controlling antibacterial activity.