Effects of dexamethasone on macrophages in fetal and neonatal rat lung

Efficacy and Safety of Human Retinal Progenitor Cells

PURPOSE

We assessed the long-term efficacy and safety of human retinal progenitor cells (hRPC) using established rodent models.

METHODS

Efficacy of hRPC was tested initially in Royal College of Surgeons (RCS) dystrophic rats immunosuppressed with cyclosporine/dexamethasone. Due to adverse effects of dexamethasone, this drug was omitted from a subsequent dose-ranging study, where different hRPC doses were tested for their ability to preserve visual function (measured by optokinetic head tracking) and retinal structure in RCS rats at 3 to 6 months after grafting. Safety of hRPC was assessed by subretinal transplantation into wild type (WT) rats and NIH-III nude mice, with analysis at 3 to 6 and 9 months after grafting, respectively.

RESULTS

The optimal dose of hRPC for preserving visual function/retinal structure in dystrophic rats was 50,000 to 100,000 cells. Human retinal progenitor cells integrated/survived in dystrophic and WT rat retina up to 6 months after grafting and expressed nestin, vimentin, GFAP, and βIII tubulin. Vision and retinal structure remained normal in WT rats injected with hRPC and there was no evidence of tumors. A comparison between dexamethasone-treated and untreated dystrophic rats at 3 months after grafting revealed an unexpected reduction in the baseline visual acuity of dexamethasone-treated animals.

CONCLUSIONS

Human retinal progenitor cells appear safe and efficacious in the preclinical models used here.

TRANSLATIONAL RELEVANCE

Human retinal progenitor cells could be deployed during early stages of retinal degeneration or in regions of intact retina, without adverse effects on visual function. The ability of dexamethasone to reduce baseline visual acuity in RCS dystrophic rats has important implications for the interpretation of preclinical and clinical cell transplant studies.

From blood to brain: amoeboid microglial cell, a nascent macrophage and its functions in developing brain

Amoeboid microglial cells (AMC) in the developing brain are active macrophages. The macrophagic nature of these cells has been demonstrated by many methods, such as the localization of various hydrolytic enzymes and the presence of complement type 3 surface receptors in them. More importantly is the direct visualization of these cells engaged in the phagocytosis of degenerating cells at the ultrastructural level. Further evidence of them being active macrophages is the avid internalization of tracers administered by the intravenous or intraperitoneal routes in developing rats. The potential involvement of AMC in immune functions is supported by the induced expression of major histocompatibility complex class I and II antigens on them when challenged by lipopolysaccharide or interferon-gamma. Immunosuppressive drugs, such as glucocorticoids and immune function-enhancing drugs like melatonin, affect the expression of surface receptors and antigens and the release of cytokines by AMC. Recent studies in our laboratory have shown the expression of insulin-like growth factors, endothelins, 2',3'-cyclic nucleotide 3'-phosphodiesterase, and N-methyl-D-asparate receptors. This along with the release of chemokines, such as stromal derived factor-1a and monocyte chemoattractant protein-1, suggests multiple functional roles of AMC in early brain development.

Monocyte function in preterm, term, and adult sheep

The preterm infant has functionally immature monocytes. The effects of common clinical interventions and exposures that might modulate inflammation were evaluated using monocytes isolated from blood of preterm lambs [130 d gestational age (GA)], near-term lambs (141 d GA), and adult sheep. Endotoxin stimulated hydrogen peroxide production by adult monocytes, but monocytes from 130-d and 141-d GA lambs had a reduced and delayed hydrogen peroxide production. Endotoxin did not decrease apoptosis of monocytes from 130-d and 141-d GA lambs but decreased apoptosis of adult monocytes. Dexamethasone increased the phagocytosis of bacteria and apoptotic cells by adult monocytes by 35% but not by monocytes from 130-d and 141-d GA lambs. Synthetic and natural surfactants and dipalmitoylphosphatidylcholine increased phagocytosis of apoptotic cells by monocytes from preterm, term, and adult sheep. Monocytes from preterm and term lambs differ from adult monocytes in tests of both the initiation and the resolution of inflammation. The reduced phagocytosis of apoptotic cells by monocytes from the preterm may contribute to prolonged inflammation in diseases such as bronchopulmonary dysplasia.

Dexamethasone therapy and Candida sepsis in neonates less than 1250 grams

OBJECTIVE

To determine whether dexamethasone use increases the risk for Candida sepsis (CS) in very low birth weight premature infants (<1250 g).

DESIGN

Retrospective chart review of all infants with a birth weight <1250 g, admitted to the neonatal intensive care unit of the MetroHealth Medical Center, Cleveland, Ohio between January 1, 1996 and December 31, 1999. Infant groups with (n=65) and without (n=229) CS were compared.

RESULTS

Two hundred and ninety four infants with a birth weight <1250 g were identified. CS was diagnosed at a median age of 18 days, and 6 of 65 (10%) infants died directly from Candida-related complications. Candida albicans (n=30, 60%) and Candida parapsilosis (n=14, 25%) were the predominant isolates. Use of dexamethasone in infants at risk for chronic lung disease before 14 days of age (p=0.001), duration of antibiotics (p=0.001), and total duration of parenteral nutrition and intralipid (p=0.0001) were all significantly greater in infants who developed CS. Regression analysis showed that duration of antibiotics before the diagnosis of Candida infection (r(2)=0.69, p=0.0002) and duration of dexamethasone (r(2)=0.93, p=0.0002) correlated with Candida infection. Early dexamethasone use was also related to the age at diagnosis of Candida infection (r(2)=0.51, p=0.01).

CONCLUSIONS

Dexamethasone therapy and prolonged duration of antibiotics are associated with Candida infection in premature infants.

Response of amoeboid and differentiating ramified microglia to glucocorticoids in postnatal rats: a lectin histochemical and ultrastructural study

After glucocorticoid injection(s), the number of amoeboid microglial cells (AMC) in the corpus callosum labelled by lectin was markedly reduced when compared with the corresponding control rats. In rats killed at the age of 7 days, all the labeled cells differentiated to become ramified microglia. Ultrastructurally, the AMC in glucocorticoid-injected rats were extremely vacuolated and showed increased lipid droplets. Furthermore, the cells displayed varied lectin labelling patterns especially at both the trans saccules of the Golgi apparatus and lysosomes. In differentiating ramified microglia, massive cellular debris and lectin-stained vesicles or vacuoles were observed; some of the latter appeared to fuse with the plasma membrane. The most striking feature after glucocorticoid (GCC) treatment was the complete diminution of lectin labelling at the Golgi saccules in some differentiating ramified microglia. The present results have demonstrated different effects of glucocorticoids on AMC and differentiating ramified microglia. The differential response of AMC and differentiating ramified microglia to the immunosuppressive drugs may be attributed to the fact that these cells in the postnatal brains subserve different functions or that they are at different differentiation stages. In other words, the sensitivity of microglial cells to the immunosuppressive drugs is dependent upon the stage of cell maturation/differentiation.

Diminished inducible nitric oxide synthase expression in fulminant early-onset neonatal pneumonia

OBJECTIVE

Fulminant early-onset neonatal pneumonia is associated with ascending intrauterine infection (IUI), prematurity, persistent pulmonary hypertension (PPHN), and septicemia. Nitric oxide (NO) as an inflammatory mediator is included in antimicrobial defense and has a role in pathogenesis of septic shock. The aim was to study the role of inflammatory NO in neonatal pneumonia.

METHODS

Lungs from 36 autopsies were studied: 12 had fulminant early-onset neonatal pneumonia, 5 pneumonia of later onset, and 19 controls had similar gestational and postnatal age. In addition, airway specimens from 21 intubated newborns were analyzed: 7 with fulminant early-onset pneumonia, 7 apparently noninfected infants born prematurely attributable to IUI, and 7 premature infants of similar gestation. Specimens were analyzed for inducible NO synthase (NOS2) and nitrotyrosine, an indicator of NO toxicity. The degree of staining was analyzed.

RESULTS

In fulminant pneumonia, alveolar macrophages (AM) showed significantly less NOS2 immunoactivity than the controls. In the airway specimens, the infants with fulminant pneumonia 0 to 2 days after birth had significantly lower intracellular NOS2 and nitrotyrosine and significantly lower interleukin-1beta and surfactant protein-A than apparently noninfected IUI infants. NOS2 and the other indices increased significantly during the recovery.

CONCLUSIONS

For the first time, we report NOS2 expression by macrophages from human neonates. In fulminant early-onset neonatal pneumonia, delayed production rather than excess of pulmonary inflammatory NO is associated with severe symptoms.

Glucocorticoids Promote Nonphlogistic Phagocytosis of Apoptotic Leukocytes

Phagocyte recognition, uptake, and nonphlogistic degradation of neutrophils and other leukocytes undergoing apoptosis promote the resolution of inflammation. This study assessed the effects of anti-inflammatory glucocorticoids on this leukocyte clearance mechanism. Pretreatment of “semimature” 5-day human monocyte-derived macrophages (Mφ) for 24 h with methylprednisolone, dexamethasone, and hydrocortisone, but not the nonglucocorticoid steroids aldosterone, estradiol, and progesterone, potentiated phagocytosis of apoptotic neutrophils. These effects were specific in that the potentiated phagocytosis of apoptotic neutrophils was completely blocked by the glucocorticoid receptor antagonist RU38486, and glucocorticoids did not promote 5-day Mφ ingestion of opsonized erythrocytes. Similar glucocorticoid-mediated potentiation was observed with 5-day Mφ uptake of alternative apoptotic “targets” (eosinophils and Jurkat T cells) and in uptake of apoptotic neutrophils by alternative phagocytes (human glomerular mesangial cells and murine Mφ elicited into the peritoneum or derived from bone marrow). Importantly, methylprednisolone-mediated enhancement of the uptake of apoptotic neutrophils did not trigger the release of the chemokines IL-8 and monocyte chemoattractant protein-1. Furthermore, longer-term potentiation by methylprednisolone was observed in maturing human monocyte-derived Mφ, with greater increases in 5-day Mφ uptake of apoptotic cells being observed the earlier glucocorticoids were added during monocyte maturation into Mφ. We conclude that potentiation of nonphlogistic clearance of apoptotic leukocytes by phagocytes is a hitherto unrecognized property of glucocorticoids that has potential implications for therapies aimed at promoting the resolution of inflammatory diseases.

Intestinal uptake of particulate material by dexamethasone-treated rats: use of a novel technique to avoid intestinal mucosal contamination

The aim of this study was to investigate the effect of immune suppression on the uptake of particles across the wall of the intestine and the dissemination of the particles to systemic organs. Normal and dexamethasone-immunosuppressed rats were dosed orally with 0.5 mL distilled water or fluorescent polystyrene latex particle suspension containing 2.33 x 10(9) 2-microm diameter particles. One hour after particle dosing, the animals were killed by CO2 asphyxiation. The intestinal tissues and systemic organs were sampled for particle quantitation. To avoid contamination by particles adherent to intestinal mucosa the epithelium of intestinal tissue samples was removed before quantification. The number of fluorescent particles in tissues was determined by fluorescence microscopy of digests of selected samples. The uptake of particulate material across the intestinal wall was significantly (P < 0.05) increased in rats treated with dexamethasone but the number of particles transferred to systemic organs did not differ from values found for control animals. The results suggest that although dexamethasone increased intestinal permeability the apparatus or mechanisms involved in particle transport to distal sites were not affected during immune suppression.

Effects of dexamethasone on the epiplexus cells in postnatal rats

The epiplexus cells in postnatal rats were markedly reduced in number and immunoreactivity for OX-42, OX-18 and ED1 following subcutaneous injections of dexamethasone. This was especially evident in rats receiving two or three successive injections of dexamethasone and killed at the age of 4 or 7 days. At 14 and 21 days, the cells did not exhibit any striking difference from their corresponding controls in terms of cell number and immunoreactivity for the above antibodies. Occasional epiplexus cells were labelled with the antibody OX-6 in both groups of rats sacrificed at different time points. In rats receiving dexamethasone coupled with rhodamine isothiocyanate (RhIc), the epiplexus cells, though fewer in number than the corresponding controls, emitted bright fluorescence. It is concluded that the reduction of epiplexus cells following dexamethasone injections is due to the suppression of their precursor cells, i.e. monocytes. The phagocytic activity of the persisting epiplexus cells did not appear to be abolished by dexamethasone as evidenced by their uptake of RhIc. Our results suggest that the effects of dexamethasone are reversible.

Intrapulmonary bacterial clearance of type III group B streptococcus is reduced in preterm compared with term rabbits and occurs independent of antibody

Intrapulmonary clearance of type III group B streptococcus (GBS) and related phagocytic recruitment was studied in preterm and term rabbits at 4 and 8 h after aerosol infection using left lung homogenates to quantify GBS and right lung bronchoalveolar lavage (BAL) to recover phagocytes. Opsonophagocytosis of type III GBS by pulmonary alveolar macrophages (PAM) was studied in vitro with a modified differential fluorescence-quenching method using PAM lavaged from preterm, term, and adult rabbits. Sera of experimental animals were tested for opsonization of type III GBS using fluorescein-labeled antibodies to rabbit IgG and C3. Although term animals showed some clearance at 8 h, preterm animals had marked intrapulmonary proliferation of GBS. The number of PAM in BAL fluid was 20-fold higher in term than in preterm rabbits at 0 h, but by 8 h, preterm rabbits had a large influx of PAM, whereas PAM remained constant in term BAL fluid. Rates of phagocytosis of GBS were twice as high in term versus preterm PAM during in vivo and in vitro studies. Among PAM from term and adult animals, opsonization of GBS with MgEGTA-sera promoted phagocytosis in vitro at levels comparable to pooled adult sera, whereas opsonization with EDTA-sera resulted in a significantly lower rate of ingestion. None of the experimental animals' sera were able to deposit IgG, but all deposited C3 on the surface of GBS. In summary, preterm rabbits had a diminished bronchoalveolar PAM population that did not ingest GBS as well via the alternative complement pathway when compared with term rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)