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Webster KE, George B, Lee A, Galbraith K, Harrington-Benton NA, Judd O, Kaski D, Maarsingh OR, MacKeith S, Murdin L, Ray J, Van Vugt VA, Burton MJ. Lifestyle and dietary interventions for Ménière's disease. Cochrane Database Syst Rev 2023; 2:CD015244. [PMID: 36848645 PMCID: PMC9969956 DOI: 10.1002/14651858.cd015244.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Ménière's disease is a condition that causes recurrent episodes of vertigo, associated with hearing loss and tinnitus. Lifestyle or dietary modifications (including reducing the amount of salt or caffeine in the diet) are sometimes suggested to be of benefit for this condition. The underlying cause of Ménière's disease is unknown, as is the way in which these interventions may work. The efficacy of these different interventions at preventing vertigo attacks, and their associated symptoms, is currently unclear. OBJECTIVES To evaluate the benefits and harms of lifestyle and dietary interventions versus placebo or no treatment in people with Ménière's disease. SEARCH METHODS The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 14 September 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs in adults with Ménière's disease comparing any lifestyle or dietary intervention with either placebo or no treatment. We excluded studies with follow-up of less than three months, or with a cross-over design (unless data from the first phase of the study could be identified). DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were: 1) improvement in vertigo (assessed as a dichotomous outcome - improved or not improved), 2) change in vertigo (assessed as a continuous outcome, with a score on a numerical scale) and 3) serious adverse events. Our secondary outcomes were: 4) disease-specific health-related quality of life, 5) change in hearing, 6) change in tinnitus and 7) other adverse effects. We considered outcomes reported at three time points: 3 to < 6 months, 6 to ≤ 12 months and > 12 months. We used GRADE to assess the certainty of evidence for each outcome. MAIN RESULTS: We included two RCTs, one related to diet, and the other related to fluid intake and sleep. In a Swedish study, 51 participants were randomised to receive 'specially processed cereals' or standard cereals. The specially processed cereals are thought to stimulate the production of anti-secretory factor - a protein that reduces inflammation and fluid secretion. Participants received the cereals for three months. The only outcome reported by this study was disease-specific health-related quality of life. The second study was conducted in Japan. The participants (223) were randomised to receive abundant water intake (35 mL/kg/day), or to sleep in darkness (in an unlit room for six to seven hours per night), or to receive no intervention. The duration of follow-up was two years. The outcomes assessed were 'improvement in vertigo' and hearing. As these studies considered different interventions we were unable to carry out any meta-analysis, and for almost all outcomes the certainty of the evidence was very low. We are unable to draw meaningful conclusions from the numerical results. AUTHORS' CONCLUSIONS The evidence for lifestyle or dietary interventions for Ménière's disease is very uncertain. We did not identify any placebo-controlled RCTs for interventions that are frequently recommended for those with Ménière's disease, such as salt restriction or caffeine restriction. We identified only two RCTs that compared a lifestyle or dietary intervention to placebo or no treatment, and the evidence that is currently available from these studies is of low or very low certainty. This means that we have very low confidence that the effects reported are accurate estimates of the true effect of these interventions. Consensus on the appropriate outcomes to measure in studies of Ménière's disease is needed (i.e. a core outcome set) in order to guide future studies in this area and enable meta-analyses of the results. This must include appropriate consideration of the potential harms of treatment, as well as the benefits.
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Affiliation(s)
- Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Ben George
- Corpus Christi College, University of Oxford, Oxford, UK
| | - Ambrose Lee
- Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Kevin Galbraith
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | | | - Owen Judd
- ENT Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Diego Kaski
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Otto R Maarsingh
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Samuel MacKeith
- ENT Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Louisa Murdin
- ENT Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Vincent A Van Vugt
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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2
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Ehinger E, Kopecky J, Darabi A, Visse E, Edvardsson C, Tomasevic G, Cederberg D, Belting M, Bengzon J, Siesjö P. Antisecretory factor is safe to use as add-on treatment in newly diagnosed glioblastoma. BMC Neurol 2023; 23:76. [PMID: 36803465 PMCID: PMC9938624 DOI: 10.1186/s12883-023-03119-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
PURPOSE Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Despite the best available treatment, prognosis remains poor. Current standard therapy consists of surgical removal of the tumor followed by radiotherapy and chemotherapy with the alkylating agent temozolomide (TMZ). Experimental studies suggest that antisecretory factor (AF), an endogenous protein with proposed antisecretory and anti-inflammatory properties, may potentiate the effect of TMZ and alleviate cerebral edema. Salovum is an egg yolk powder enriched for AF and is classified as a medical food in the European Union. In this pilot study, we evaluate the safety and feasibility of add-on Salovum in GBM patients. METHODS Eight patients with newly diagnosed, histologically confirmed GBM were prescribed Salovum during concomitant radiochemotherapy. Safety was determined by the number of treatment-related adverse events. Feasibility was determined by the number of patients who completed the full prescribed Salovum treatment. RESULTS No serious treatment-related adverse events were observed. Out of 8 included patients, 2 did not complete the full treatment. Only one of the dropouts was due to issues directly related to Salovum, which were nausea and loss of appetite. Median survival was 23 months. CONCLUSIONS We conclude that Salovum is safe to use as an add-on treatment for GBM. In terms of feasibility, adherence to the treatment regimen requires a determined and independent patient as the large doses prescribed may cause nausea and loss of appetite. TRIAL REGISTRATION ClinicalTrials.gov NCT04116138. Registered on 04/10/2019.
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Affiliation(s)
- Erik Ehinger
- Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden. .,Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden.
| | - Jan Kopecky
- grid.4514.40000 0001 0930 2361Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anna Darabi
- grid.4514.40000 0001 0930 2361Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Edward Visse
- grid.4514.40000 0001 0930 2361Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Charlotte Edvardsson
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Gregor Tomasevic
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - David Cederberg
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Mattias Belting
- grid.4514.40000 0001 0930 2361Oncology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden ,grid.8993.b0000 0004 1936 9457Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden ,grid.411843.b0000 0004 0623 9987Department of Hematology, Oncology and Radiophysics, Skåne University Hospital, Lund, Sweden
| | - Johan Bengzon
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden ,grid.4514.40000 0001 0930 2361Lund Stem Cell Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Peter Siesjö
- grid.4514.40000 0001 0930 2361Neurosurgery, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden ,grid.4514.40000 0001 0930 2361Glioma Immunotherapy Group, Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden
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3
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Cederberg D, Harrington BM, Vlok AJ, Siesjö P. Effect of antisecretory factor, given as a food supplement to adult patients with severe traumatic brain injury (SASAT): protocol for an exploratory randomized double blind placebo-controlled trial. Trials 2022; 23:340. [PMID: 35461285 PMCID: PMC9034076 DOI: 10.1186/s13063-022-06275-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 04/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background Traumatic brain injury (TBI) constitutes a global epidemic. Overall outcome is poor, with mortality ranging from 10 to 70% and significant long-term morbidity. Several experimental reports have claimed effect on traumatic edema, but no clinical trials have shown effect on edema or outcome. Antisecretory factor, an endogenous protein, is commercially available as Salovum®, which is classified as a medical food by the European Union and has shown effect in experimental trauma models and feasibility with signs of effect in 2 pilot case series. The aim of this study is to assess the effect of antisecretory factor in adult patients with severe traumatic brain injury as measured by 30-day mortality, treatment intensity level (TIL), and intracranial pressure (ICP). Methods/design This is a single-center, double-blind, randomized, placebo-controlled clinical phase 2 trial, investigating the clinical superiority of Salovum® given as a food supplement to adults with severe TBI (GCS < 9), presenting to the trauma unit at Tygerberg University Hospital, Cape Town, South Africa, that are planned for invasive ICP monitoring and neurointensive care, will be screened for eligibility, and assigned to either treatment group (n = 50) or placebo group (n = 50). In both groups, the primary outcome will be 30-day mortality, recorded via hospital charts, follow-up phone calls, and the population registry. Secondary outcomes will be treatment intensity level (TIL), scored from hospital charts, and ICP registered from hospital data monitoring. Trial registration ClinicalTrials.gov NCT03339505. Registered on September 17, 2017. Protocol version 3.0 from November 13, 2020 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06275-z.
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Affiliation(s)
- David Cederberg
- Department of Neurosurgery, Skane University Hospital, Lund, Sweden.
| | - Bradley M Harrington
- Department of Neurosurgery, Tygerberg University Hospital, Tygerberg, Cape Town, Republic of South Africa
| | - Adriaan Johannes Vlok
- Department of Neurosurgery, Tygerberg University Hospital, Tygerberg, Cape Town, Republic of South Africa
| | - Peter Siesjö
- Department of Neurosurgery, Skane University Hospital, Lund, Sweden
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4
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Kopecky J, Pérez JE, Eriksson H, Visse E, Siesjö P, Darabi A. Intratumoral administration of the antisecretory peptide AF16 cures murine gliomas and modulates macrophage functions. Sci Rep 2022; 12:4609. [PMID: 35301393 PMCID: PMC8930985 DOI: 10.1038/s41598-022-08618-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/09/2022] [Indexed: 11/09/2022] Open
Abstract
Glioblastoma has remained the deadliest primary brain tumor while its current therapy offers only modest survival prolongation. Immunotherapy has failed to record notable benefits in routine glioblastoma treatment. Conventionally, immunotherapy relies on T cells as tumor-killing agents; however, T cells are outnumbered by macrophages in glioblastoma microenvironment. In this study, we explore the effect of AF16, a peptide from the endogenous antisecretory factor protein, on the survival of glioma-bearing mice, the tumor size, and characteristics of the tumor microenvironment with specific focus on macrophages. We elucidate the effect of AF16 on the inflammation-related secretome of human and murine macrophages, as well as human glioblastoma cells. In our results, AF16 alone and in combination with temozolomide leads to cure in immunocompetent mice with orthotopic GL261 gliomas, as well as prolonged survival in immunocompromised mice. We recorded decreased tumor size and changes in infiltration of macrophages and T cells in the murine glioma microenvironment. Human and murine macrophages increased expression of proinflammatory markers in response to AF16 treatment and the same effect was seen in human primary glioblastoma cells. In summary, we present AF16 as an immunomodulatory factor stimulating pro-inflammatory macrophages with a potential to be implemented in glioblastoma treatment protocols.
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Affiliation(s)
- Jan Kopecky
- Glioma Immunotherapy Group, Division of Neurosurgery, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Barngatan 4, 221 85, Lund, Sweden.
| | - Julio Enríquez Pérez
- Glioma Immunotherapy Group, Division of Neurosurgery, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Barngatan 4, 221 85, Lund, Sweden
| | - Håkan Eriksson
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Edward Visse
- Glioma Immunotherapy Group, Division of Neurosurgery, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Barngatan 4, 221 85, Lund, Sweden
| | - Peter Siesjö
- Glioma Immunotherapy Group, Division of Neurosurgery, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Barngatan 4, 221 85, Lund, Sweden.,Section of Neurosurgery, Department of Clinical Sciences Lund, Skåne University Hospital, Lund, Sweden
| | - Anna Darabi
- Glioma Immunotherapy Group, Division of Neurosurgery, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Barngatan 4, 221 85, Lund, Sweden
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5
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Webster KE, Harrington-Benton NA, Judd O, Kaski D, Maarsingh OR, MacKeith S, Murdin L, Ray J, Van Vugt VA, Burton MJ. Lifestyle and dietary interventions for Ménière’s disease. Hippokratia 2022. [DOI: 10.1002/14651858.cd015244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences; University of Oxford; Oxford UK
| | | | - Owen Judd
- ENT Department; University Hospitals of Derby and Burton NHS Foundation Trust; Derby UK
| | - Diego Kaski
- National Hospital for Neurology and Neurosurgery; London UK
| | - Otto R Maarsingh
- Department of General Practice, Amsterdam UMC; Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute; Amsterdam Netherlands
| | - Samuel MacKeith
- ENT Department; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| | - Louisa Murdin
- Ear Institute; Faculty of Brain Sciences, University College London; London UK
| | | | - Vincent A Van Vugt
- Department of General Practice, Amsterdam UMC; Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute; Amsterdam Netherlands
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6
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Viola P, Pisani D, Scarpa A, Cassandro C, Laria C, Aragona T, Ciriolo M, Spadera L, Ralli M, Cavaliere M, Iengo M, Chiarella G. The role of endogenous Antisecretory Factor (AF) in the treatment of Ménière's Disease: A two-year follow-up study. Preliminary results. Am J Otolaryngol 2020; 41:102673. [PMID: 32829060 DOI: 10.1016/j.amjoto.2020.102673] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/15/2020] [Accepted: 08/09/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the effects of increased endogenous Antisecretory Factor (AF) synthesis using specially processed cereals (SPC) in a sample of patients with defined unilateral Meniere's disease (MD), compared to the results of a treatment protocol of intravenous glycerol and dexamethasone. MATERIALS AND METHODS Twenty-six patients with unilateral MD were divided in 2 groups and treated with SPC and with intravenous glycerol and dexamethasone for 24 months. Audio-vestibular evaluation was performed before (T0) and every six months. The number of vertigo spells were evaluated before and after therapy and the Efficacy Index (EI) was calculated. Questionnaires for hearing loss, tinnitus and quality of life were administered. RESULTS EI decreased in the SPC group after 18 (T18) (p = .0017) and 24 (T24) months of therapy (p = .0111). There was a significant reduction for tinnitus score in the SPC group at T24 (p = .0131). No significant differences were found between the two groups at T0 (p = .4723), while a significant difference was found at T24 (p = .0027). Quality of life showed a significant improvement in daily activities in the SPC group (p = .0033) compared to the infusion therapy group. No statistically significant changes in PTA thresholds were found in both groups between T0 and T24. CONCLUSION The preliminary results of our study show a significant reduction of vertigo spells and a positive effect on tinnitus severity and on quality of life in patients with unilateral MD treated with SPC and when compared to patients treated with intravenous glycerol and dexamethasone. No effects on hearing thresholds were noted in both groups.
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Affiliation(s)
- Pasquale Viola
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Davide Pisani
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
| | | | - Carla Laria
- Department of Neurosciences, Reproductives and Odontostomatologic Sciences, Unit of Audiology, University of Naples "Federico II", Naples, Italy
| | | | - Marco Ciriolo
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
| | - Lucrezia Spadera
- Otolaryngology, San Leonardo Hospital, Castellammare di Stabia, Napoli, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Michele Cavaliere
- Department of Neurosciences, Reproductives and Odontostomatologic Sciences, Unit Ear, Nose and Throat Section, University of Naples "Federico II", Naples, Italy
| | - Maurizio Iengo
- Department of Neurosciences, Reproductives and Odontostomatologic Sciences, Unit Ear, Nose and Throat Section, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Chiarella
- Department of Experimental and Clinical Medicine, Unit of Audiology, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy
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7
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Cederberg D, Hansson HA, Visse E, Siesjö P. Antisecretory Factor May Reduce ICP in Severe TBI-A Case Series. Front Neurol 2020; 11:95. [PMID: 32210902 PMCID: PMC7067821 DOI: 10.3389/fneur.2020.00095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/27/2020] [Indexed: 12/11/2022] Open
Abstract
Traumatic brain injury (TBI) constitutes a global epidemic. Overall outcome is poor, with mortality ranging from 10 to 70% and significant long-term morbidity. Several experimental reports have claimed effect on traumatic edema, but all clinical trials have failed. Antisecretory factor, an endogenous protein, is commercially available as Salovum®, which is classified as a medical food by the European Union and has been proven effective in experimental trauma models. It has, however, previously not been tested in humans with severe TBI. We hereby report a case series of five adult patients with severe TBI, treated with Salovum. The objective of the intervention was to evaluate safety and, if possible, its effect on intracranial pressure and outcome. Patients received 1 g Salovum per kilo of body weight divided into six doses per 24 h. Each dose was administered through the nasogastric tube. Patients were scheduled for 5 days of treatment with Salovum. Intracranial pressure was controlled in all patients. In three of five patients, intracranial pressure could be controlled with Salovum and deep sedation (no barbiturates), except during periods of gastroparesis. Five of five patients had a favorable short-term outcome, and four of five patients had a favorable long-term outcome. No toxicity was observed. We conclude that at least three of the five treated patients experienced an effect of Salovum with signs of reduction of intracranial pressure and signs of clinical benefit. In order to validate the potential of antisecretory factor in TBI, a prospective, randomized, double-blind, placebo-controlled trial with Salovum has been initiated. Primary outcome for the trial is 30-day mortality; secondary outcomes are treatment intensity level, intracranial pressure, and number of days at the neurointensive care unit.
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Affiliation(s)
- David Cederberg
- Department of Neurosurgery, Skane University Hospital, Lund, Sweden
| | - Hans-Arne Hansson
- Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | - Edward Visse
- Department of Neurosurgery, Skane University Hospital, Lund, Sweden
| | - Peter Siesjö
- Department of Neurosurgery, Skane University Hospital, Lund, Sweden
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8
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Barrueta Tenhunen A, Massaro F, Hansson HA, Feinstein R, Larsson A, Larsson A, Perchiazzi G. Does the antisecretory peptide AF-16 reduce lung oedema in experimental ARDS? Ups J Med Sci 2019; 124:246-253. [PMID: 31701794 PMCID: PMC6968528 DOI: 10.1080/03009734.2019.1685029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Acute respiratory distress syndrome (ARDS) is an acute inflammatory condition with pulmonary capillary leakage and lung oedema formation. There is currently no pharmacologic treatment for the condition. The antisecretory peptide AF-16 reduces oedema in experimental traumatic brain injury. In this study, we tested AF-16 in an experimental porcine model of ARDS.Methods: Under surgical anaesthesia 12 piglets were subjected to lung lavage followed by 2 hours of injurious ventilation. Every hour for 4 hours, measurements of extravascular lung water (EVLW), mechanics of the respiratory system, and hemodynamics were obtained.Results: There was a statistically significant (p = 0.006, two-way ANOVA) reduction of EVLW in the AF-16 group compared with controls. However, this was not mirrored in any improvement in the wet-to-dry ratio of lung tissue samples, histology, inflammatory markers, lung mechanics, or gas exchange.Conclusions: This pilot study suggests that AF-16 might improve oedema resolution as indicated by a reduction in EVLW in experimental ARDS.
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Affiliation(s)
- Annelie Barrueta Tenhunen
- Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
- CONTACT Annelie Barrueta Tenhunen
Hedenstierna Laboratory, Department of Surgical Sciences, Uppsala
University, 75185 Uppsala, Sweden
| | - Fabrizia Massaro
- Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
- Cardiac Anesthesia and Intensive Care, Anthea
Hospital, GVM Care & Research, Bari, Italy
| | - Hans Arne Hansson
- Institute of Biomedicine, University of
Gothenburg, Göteborg, Sweden
| | - Ricardo Feinstein
- Department of Pathology and Wildlife Diseases,
National Veterinary Institute, Uppsala, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Uppsala
University, Uppsala, Sweden
| | - Anders Larsson
- Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Gaetano Perchiazzi
- Hedenstierna Laboratory, Department of
Surgical Sciences, Uppsala University, Uppsala, Sweden
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9
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Leong SC, Narayan S, Lesser TH. Antisecretory Factor–Inducing Therapy Improves Patient-Reported Functional Levels in Meniere's Disease. Ann Otol Rhinol Laryngol 2019. [DOI: 10.1177/000348941312201004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Samuel C. Leong
- Skull Base Unit, Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital Aintree, Liverpool, England
| | - Surya Narayan
- Department of Otorhinolaryngology, Royal Blackburn Hospital, Blackburn, England
| | - Tristram H. Lesser
- Skull Base Unit, Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital Aintree, Liverpool, England
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10
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Inhibitory effect of high leucine concentration on α-amylase secretion by pancreatic acinar cells: possible key factor of proteasome. Biosci Rep 2018; 38:BSR20181455. [PMID: 30361293 PMCID: PMC6294628 DOI: 10.1042/bsr20181455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 01/13/2023] Open
Abstract
The present study aimed to investigate whether leucine affects the pancreatic exocrine by controlling the antisecretory factor (AF) and cholecystokinin receptor (CCKR) expression as well as the proteasome activity in pancreatic acinar cells of dairy calves. The pancreatic acinar cells were isolated from newborn Holstein bull calves and cultured using the Dulbecco’s modified Eagle’s medium/nutrient mixture F12 Ham’s liquid (DMEM/F12). There were six treatments of leucine dosage including 0 (control), 0.23, 0.45, 1.35, 4.05, and 12.15 mM, respectively. After culture for 3 h, the samples were collected for subsequent analysis. As the leucine concentration increased from 0 to 1.35 mM, the α-amylase activity in media decreased significantly (P<0.05), while further increase in leucine concentration did not show any decrease in α-amylase activity. Addition of leucine inhibited (P<0.05) the expression of AF and CCKR, and decreased the activity of proteasome (P<0.05) by 76%, 63%, 24%, 7%, and 9%, respectively. Correlation analysis results showed α-amylase secretion was negatively correlated with leucine concentration (P<0.01), and positively correlated with proteasome activity (P<0.01) and the expression of CCK1R (P<0.01) and AF (P<0.05). The biggest regression coefficient was showed between α-amylase activity and proteasome (0.7699, P<0.001). After inhibition of proteasome by MG-132, low dosage leucine decreased (P<0.05) the activity of proteasome and α-amylase, as well as the expression of CCK1R. In conclusion, we demonstrated that the high-concentration leucine induced decrease in α-amylase release was mainly by decreasing proteasome activity.
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Gustafsson A, Granström E, Stecksén-Blicks C, West CE, Silfverdal SA. The Antisecretory Factor in Plasma and Breast Milk in Breastfeeding Mothers-A Prospective Cohort Study in Sweden. Nutrients 2018; 10:E1227. [PMID: 30181494 PMCID: PMC6164404 DOI: 10.3390/nu10091227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/29/2018] [Accepted: 09/03/2018] [Indexed: 12/25/2022] Open
Abstract
Inflammation and infection postpartum threaten the mother and her infant. Human milk provides a defense for the infant, but inflammatory complications like mastitis may lead to the cessation of breastfeeding. Antisecretory factor (AF) has a role in the regulation of secretory processes and inflammation. The objective of the study was to describe AF-levels in plasma and breast milk, and in relation to breast complications. Breastfeeding mothers (n = 95) were consecutively recruited at a Well Baby Clinic in Umeå, Sweden. At inclusion four weeks postpartum, samples of venous blood (10 mL) and breast milk (10 mL) were collected. Active AF was analyzed with ELISA using a monoclonal antibody mAb43, and was detected in all samples of plasma and breast milk with a positive correlation (Spearman coefficient = 0.40, p < 0.001; Pearson correlation = 0.34, p < 0.01). High AF-levels in plasma correlated with high AF-levels in breast milk. The results suggest a co-regulation between active AF in plasma and breastmilk, and/or a local regulation of AF in the breast. Further studies are needed to determine the pathways for the activation of AF-levels in breast milk and plasma.
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Affiliation(s)
- Anna Gustafsson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE 141 86 Stockholm, Sweden.
- Department of Neonatology, Karolinska University Hospital, SE 171 76 Stockholm, Sweden.
| | - Elisabeth Granström
- Department of Odontology, Pediatric dentistry, Umeå university, SE 901 87 Umeå, Sweden.
| | | | - Christina E West
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 87 Umeå, Sweden.
| | - Sven-Arne Silfverdal
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 87 Umeå, Sweden.
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Ilkhanizadeh S, Sabelström H, Miroshnikova YA, Frantz A, Zhu W, Idilli A, Lakins JN, Schmidt C, Quigley DA, Fenster T, Yuan E, Trzeciak JR, Saxena S, Lindberg OR, Mouw JK, Burdick JA, Magnitsky S, Berger MS, Phillips JJ, Arosio D, Sun D, Weaver VM, Weiss WA, Persson AI. Antisecretory Factor-Mediated Inhibition of Cell Volume Dynamics Produces Antitumor Activity in Glioblastoma. Mol Cancer Res 2018; 16:777-790. [PMID: 29431617 PMCID: PMC5932284 DOI: 10.1158/1541-7786.mcr-17-0413] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/13/2017] [Accepted: 01/24/2018] [Indexed: 12/31/2022]
Abstract
Interstitial fluid pressure (IFP) presents a barrier to drug uptake in solid tumors, including the aggressive primary brain tumor glioblastoma (GBM). It remains unclear how fluid dynamics impacts tumor progression and can be targeted therapeutically. To address this issue, a novel telemetry-based approach was developed to measure changes in IFP during progression of GBM xenografts. Antisecretory factor (AF) is an endogenous protein that displays antisecretory effects in animals and patients. Here, endogenous induction of AF protein or exogenous administration of AF peptide reduced IFP and increased drug uptake in GBM xenografts. AF inhibited cell volume regulation of GBM cells, an effect that was phenocopied in vitro by the sodium-potassium-chloride cotransporter 1 (SLC12A2/NKCC1) inhibitor bumetanide. As a result, AF induced apoptosis and increased survival in GBM models. In vitro, the ability of AF to reduce GBM cell proliferation was phenocopied by bumetanide and NKCC1 knockdown. Next, AF's ability to sensitize GBM cells to the alkylating agent temozolomide, standard of care in GBM patients, was evaluated. Importantly, combination of AF induction and temozolomide treatment blocked regrowth in GBM xenografts. Thus, AF-mediated inhibition of cell volume regulation represents a novel strategy to increase drug uptake and improve outcome in GBM. Mol Cancer Res; 16(5); 777-90. ©2018 AACR.
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Affiliation(s)
- Shirin Ilkhanizadeh
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Brain Tumor Research Center (BTRC) at the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
| | - Hanna Sabelström
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Sandler Neurosciences Center, University of California, San Francisco, San Francisco, California
| | | | - Aaron Frantz
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Sandler Neurosciences Center, University of California, San Francisco, San Francisco, California
| | - Wen Zhu
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Aurora Idilli
- Institute of Biophysics, CNR and FBK, Trento, Italy
- CIBIO, University of Trento, Trento, Italy
| | - Jon N Lakins
- Department of Surgery, University of California, San Francisco, San Francisco, California
| | - Christin Schmidt
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Sandler Neurosciences Center, University of California, San Francisco, San Francisco, California
| | - David A Quigley
- Brain Tumor Research Center (BTRC) at the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Trenten Fenster
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Sandler Neurosciences Center, University of California, San Francisco, San Francisco, California
| | - Edith Yuan
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Sandler Neurosciences Center, University of California, San Francisco, San Francisco, California
| | - Jacqueline R Trzeciak
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Sandler Neurosciences Center, University of California, San Francisco, San Francisco, California
| | - Supna Saxena
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Sandler Neurosciences Center, University of California, San Francisco, San Francisco, California
| | - Olle R Lindberg
- Brain Tumor Research Center (BTRC) at the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Department of Pathology, University of California, San Francisco, San Francisco, California
| | - Janna K Mouw
- Department of Surgery, University of California, San Francisco, San Francisco, California
| | - Jason A Burdick
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sergey Magnitsky
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
| | - Mitchel S Berger
- Brain Tumor Research Center (BTRC) at the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
| | - Joanna J Phillips
- Brain Tumor Research Center (BTRC) at the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Department of Pathology, University of California, San Francisco, San Francisco, California
| | - Daniele Arosio
- Institute of Biophysics, CNR and FBK, Trento, Italy
- CIBIO, University of Trento, Trento, Italy
| | - Dandan Sun
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Valerie M Weaver
- Department of Surgery, University of California, San Francisco, San Francisco, California
- Brain Tumor Research Center (BTRC) at the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
| | - William A Weiss
- Department of Neurology, University of California, San Francisco, San Francisco, California
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Brain Tumor Research Center (BTRC) at the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
| | - Anders I Persson
- Department of Neurology, University of California, San Francisco, San Francisco, California.
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
- Sandler Neurosciences Center, University of California, San Francisco, San Francisco, California
- Brain Tumor Research Center (BTRC) at the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
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Food-induced changes of lipids in rat neuronal tissue visualized by ToF-SIMS imaging. Sci Rep 2016; 6:32797. [PMID: 27596988 PMCID: PMC5011716 DOI: 10.1038/srep32797] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/15/2016] [Indexed: 12/30/2022] Open
Abstract
Time of flight secondary ion mass spectrometry (ToF-SIMS) was used to image the lipid localization in brain tissue sections from rats fed specially processed cereals (SPC). An IonTof 5 instrument equipped with a Bi cluster ion gun was used to analyze the tissue sections. Data from 15 brain samples from control and cereal-fed rats were recorded and exported to principal components analysis (PCA). The data clearly show changes of certain lipids in the brain following cereal feeding. PCA score plots show a good separation in lipid distribution between the control and the SPC-fed group. The loadings plot reveal that the groups separated mainly due to changes in cholesterol, vitamin E and c18:2, c16:0 fatty acid distribution as well as some short chain monocarboxylic fatty acid compositions. These insights relate to the working mechanism of SPC as a dietary supplement. SPC is thought to activate antisecretory factor (AF), an endogenous protein with regulatory function for inflammation and fluid secretion. These data provide insights into lipid content in brain following SPC feeding and suggest a relation to activating AF.
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Mass spectrometric profiling of lipids in intestinal tissue from rats fed cereals processed for medical conditions. Biointerphases 2016; 11:02A310. [PMID: 26753787 DOI: 10.1116/1.4939599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Time-of-flight secondary ion mass spectrometry (ToF-SIMS) was used for lipid profiling of intestine tissue sections from rats fed specially processed cereals and rats fed ordinary feed as a control. This cereal is known to increase the activity of antisecretory factor in plasma and the exact mechanism for the activation process at the cellular level is unclear. ToF-SIMS has been used to track food induced changes in lipid content in intestinal tissue sections to gain insight into the possible mechanisms involved. Data from 20 intestine sections belonging to four different rats from each group of control and specially processed cereals-fed rats were obtained using the stage scan macroraster with a lateral resolution of 5 μm. Data were subsequently subjected to orthogonal partial least squares discriminant analysis. The data clearly show that changes of certain lipids are induced by the specially processed cereal feed. Scores plots show a well-defined separation between the two groups. The corresponding loading plots reveal that the groups separate mainly due to changes of vitamin E, phosphocholine, and phosphosphingolipid fragments, and that for the c18:2 fatty acid. The observed changes in lipids might give insight into the working mechanisms of antisecretory factor in the body, and this has been successfully used to understand the working mechanism of specially processed cereal-induced antisecretory factor activation in intestine.
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Nawrot-Porąbka K, Jaworek J, Leja-Szpak A, Kot M, Lange S. The role of antisecretory factor in pancreatic exocrine secretion: studies in vivo and in vitro. Exp Physiol 2015; 100:267-77. [PMID: 25641073 DOI: 10.1113/expphysiol.2014.083899] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/09/2015] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Antisecretory factor, an endogenous protein detected in many tissues of the body, is known as an inhibitor of intestinal secretion, but its role in pancreatic exocrine secretory function has not yet been investigated. What is the main finding and its importance? In a rodent model, we show that antisecretory factor reduces pancreatic exocrine secretion, probably via its direct action on the pancreatic acini and via modulation of the enteropancreatic reflexes involving cholecystokinin and sensory nerves. Antisecretory factor (AF) regulates ion and water transport through the intestinal cell membrane. Antisecretory factor inhibits intestinal secretion, but its effect on the exocrine pancreas has not yet been shown. We investigated the effect of AF on pancreatic amylase secretion in vivo and in vitro using pancreatic acini isolated by collagenase digestion. For the in vivo study, Wistar rats were surgically equipped with silicone catheters, inserted into the pancreaticobiliary duct and into the duodenum. Capsaicin was used to deactivate the sensory nerves in turn to assess their involvement in the effects of AF on the exocrine pancreas. Antisecretory factor (1, 3 or 10 μg kg(-1) i.p.) was given in basal conditions or following stimulation of pancreatic secretion with diversion of pancreaticobiliary juice. For the in vitro study, rat pancreatic acini were incubated in the presence of increasing doses of AF (from 10(-8) to 10(-5) m) alone or in combination with caerulein (10(-12) m). Cytoplasmic cholecystokinin 1 (CCK1 ) receptor protein was detected by Western blot and immunoprecipitation studies. Antisecretory factor markedly reduced the output of pancreatic amylase both in basal conditions and when stimulated by diversion of pancreaticobiliary juice. Deactivation of the sensory nerves with capsaicin completely reversed the inhibitory effects of AF on the exocrine pancreas. Caerulein-induced enzyme secretion from the pancreatic acini was inhibited by AF, whereas basal secretion was unaffected. Administration of AF to the rats significantly diminished the synthesis of CCK1 receptor protein. We conclude that AF inhibits pancreatic exocrine secretion indirectly via sensory nerves and directly decreases amylase release from isolated pancreatic acini. The direct inhibitory action of AF on the exocrine pancreas could be related, at least in part, to a reduction of CCK1 receptors on pancreatic acinar cells.
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Affiliation(s)
- Katarzyna Nawrot-Porąbka
- Department of Medical Physiology, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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Antisecretory factor peptide AF-16 inhibits the secreted autotransporter toxin-stimulated transcellular and paracellular passages of fluid in cultured human enterocyte-like cells. Infect Immun 2014; 83:907-22. [PMID: 25534938 DOI: 10.1128/iai.02759-14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Both the endogenous antisecretory factor (AF) protein and peptide AF-16, which has a sequence that matches that of the active N-terminal region of AF, inhibit the increase in the epithelial transport of fluid and electrolytes induced by bacterial toxins in animal and ex vivo models. We conducted a study to investigate the inhibitory effect of peptide AF-16 against the increase of transcellular passage and paracellular permeability promoted by the secreted autotransporter toxin (Sat) in a cultured cellular model of the human intestinal epithelial barrier. Peptide AF-16 produced a concentration-dependent inhibition of the Sat-induced increase in the formation of fluid domes, in the mucosal-to-serosal passage of D-[1-(14)C]mannitol, and in the rearrangements in the distribution and protein expression of the tight junction (TJ)-associated proteins ZO-1 and occludin in cultured human enterocyte-like Caco-2/TC7 cell monolayers. In addition, we show that peptide AF-16 also inhibits the cholera toxin-induced increase of transcellular passage and the Clostridium difficile toxin-induced effects on paracellular permeability and TJ protein organization in Caco-2/TC7 cell monolayers. Treatment of cell monolayers by the lipid raft disorganizer methyl-β-cyclodextrin abolished the inhibitory activity of peptide AF-16 at the transcellular passage level and did not modify the effect of the peptide at the paracellular level.
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Strandberg J, Lindquist C, Lange S, Asztely F, Hanse E. The endogenous peptide antisecretory factor promotes tonic GABAergic signaling in CA1 stratum radiatum interneurons. Front Cell Neurosci 2014; 8:13. [PMID: 24478633 PMCID: PMC3904124 DOI: 10.3389/fncel.2014.00013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 01/08/2014] [Indexed: 01/18/2023] Open
Abstract
Tonic GABAergic inhibition regulates neuronal excitability and has been implicated to be involved in both neurological and psychiatric diseases. We have previously shown that the endogenous peptide antisecretory factor (AF) decreases phasic GABAergic inhibition onto pyramidal CA1 neurons. In the present study, using whole-cell patch-clamp recordings, we investigated the mechanisms behind this disinhibition of CA1 pyramidal neurons by AF. We found that application of AF to acute rat hippocampal slices resulted in a reduction of the frequency, but not of the amplitude, of spontaneous inhibitory postsynaptic currents (sIPSCs) in CA1 pyramidal neurons. Miniature inhibitory postsynaptic currents (mIPSCs), recorded in the presence of tetrodotoxin (TTX), were however not affected by AF, neither in CA1 pyramidal cells, nor in stratum radiatum interneurons. Instead, AF caused an increase of the tonic GABAA current in stratum radiatum interneurons, leaving the tonic GABAergic transmission in CA1 pyramidal cells unaffected. These results show that the endogenous peptide AF enhances tonic, but not phasic, GABAergic signaling in CA1 stratum radiatum interneurons, without affecting tonic GABAergic signaling in CA1 pyramidal neurons. We suggest that this increased tonic GABAergic signaling in GABAergic interneurons could be a mechanism for the AF-mediated disinhibition of pyramidal neurons.
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Affiliation(s)
- Joakim Strandberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Göteborg, Sweden
| | - Catarina Lindquist
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Göteborg, Sweden
| | - Stefan Lange
- Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg Göteborg, Sweden
| | - Fredrik Asztely
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Göteborg, Sweden
| | - Eric Hanse
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg Göteborg, Sweden
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Diet-induced antisecretory factor prevents intracranial hypertension in a dosage-dependent manner. Br J Nutr 2012; 109:2247-52. [PMID: 23153478 DOI: 10.1017/s0007114512004552] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Intake of specially processed cereal (SPC) stimulates endogenous antisecretory factor (AF) activity, and SPC intake has proven to be beneficial for a number of clinical conditions. The aim of the present study was to investigate the dosage relationship between SPC intake and plasma AF activity and to further correlate achieved AF levels to a biological effect. SPC was fed to rats in concentrations of 5, 10 or 15% for 2 weeks. A further group was fed 5% SPC for 4 weeks. AF activity and the complement factors C3c and factor H were analysed in plasma after the feeding period. Groups of rats fed the various SPC concentrations were subjected to a standardised freezing brain injury, known to induce increases in intracranial pressure (ICP). The AF activity in plasma increased after intake of SPC, in a dosage- and time-dependent manner. The complement factors C3c and factor H increased in a time-dependent manner. Measurements of ICP in animals fed with SPC prior to the brain injury showed that the ICP was significantly lower, compared with that of injured rats fed with a standard feed, and that the change was dose and time dependent. AF activity increases, in a dosage- and time-dependent manner, after intake of SPC. The inverse relationship between ICP after a head injury and the percentage of SPC in the feed indicate that the protective effect is, to a large extent, due to AF.
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Abstract
Intracranial hypertension develops after, for example, trauma, stroke and brain inflammation, and contributes to increased morbidity, mortality, and persistent neuropsychiatric sequelae. Nonsurgical therapy offers limited relief. We investigated whether the peptide AF-16 and the endogenous protein Antisecretory Factor (AF) counteracted abnormal fluid transfer by cells, and lowered raised intracranial pressure (ICP). Adult rats, infected with an encephalitogenic Herpes simplex virus (HSV-1), developed after 5 days' sickness of increasing severity. AF-16 rescued all rats while vehicle treatment only saved 20%. AF-16 from day 4 reduced the ICP in HSV-1-infected rats from 30.7 to 14.6 mmHg and all survived without sequelae. A standardised closed head brain injury in rats raised the ICP. Continuous and intermittent AF-16 kept ICP at an almost normal level. A single dose of AF-16 maintained the raised ICP after a TBI lowered during 3-9 h. The AF protein, enriched in egg yolk, similarly lowered the post-traumatically raised ICP in rats. AF-16 also lowered the ICP in rabbits with diffuse brain injury. We conclude that the peptide AF-16 and the AF protein offer new approaches to treat raised ICP with no side effects.
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