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Effects of Social Hierarchy Establishment on Stress Response and Cell Phagocytosis in Gilt-Head Sea Bream (Sparus aurata). FISHES 2022. [DOI: 10.3390/fishes7020075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Social stress can affect the ability of fish to respond to various stressors, such as pathogens or environmental variations. In this paper, the effects of social stress on gilt-head bream (Sparus aurata) were investigated. To study the effects of physiological stress, we evaluated biochemical and cellular parameters, such as cortisol, glucose, lactate, osmolarity, and phagocytosis, 24 h after the establishment of social hierarchy in a group of three fish. Social hierarchy was determined and characterized by behavioral observation (aggressive acts and feeding order) of the specimens (dominant: “α”; subordinate: “β” and “γ”). After the establishment of social hierarchy, we observed that, overall, levels of plasma cortisol and other biochemical plasmatic stress markers (glucose and lactate) were higher in subordinate individuals than in dominant individuals. In addition, the modulation of phagocytic activity of the peritoneal exudate cells (PECs) demonstrated that social stress appeared to affect immune response. Finally, principal component analysis clearly separated the subordinate fish groups from the dominant groups, based on stress markers and the phagocytic activity of peritoneal exudate cells. This study contributes to current knowledge on gilt-head sea bream, helping to understand the link between social stress, behavior, and physiology of this species, relevant in the aquaculture sector, where fish are subjected to several kinds of stress.
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Deiss R, Campbell CDRJ, Watson CWM, Moore RC, Crum-Cianflone NF, Wang X, Ganesan A, Okulicz LCJ, Letendre S, Maves RC, Moore DJ, Agan BK. Posttraumatic Stress Disorder and Neurocognitive Impairment in a U.S. Military Cohort of Persons Living with HIV. Psychiatry 2019; 82:228-239. [PMID: 30925113 PMCID: PMC6766407 DOI: 10.1080/00332747.2019.1586503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Neurocognitive impairment (NCI) is a well-known complication of human immunodeficiency virus (HIV) infection and may be influenced by a number of psychological factors. We examined the relationship between NCI and mental health disorders, including posttraumatic stress disorder (PTSD), in a cohort of 189 active-duty and retired U.S. military men living with HIV. Methods: Participants completed selected modules of the Composite International Diagnostic Interview (CIDI) to ascertain the presence of PTSD, major depressive disorder, and other mental health diagnoses. We also obtained demographic data, including history of head trauma, via personal interview. NCI was assessed with a comprehensive battery of standardized neuropsychological tests. Results: The median age of study subjects was 36 years (interquartile range [IQR] 28 to 43) and median total years of education was 14 (IQR 12 to 16). NCI was diagnosed in 19% of subjects. Individuals with and without a history of PTSD were similar with respect to most HIV-related characteristics; however, the former were significantly more likely to have a prior acquired immunodeficiency syndrome (AIDS) diagnosis. In multivariate analysis, lifetime history of PTSD was independently associated with NCI (odds ration [OR] = 6.12; 95% confidence interval [CI] = 1.85, 20.27), while a history of head of trauma was negatively associated (OR = 0.37 95% CI = 0.15,0.92). Conclusions: Our findings demonstrate that PTSD is an important predictor of NCI in this U.S. military cohort. HIV-infected individuals with cognitive difficulties should be screened for mental health disorders, including PTSD, and prospective studies of the longitudinal relationship between PTSD and NCI, as well as the impact of PTSD treatment on future NCI, are warranted.
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Affiliation(s)
- Robert Deiss
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences. Rockville, MD 20852
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Bethesda, MD
- Division of Infectious Diseases, Naval Medical Center San Diego. San Diego, CA
| | | | - Caitlin Wei-Ming Watson
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology. San Diego, CA
| | - Raeanne C. Moore
- HIV Neurobehavioral Research Program, University of California, San Diego. San Diego, CA
- Veterans Administration San Diego Health Care System, San Diego, CA. San Diego, CA
| | - Nancy F. Crum-Cianflone
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences. Rockville, MD 20852
- Division of Infectious Diseases, Naval Medical Center San Diego. San Diego, CA
| | - Xun Wang
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences. Rockville, MD 20852
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Bethesda, MD
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences. Rockville, MD 20852
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Bethesda, MD
- Division of Infectious Diseases. Walter Reed National Military Medical Center. Bethesda, MD
| | - Lt Col Jason Okulicz
- Infectious Disease Service, San Antonio Military Medical Center. Fort Sam Houston, TX
| | - Scott Letendre
- HIV Neurobehavioral Research Program, University of California, San Diego. San Diego, CA
| | - Ryan C. Maves
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences. Rockville, MD 20852
- Division of Infectious Diseases, Naval Medical Center San Diego. San Diego, CA
| | - David J. Moore
- HIV Neurobehavioral Research Program, University of California, San Diego. San Diego, CA
| | - Brian K. Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences. Rockville, MD 20852
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Bethesda, MD
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Maldonado JR. Delirium pathophysiology: An updated hypothesis of the etiology of acute brain failure. Int J Geriatr Psychiatry 2018; 33:1428-1457. [PMID: 29278283 DOI: 10.1002/gps.4823] [Citation(s) in RCA: 268] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/19/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Delirium is the most common neuropsychiatric syndrome encountered by clinicians dealing with older adults and the medically ill and is best characterized by 5 core domains: cognitive deficits, attentional deficits, circadian rhythm dysregulation, emotional dysregulation, and alteration in psychomotor functioning. DESIGN An extensive literature review and consolidation of published data into a novel interpretation of known pathophysiological causes of delirium. RESULTS Available data suggest that numerous pathological factors may serve as precipitants for delirium, each having differential effects depending on patient-specific patient physiological characteristics (substrate). On the basis of an extensive literature search, a newly proposed theory, the systems integration failure hypothesis, was developed to bring together the most salient previously described theories, by describing the various contributions from each into a complex web of pathways-highlighting areas of intersection and commonalities and explaining how the variable contribution of these may lead to the development of various cognitive and behavioral dysfunctions characteristic of delirium. The specific cognitive and behavioral manifestations of the specific delirium picture result from a combination of neurotransmitter function and availability, variability in integration and processing of sensory information, motor responses to both external and internal cues, and the degree of breakdown in neuronal network connectivity, hence the term acute brain failure. CONCLUSIONS The systems integration failure hypothesis attempts to explain how the various proposed delirium pathophysiologic theories interact with each other, causing various clinically observed delirium phenotypes. A better understanding of the underlying pathophysiology of delirium may eventually assist in designing better prevention and management approaches.
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Intrinsic Functional Hypoconnectivity in Core Neurocognitive Networks Suggests Central Nervous System Pathology in Patients with Myalgic Encephalomyelitis: A Pilot Study. Appl Psychophysiol Biofeedback 2018; 41:283-300. [PMID: 26869373 DOI: 10.1007/s10484-016-9331-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Exact low resolution electromagnetic tomography (eLORETA) was recorded from nineteen EEG channels in nine patients with myalgic encephalomyelitis (ME) and 9 healthy controls to assess current source density and functional connectivity, a physiological measure of similarity between pairs of distributed regions of interest, between groups. Current source density and functional connectivity were measured using eLORETA software. We found significantly decreased eLORETA source analysis oscillations in the occipital, parietal, posterior cingulate, and posterior temporal lobes in Alpha and Alpha-2. For connectivity analysis, we assessed functional connectivity within Menon triple network model of neuropathology. We found support for all three networks of the triple network model, namely the central executive network (CEN), salience network (SN), and the default mode network (DMN) indicating hypo-connectivity in the Delta, Alpha, and Alpha-2 frequency bands in patients with ME compared to controls. In addition to the current source density resting state dysfunction in the occipital, parietal, posterior temporal and posterior cingulate, the disrupted connectivity of the CEN, SN, and DMN appears to be involved in cognitive impairment for patients with ME. This research suggests that disruptions in these regions and networks could be a neurobiological feature of the disorder, representing underlying neural dysfunction.
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Makhathini KB, Abboussi O, Stein DJ, Mabandla MV, Daniels WM. Repetitive stress leads to impaired cognitive function that is associated with DNA hypomethylation, reduced BDNF and a dysregulated HPA axis. Int J Dev Neurosci 2017; 60:63-69. [DOI: 10.1016/j.ijdevneu.2017.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 03/13/2017] [Accepted: 04/11/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- Khayelihle B. Makhathini
- Department of Human PhysiologyCollege of Health Sciences, University of KwaZulu‐ NatalDurbanSouth Africa
| | - Oualid Abboussi
- Department of Human PhysiologyCollege of Health Sciences, University of KwaZulu‐ NatalDurbanSouth Africa
| | - Dan J. Stein
- Department of PsychiatryUniversity of Cape TownCape TownSouth Africa
| | - Musa V. Mabandla
- Department of Human PhysiologyCollege of Health Sciences, University of KwaZulu‐ NatalDurbanSouth Africa
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Choi HI, Lee HW, Eom TM, Lim SA, Ha HY, Seol IC, Kim YS, Oh DS, Yoo HR. A traditional Korean multiple herbal formulae (Yuk-Mi-Jihwang-Tang) attenuates acute restraint stress-induced brain tissue oxidation. Drug Chem Toxicol 2017; 40:125-133. [DOI: 10.1080/01480545.2016.1183209] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Hyoung-Il Choi
- The Graduate School of Alternative Medicine, Kyonggi University, Seoul, Korea,
| | - Hye-Won Lee
- TKM-Based Herbal Drug Research Group, Korea Institute of Oriental Medicine, Daejeon, Korea,
| | - Tae-Min Eom
- Internal Medicine of Physical Constitution and Immunology, Dunsan Oriental Hospital of Daejeon University, Daejeon, Korea,
| | - Sung-Ah Lim
- Department of Beauty and Health-Care, College of Public Health Care, Daejeon University, Daejeon, Korea, and
| | - Hun-Yong Ha
- Department of Natural Medicine Resources, Semyung University, Jecheon, Korea
| | - In-Chan Seol
- Internal Medicine of Physical Constitution and Immunology, Dunsan Oriental Hospital of Daejeon University, Daejeon, Korea,
| | - Yoon-Sik Kim
- Internal Medicine of Physical Constitution and Immunology, Dunsan Oriental Hospital of Daejeon University, Daejeon, Korea,
| | - Dal-Seok Oh
- TKM-Based Herbal Drug Research Group, Korea Institute of Oriental Medicine, Daejeon, Korea,
| | - Ho-Ryong Yoo
- Internal Medicine of Physical Constitution and Immunology, Dunsan Oriental Hospital of Daejeon University, Daejeon, Korea,
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Abstract
The innate immune response is a coordinated set of reactions involving cells of myeloid lineage and a network of signaling molecules. Such a response takes place in the CNS during trauma, stroke, spinal cord injury, and neurodegenerative diseases, suggesting that macrophages/microglia are the cells that perpetuate the progressive neuronal damage. However, there is accumulating evidence that these cells and their secreted proinflammatory molecules have more beneficial effects than detrimental consequences for the neuronal elements. Indeed, a timely controlled innate immune response may limit toxicity in swiftly eliminating foreign materials and debris that are known to interfere with recovery and regeneration. Each step of the immune cascade is under the tight control of stimulatory and inhibitory signals. Glucocorticoids (GCs) act as the critical negative feedback on all myeloid cells, including those present within the brain parenchyma. Because too little is like too much, both an inappropriate feedback of GCs on microglia and high circulating GC levels in stressed individuals have been associated with deleterious consequences for the brain. In this review, the authors discuss both sides of the story with a particular emphasis on the neuro-protective role of endogenous GCs during immune challenges and the problems in determining whether GCs can be a good therapy for the treatment of neuropathological conditions.
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Affiliation(s)
- Isaias Glezer
- Laboratory of Molecular Endocrinology, CHUL Research Center, Department of Anatomy and Physiology, Laval University, Québec, Canada
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8
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Son SW, Lee JS, Kim HG, Kim DW, Ahn YC, Son CG. Testosterone depletion increases the susceptibility of brain tissue to oxidative damage in a restraint stress mouse model. J Neurochem 2015; 136:106-17. [PMID: 26385432 DOI: 10.1111/jnc.13371] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Seung-Wan Son
- Department of Biomedical Engineering; College of Health Science; Korea University; Seongbuk-Gu Seoul Korea
| | - Jin-Seok Lee
- Liver and Immunology Research Center; Daejeon Oriental Hospital of Oriental Medical Collage of Daejeon University; Jung-gu Daejeon South Korea
| | - Hyeong-Geug Kim
- Liver and Immunology Research Center; Daejeon Oriental Hospital of Oriental Medical Collage of Daejeon University; Jung-gu Daejeon South Korea
| | - Dong-Woon Kim
- Department of Anatomy; Brain Research Institute; Chungnam National University School of Medicine; Daejeon South Korea
| | - Yo-Chan Ahn
- Department of Health Service Management; Daejeon University; Dong-gu Daejeon Korea
| | - Chang-Gue Son
- Department of Biomedical Engineering; College of Health Science; Korea University; Seongbuk-Gu Seoul Korea
- Liver and Immunology Research Center; Daejeon Oriental Hospital of Oriental Medical Collage of Daejeon University; Jung-gu Daejeon South Korea
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Santarsieri M, Kumar RG, Kochanek PM, Berga SL, Wagner AK. Variable neuroendocrine-immune dysfunction in individuals with unfavorable outcome after severe traumatic brain injury. Brain Behav Immun 2015; 45:15-27. [PMID: 25218898 PMCID: PMC4342288 DOI: 10.1016/j.bbi.2014.09.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 08/07/2014] [Accepted: 09/02/2014] [Indexed: 01/08/2023] Open
Abstract
Bidirectional communication between the immune and neuroendocrine systems is not well understood in the context of traumatic brain injury (TBI). The purpose of this study was to characterize relationships between cerebrospinal fluid (CSF) cortisol and inflammation after TBI, and to determine how these relationships differ by outcome. CSF samples were collected from 91 subjects with severe TBI during days 0-6 post-injury, analyzed for cortisol and inflammatory markers, and compared to healthy controls (n=13 cortisol, n=11 inflammatory markers). Group-based trajectory analysis (TRAJ) delineated subpopulations with similar longitudinal CSF cortisol profiles (high vs. low cortisol). Glasgow Outcome Scale (GOS) scores at 6months served as the primary outcome measure reflecting global outcome. Inflammatory markers that displayed significant bivariate associations with both GOS and cortisol TRAJ (interleukin [IL]-6, IL-10, soluble Fas [sFas], soluble intracellular adhesion molecule [sICAM]-1, and tumor necrosis factor alpha [TNF]-α) were used to generate a cumulative inflammatory load score (ILS). Subsequent analysis revealed that cortisol TRAJ group membership mediated ILS effects on outcome (indirect effect estimate=-0.253, 95% CI (-0.481, -0.025), p=0.03). Correlational analysis between mean cortisol levels and ILS were examined separately within each cortisol TRAJ group and by outcome. Within the low cortisol TRAJ group, subjects with unfavorable 6-month outcome displayed a negative correlation between ILS and mean cortisol (r=-0.562, p=0.045). Conversely, subjects with unfavorable outcome in the high cortisol TRAJ group displayed a positive correlation between ILS and mean cortisol (r=0.391, p=0.006). Our results suggest that unfavorable outcome after TBI may result from dysfunctional neuroendocrine-immune communication wherein an adequate immune response is not mounted or, alternatively, neuroinflammation is prolonged. Importantly, the nature of neuroendocrine-immune dysfunction differs between cortisol TRAJ groups. These results present a novel biomarker-based index from which to discriminate outcome and emphasize the need for evaluating tailored treatments targeting inflammation early after injury.
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Affiliation(s)
- Martina Santarsieri
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh
| | - Raj G. Kumar
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh
| | - Patrick M. Kochanek
- Safar Center for Resuscitation Research, University of Pittsburgh,Department of Critical Care Medicine, University of Pittsburgh
| | - Sarah L. Berga
- Department of Obstetrics and Gynecology, Wake Forest University
| | - Amy K. Wagner
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh,Center for Neuroscience, University of Pittsburgh,Safar Center for Resuscitation Research, University of Pittsburgh
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Yang Y, Wang Y, Zhang J, Han Z, Chen A, Pan S, Liang S, Wang S. System responses to chronic cold stress probed via1H NMR spectroscopy in plasma and urine matrices. MOLECULAR BIOSYSTEMS 2015; 11:1425-33. [DOI: 10.1039/c5mb00033e] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The metabolic pathways in plasma and urine revealed the biochemical changes under chronic cold stress from a systematic and holistic view.
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Affiliation(s)
- Yongxia Yang
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou
- P. R. China
| | - Yaling Wang
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou
- P. R. China
- School of Traditional Chinese Medicine
| | - Jingli Zhang
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou
- P. R. China
| | - Zhihui Han
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou
- P. R. China
- School of Traditional Chinese Medicine
| | - Ali Chen
- School of Medicine and Chemical Industry
- Guangdong Pharmaceutical University
- Guangzhou
- P. R. China
| | - Sina Pan
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou
- P. R. China
- School of Traditional Chinese Medicine
| | - Shengwang Liang
- School of Traditional Chinese Medicine
- Guangdong Pharmaceutical University
- Guangzhou
- P. R. China
| | - Shumei Wang
- School of Traditional Chinese Medicine
- Guangdong Pharmaceutical University
- Guangzhou
- P. R. China
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11
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Kim HG, Lee JS, Choi MK, Han JM, Son CG. Ethanolic extract of Astragali radix and Salviae radix prohibits oxidative brain injury by psycho-emotional stress in whisker removal rat model. PLoS One 2014; 9:e98329. [PMID: 24870587 PMCID: PMC4037216 DOI: 10.1371/journal.pone.0098329] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 04/30/2014] [Indexed: 11/18/2022] Open
Abstract
Myelophil, an ethanolic extract of Astragali Radix and Salviae Radix, has been clinically used to treat chronic fatigue and stress related disorders in South Korea. In this study, we investigated the protective effects of Myelophil on a whisker removal-induced psycho-emotional stress model. SD rats were subjected to whisker removal after oral administration of Myelophil or ascorbic acid for consecutive 4 days. Whisker removal considerably increased total reactive oxygen species in serum levels as well as cerebral cortex and hippocampal regions in brain tissues. Lipidperoxidation levels were also increased in the cerebral cortex, hippocampus regions, and brain tissue injuries as shown in histopathology and immunohistochemistry. However, Myelophil significantly ameliorated these alterations, and depletion of glutathione contents in both cerebral cortex and hippocampus regions respectively. Serum levels of corticosterone and adrenaline were notably altered after whisker removal stress, whereas these abnormalities were significantly normalized by pre-treatment with Myelophil. The NF-κB was notably activated in both cerebral cortex and hippocampus after whisker removal stress, while it was efficiently blocked by pre-treatment with Myelophil. Myelophil also significantly normalizes alterations of tumor necrosis factor-α, interleukin (IL)-1β, IL-6 and interferon-γ in both gene expressions and protein levels. These results suggest that Myelophil has protective effects on brain damages in psycho-emotional stress, and the underlying mechanisms involve regulation of inflammatory proteins, especially NF-κB modulation.
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Affiliation(s)
- Hyeong-Geug Kim
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, Daejeon, Rep. of Korea
| | - Jin-Seok Lee
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, Daejeon, Rep. of Korea
| | - Min-Kyung Choi
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, Daejeon, Rep. of Korea
| | - Jong-Min Han
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, Daejeon, Rep. of Korea
| | - Chang-Gue Son
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, Daejeon, Rep. of Korea
- * E-mail:
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12
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Maldonado JR. Neuropathogenesis of delirium: review of current etiologic theories and common pathways. Am J Geriatr Psychiatry 2013; 21:1190-222. [PMID: 24206937 DOI: 10.1016/j.jagp.2013.09.005] [Citation(s) in RCA: 402] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/10/2013] [Accepted: 09/13/2013] [Indexed: 12/20/2022]
Abstract
Delirium is a neurobehavioral syndrome caused by dysregulation of neuronal activity secondary to systemic disturbances. Over time, a number of theories have been proposed in an attempt to explain the processes leading to the development of delirium. Each proposed theory has focused on a specific mechanism or pathologic process (e.g., dopamine excess or acetylcholine deficiency theories), observational and experiential evidence (e.g., sleep deprivation, aging), or empirical data (e.g., specific pharmacologic agents' association with postoperative delirium, intraoperative hypoxia). This article represents a review of published literature and summarizes the top seven proposed theories and their interrelation. This review includes the "neuroinflammatory," "neuronal aging," "oxidative stress," "neurotransmitter deficiency," "neuroendocrine," "diurnal dysregulation," and "network disconnectivity" hypotheses. Most of these theories are complementary, rather than competing, with many areas of intersection and reciprocal influence. The literature suggests that many factors or mechanisms included in these theories lead to a final common outcome associated with an alteration in neurotransmitter synthesis, function, and/or availability that mediates the complex behavioral and cognitive changes observed in delirium. In general, the most commonly described neurotransmitter changes associated with delirium include deficiencies in acetylcholine and/or melatonin availability; excess in dopamine, norepinephrine, and/or glutamate release; and variable alterations (e.g., either a decreased or increased activity, depending on delirium presentation and cause) in serotonin, histamine, and/or γ-aminobutyric acid. In the end, it is unlikely that any one of these theories is fully capable of explaining the etiology or phenomenologic manifestations of delirium but rather that two or more of these, if not all, act together to lead to the biochemical derangement and, ultimately, to the complex cognitive and behavioral changes characteristic of delirium.
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Affiliation(s)
- José R Maldonado
- Departments of Psychiatry, Internal Medicine & Surgery and the Psychosomatic Medicine Service, Stanford University School of Medicine, and Board of Directors, American Delirium Society, Stanford, CA.
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13
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Kim HG, Lee JS, Han JM, Lee JS, Choi MK, Son SW, Kim YK, Son CG. Myelophil attenuates brain oxidative damage by modulating the hypothalamus-pituitary-adrenal (HPA) axis in a chronic cold-stress mouse model. JOURNAL OF ETHNOPHARMACOLOGY 2013; 148:505-514. [PMID: 23665312 DOI: 10.1016/j.jep.2013.04.046] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 04/12/2013] [Accepted: 04/23/2013] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Myelophil is composed of Astragali Radix and Salviae Miltiorrhizae Radix, according to the long traditional pharmacological practices, and it has been used for patients with chronic fatigue-associated symptoms including concentration problem or memory loss. AIM OF THE STUDY This study aimed to evaluate the clinical relevance of Myelophil on brain oxidative damage using a chronic cold stress mice model. MATERIAL AND METHODS Balb/c mice were subjected to cold stress (4°C for 4h) six times per week for 2 weeks with or without oral administration of Myelophil (50, 100, or 200mg/kg), or ascorbic acid (50mg/kg). RESULTS Chronic cold stress induced histopathological hippocampal apoptosis with drastically increased serum levels of total reactive oxygen species and nitric oxide, as well as brain lipid peroxidation levels, protein carbonyl, and caspase-3/7 activity. These alterations were significantly ameliorated by Myelophil treatment. Myelophil administration significantly recovered the depleted glutathione and its enzymes, superoxide dismutase activity, and catalase protein and gene expression levels. Serum levels of corticosterone, dopamine, and adrenaline were notably altered by chronic cold stress but were significantly ameliorated by Myelophil treatment. Myelophil also normalized alterations in tumor necrosis factor-α, interleukin (IL)-1β, and IL-10 gene expression and protein levels. Chronic cold stress up-regulated gene expression levels of phenylethanolamine N-methyltransferase and monoamine oxidase-B, and glucocorticoid receptors in the hypothalamus and hippocampus, respectively, whereas Myelophil treatment completely normalized these levels. CONCLUSIONS These results suggest that Myelophil has potent pharmaceutical effects against chronic cold-stress-induced brain damage by relieving oxidative stress and inflammation and regulating stress hormones in mice.
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Affiliation(s)
- Hyeong-Geug Kim
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 22-5 Daehung-dong, Jung-gu, Daejeon 301-724, Republic of Korea
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14
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Enhanced brain delivery of liposomal methylprednisolone improved therapeutic efficacy in a model of neuroinflammation. J Control Release 2012; 164:364-9. [DOI: 10.1016/j.jconrel.2012.06.022] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 06/05/2012] [Accepted: 06/16/2012] [Indexed: 12/18/2022]
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15
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Kirkland SW, Smith LK, Metz GA. Task-specific compensation and recovery following focal motor cortex lesion in stressed rats. J Integr Neurosci 2012; 11:33-59. [PMID: 22744782 DOI: 10.1142/s0219635212500033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 09/09/2011] [Indexed: 11/18/2022] Open
Abstract
One reason for the difficulty to develop effective therapies for stroke is that intrinsic factors, such as stress, may critically influence pathological mechanisms and recovery. In cognitive tasks, stress can both exaggerate and alleviate functional loss after focal ischemia in rodents. Using a comprehensive motor assessment in rats, this study examined if chronic stress and corticosterone treatment affect skill recovery and compensation in a task-specific manner. Groups of rats received daily restraint stress or oral corticosterone supplementation for two weeks prior to a focal motor cortex lesion. After lesion, stress and corticosterone treatments continued for three weeks. Motor performance was assessed in two skilled reaching tasks, skilled walking, forelimb inhibition, forelimb asymmetry and open field behavior. The results revealed that persistent stress and elevated corticosterone levels mainly limit motor recovery. Treated animals dropped larger amounts of food in successful reaches and showed exaggerated loss of forelimb inhibition early after lesion. Stress also caused a moderate, but non-significant increase in infarct size. By contrast, stress and corticosterone treatments promoted reaching success and other quantitative measures in the tray reaching task. Comparative analysis revealed that improvements are due to task-specific development of compensatory strategies. These findings suggest that stress and stress hormones may partially facilitate task-specific and adaptive compensatory movement strategies. The observations support the notion that hypothalamic-pituitary-adrenal axis activation may be a key determinant of recovery and motor system plasticity after ischemic stroke.
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Affiliation(s)
- Scott W Kirkland
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
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16
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Cammarata M, Vazzana M, Accardi D, Parrinello N. Seabream (Sparus aurata) long-term dominant-subordinate interplay affects phagocytosis by peritoneal cavity cells. Brain Behav Immun 2012; 26:580-7. [PMID: 22289430 DOI: 10.1016/j.bbi.2012.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 01/03/2012] [Accepted: 01/12/2012] [Indexed: 11/28/2022] Open
Abstract
Fish are sensitive to stressful conditions that affect their innate immune systems and increase their susceptibility to diseases. We examined the social stress of paired gilthead seabream (Sparus aurata). Social hierarchies (dominant/subordinate) were characterised by behavioural changes, such as "aggressiveness" and "feeding order"; hierarchical positions were established within an hour of exposure to social stress and remained unchanged for approximately 1 year. To characterise physiological stress, we measured blood plasma levels of cortisol, glucose, and lactate as well as osmolarity and observed that the levels of these stress markers were higher in subordinate individuals than in dominant ones. The discriminant analysis revealed a separation of the subordinate fish groups, and at 15 days, a significant separation among groups was observed. Moreover, diminished phagocytic and respiratory burst activities revealed that social stress appeared to affect the cellular innate immune response of the subordinate specimens. Finally, to examine the effect of cortisol on phagocytosis, peritoneal cavity cells were treated in vitro, and an inhibitory effect was observed.
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Affiliation(s)
- M Cammarata
- Marine Immunobiology Laboratory, Department of Environmental Biology and Biodiversity, Division of Animal Biology and Antropology, University of Palermo, Via Archirafi 18, Palermo, Italy.
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17
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Kwon KJ, Cho KS, Lee SH, Kim JN, Joo SH, Ryu JH, Ignarro LJ, Han SH, Young Shin C. Regulation of tissue plasminogen activator/plasminogen activator inhibitor-1 by hydrocortisone in rat primary astrocytes. J Neurosci Res 2011; 89:1059-69. [DOI: 10.1002/jnr.22619] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 12/30/2010] [Accepted: 01/11/2011] [Indexed: 12/16/2022]
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García-Bueno B, Caso JR, Leza JC. Stress as a neuroinflammatory condition in brain: Damaging and protective mechanisms. Neurosci Biobehav Rev 2008; 32:1136-51. [DOI: 10.1016/j.neubiorev.2008.04.001] [Citation(s) in RCA: 180] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Revised: 04/02/2008] [Accepted: 04/02/2008] [Indexed: 01/07/2023]
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19
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Ji L, Nazarali AJ, Paterson PG. Protein-energy malnutrition increases activation of the transcription factor, nuclear factor kappaB, in the gerbil hippocampus following global ischemia. J Nutr Biochem 2008; 19:770-7. [PMID: 18430555 DOI: 10.1016/j.jnutbio.2007.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Revised: 08/12/2007] [Accepted: 09/14/2007] [Indexed: 12/20/2022]
Abstract
Protein-energy malnutrition (PEM) exacerbates functional impairment caused by brain ischemia. This is correlated with reactive gliosis, which suggests an increased inflammatory response. The objective of the current study was to investigate if PEM increases hippocampal activation of nuclear factor kappaB (NFkappaB), a transcription factor that amplifies the inflammatory response involved in ischemic brain injury. Mongolian gerbils (11-12 weeks old) were randomly assigned to control diet (12.5% protein) or protein-deficient diet (2%) for 4 weeks. The 2% protein group had a 15% decrease in voluntary food intake (P<.001; unpaired t test), resulting in PEM. Body weight after 4 weeks was 20% lower in the PEM group (P<.001). Gerbils were then exposed to sham surgery or global ischemia induced by 5-min bilateral common carotid artery occlusion. PEM independently increased hippocampal NFkappaB activation detected by electrophoretic mobility shift assay at 6 h after surgery (P=.014; 2-factor ANOVA). Ischemia did not significantly affect NFkappaB activation nor was there interaction between diet and ischemia. Serum glucose and cortisol concentrations at 6 h postischemia were unaltered by diet or ischemia. A second experiment using gerbils of the same age and feeding paradigm demonstrated that PEM also increases hippocampal NFkappaB activation in the absence of surgery. These findings suggest that PEM, which exists in 16% of elderly patients at admission for stroke, may worsen outcome by increasing activation of NFkappaB. Since PEM increased NFkappaB activation independent of ischemia or surgery, the data also have implications for the inflammatory response of the many individuals affected globally by PEM.
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Affiliation(s)
- Liang Ji
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada S7N 5C9
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20
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Sierra A, Gottfried-Blackmore A, Milner TA, McEwen BS, Bulloch K. Steroid hormone receptor expression and function in microglia. Glia 2008; 56:659-74. [DOI: 10.1002/glia.20644] [Citation(s) in RCA: 290] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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21
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Glezer I, Simard AR, Rivest S. Neuroprotective role of the innate immune system by microglia. Neuroscience 2007; 147:867-83. [PMID: 17459594 DOI: 10.1016/j.neuroscience.2007.02.055] [Citation(s) in RCA: 258] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Revised: 02/20/2007] [Accepted: 02/21/2007] [Indexed: 12/14/2022]
Abstract
Innate immunity is a rapid series of reactions to pathogens, cell injuries and toxic proteins. A key component of this natural response is the production of inflammatory mediators by resident microglia and infiltrating macrophages. There is accumulating evidence that inflammation contributes to acute injuries and more chronic CNS diseases, though other studies have shown that inhibition of microglia is, in contrast, associated with more damages or less repair. The controversies regarding the neuroprotective and neurodegenerative properties of microglia may depend on the experimental approaches. Neurotoxic substances are frequently used to produce animal models of acute injuries or diseases and they may activate microglia either directly or indirectly by their ability to cause neuronal death and demyelination. Whether microglia and the immune response play a direct role in such processes still remains an open question. On the other hand, there are data supporting the role of resident microglia and those derived from the bone marrow in the stimulation of myelin repair, removal of toxic proteins from the CNS and the prevention of neurodegeneration in chronic brain diseases. The ability of glucocorticoids to provide a negative feedback on nuclear factor kappa B pathways in microglia may be a determinant mechanism underlying the ultimate fate of the inflammatory response in the CNS. This review presents new concepts regarding the neuroprotective role of the innate immune response in the brain and how microglia can be directed to improve recovery after injuries and prevent/delay neurodegeneration.
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Affiliation(s)
- I Glezer
- Laboratory of Molecular Endocrinology, CHUL Research Center, Laval University, 2705 Laurier Boul., Québec, Canada G1V 4G2
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22
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Abstract
BACKGROUND AND PURPOSE Newborn cells may participate in repair following ischemic brain injury, but their survival and function may be influenced by inflammation. METHODS We investigated the effects of indomethacin, a nonsteroidal antiinflammatory drug, on the fate of newborn cells following transient focal ischemia. RESULTS Bromodeoxyuridine (BrdU)-labeled cells, including migrating neuroblasts, were observed in the neighboring striatum and overlying cortex 1 day poststroke. The density of BrdU+ cells labeled with doublecortin, nestin, glial fibrillary acidic protein, or NG2 was increased at 14 and 28 days. Indomethacin increased BrdU+ cells of all lineages and reduced microglial/monocyte activation. CONCLUSIONS Indomethacin enhanced the accumulation of newborn cells following stroke.
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Affiliation(s)
- Benjamin D Hoehn
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
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23
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Persidsky Y, Potula R, Haorah J. Rodent model systems for studies of HIV-1 associated dementia. Neurotox Res 2005; 8:91-106. [PMID: 16260388 DOI: 10.1007/bf03033822] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Understanding of HIV-1 neuropathogenesis and development of rationale therapeutic approaches requires relevant animal models. The putative mechanisms of neuroinflammatory and neurotoxic events triggered by HIV-1 brain infection are reflected by a number of rodent models. These include transgenic animals (either expressing viral proteins or pro-inflammatory factors), infection with murine retroviruses, and severe combined immunodeficient (SCID) mice reconstituted with human lymphocytes and injected intracerebrally with HIV-1-infected human monocyte-derived macrophages. The potential importance and limitations of the models in reflecting human disease are discussed with emphasis on their utility for development of therapies to combat HIV-1-associated neurologic impairment.
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Affiliation(s)
- Y Persidsky
- Center for Neurovirology and Neurodegenerative Disorders, University of Nebraska Medical Center, Omaha, NE 68198, USA.
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Bobyn PJ, Corbett D, Saucier DM, Noyan-Ashraf MH, Juurlink BHJ, Paterson PG. Protein-energy malnutrition impairs functional outcome in global ischemia. Exp Neurol 2005; 196:308-15. [PMID: 16171806 DOI: 10.1016/j.expneurol.2005.08.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2005] [Revised: 08/10/2005] [Accepted: 08/12/2005] [Indexed: 11/30/2022]
Abstract
We investigated whether protein-energy malnutrition (PEM) exacerbates brain injury in global ischemia. It was hypothesized that PEM would increase secondary brain damage by worsening ischemia-induced depletion of glutathione (GSH) and increasing oxidative stress. Adult male gerbils were fed an adequate protein (12.5%; C) or low protein (2%; PEM) diet for 4 weeks and subjected to 5 min of bilateral carotid artery occlusion (Ischemia) or sham surgery (Sham). At 12 h post-ischemia, GSH and markers of oxidative stress were measured in hippocampus and neocortex. The remaining gerbils were tested in the open field on days 3, 7, and 10, with viable hippocampal CA1 neurons assessed on day 10. Although the habituation of C-Ischemia gerbils in the open field was normal by day 7, PEM-Ischemia gerbils failed to habituate even by day 10 and spent greater time in the outer zone (P < 0.05). Mean (+/-SEM) total number of viable CA1 neurons at 10 days post-ischemia were C-Sham = 713 (13), C-Ischemia = 264 (48), PEM-Sham = 716 (12), and PEM-Ischemia = 286 (66). Although PEM did not increase CA1 neuron loss caused by ischemia, a subset (4/12) of PEM-Ischemia gerbils showed dramatic reactive gliosis accompanied by extensive neuronal loss. Hippocampal protein thiols were decreased by PEM and ischemia. Although the mechanism is yet to be established, the finding that PEM worsens functional outcome following global ischemia is clinically relevant since 16% of elderly are nutritionally compromised at the time of admission for stroke.
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Affiliation(s)
- P Joan Bobyn
- College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, Saskatoon, SK, Canada S7N 5C9
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Zschocke J, Bayatti N, Clement AM, Witan H, Figiel M, Engele J, Behl C. Differential promotion of glutamate transporter expression and function by glucocorticoids in astrocytes from various brain regions. J Biol Chem 2005; 280:34924-32. [PMID: 16079146 DOI: 10.1074/jbc.m502581200] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Steroids that activate glucocorticoid receptors (GRs) and mineralocorticoid receptors have important regulatory effects on neural development, plasticity, and the body's stress response. Here, we investigated the role of corticosteroids in regulating the expression of the glial glutamate transporters glial glutamate transporter-1 (GLT-1) and glutamate-aspartate transporter (GLAST) in rat primary astrocytes. The synthetic glucocorticoid dexamethasone provoked a marked increase of GLT-1 transcription and protein levels in cortical astrocytes, whereas GLAST expression remained unaffected. Up-regulation of GLT-1 expression was accompanied by an enhanced glutamate uptake, which could be blocked by the specific GLT-1 inhibitor dihydrokainate. The promoting effect of dexamethasone on GLT-1 gene expression and function was abolished by the GR antagonist mifepristone. A predominant role of the GR was further supported by the observation that corticosterone could elevate GLT-1 expression in a dose-dependent manner, whereas aldosterone, the physiological ligand of the mineralocorticoid receptor, exerted only weak effects even when applied at high concentrations. Moreover, we monitored brain region-specific differences, since all corticosteroids used in this study failed to alter the expression of GLT-1 in midbrain and cerebellar glia, although expression levels of both corticosteroid receptor subtypes were similar in all brain regions analyzed. Dexamethasone, however, modestly enhanced GLT-1 expression in cerebellar glia in combination with the DNA methyltransferase inhibitor 5-aza-2-deoxycytidine, suggesting that suppression of GLT-1 expression in cerebellar cultures may at least in part be epigenetically mediated by a DNA methylation-dependent process. Taken together, our data highlight a potential role for glucocorticoids in regulating GLT-1 gene expression during central nervous system development or pathophysiological processes including stress.
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Affiliation(s)
- Jürgen Zschocke
- Department of Pathobiochemistry, Johannes Gutenberg University Mainz, 55099 Mainz, Germany
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Martin Ii LB, Gilliam J, Han P, Lee K, Wikelski M. Corticosterone suppresses cutaneous immune function in temperate but not tropical House Sparrows, Passer domesticus. Gen Comp Endocrinol 2005; 140:126-35. [PMID: 15613275 DOI: 10.1016/j.ygcen.2004.10.010] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2004] [Revised: 09/28/2004] [Accepted: 10/20/2004] [Indexed: 10/26/2022]
Abstract
Levels of corticosterone (CORT), the primary avian stress hormone, tend to vary over space and time in passerines, but why this is so remains unclear. One reason may be differential need for immune defense. Typically, sustained high levels of CORT suppress immune activity in vertebrates. Thus, animals living where parasite threats are high might maintain low levels of CORT and mount weak CORT stress responses to ensure that their immune defenses are in a high state of readiness at all times. Here, we addressed this hypothesis by comparing CORT levels in two populations of House Sparrows (Passer domesticus), one from the tropics (Colon, Panama) where parasite threats are high and one from the North-temperate zone (New Jersey, USA) where they are lower. Indeed, we found that House Sparrows from Panama had lower baseline and stress-induced CORT levels than House Sparrows from New Jersey. To more directly test our hypothesis, we artificially elevated CORT (via implant) in both populations of birds, expecting that cutaneous immune activity (induced by phytohemagglutinin (PHA)) would be suppressed as it is in most vertebrates studied to date. Surprisingly, we found that CORT implants did not affect immune function in Panamanian sparrows, while immune function in (non-breeding) New Jersey sparrows was suppressed. This suggests that Panamanian House Sparrows may be immunologically insensitive to CORT, in addition to maintaining low baseline and stress-induced levels of this hormone. We propose that other animals living where disease threats are high may use CORT in a similar way.
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Affiliation(s)
- Lynn B Martin Ii
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA.
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Abstract
The articles compiled in this special edition of Journal of NeuroVirology target a developing field of investigation seeking to uncover how the immune system affects both the pathogenic process and protection against the ravages of neurodegenerative processes. Whether caused by a microbe, trauma, toxic metabolite, autoimmunity, or part of a wide degenerative process, immune dysfunction commonly affects central nervous system (CNS) disease. All together, the work presented here proved to be a unique undertaking with contributing scientists outside the field of neurovirology. Indeed, multiple disciplines including molecular neuroscience, neuroimmunology, virology, cellular immunology, receptor pharmacology, neuronal electrophysiology, neurochemistry, clinical neurology, and development neurobiology were joined. The basis of this work rests with the hypothesis that brain mononuclear phagocytes (MP; perivascular and brain macrophages and microglia) act as inducers of disease by engaging the immune system to protect, defend, or induce neural injury. Indeed, it is the brain MP that act as scavengers killing microblial pathogens, regulate immune responses through antigen presentation and mobilization of adaptive immune activities, and affect the production of neurotrophic or toxic secretory factors that incite disease processes. For many years, these responses were thought to be reactive to ongoing disease mechanisms with little effects on disease itself, let alone repair. The works compiled in this issue demonstrate quite clearly this is no longer true. Immune responses cannot be directed only against a microbe but also against self-antigens that are expressed in damaged CNS, leading to innate neurotoxic or adaptive anti-self immunity that commonly follow viral infections. Importantly, therapeutic modalities may take advantage of CNS immune responses through vaccination generating neuroprotection. Together, these articles serve to bring together common neuroimmune links between highly divergent diseases (for example, Parkinson's and Alzheimer's disease and human immunodeficiency virus type-one dementia). In the end, I hope this work will serve as discussion points for future collaborations and began to break down the barriers of disease, enabling targeted research activities toward what we have in common.
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