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Dobson GP, Morris JL, Letson HL. Traumatic brain injury: Symptoms to systems in the 21st century. Brain Res 2024; 1845:149271. [PMID: 39395646 DOI: 10.1016/j.brainres.2024.149271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Accepted: 10/07/2024] [Indexed: 10/14/2024]
Abstract
Severe traumatic brain injury (TBI) is a devastating injury with a mortality of ∼ 25-30 %. Despite decades of high-quality research, no drug therapy has reduced mortality. Why is this so? We argue two contributing factors for the lack of effective drug therapies include the use of specific-pathogen free (SPF) animals for translational research and the flawed practice of single-nodal targeting for drug design. A revolution is required to better understand how the whole body responds to TBI, identify new markers of its progression, and discover new system-acting drugs to treat it. In this review, we present a brief history of TBI, discuss its system's pathophysiology and propose a new research strategy for the 21st century. TBI progression develops from injury signals radiating from the primary impact, which can cause local ischemia, hemorrhage, excitotoxicity, cellular depolarization, immune dysfunction, sympathetic hyperactivity, blood-brain barrier breach, coagulopathy and whole-body dysfunction. Metabolic reprograming of immune cells drives neuroinflammation and secondary injury processes. We propose if sympathetic hyperactivity and immune cell activation can be corrected early, cardiovascular function and endothelial-glycocalyx-mitochondrial coupling can be restored, and secondary injury minimized with improved patient outcomes. The therapeutic goal is to switch the injury phenotype to a healing phenotype by restoring homeostasis and maintaining sufficient tissue O2 delivery. We have been developing a small-volume fluid therapy comprising adenosine, lidocaine and magnesium (ALM) to treat TBI and have shown that it blunts the CNS-stress response, supports cardiovascular function and reduces secondary injury. Future research will investigate its suitability for human translation.
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Affiliation(s)
- Geoffrey P Dobson
- Heart, Sepsis and Trauma Research Laboratory, College of Medicine and Dentistry, James Cook University, Queensland 4811, Australia.
| | - Jodie L Morris
- Heart, Sepsis and Trauma Research Laboratory, College of Medicine and Dentistry, James Cook University, Queensland 4811, Australia.
| | - Hayley L Letson
- Heart, Sepsis and Trauma Research Laboratory, College of Medicine and Dentistry, James Cook University, Queensland 4811, Australia.
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Cattaneo A, Bellenghi M, Ferroni E, Mangia C, Marconi M, Rizza P, Borghini A, Martini L, Luciani MN, Ortona E, Carè A, Appetecchia M, Ministry Of Health-Gender Medicine Team. Recommendations for the Application of Sex and Gender Medicine in Preclinical, Epidemiological and Clinical Research. J Pers Med 2024; 14:908. [PMID: 39338162 PMCID: PMC11433203 DOI: 10.3390/jpm14090908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/05/2024] [Accepted: 08/20/2024] [Indexed: 09/30/2024] Open
Abstract
Gender medicine studies how health status and diseases differ between men and women in terms of prevention, therapeutic approach, prognosis, and psychological and social impact. Sex and gender analyses have been demonstrated to improve science, contributing to achieving real appropriateness and equity in the cure for each person. Therefore, it is fundamental to consider, both in preclinical and clinical research, the different clinical and biological features associated with sex and/or gender, where sex differences are mainly influenced by biological determinants and gender ones by socio-cultural and economic matters. This article was developed to provide knowledge and methodological tools for the development of studies/research protocols in which sex and gender should be taken into account.
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Affiliation(s)
- Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni, 4, 25125 Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, 20133 Milan, Italy
| | - Maria Bellenghi
- Center of Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Eliana Ferroni
- Epidemiological System of the Veneto Region, Regional Center for Epidemiology, Veneto Region, 35100 Padova, Italy
| | - Cristina Mangia
- Istituto di Scienze dell'Atmosfera e del Clima, Consiglio Nazionale delle Ricerche, 73100 Lecce, Italy
| | - Matteo Marconi
- Center of Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Paola Rizza
- Center of Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Alice Borghini
- Agenzia Nazionale per i Servizi Sanitari Regionali, 00187 Rome, Italy
| | - Lorena Martini
- Agenzia Nazionale per i Servizi Sanitari Regionali, 00187 Rome, Italy
| | | | - Elena Ortona
- Center of Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Alessandra Carè
- Center of Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Marialuisa Appetecchia
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 00144 Rome, Italy
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Verzeletti GN, Gaio EJ, Machado KG, Spuldaro TR, Demeda CF, Frassini R, Streck AF, Moura E Silva S, Rösing CK, Henriques JAP, Roesch-Ely M. Desmarestia anceps Montagne modulates inflammatory response in experimental periodontitis in male Wistar rats. Arch Oral Biol 2024; 157:105825. [PMID: 37918302 DOI: 10.1016/j.archoralbio.2023.105825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/25/2023] [Accepted: 10/14/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Desmarestia anceps Montagne (D. anceps) seaweed has been shown to play a range of biologic activities, such as anti-inflammatory and antioxidant properties. The purpose of this study was to investigate the effects of D. anceps on pathogenesis of ligature-induced experimental periodontitis in rats. DESIGN Fifty-four male Wistar rats were randomly divided into six groups. Doses of D. anceps (100 and 200 mg/kg) were administered for 14 days to animals with or without ligature-induced periodontitis, in order to compare to control groups (vehicle solution). Morphometric registration of alveolar bone loss and histological analysis were conducted. Inflammatory cells were counted on hematoxylin-eosin-stained slides. Immunohistochemical expressions for interleukin-1 beta (IL-1β), tumor necrosis factor (TNF-α), receptor activator of nuclear factor kappa-Β ligand (RANKL) and bone morphogenetic protein 2 (BMP-2) were evaluated. RESULTS Alveolar bone loss was higher in groups exposed to ligature-induced periodontitis, but no significant differences were observed comparing different treatment and control groups. Animals that received D. anceps extracts showed significant lower counts of inflammatory cells. D. anceps promoted increased expression of BMP-2 and inhibited IL-1β, TNF-α and RANKL. CONCLUSION D. anceps modulates inflammatory response in experimental periodontitis in rats. Further pharmacological and immunological analyses are warranted.
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Affiliation(s)
- Giliano Nicolini Verzeletti
- Biotechnology Institute, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, Caxias do Sul, RS 95070-560, Brazil; School of Dentistry, Department of Periodontology, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130 Bloco S, Caxias do Sul, RS 95070-560, Brazil.
| | - Eduardo José Gaio
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Keilla Gomes Machado
- Biotechnology Institute, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, Caxias do Sul, RS 95070-560, Brazil
| | - Tobias Rauber Spuldaro
- Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Clarissa Favero Demeda
- School of Dentistry, Department of Periodontology, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130 Bloco S, Caxias do Sul, RS 95070-560, Brazil
| | - Rafaele Frassini
- Biotechnology Institute, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, Caxias do Sul, RS 95070-560, Brazil
| | - André Felipe Streck
- Biotechnology Institute, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, Caxias do Sul, RS 95070-560, Brazil
| | - Sidnei Moura E Silva
- Biotechnology Institute, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, Caxias do Sul, RS 95070-560, Brazil
| | | | - João Antonio Pêgas Henriques
- Biotechnology Institute, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, Caxias do Sul, RS 95070-560, Brazil
| | - Mariana Roesch-Ely
- Biotechnology Institute, University of Caxias do Sul, Rua Francisco Getúlio Vargas, 1130, Caxias do Sul, RS 95070-560, Brazil
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Kyler KE, Szefler SJ. Fifty Years of Unraveling the Clinical Pharmacology of Corticosteroids. J Pharm Sci 2024; 113:47-54. [PMID: 37844761 DOI: 10.1016/j.xphs.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
This review will highlight portions of Dr. William Jusko's and colleagues' work that affected the clinical use and study of corticosteroids in acute and chronic disease management. Selected publications related to corticosteroid pharmacokinetics and pharmacodynamics from the 1970s through today were included in this review, with a focus on the foundational human-based studies conducted in the 1970s-1990s. Dr. Jusko contributed significantly to early corticosteroid pharmacology across several domains including: 1) foundational corticosteroid pharmacokinetic methods and parameter development, 2) disease state-variation in corticosteroid pharmacokinetics, 3) drug interaction effects on corticosteroid pharmacokinetics, and 4) early corticosteroid pharmacodynamic studies. In an era where little was known about the pharmacokinetics and pharmacodynamics of corticosteroids, Dr. Jusko's work opened the eyes of researchers and clinicians to the potential for disease and drug interactions that could reduce or enhance the effects of corticosteroids. This significant body of work paved the way for alternative routes of administration that would be useful in concentrating the activity at the site of action and markedly reduced systemic drug exposure, minimizing the risk of adverse effects through application of the dose-sparing pharmacokinetic and pharmacodynamic principles.
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Affiliation(s)
- Kathryn E Kyler
- Division of Hospital Medicine, Children's Mercy Kansas City, Kansas City, MO, United States; School of Medicine, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Stanley J Szefler
- University of Colorado School of Medicine, Department of Pediatrics Pediatric Pulmonary and Sleep Medicine Section, United States; Children's Hospital Colorado, Breathing Institute, United States.
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Gilmer G, Hettinger ZR, Tuakli-Wosornu Y, Skidmore E, Silver JK, Thurston RC, Lowe DA, Ambrosio F. Female aging: when translational models don't translate. NATURE AGING 2023; 3:1500-1508. [PMID: 38052933 PMCID: PMC11099540 DOI: 10.1038/s43587-023-00509-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/25/2023] [Indexed: 12/07/2023]
Abstract
For many pathologies associated with aging, female patients present with higher morbidity and more frequent adverse events from treatments compared to male patients. While preclinical models are the foundation of our mechanistic understanding of age-related diseases, the most common models fail to recapitulate archetypical female aging trajectories. For example, while over 70% of the top age-related diseases are influenced by the systemic effects of reproductive senescence, we found that preclinical studies that include menopausal phenotypes modeling those seen in humans make up <1% of published aging biology research. The long-term impacts of pregnancy, birthing and breastfeeding are also typically omitted from preclinical work. In this Perspective, we summarize limitations in the most commonly used aging models, and we provide recommendations for better incorporating menopause, pregnancy and other considerations of sex in vivo and in vitro. Lastly, we outline action items for aging biology researchers, journals, funding agencies and animal providers to address this gap.
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Affiliation(s)
- Gabrielle Gilmer
- Discovery Center for Musculoskeletal Recovery, Schoen Adams Research Institute at Spaulding Rehabilitation, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Medical Scientist Training Program, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Cellular and Molecular Pathology Graduate Program, University of Pittsburgh, Pittsburgh, PA, USA
| | - Zachary R Hettinger
- Discovery Center for Musculoskeletal Recovery, Schoen Adams Research Institute at Spaulding Rehabilitation, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yetsa Tuakli-Wosornu
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Elizabeth Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dawn A Lowe
- Divisions of Rehabilitation Science and Physical Therapy, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Fabrisia Ambrosio
- Discovery Center for Musculoskeletal Recovery, Schoen Adams Research Institute at Spaulding Rehabilitation, Boston, MA, USA.
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA.
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, MA, USA.
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Mitchell SJ, MacArthur MR, Kane AE. Optimizing preclinical models of ageing for translation to clinical trials. Br J Clin Pharmacol 2023. [PMID: 37675638 DOI: 10.1111/bcp.15902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/25/2023] [Accepted: 09/03/2023] [Indexed: 09/08/2023] Open
Abstract
Preclinical models have been the backbone of translational research for more than a century. Rats and mice are critical models in the preliminary stages of drug testing, both for determining efficacy and ruling out potential human-relevant toxicities. Historically, most preclinical pharmacological studies have used young, relatively healthy, inbred male models in highly controlled environments. In the field of geriatric pharmacology, there is a growing focus on the importance of using more appropriate preclinical models both in the testing of therapeutics commonly used in older populations, and in the evaluation of potential geroprotective drug candidates. Here we provide a commentary on optimizing preclinical models of ageing for translation to clinical trials. We will discuss approaches to modelling clinically relevant contexts such as age, sex, genetic diversity, exposures and environment, as well as measures of clinically relevant outcomes such as frailty and healthspan. We will identify the strengths and limitations of these approaches and areas for improvement. We will also briefly cover new preclinical models that move beyond rodents. We hope this commentary will be a springboard for larger discussions on optimizing preclinical ageing models for testing therapeutics.
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Affiliation(s)
- Sarah J Mitchell
- Ludwig Princeton Branch, Princeton University, Princeton, New Jersey, USA
| | | | - Alice E Kane
- Institute for Systems Biology, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
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Knufinke M, MacArthur MR, Ewald CY, Mitchell SJ. Sex differences in pharmacological interventions and their effects on lifespan and healthspan outcomes: a systematic review. FRONTIERS IN AGING 2023; 4:1172789. [PMID: 37305228 PMCID: PMC10249017 DOI: 10.3389/fragi.2023.1172789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/10/2023] [Indexed: 06/13/2023]
Abstract
With an increasing aging population, the burden of age-related diseases magnifies. To alleviate this burden, geroprotection has been an area of intense research focus with the development of pharmacological interventions that target lifespan and/or healthspan. However, there are often sex differences, with compounds mostly tested in male animals. Given the importance of considering both sexes in preclinical research, this neglects potential benefits for the female population, as interventions tested in both sexes often show clear sexual dimorphisms in their biological responses. To further understand the prevalence of sex differences in pharmacological geroprotective intervention studies, we performed a systematic review of the literature according to the PRISMA guidelines. Seventy-two studies met our inclusion criteria and were classified into one of five subclasses: FDA-repurposed drugs, novel small molecules, probiotics, traditional Chinese medicine, and antioxidants, vitamins, or other dietary supplements. Interventions were analyzed for their effects on median and maximal lifespan and healthspan markers, including frailty, muscle function and coordination, cognitive function and learning, metabolism, and cancer. With our systematic review, we found that twenty-two out of sixty-four compounds tested were able to prolong both lifespan and healthspan measures. Focusing on the use of female and male mice, and on comparing their outcomes, we found that 40% of studies only used male mice or did not clarify the sex. Notably, of the 36% of pharmacologic interventions that did use both male and female mice, 73% of these studies showed sex-specific outcomes on healthspan and/or lifespan. These data highlight the importance of studying both sexes in the search for geroprotectors, as the biology of aging is not the same in male and female mice. Systematic Review Registration: [website], identifier [registration number].
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Roiz-Valle D, Caravia XM, López-Otín C. Mechanisms of mitochondrial microRNA regulation in cardiovascular diseases. Mech Ageing Dev 2023; 212:111822. [PMID: 37182718 DOI: 10.1016/j.mad.2023.111822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023]
Abstract
In the past years, microRNAs (miRNAs) have emerged as important biomarkers and essential regulators of many pathophysiological processes. Several studies have focused on the importance of these noncoding RNAs (ncRNAs) in maintaining mitochondrial function, introducing the term mitochondrial microRNAs (mitomiRs) to refer to those miRNAs controlling mitochondrial activity, either by targeting cytoplasmatic messenger RNAs (mRNAs) or by acting inside the mitochondria. Mitochondrial homeostasis is paramount in the cardiovascular system, where an important energy supply is needed to maintain the homeostasis of tissues, such as the myocardium. In this review, we will address the relevance of mitomiRs in cardiovascular pathologies by dissecting and categorizing their effect in mitochondrial function in order to provide a robust framework for new mitomiR-based therapeutical approaches to this group of diseases.
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Affiliation(s)
- David Roiz-Valle
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología (IUOPA), Universidad de Oviedo.
| | - Xurde M Caravia
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología (IUOPA), Universidad de Oviedo
| | - Carlos López-Otín
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología (IUOPA), Universidad de Oviedo
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Ferraro KF. Disciplinary Roots of 300 Top-Ranked Scientific Contributors to Gerontology: From Legacy to Enriching Our Discovery. J Gerontol A Biol Sci Med Sci 2022; 77:2149-2154. [PMID: 36409829 PMCID: PMC9678198 DOI: 10.1093/gerona/glac129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Gerontology is viewed by many as a multidisciplinary field of inquiry, but which disciplines have had the greatest impact on research in the field? Combining data from a composite score incorporating multiple citation indicators with information on the highest degree, we examine the disciplinary origins of the 300 top-ranked scholars in gerontology. Despite efforts for gerontology to be distinct from geriatrics, more than 30 percent of the most influential scholars in gerontology during the past 6 decades hold a degree in medicine. Other fields of the leading contributors to gerontology include psychology, sociology, biology, biochemistry, and genetics. Although the disciplinary origins of gerontology will likely shift in the coming decades, we conclude that biomedical sciences are likely to remain core to the development of gerontology. To build on the scientific contributions of leading scholars in gerontology, future research should reflect conceptual precision and scientific innovation while prioritizing methodological rigor and transparency.
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Affiliation(s)
- Kenneth F Ferraro
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
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