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Lin Z, Zhou F, Ni L, Dong S, Fu G, Zhao J. Case report: Successful treatment of an anti-D2R and DPPX antibody-associated autoimmune encephalitis patient with high-dose methylprednisolone and intravenous immunoglobulin. Front Immunol 2024; 15:1338714. [PMID: 38469308 PMCID: PMC10925708 DOI: 10.3389/fimmu.2024.1338714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/02/2024] [Indexed: 03/13/2024] Open
Abstract
Background Autoimmune encephalitis is a neurological condition caused by abnormal immune responses, manifesting as cognitive impairments, behavioral abnormalities, and seizures. Its diagnosis depends on the detecting neuronal surface antibodies in serum or cerebrospinal fluid. Despite recent advances in understanding, clinical recognition remains challenging, especially with rare antibodies such as anti-dopamine D2 receptor (D2R) and anti-dipeptidyl-peptidase-like protein 6 (DPPX) antibodies. Delayed diagnosis can lead to severe complications. This case presentation emphasizes the diagnostic intricacies and effective treatment of the anti-D2R and DPPX antibody-associated autoimmune encephalitis. Case description The patient presented with a 3-day history of fatigue and limb soreness followed by a 3-h episode of confusion and limb convulsions. Upon admission to our facility, the initial diagnosis included status epilepticus, aspiration pneumonia, metabolic acidosis, respiratory alkalosis, and suspected encephalitis. Despite receiving antiepileptic, anti-infection, and antivirus therapy, the patient's condition deteriorated. Both computed tomography (CT) scan and magnetic resonance imaging (MRI) of the brain showed no significant abnormalities. No pathogen was identified in the cerebrospinal fluid (CSF). However, further CSF and serum examination revealed positive results of anti-D2R and anti-DPPX antibodies, confirming a diagnosis of anti-D2R and DPPX antibody-associated autoimmune encephalitis. The patient underwent a comprehensive treatment regimen, including high-dose methylprednisolone pulse therapy combined with intravenous immunoglobulin (IVIG), antiviral and anti-infection treatments, and antiepileptic medications. Significant clinical improvement was observed, and by the 18th day of admission, the patient was stable and coherent. Conclusions The current patient represents the first reported case of double-positive autoimmune encephalitis for anti-D2R and DPPX antibodies, with epilepsy as a prominent feature. High-dose methylprednisolone pulse therapy combined with IVIG has shown significant safety and efficacy in treating anti-D2R and DPPX antibody-positive autoimmune encephalitis-associated epilepsy.
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Affiliation(s)
- Zhangliang Lin
- Neurology Department, Shaoxing No.2 Hospital Meical Community General Hospital, Shaoxing, China
| | - Feng Zhou
- Neurology Department, Shaoxing No.2 Hospital Meical Community General Hospital, Shaoxing, China
| | - Lili Ni
- Neurology Department, Shaoxing No.2 Hospital Meical Community General Hospital, Shaoxing, China
| | - Shiye Dong
- Department of Medicine, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
| | - Guoping Fu
- Neurology Department, Shaoxing No.2 Hospital Meical Community General Hospital, Shaoxing, China
| | - Jiangman Zhao
- Department of Medicine, Shanghai Biotecan Pharmaceuticals Co., Ltd., Shanghai Zhangjiang Institute of Medical Innovation, Shanghai, China
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Cárdenas G, Chávez-Canales M, Espinosa AM, Jordán-Ríos A, Malagon DA, Murillo MFM, Araujo LVT, Campos RLB, Wong-Chew RM, González LER, Cresencio KI, Velázquez EG, de la Cerda MR, Leyva Y, Hernández-Ruiz J, Hernández-Medel ML, León-Hernández M, Quero KM, Monciváis AS, Sarmiento EB, Reynoso RIA, Reyes DM, Del Río Ambriz LR, Hernández JSG, Cruz J, Ferrer SIV, Huerta L, Fierro NA, Hernández M, Pérez-Tapia M, Meneses G, Rosas G, Hernández-Aceves JA, Cervantes-Torres J, Valdez RA, Rodríguez AF, Espíndola-Arriaga E, Ortiz M, Salazar EA, Barba CC, Besedovsky H, Romano MC, Jung H, Bobes RJ, Soldevila G, López-Alvarenga JC, Fragoso G, Laclette JP, Sciutto E. Intranasal Versus Intravenous Dexamethasone to Treat Hospitalized COVID-19 Patients: A Randomized Multicenter Clinical Trial. Arch Med Res 2024; 55:102960. [PMID: 38290199 DOI: 10.1016/j.arcmed.2024.102960] [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: 07/15/2023] [Revised: 12/04/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND SARS-CoV2 induces flu-like symptoms that can rapidly progress to severe acute lung injury and even death. The virus also invades the central nervous system (CNS), causing neuroinflammation and death from central failure. Intravenous (IV) or oral dexamethasone (DXM) reduced 28 d mortality in patients who required supplemental oxygen compared to those who received conventional care alone. Through these routes, DMX fails to reach therapeutic levels in the CNS. In contrast, the intranasal (IN) route produces therapeutic levels of DXM in the CNS, even at low doses, with similar systemic bioavailability. AIMS To compare IN vs. IV DXM treatment in hospitalized patients with COVID-19. METHODS A controlled, multicenter, open-label trial. Patients with COVID-19 (69) were randomly assigned to receive IN-DXM (0.12 mg/kg for three days, followed by 0.6 mg/kg for up to seven days) or IV-DXM (6 mg/d for 10 d). The primary outcome was clinical improvement, as defined by the National Early Warning Score (NEWS) ordinal scale. The secondary outcome was death at 28 d between IV and IN patients. Effects of both treatments on biochemical and immunoinflammatory profiles were also recorded. RESULTS Initially, no significant differences in clinical severity, biometrics, and immunoinflammatory parameters were found between both groups. The NEWS-2 score was reduced, in 23 IN-DXM treated patients, with no significant variations in the 46 IV-DXM treated ones. Ten IV-DXM-treated patients and only one IN-DXM patient died. CONCLUSIONS IN-DMX reduced NEWS-2 and mortality more efficiently than IV-DXM, suggesting that IN is a more efficient route of DXM administration.
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Affiliation(s)
- Graciela Cárdenas
- Neurology Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - María Chávez-Canales
- Research Unit Universidad Autónoma de Mexico, Instituto Nacional de Cardiología Ignacio Chávez and Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ana María Espinosa
- Clinical Pharmacology Unit, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | | | - Daniel Anica Malagon
- Clinical Pharmacology Unit, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | | | | | | | - Rosa María Wong-Chew
- Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | | | | | | | - Yoana Leyva
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Joselin Hernández-Ruiz
- Clinical Pharmacology Unit, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | | | - Mireya León-Hernández
- Clinical Pharmacology Unit, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Karen Medina Quero
- Hospital Militar, Secretaría de la Defensa Nacional, Mexico City, Mexico
| | | | | | | | | | | | | | - Jocelyn Cruz
- Neurology Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Sergio Iván Valdés Ferrer
- Neurology and Psychiatry Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Leonor Huerta
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Nora Alma Fierro
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Marisela Hernández
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Mayra Pérez-Tapia
- Bioprocess Development and Research Unit, Escuela Nacional de Ciencias Biológicas del Instituto Politécnico Nacional, Mexico City, Mexico
| | - Gabriela Meneses
- Instituto de Diagnóstico y Referencia Epidemiológicos Dr. Manuel Martínez Báez, Mexico City, Mexico
| | - Gabriela Rosas
- Faculty of Medicine, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, Mexico
| | - Juan Alberto Hernández-Aceves
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jaquelynne Cervantes-Torres
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ricardo A Valdez
- Physiology, Biophysics and Neurosciences Department, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
| | - Anai Fuentes Rodríguez
- National Flow Cytometry Laboratory, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México
| | - Erick Espíndola-Arriaga
- National Flow Cytometry Laboratory, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México
| | - Mauricio Ortiz
- National Flow Cytometry Laboratory, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México
| | - Evelyn Alvarez Salazar
- National Flow Cytometry Laboratory, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México
| | - Carlos Castellanos Barba
- National Flow Cytometry Laboratory, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México
| | - Hugo Besedovsky
- Institute of Physiology and Pathophysiology, Marburg, Germany
| | - Marta C Romano
- Physiology, Biophysics and Neurosciences Department, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
| | - Helgi Jung
- Faculty of Chemistry, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Raúl J Bobes
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Gloria Soldevila
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico; National Flow Cytometry Laboratory, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, México
| | | | - Gladis Fragoso
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Juan Pedro Laclette
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Edda Sciutto
- Inmunology Department, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico.
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Mwema A, Muccioli GG, des Rieux A. Innovative drug delivery strategies to the CNS for the treatment of multiple sclerosis. J Control Release 2023; 364:435-457. [PMID: 37926243 DOI: 10.1016/j.jconrel.2023.10.052] [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: 07/05/2023] [Revised: 10/05/2023] [Accepted: 10/31/2023] [Indexed: 11/07/2023]
Abstract
Disorders of the central nervous system (CNS), such as multiple sclerosis (MS) represent a great emotional, financial and social burden. Despite intense efforts, great unmet medical needs remain in that field. MS is an autoimmune, chronic inflammatory demyelinating disease with no curative treatment up to date. The current therapies mostly act in the periphery and seek to modulate aberrant immune responses as well as slow down the progression of the disease. Some of these therapies are associated with adverse effects related partly to their administration route and show some limitations due to their rapid clearance and inability to reach the CNS. The scientific community have recently focused their research on developing MS therapies targeting different processes within the CNS. However, delivery of therapeutics to the CNS is mainly limited by the presence of the blood-brain barrier (BBB). Therefore, there is a pressing need to develop new drug delivery strategies that ensure CNS availability to capitalize on identified therapeutic targets. Several approaches have been developed to overcome or bypass the BBB and increase delivery of therapeutics to the CNS. Among these strategies, the use of alternative routes of administration, such as the nose-to-brain (N2B) pathway, offers a promising non-invasive option in the scope of MS, as it would allow a direct transport of the drugs from the nasal cavity to the brain. Moreover, the combination of bioactive molecules within nanocarriers bring forth new opportunities for MS therapies, allowing and/or increasing their transport to the CNS. Here we will review and discuss these alternative administration routes as well as the nanocarrier approaches useful to deliver drugs for MS.
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Affiliation(s)
- Ariane Mwema
- Université catholique de Louvain, UCLouvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, Avenue E. Mounier 73, 1200 Brussels, Belgium; Université catholique de Louvain, UCLouvain, Louvain Drug Research Institute, Bioanalysis and Pharmacology of Bioactive Lipids, Avenue E. Mounier 72, 1200 Brussels, Belgium
| | - Giulio G Muccioli
- Université catholique de Louvain, UCLouvain, Louvain Drug Research Institute, Bioanalysis and Pharmacology of Bioactive Lipids, Avenue E. Mounier 72, 1200 Brussels, Belgium.
| | - Anne des Rieux
- Université catholique de Louvain, UCLouvain, Louvain Drug Research Institute, Advanced Drug Delivery and Biomaterials, Avenue E. Mounier 73, 1200 Brussels, Belgium.
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Zhao M, Zhang Y, Wu J, Li X, Gao Y. Early urinary candidate biomarkers and clinical outcomes of intervention in a rat model of experimental autoimmune encephalomyelitis. ROYAL SOCIETY OPEN SCIENCE 2023; 10:230118. [PMID: 37621667 PMCID: PMC10445012 DOI: 10.1098/rsos.230118] [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: 01/31/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
Multiple sclerosis is a chronic autoimmune demyelinating disease of the central nervous system and is difficult to diagnose in early stages. Without homeostatic control, urine was reported to have the ability to accumulate early changes in the body. We expect that urinary proteome can reflect early changes in the nervous system. The early urinary proteome changes in a most employed multiple sclerosis rat model (experimental autoimmune encephalomyelitis) were analysed to explore early urinary candidate biomarkers, and early treatment of methylprednisolone was used to evaluate the therapeutic effect. Twenty-five urinary proteins were altered at day 7 when there were no clinical symptoms and obvious histological changes. Fourteen were reported to be differently expressed in the serum/cerebrospinal fluid/brain tissues of multiple sclerosis patients or animals such as angiotensinogen and matrix metallopeptidase 8. Functional analysis showed that the dysregulated proteins were associated with asparagine degradation, neuroinflammation and lipid metabolism. After the early treatment of methylprednisolone, the incidence of encephalomyelitis in the intervention group was only 1/13. This study demonstrates that urine may be a good source of biomarkers for the early detection of multiple sclerosis. These findings may provide important information for early diagnosis and intervention of multiple sclerosis in the future.
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Affiliation(s)
- Mindi Zhao
- Department of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yameng Zhang
- Gene Engineering Drug and Biotechnology Beijing Key Laboratory, College of Life Sciences, Beijing Normal University, Beijing 100875, People's Republic of China
- Department of Pathology, Henan Provincial People's Hospital; People's Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jianqiang Wu
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Xundou Li
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences/School of Basic Medicine, Peking Union Medical College, Beijing, People's Republic of China
| | - Youhe Gao
- Gene Engineering Drug and Biotechnology Beijing Key Laboratory, College of Life Sciences, Beijing Normal University, Beijing 100875, People's Republic of China
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Acosta-Galeana I, Hernández-Martínez R, Reyes-Cruz T, Chiquete E, Aceves-Buendia JDJ. RNA-binding proteins as a common ground for neurodegeneration and inflammation in amyotrophic lateral sclerosis and multiple sclerosis. Front Mol Neurosci 2023; 16:1193636. [PMID: 37475885 PMCID: PMC10355071 DOI: 10.3389/fnmol.2023.1193636] [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: 03/25/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
The neurodegenerative and inflammatory illnesses of amyotrophic lateral sclerosis and multiple sclerosis were once thought to be completely distinct entities that did not share any remarkable features, but new research is beginning to reveal more information about their similarities and differences. Here, we review some of the pathophysiological features of both diseases and their experimental models: RNA-binding proteins, energy balance, protein transportation, and protein degradation at the molecular level. We make a thorough analysis on TDP-43 and hnRNP A1 dysfunction, as a possible common ground in both pathologies, establishing a potential link between neurodegeneration and pathological immunity. Furthermore, we highlight the putative variations that diverge from a common ground in an atemporal course that proposes three phases for all relevant molecular events.
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Affiliation(s)
| | | | - Tania Reyes-Cruz
- Laboratorio de Biología Molecular, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Erwin Chiquete
- Departamento de Neurología y Psiquiatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Jose de Jesus Aceves-Buendia
- Departamento de Neurología y Psiquiatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Lara-Espinosa JV, Arce-Aceves MF, Barrios-Payán J, Mata-Espinosa D, Lozano-Ordaz V, Becerril-Villanueva E, Ponce-Regalado MD, Hernández-Pando R. Effect of Low Doses of Dexamethasone on Experimental Pulmonary Tuberculosis. Microorganisms 2023; 11:1554. [PMID: 37375056 DOI: 10.3390/microorganisms11061554] [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: 05/15/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Tuberculosis (TB) is the deadliest disease caused by a bacterial agent. Glucocorticoids (GCs) have a typical anti-inflammatory effect, but recently it has been shown that they can present proinflammatory activity, mainly by increasing molecules from innate immunity. In the current study, we evaluated the effect of low doses of dexamethasone on Mycobacterium tuberculosis in vivo and in vitro. We used an established mice model of progressing tuberculosis (TB) in the in vivo studies. Intratracheal or intranasal dexamethasone therapy administered with conventional antibiotics in the late stage of the disease decreased the lung bacilli load and lung pneumonia, and increased the survival of the animals. Finally, the treatment decreased the inflammatory response in the SNC and, therefore, sickness behavior and neurological abnormalities in the infected animals. In the in vitro experiments, we used a cell line of murine alveolar macrophages infected with Mtb. Low-dose dexamethasone treatment increased the clearance capacity of Mtb by MHS macrophages, MIP-1α, and TLR2 expression, decreased proinflammatory and anti-inflammatory cytokines, and induced apoptosis, a molecular process that contributes to the control of the mycobacteria. In conclusion, the administration of low doses of dexamethasone represents a promising adjuvant treatment for pulmonary TB.
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Affiliation(s)
- Jacqueline V Lara-Espinosa
- Sección de Patología Experimental, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, Mexico City 14080, Mexico
| | - María Fernanda Arce-Aceves
- Laboratorio de Estudios en Tripasomiasis y Leishmaniasis, Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Jorge Barrios-Payán
- Sección de Patología Experimental, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, Mexico City 14080, Mexico
| | - Dulce Mata-Espinosa
- Sección de Patología Experimental, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, Mexico City 14080, Mexico
| | - Vasti Lozano-Ordaz
- Sección de Patología Experimental, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, Mexico City 14080, Mexico
| | - Enrique Becerril-Villanueva
- Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Calzada México-Xochimilco 101, Colonia, Huipulco, Tlalpan, Mexico City 14370, Mexico
| | - María Dolores Ponce-Regalado
- Departamento de Ciencias de la Salud, Centro Universitario de los Altos, Universidad de Guadalajara, Av Rafael Casillas Aceves 120, Tepatitlán de Morelos 47620, Mexico
| | - Rogelio Hernández-Pando
- Sección de Patología Experimental, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, Mexico City 14080, Mexico
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Kanemaru E, Miyazaki Y, Marutani E, Ezaka M, Goto S, Ohshima E, Bloch DB, Ichinose F. Intranasal administration of polysulfide prevents neurodegeneration in spinal cord and rescues mice from delayed paraplegia after spinal cord ischemia. Redox Biol 2023; 60:102620. [PMID: 36753926 PMCID: PMC9932672 DOI: 10.1016/j.redox.2023.102620] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/25/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Delayed paraplegia is a devastating complication of thoracoabdominal aortic surgery. Hydrogen sulfide (H2S) was reported to be protective in a mouse model of spinal cord ischemia and the beneficial effect of H2S has been attributed to polysulfides. The objective of this study was to investigate the effects of polysulfides on delayed paraplegia after spinal cord ischemia. METHODS AND RESULTS Spinal cord ischemia was induced in male and female C57BL/6J mice by clamping the aortic arch and the left subclavian artery. Glutathione trisulfide (GSSSG), glutathione (GSH), glutathione disulfide (GSSG), or vehicle alone was administered intranasally at 0, 8, 23, and 32 h after surgery. All mice treated with vehicle alone developed paraplegia within 48 h after surgery. GSSSG, but not GSH or GSSG, prevented paraplegia in 8 of 11 male mice (73%) and 6 of 8 female mice (75%). Intranasal administration of 34S-labeled GSSSG rapidly increased 34S-labeled sulfane sulfur species in the lumbar spinal cord. In mice treated with intranasal GSSSG, there were increased sulfane sulfur levels, and decreased neurodegeneration, microglia activation, and caspase-3 activation in the lumbar spinal cord. In vitro studies using murine primary cortical neurons showed that GSSSG increased intracellular levels of sulfane sulfur. GSSSG, but not GSH or GSSG, dose-dependently improved cell viability after oxygen and glucose deprivation/reoxygenation (OGD/R). Pantethine trisulfide (PTN-SSS) also increased intracellular sulfane sulfur and improved cell viability after OGD/R. Intranasal administration of PTN-SSS, but not pantethine, prevented paraplegia in 6 of 9 male mice (66%). CONCLUSIONS Intranasal administration of polysulfides rescued mice from delayed paraplegia after transient spinal cord ischemia. The neuroprotective effects of GSSSG were associated with increased levels of polysulfides and sulfane sulfur in the lumbar spinal cord. Targeted delivery of sulfane sulfur by polysulfides may prove to be a novel approach to the treatment of neurodegenerative diseases.
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Affiliation(s)
- Eiki Kanemaru
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
| | - Yusuke Miyazaki
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
| | - Eizo Marutani
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
| | - Mariko Ezaka
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
| | - Shunsaku Goto
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
| | - Etsuo Ohshima
- Corporate Strategy Department, Kyowa Hakko Bio Co., Ltd., Tokyo, 164-0001, Japan.
| | - Donald B. Bloch
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Fumito Ichinose
- Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
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Resveratrol-loaded macrophage exosomes alleviate multiple sclerosis through targeting microglia. J Control Release 2023; 353:675-684. [PMID: 36521687 DOI: 10.1016/j.jconrel.2022.12.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/01/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Despite exosome promise as endogenous drug delivery vehicles, the current understanding of exosome may be insufficient to develop their various applications. Here we synthesized five sialic acid analogues with different length N-acyl side chains and screened out the optimal metabolic precursor for exosome labeling via bio-orthogonal click chemistry. In proof-of-principle labeling experiments, exosomes derived from macrophages (RAW-Exo) strongly co-localized with central nervous system (CNS) microglia. Inspired by this discovery, we developed a resveratrol-loaded RAW-Exo formulation (RSV&Exo) for multiple sclerosis (MS) treatment. Intranasal administration of RSV&Exo significantly inhibited inflammatory responses in the CNS and peripheral system in a mouse model of MS and effectively improved the clinical evolution of MS in vivo. These findings suggested the feasibility and efficacy of engineered RSV&Exo administration for MS, providing a potential therapeutic strategy for CNS diseases.
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Pharmacokinetic Study of Intranasal Dexamethasone and Methylprednisolone Compared with Intravenous Administration: Two Open-Label, Single-Dose, Two-Period, Two-Sequence, Cross-Over Study in Healthy Volunteers. Pharmaceutics 2022; 15:pharmaceutics15010105. [PMID: 36678735 PMCID: PMC9861764 DOI: 10.3390/pharmaceutics15010105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/09/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022] Open
Abstract
Dexamethasone (DXM) and methylprednisolone (MEP) are potent glucocorticoids used to control several inflammatory conditions. Evidence of delayed DXM reaching the central nervous system (CNS) as well as tachyphylaxis and systemic, undesirable side effects are the main limitations of peripheral delivery. Intranasal administration offers direct access to the brain as it bypasses the blood-brain barrier. The Mucosal Atomization Device is an optimal tool that can achieve rapid absorption into the CNS and the bloodstream across mucosal membranes. This study was designed to evaluate and compare the bioavailability of DXM and MEP after intranasal versus intravenous administration. Two open-label, balanced, randomized, two-treatment, two-period, two-sequence, single-dose, crossover studies were conducted, which involved healthy male and female adult volunteers. After intranasal administration, DXM and MEP were detected in plasma after the first sampling time. Mean peak concentrations of DXM and MEP were 86.61 ng/mL at 60 min and 843.2 ng/mL at 1.5 h post-administration, respectively. DXM and MEP showed high absolute bioavailability, with values of 80% and 95%, respectively. No adverse effects were observed. DXM and MEP systemic bioavailability by intranasal administration was comparable with the intravenous one, suggesting that the intranasal route can be used as a non-invasive and appropriate alternative for systemic drug delivery.
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Pharmacokinetic considerations to optimize clinical outcomes for COVID-19 drugs. Trends Pharmacol Sci 2022; 43:1041-1054. [PMID: 36374805 PMCID: PMC9510059 DOI: 10.1016/j.tips.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/12/2022] [Accepted: 09/21/2022] [Indexed: 01/13/2023]
Abstract
The development of clinically effective drugs that could complement existing vaccines is urgently needed to reduce the morbidity and mortality associated with COVID-19. Drug-metabolizing enzymes, membrane-associated drug transporters, and inflammatory responses can partly determine the safety and efficacy of COVID-19 drugs by controlling their concentrations in both the systemic circulation and in peripheral tissues. It is still unknown how these factors affect how well COVID-19 drugs work in the clinic. We explore how drug metabolism and transport, as well as SARS-CoV-2-associated inflammatory response at disease target sites, may affect the clinical outcomes of COVID-19 drugs. In addition, we provide expert opinion on potential strategies for overcoming the clinical pharmacology and pathophysiological obstacles to improve COVID-19 drug effectiveness.
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11
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Intranasal Methylprednisolone Ameliorates Neuroinflammation Induced by Chronic Toluene Exposure. Pharmaceutics 2022; 14:pharmaceutics14061195. [PMID: 35745768 PMCID: PMC9230943 DOI: 10.3390/pharmaceutics14061195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/17/2021] [Accepted: 01/10/2022] [Indexed: 01/27/2023] Open
Abstract
Inhalants are chemical substances that induce intoxication, and toluene is the main component of them. Increasing evidence indicates that a dependence on inhalants involves a state of chronic stress associated to the activation of immune cells in the central nervous system and release of proinflammatory mediators, especially in some brain areas such as the nucleus accumbens and frontal cortex, where the circuits of pleasure and reward are. In this study, anti-neuroinflammatory treatment based on a single dose of intranasal methylprednisolone was assessed in a murine model of chronic toluene exposure. The levels of proinflammatory mediators, expression levels of Iba-1 and GFAP, and histological changes in the frontal cortex and nucleus accumbens were evaluated after the treatment. The chronic exposure to toluene significantly increased the levels of TNF-α, IL-6, and NO, the expression of GFAP, and induced histological alterations in mouse brains. The treatment with intranasally administered MP significantly reduced the expression of TNF-α and NO and the expression of GFAP (p < 0.05); additionally, it reversed the central histological damage. These results indicate that intranasally administered methylprednisolone could be considered as a treatment to reverse neuroinflammation and histological damages associated with the use of inhalants.
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Ghasemi-Kasman M, Nosratiyan N, Hashemian M, Ahmadian SR, Parsian H, Rostami-Mansoor S. Intranasal administration of fingolimod (FTY720) attenuates demyelination area in lysolecithin-induced demyelination model of rat optic chiasm. Mult Scler Relat Disord 2022; 59:103518. [DOI: 10.1016/j.msard.2022.103518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/19/2021] [Accepted: 01/09/2022] [Indexed: 11/16/2022]
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13
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Wan F, Wang H, Wang M, Lv J, Zhao M, Zhang H. Sustained release of Lactobacillus casei cell wall extract can induce a continuous and stable IgA deposition model. J Pathol 2022; 257:262-273. [PMID: 35170753 DOI: 10.1002/path.5884] [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: 10/20/2021] [Revised: 01/30/2022] [Accepted: 02/14/2022] [Indexed: 11/08/2022]
Abstract
Mucosal immune regulation is considered a key aspect of immunopathogenesis of IgA nephropathy (IgAN). Direct experimental evidence clarifying the role of intestinal mucosa attributes in IgAN is lacking. In this study, a mouse model was established via multiple low-dose intraperitoneal injections of Lactobacillus casei cell wall extract (LCWE) emulsified with Complete Freund's Adjuvant (CFA). We found continuous and stable deposition of IgA in glomerular mesangial areas, accompanying high circulating levels of IgA and IgA-IgG complexes. Expression of key extracellular matrix components Collage IV and fibronectin also increased in the mesangial areas of LCWE-induced mice. IgA+ B220+ B-cell proportion increased in the small intestine (SI), Peyer's patches, inguinal lymph nodes, spleen, and bone marrow. The intestinal barrier was dysfunctional in the LCWE-induced mice, and consistent with this higher levels of serum zonulin (namely prehaptoglobin-2), a regulator of epithelial and endothelial barrier function were observed in patients with IgAN. Hematoxylin and eosin staining results showed immune tissues such as liver, spleen, and lymph nodes showed an inflammatory response and focal lesions. Glucocorticoid methylprednisolone treatment could alleviate serum IgA and IgA-IgG complexes level and mesangial IgA deposition. Taken together, our results indicate that we have successfully constructed a mouse model with IgA deposition in the mesangial areas of the glomeruli and provided evidence for the connection between the intestinal barrier and elevated circulating IgA and IgA-IgG in IgAN. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Feng Wan
- Renal Division, Peking University First Hospital, Beijing; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China.,Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Hui Wang
- Laboratory of Electron Microscopy, Pathological Center, Peking University First Hospital, Beijing, China
| | - Manliu Wang
- Renal Division, Peking University First Hospital, Beijing; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Jicheng Lv
- Renal Division, Peking University First Hospital, Beijing; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-mediate Kidney Disease, Chinese Academy of Medical Sciences, Beijing, China
| | - MingHui Zhao
- Renal Division, Peking University First Hospital, Beijing; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-mediate Kidney Disease, Chinese Academy of Medical Sciences, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Hong Zhang
- Renal Division, Peking University First Hospital, Beijing; Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China.,Research Units of Diagnosis and Treatment of Immune-mediate Kidney Disease, Chinese Academy of Medical Sciences, Beijing, China
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14
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Cárdenas G, Chávez-Canales M, Espinosa AM, Jordán-Ríos A, Malagon DA, Murillo MFM, Araujo LVT, Campos RLB, Wong-Chew RM, González LER, Cresencio KI, Velázquez EG, de la Cerda MR, Leyva Y, Hernández-Ruiz J, Hernández-Medel ML, León-Hernández M, Quero KM, Monciváis AS, Díaz SH, Martínez IRZ, Martínez-Cuazitl A, Salazar INM, Sarmiento EB, Peña AF, Hernández PS, Reynoso RIA, Reyes DM, del Río Ambriz LR, Bonilla RAA, Cruz J, Huerta L, Fierro NA, Hernández M, Pérez-Tapia M, Meneses G, Espíndola-Arriaga E, Rosas G, Chinney A, Mendoza SR, Hernández-Aceves JA, Cervantes-Torres J, Rodríguez AF, Alor RO, Francisco SO, Salazar EA, Besedovsky H, Romano MC, Bobes RJ, Jung H, Soldevila G, López-Alvarenga J, Fragoso G, Laclette JP, Sciutto E. Intranasal dexamethasone: a new clinical trial for the control of inflammation and neuroinflammation in COVID-19 patients. Trials 2022; 23:148. [PMID: 35164840 PMCID: PMC8845269 DOI: 10.1186/s13063-022-06075-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 02/01/2022] [Indexed: 12/15/2022] Open
Abstract
Background By end December of 2021, COVID-19 has infected around 276 million individuals and caused over 5 million deaths worldwide. Infection results in dysregulated systemic inflammation, multi-organ dysfunction, and critical illness. Cells of the central nervous system are also affected, triggering an uncontrolled neuroinflammatory response. Low doses of glucocorticoids, administered orally or intravenously, reduce mortality among moderate and severe COVID-19 patients. However, low doses administered by these routes do not reach therapeutic levels in the CNS. In contrast, intranasally administered dexamethasone can result in therapeutic doses in the CNS even at low doses. Methods This is an approved open-label, multicenter, randomized controlled trial to compare the effectiveness of intranasal versus intravenous dexamethasone administered in low doses to moderate and severe COVID-19 adult patients. The protocol is conducted in five health institutions in Mexico City. A total of 120 patients will be randomized into two groups (intravenous vs. intranasal) at a 1:1 ratio. Both groups will be treated with the corresponding dexamethasone scheme for 10 days. The primary outcome of the study will be clinical improvement, defined as a statistically significant reduction in the NEWS-2 score of patients with intranasal versus intravenous dexamethasone administration. The secondary outcome will be the reduction in mortality during hospitalization. Conclusions This protocol is currently in progress to improve the efficacy of the standard therapeutic dexamethasone regimen for moderate and severe COVID-19 patients. Trial registration ClinicalTrials.govNCT04513184. Registered November 12, 2020. Approved by La Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS) with identification number DI/20/407/04/36. People are currently being recruited. Graphical abstract ![]()
REVIVAL is a multicenter, open-label, randomized, controlled study to compare the standard low doses of intravenous dexamethasone with weight-adjusted low doses of intranasal dexamethasone. Intranasal dexamethasone can reach the respiratory tract more effectively than intravenous administration. Intranasal dexamethasone can reach the central nervous system in therapeutic concentrations, even at low doses. REVIVAL aims to reduce central failures and sequelae by controlling not only systemic inflammation but also neuroinflammation.
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Zarkesh K, Entezar-Almahdi E, Ghasemiyeh P, Akbarian M, Bahmani M, Roudaki S, Fazlinejad R, Mohammadi-Samani S, Firouzabadi N, Hosseini M, Farjadian F. Drug-based therapeutic strategies for COVID-19-infected patients and their challenges. Future Microbiol 2021; 16:1415-1451. [PMID: 34812049 PMCID: PMC8610072 DOI: 10.2217/fmb-2021-0116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022] Open
Abstract
Emerging epidemic-prone diseases have introduced numerous health and economic challenges in recent years. Given current knowledge of COVID-19, herd immunity through vaccines alone is unlikely. In addition, vaccination of the global population is an ongoing challenge. Besides, the questions regarding the prevalence and the timing of immunization are still under investigation. Therefore, medical treatment remains essential in the management of COVID-19. Herein, recent advances from beginning observations of COVID-19 outbreak to an understanding of the essential factors contributing to the spread and transmission of COVID-19 and its treatment are reviewed. Furthermore, an in-depth discussion on the epidemiological aspects, clinical symptoms and most efficient medical treatment strategies to mitigate the mortality and spread rates of COVID-19 is presented.
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Affiliation(s)
- Khatereh Zarkesh
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elaheh Entezar-Almahdi
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Ghasemiyeh
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Akbarian
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Bahmani
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Roudaki
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rahil Fazlinejad
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soliman Mohammadi-Samani
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Firouzabadi
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Hosseini
- Department of Manufacturing & Industrial Engineering, The University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Fatemeh Farjadian
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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16
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Pérez-Osorio IN, Espinosa A, Giraldo Velázquez M, Padilla P, Bárcena B, Fragoso G, Jung-Cook H, Besedovsky H, Meneses G, Sciutto Conde EL. Nose-to-Brain Delivery of Dexamethasone: Biodistribution Studies in Mice. J Pharmacol Exp Ther 2021; 378:244-250. [PMID: 34531307 DOI: 10.1124/jpet.121.000530] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/09/2021] [Indexed: 12/17/2022] Open
Abstract
Neuroinflammation (NI) is an important physiologic process which promotes the tissue repair and homeostatic maintenance in the central nervous system after different types of insults. However, when it is exacerbated and sustained in time, NI plays a critical role in the pathogenesis of different neurologic diseases. The high systemic doses required for brain-specific targeting lead to severe undesirable effects. The intranasal (IN) route has been proposed as an alternative drug administration route for a better NI control. Herein, the brain biodistribution of intranasally administered dexamethasone versus intravenously administered one is reported. A higher amount of dexamethasone was found in every analyzed region of those brains of intranasally administered mice. HPLC analysis also revealed that IN administration allows Dex to arrive faster and in a greater concentration to the brain in comparison with intravenous administration, data confirmed by immunofluorescence and HPLC analysis. These data support the proposal of the IN administration of Dex as an alternative for a more efficient control of NI. SIGNIFICANCE STATEMENT: This work highlights the biodistribution of dexamethasone after its intranasal administration. Intranasal administration allows for a faster arrival, better distribution, and a higher concentration of the drug within the brain compared to its intravenous administration. These results explain some of the evidence shown in a previous work in which dexamethasone controls neuroinflammation in a murine stroke model and can be used to propose alternative treatments for neuroinflammatory diseases.
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Affiliation(s)
- Iván Nicolás Pérez-Osorio
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Alejandro Espinosa
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Manuel Giraldo Velázquez
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Patricia Padilla
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Brandon Bárcena
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Gladis Fragoso
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Helgi Jung-Cook
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Hugo Besedovsky
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Gabriela Meneses
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
| | - Edda Lydia Sciutto Conde
- Instituto de Investigaciones Biomédicas, (I.N.P.O, A.E., M.G.V., P.P., B.B., G.F., E.L.S.C.), Facultad de Químicas (H.J.-C.), Universidad Nacional Autónoma de México, Mexico City, Mexico; Research Group Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps Universität, Marburg, Germany (H.B.); and Departament of Parasitology, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Mexico City, Mexico (G.M.)
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Lara-Espinosa JV, Arce-Aceves MF, Mata-Espinosa D, Barrios-Payán J, Marquina-Castillo B, Hernández-Pando R. The Therapeutic Effect of Intranasal Administration of Dexamethasone in Neuroinflammation Induced by Experimental Pulmonary Tuberculosis. Int J Mol Sci 2021; 22:ijms22115997. [PMID: 34206086 PMCID: PMC8199538 DOI: 10.3390/ijms22115997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022] Open
Abstract
Tuberculosis (TB) is an important infectious disease and a public health problem. The organs most frequently affected by TB are the lungs; despite this, it has been reported that TB patients suffer from depression and anxiety, which have been attributed to social factors. In previous experimental work, we observed that the extensive pulmonary inflammation characteristic of TB with high cytokine production induces neuroinflammation, neuronal death and behavioral abnormalities in the absence of brain infection. The objective of the present work was to reduce this neuroinflammation and avoid the psycho-affective disorders showed during pulmonary TB. Glucocorticoids (GCs) are the first-line treatment for neuroinflammation; however, their systemic administration generates various side effects, mostly aggravating pulmonary TB due to immunosuppression of cellular immunity. Intranasal administration is a route that allows drugs to be released directly in the brain through the olfactory nerve, reducing their doses and side effects. In the present work, dexamethasone’s (DEX) intranasal administration was evaluated in TB BALB /c mice comparing three different doses (0.05, 0.25 and 2.5 mg/kg BW) on lung disease evolution, neuroinflammation and behavioral alterations. Low doses of dexamethasone significantly decreased neuroinflammation, improving behavioral status without aggravating lung disease.
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Matrine treatment reduces retinal ganglion cell apoptosis in experimental optic neuritis. Sci Rep 2021; 11:9520. [PMID: 33947942 PMCID: PMC8097076 DOI: 10.1038/s41598-021-89086-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/20/2021] [Indexed: 11/25/2022] Open
Abstract
Inflammatory demyelination and axonal injury of the optic nerve are hallmarks of optic neuritis (ON), which often occurs in multiple sclerosis and is a major cause of visual disturbance in young adults. Although a high dose of corticosteroids can promote visual recovery, it cannot prevent permanent neuronal damage. Novel and effective therapies are thus required. Given the recently defined capacity of matrine (MAT), a quinolizidine alkaloid derived from the herb Radix Sophorae flavescens, in immunomodulation and neuroprotection, we tested in this study the effect of matrine on rats with experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. MAT administration, started at disease onset, significantly suppressed optic nerve infiltration and demyelination, with reduced numbers of Iba1+ macrophages/microglia and CD4+ T cells, compared to those from vehicle-treated rats. Increased expression of neurofilaments, an axon marker, reduced numbers of apoptosis in retinal ganglion cells (RGCs). Moreover, MAT treatment promoted Akt phosphorylation and shifted the Bcl-2/Bax ratio back towards an antiapoptotic one, which could be a mechanism for its therapeutic effect in the ON model. Taken as a whole, our results demonstrate that MAT attenuated inflammation, demyelination and axonal loss in the optic nerve, and protected RGCs from inflammation-induced cell death. MAT may therefore have potential as a novel treatment for this disease that may result in blindness.
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