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Harper MM, Gramlich OW, Elwood BW, Boehme NA, Dutca LM, Kuehn MH. Immune responses in mice after blast-mediated traumatic brain injury TBI autonomously contribute to retinal ganglion cell dysfunction and death. Exp Eye Res 2022; 225:109272. [PMID: 36209837 DOI: 10.1016/j.exer.2022.109272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE The purpose of this study was to examine the role of the immune system and its influence on chronic retinal ganglion cell (RGC) dysfunction following blast-mediated traumatic brain injury (bTBI). METHODS C57BL/6J and B6.129S7-Rag1tm1Mom/J (Rag-/-) mice were exposed to one blast injury of 140 kPa. A separate cohort of C57BL/6J mice was exposed to sham-blast. Four weeks following bTBI mice were euthanized, and splenocytes were collected. Adoptive transfer (AT) of splenocytes into naïve C57BL/6J recipient mice was accomplished via tail vein injection. Three groups of mice were analyzed: those receiving AT of splenocytes from C57BL/6J mice exposed to blast (AT-TBI), those receiving AT of splenocytes from C57BL/6J mice exposed to sham (AT-Sham), and those receiving AT of splenocytes from Rag-/- mice exposed to blast (AT-Rag-/-). The visual function of recipient mice was analyzed with the pattern electroretinogram (PERG), and the optomotor response (OMR). The structure of the retina was evaluated using optical coherence tomography (OCT), and histologically using BRN3A-antibody staining. RESULTS Analysis of the PERG showed a decreased amplitude two months post-AT that persisted for the duration of the study in AT-TBI mice. We also observed a significant decrease in the retinal thickness of AT-TBI mice two months post-AT compared to sham, but not at four or six months post-AT. The OMR response was significantly decreased in AT-TBI mice 5- and 6-months post-AT. BRN3A staining showed a loss of RGCs in AT-TBI and AT-Rag-/- mice. CONCLUSION These results suggest that the immune system contributes to chronic RGC dysfunction following bTBI.
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Affiliation(s)
- Matthew M Harper
- Departments of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA; Departments of Biology, And Pharmacology, The University of Iowa, Iowa City, IA, USA; Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City VA Healthcare System, Iowa City, IA, USA.
| | - Oliver W Gramlich
- Departments of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA; Departments of Neuroscience and Pharmacology, The University of Iowa, Iowa City, IA, USA; Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City VA Healthcare System, Iowa City, IA, USA
| | - Benjamin W Elwood
- Departments of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA; Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City VA Healthcare System, Iowa City, IA, USA
| | - Nickolas A Boehme
- Departments of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA; Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City VA Healthcare System, Iowa City, IA, USA
| | - Laura M Dutca
- Departments of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA; Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City VA Healthcare System, Iowa City, IA, USA
| | - Markus H Kuehn
- Departments of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA; Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City VA Healthcare System, Iowa City, IA, USA
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Mooney SWJ, Alam NM, Prusky GT. Tracking-Based Interactive Assessment of Saccades, Pursuits, Visual Field, and Contrast Sensitivity in Children With Brain Injury. Front Hum Neurosci 2021; 15:737409. [PMID: 34776907 PMCID: PMC8586078 DOI: 10.3389/fnhum.2021.737409] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/07/2021] [Indexed: 11/15/2022] Open
Abstract
Visual deficits in children that result from brain injury, including cerebral/cortical visual impairment (CVI), are difficult to assess through conventional methods due to their frequent co-occurrence with cognitive and communicative disabilities. Such impairments hence often go undiagnosed or are only determined through subjective evaluations of gaze-based reactions to different forms, colors, and movements, which limits any potential for remediation. Here, we describe a novel approach to grading visual health based on eye movements and evidence from gaze-based tracking behaviors. Our approach—the “Visual Ladder”—reduces reliance on the user’s ability to attend and communicate. The Visual Ladder produces metrics that quantify spontaneous saccades and pursuits, assess visual field responsiveness, and grade spatial visual function from tracking responses to moving stimuli. We used the Ladder to assess fourteen hospitalized children aged 3 to 18 years with a diverse range of visual impairments and causes of brain injury. Four children were excluded from analysis due to incompatibility with the eye tracker (e.g., due to severe strabismus). The remaining ten children—including five non-verbal children—were tested multiple times over periods ranging from 2 weeks to 9 months, and all produced interpretable outcomes on at least three of the five visual tasks. The results suggest that our assessment tasks are viable in non-communicative children, provided their eyes can be tracked, and hence are promising tools for use in a larger clinical study. We highlight and discuss informative outcomes exhibited by each child, including directional biases in eye movements, pathological nystagmus, visual field asymmetries, and contrast sensitivity deficits. Our findings indicate that these methodologies will enable the rapid, objective classification and grading of visual impairments in children with CVI, including non-verbal children who are currently precluded from most vision assessments. This would provide a much-needed differential diagnostic and prognostic tool for CVI and other impairments of the visual system, both ocular and cerebral.
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Affiliation(s)
- Scott W J Mooney
- Burke Neurological Institute, White Plains, NY, United States.,Blythedale Children's Hospital, Valhalla, NY, United States
| | - Nazia M Alam
- Burke Neurological Institute, White Plains, NY, United States.,Blythedale Children's Hospital, Valhalla, NY, United States
| | - Glen T Prusky
- Burke Neurological Institute, White Plains, NY, United States.,Blythedale Children's Hospital, Valhalla, NY, United States.,Weill Cornell Medicine, New York, NY, United States
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Harper MM, Rudd D, Meyer KJ, Kanthasamy AG, Anantharam V, Pieper AA, Vázquez-Rosa E, Shin MK, Chaubey K, Koh Y, Evans LP, Bassuk AG, Anderson MG, Dutca L, Kudva IT, John M. Identification of chronic brain protein changes and protein targets of serum auto-antibodies after blast-mediated traumatic brain injury. Heliyon 2020; 6:e03374. [PMID: 32099918 PMCID: PMC7029173 DOI: 10.1016/j.heliyon.2020.e03374] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/19/2019] [Accepted: 02/03/2020] [Indexed: 12/13/2022] Open
Abstract
In addition to needing acute emergency management, blast-mediated traumatic brain injury (TBI) is also a chronic disorder with delayed-onset symptoms that manifest and progress over time. While the immediate consequences of acute blast injuries are readily apparent, chronic sequelae are harder to recognize. Indeed, the identification of individuals with mild-TBI or TBI-induced symptoms is greatly impaired in large part due to the lack of objective and robust biomarkers. The purpose of this study was to address these need by identifying candidates for serum-based biomarkers of blast TBI, and also to identify unique or differentially regulated protein expression in the thalamus in C57BL/6J mice exposed to blast using high throughput qualitative screens of protein expression. To identify thalamic proteins differentially or uniquely associated with blast exposure, we utilized an antibody-based affinity-capture strategy (referred to as "proteomics-based analysis of depletomes"; PAD) to deplete thalamic lysates from blast-treated mice of endogenous thalamic proteins also found in control mice. Analysis of this "depletome" detected 75 unique proteins, many with associations to the myelin sheath. To identify blast-associated proteins eliciting production of circulating autoantibodies, serum antibodies of blast-treated mice were immobilized, and their immunogens subsequently identified by proteomic analysis of proteins specifically captured following incubation with thalamic lysates (a variant of a strategy referred to as "proteomics-based expression library screening"; PELS). This analysis identified 46 blast-associated immunogenic proteins, including 6 shared in common with the PAD analysis (ALDOA, PHKB, HBA-A1, DPYSL2, SYN1, and CKB). These proteins and their autoantibodies are appropriate for further consideration as biomarkers of blast-mediated TBI.
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Affiliation(s)
- Matthew M. Harper
- The Iowa City Department of Veterans Affairs Medical Center, Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA
- The University of Iowa Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
| | - Danielle Rudd
- The Iowa City Department of Veterans Affairs Medical Center, Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA
| | - Kacie J. Meyer
- The University of Iowa Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA, USA
| | | | | | - Andrew A. Pieper
- Harrington Discovery Institute, University Hospitals of Cleveland, Department of Psychiatry Case Western Reserve University, Geriatric Research Education and Clinical Centers, Louis Stokes VA Medical Center, Cleveland, OH 44106, USA
| | - Edwin Vázquez-Rosa
- Harrington Discovery Institute, University Hospitals of Cleveland, Department of Psychiatry Case Western Reserve University, Geriatric Research Education and Clinical Centers, Louis Stokes VA Medical Center, Cleveland, OH 44106, USA
| | - Min-Kyoo Shin
- Harrington Discovery Institute, University Hospitals of Cleveland, Department of Psychiatry Case Western Reserve University, Geriatric Research Education and Clinical Centers, Louis Stokes VA Medical Center, Cleveland, OH 44106, USA
| | - Kalyani Chaubey
- Harrington Discovery Institute, University Hospitals of Cleveland, Department of Psychiatry Case Western Reserve University, Geriatric Research Education and Clinical Centers, Louis Stokes VA Medical Center, Cleveland, OH 44106, USA
| | - Yeojung Koh
- Harrington Discovery Institute, University Hospitals of Cleveland, Department of Psychiatry Case Western Reserve University, Geriatric Research Education and Clinical Centers, Louis Stokes VA Medical Center, Cleveland, OH 44106, USA
| | - Lucy P. Evans
- The University of Iowa Department of Pediatrics, University of Iowa, Iowa City, IA, USA
- The University of Iowa Department of Neurology, University of Iowa, Iowa City, IA, USA
- The University of Iowa Department of Medical Scientist Training Program, University of Iowa, Iowa City, IA, USA
| | - Alexander G. Bassuk
- The University of Iowa Department of Pediatrics, University of Iowa, Iowa City, IA, USA
- The University of Iowa Department of Neurology, University of Iowa, Iowa City, IA, USA
| | - Michael G. Anderson
- The Iowa City Department of Veterans Affairs Medical Center, Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA
- The University of Iowa Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
- The University of Iowa Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA, USA
| | - Laura Dutca
- The Iowa City Department of Veterans Affairs Medical Center, Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA
| | - Indira T. Kudva
- Food Safety and Enteric Pathogens Research Unit, National Animal Disease Center, Agricultural Research Service, U.S. Department of Agriculture, Ames, IA, USA
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Aguilar MC, Gonzalez A, Rowaan C, de Freitas C, Alawa KA, Durkee H, Feuer WJ, Manns F, Asfour SS, Lam BL, Parel JMA. Automated instrument designed to determine visual photosensitivity thresholds. BIOMEDICAL OPTICS EXPRESS 2018; 9:5583-5596. [PMID: 30460148 PMCID: PMC6238927 DOI: 10.1364/boe.9.005583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 06/09/2023]
Abstract
The Ocular Photosensitivity Analyzer (OPA), a new automated instrument to quantify the visual photosensitivity thresholds (VPT) in healthy and light sensitive subjects, is described. The OPA generates light stimuli of varying intensities utilizing unequal ascending and descending steps to yield the VPT. The performance of the OPA was evaluated in healthy subjects, as well as light sensitive subjects with achromatopsia or traumatic brain injury (TBI). VPT in healthy, achromatopsia, and TBI subjects were 3.2 ± 0.6 log lux, 0.5 ± 0.5 log lux, and 0.4 ± 0.6 log lux, respectively. Light sensitive subjects manifested significantly lower VPT compared to healthy subjects. Longitudinal analysis revealed that the OPA reliably measured VPT in healthy subjects.
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Affiliation(s)
- Mariela C. Aguilar
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Industrial Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA
| | - Alex Gonzalez
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Cornelis Rowaan
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Carolina de Freitas
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Karam A. Alawa
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Heather Durkee
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA
| | - William J. Feuer
- Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA
| | - Shihab S. Asfour
- Department of Industrial Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA
| | - Byron L. Lam
- Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jean-Marie A. Parel
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, College of Engineering, University of Miami, Coral Gables, FL, USA
- Brien Holden Vision Institute, University of New South Wales, Sydney, Australia
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Abstract
Visual dysfunctions and symptoms are commonly experienced after even mild traumatic brain injury (TBI) despite excellent visual acuity. All individuals who have experienced a TBI/concussion should be screened for vision symptoms and visual dysfunction. A TBI-specific eye examination is necessary to identify the visual sequelae of TBI and address any vision/ocular issues that may be contributing to other post-TBI complaints. A vision rehabilitation plan that includes vision therapy can improve visual dysfunction secondary to TBI. Combining office-based and home-based vision therapy training will maximize visual potential and functional results.
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Affiliation(s)
- Sandra M Fox
- Surgical Service, Ophthalmology, Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, 7400 Merton Minter, San Antonio, TX 78229, USA.
| | - Paul Koons
- Blind Rehabilitation Service, Major Charles Robert Soltes, Jr. O.D. Blind Rehabilitation Center (BRC), Tibor Rubin VA Medical Center, 5901 East 7th Street, Long Beach, CA 90822, USA
| | - Sally H Dang
- Optometry Service, VA Long Beach Healthcare System, 5901 East 7th Street, Long Beach, CA 90822, USA
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