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Chen Z, Bains SS, Dubin JA, Monárrez R, Remily EA, Sax OC, Ingari JV. The temporal effect of corticosteroid injections into large joints prior to trigger finger release on infection. HAND SURGERY & REHABILITATION 2023; 42:419-423. [PMID: 37302572 DOI: 10.1016/j.hansur.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Trigger finger may be treated with open surgical release. Local corticosteroid injections have also demonstrated success. Studies suggest recipients of flexor sheath corticosteroid up to 90-days prior to open surgery are at increased risk of post-operative infection. However, the possible link between large joints corticosteroid prior to trigger finger release remains unexplored. Therefore, this study aimed to provide complication risks for trigger finger release recipients after large joint corticosteroid. METHODS We reviewed a national, all-payer database and examined patients who did not receive and did receive corticosteroid two, four, or six weeks prior to trigger finger release. Primary outcomes assessed were 90-day risk for antibiotics, infection, and irrigations and debridement. Multivariate logistic analyses compared cohorts using odds ratios with 95% confidence intervals. RESULTS No trends were found regarding antibiotic requirements, infection, as well irrigations and debridement within 90-days for recipients of corticosteroid into large joints two, four, or six weeks prior to open trigger finger release. Elixhauser Comorbidity Index, alcohol abuse, diabetes mellitus, and tobacco use were identified as independent risks for requiring antibiotics as well as irrigations and debridement (all Odds Ratios > 1.06, all p ≤ 0.048). CONCLUSIONS Patients who underwent trigger finger release after receiving a corticosteroid into a large joint two, four, or six weeks prior has no association with 90-day antibiotics, infection, or irrigations and debridement. While the comfort levels for individual surgeons vary, optimizing these comorbidities prior to surgery is an important goal discussed with patients to lower risks for infections. RETROSPECTIVE Level III.
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Affiliation(s)
- Zhongming Chen
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Sandeep S Bains
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Jeremy A Dubin
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Rubén Monárrez
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Ethan A Remily
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Oliver C Sax
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - John V Ingari
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States.
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2
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Jou E, Zhou AK, Ho JSY, Thahir A. Perioperative use of intra-articular steroids during the COVID-19 pandemic. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2022; 32:1225-1235. [PMID: 34468841 PMCID: PMC8408365 DOI: 10.1007/s00590-021-03105-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/23/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE There are growing concerns with the widely used glucocorticoids during the Coronavirus disease-19 (COVID-19) pandemic due to the associated immunosuppressive effects, which may increase the risk of COVID-19 infection and worsen COVID-19 patient outcome. Heavily affecting orthopaedics, the pandemic led to delay and cancellation of almost all surgical cases, and procedures including perioperative intra-articular corticosteroid injections (ICIs) saw similar decreases. However, the benefits of ICI treatments during the pandemic may outweigh these potential risks, and their continued use may be warranted. METHODS A literature search was conducted, and all relevant articles including original articles and reviews were identified and considered in full for inclusion, and analysed with expert opinion. Epidemiological statistics and medical guidelines were consulted from relevant authorities. RESULTS ICIs allow a targeted approach on the affected joint and are effective in reducing pain while improving functional outcome and patient quality-of-life. ICIs delay the requirement for surgery, accommodating for the increased healthcare burden during the pandemic, while reducing postoperative hospital stay, bringing significant financial benefits. However, ICIs can exert systemic effects and suppress the immune system. ICIs may increase the risk of COVID-19 infection and reduce the efficacy of COVID-19 vaccinations, leading to important public health implications. CONCLUSION Perioperative ICI treatments may bring significant, multifaceted benefits during the pandemic. However, ICIs increase the risk of infection, and perioperative COVID-19 is associated with mortality. The use of ICIs during the COVID-19 pandemic should therefore be considered carefully on an individual patient basis, weighing the associated risks and benefits.
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Affiliation(s)
- Eric Jou
- School of Clinical Medicine, University of Cambridge, Cambridge, UK.
- MRC Laboratory of Molecular Biology, Cambridge Biomedical Campus, Cambridge, UK.
| | | | | | - Azeem Thahir
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Trauma and Orthopaedic Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Ferrao Blanco MN, Bastiaansen Jenniskens YM, Kops N, Chavli A, Narcisi R, Botter SM, Leenen PJM, van Osch GJVM, Fahy N. Intra-articular injection of triamcinolone acetonide sustains macrophage levels and aggravates osteophytosis during degenerative joint disease in mice. Br J Pharmacol 2022; 179:2771-2784. [PMID: 34907535 PMCID: PMC9305889 DOI: 10.1111/bph.15780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/03/2021] [Accepted: 11/27/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND PURPOSE Corticosteroids such as triamcinolone acetonide (TAA) are potent drugs administered intra-articularly as an anti-inflammatory therapy to relieve pain associated with osteoarthritis (OA). However, the ability of early TAA intervention to mitigate OA progression and modulate immune cell subsets remains unclear. Here, we sought to understand the effect of early intra-articular injection of TAA on OA progression, local macrophages, and peripheral blood monocytes. EXPERIMENTAL APPROACH Degenerative joint disease was induced by intra-articular injection of collagenase into the knee joint of male C57BL/6 mice. After 1 week, TAA or saline was injected intra-articularly. Blood was taken throughout the study to analyse monocyte subsets. Mice were killed at days 14 and 56 post-induction of collagenase-induced OA (CiOA) to examine synovial macrophages and structural OA features. KEY RESULTS The percentage of macrophages relative to total live cells present within knee joints was increased in collagenase- compared with saline-injected knees at day 14 and was not altered by TAA treatment. However, at day 56, post-induction of CiOA, TAA-treated knees had increased levels of macrophages compared with the knees of untreated CiOA-mice. The distribution of monocyte subsets present in peripheral blood was not altered by TAA treatment during the development of CiOA. Osteophyte maturation was increased in TAA-injected knees at day 56. CONCLUSION AND IMPLICATIONS Intra-articular injection of TAA increases long-term synovial macrophage numbers and osteophytosis. Our findings suggest that TAA accentuates the progression of osteoarthritis-associated features when applied to an acutely inflamed knee.
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Affiliation(s)
- Mauricio N. Ferrao Blanco
- Department of Orthopaedics and Sports Medicine, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | | | - Nicole Kops
- Department of Orthopaedics and Sports Medicine, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Athina Chavli
- Department of Orthopaedics and Sports Medicine, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Roberto Narcisi
- Department of Orthopaedics and Sports Medicine, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Sander M. Botter
- Swiss Center for Musculoskeletal Biobanking, Balgrist Campus AGZürichSwitzerland
| | - Pieter J. M. Leenen
- Department of Immunology, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Gerjo J. V. M. van Osch
- Department of Orthopaedics and Sports Medicine, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- Department of Otorhinolaryngology, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- Department of Biomechanical EngineeringUniversity of Technology DelftDelftThe Netherlands
| | - Niamh Fahy
- Department of Orthopaedics and Sports Medicine, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- Department of Oral and Maxillofacial Surgery, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
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4
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Regan P, Elkhalifa S, Barratt P. The systemic immunosuppressive effects of peripheral corticosteroid injections: A narrative review of the evidence in the context of COVID-19. Musculoskeletal Care 2021; 20:431-441. [PMID: 34882956 PMCID: PMC9015551 DOI: 10.1002/msc.1603] [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: 11/08/2021] [Accepted: 11/13/2021] [Indexed: 12/22/2022]
Abstract
Introduction Injected glucocorticoid's (corticosteroids) are commonly used in musculoskeletal practice. The current global COVID‐19 pandemic has increased attention on the potential for locally injected corticosteroids to exert a systemic immunosuppressive effect and the implications this may have in relation to COVID‐19 infection and vaccination. Aim This narrative review summarises the evidence regarding the potential systemic immunosuppressive effects of peripheral corticosteroid injections in relation to the ongoing COVID‐19 pandemic. Method A narrative review was selected to allow inclusion of evidence related to a diverse range of topics relevant to this subject in order to provide the most comprehensive and clinically relevant guidance for clinicians. Results/discussion Current evidence demonstrates that cytotoxic, phagocytic and antigen presenting cells involved in both the innate and adaptive immune responses are suppressed for 48 h post‐injection and messenger cytokines that are integral to immune function are suppressed for over 96 h post‐injection. This potentially reduces an individual's ability to prevent viral infection, limit early viral replication, and delays activation of adaptive immune mechanisms (T and B lymphocytes) and subsequent viral clearance and elimination. The hypothalamic–pituitary–adrenal (HPA) axis can be suppressed for 2–4 weeks or longer following peripheral corticosteroid injections. The role of the HPA axis in immune function is not fully understood, however this could potentially indicate longer lasting immunosuppression. Conclusions This review found evidence of suppression of immune cell numbers for the first 48 h post‐injection, cytokines for over 96 h post‐injection and HPA axis suppression lasting for 2–4 weeks or longer. There is currently no evidence that these physiological changes translate into a clinically meaningful increased risk of COVID‐19 infection or related morbidity or mortality, but there is also no persuasive evidence that they do not. This review discusses the implications of the current evidence in relation to shared decision making, informed consent, risk management and COVID‐19 vaccination to provide clinicians with a pragmatic guide to help navigate the current uncertainty regarding the potential immunosuppressive effects of peripheral corticosteroid injections.
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Affiliation(s)
- Paul Regan
- Musculoskeletal Clinical and Assessment and Treatment Service, Salford Royal NHS Foundation Trust, Salford Care Organisation (Part of the Northern Care Alliance), Salford, UK
| | - Shuayb Elkhalifa
- Department of Immunology, Salford Royal NHS Foundation Trust, Salford Care Organisation (part of the Northern Care Alliance), Salford, UK
| | - Paul Barratt
- Musculoskeletal Clinical and Assessment and Treatment Service, Salford Royal NHS Foundation Trust, Salford Care Organisation (Part of the Northern Care Alliance), Salford, UK
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The role of the microbiota in acute stress-induced myeloid immune cell trafficking. Brain Behav Immun 2020; 84:209-217. [PMID: 31812778 DOI: 10.1016/j.bbi.2019.12.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/21/2019] [Accepted: 12/02/2019] [Indexed: 12/17/2022] Open
Abstract
There has been a growing recognition of the involvement of the gastrointestinal microbiota in the development of stress-related disorders. Acute stress leads to activation of neuroendocrine systems, which in turn orchestrate a large-scale redistribution of innate immune cells. Both these response systems are independently known to be primed by the microbiota, even though much is still unclear about the role of the gastrointestinal microbiota in acute stress-induced immune activation. In this study, we investigated whether the microbiota influences acute stress-induced changes in innate immunity using conventionally colonised mice, mice devoid of any microbiota (i.e. germ-free, GF), and colonised GF mice (CGF). We also explored the kinetics of stress-induced immune cell mobilisation in the blood, the spleen and mesenteric lymph nodes (MLNs). Mice were either euthanised prior to stress or underwent restraint stress and were then euthanised at various time points (i.e. 0, 45- and 240-minutes) post-stress. Plasma adrenaline and noradrenaline levels were analysed using ELISA and immune cell levels were quantified using flow cytometry. GF mice had increased baseline levels of adrenaline and noradrenaline, of which adrenaline was normalised in CGF mice. In tandem, GF mice had decreased circulating levels of LY6Chi and LY6Cmid, CCR2+ monocytes, and granulocytes, but not LY6C-, CX3CR1+ monocytes. These deficits were normalised in CGF mice. Acute stress decreased blood LY6Chi and LY6Cmid, CCR2+ monocytes while increasing granulocyte levels in all groups 45 min post-stress. However, only GF mice showed stress-induced changes in LY6Chi monocytes and granulocytes 240 min post-stress, indicating impairments in the recovery from acute stress-induced changes in levels of specific innate immune cell types. LY6C-, CX3CR1+ monocytes remained unaffected by stress, indicating that acute stress impacts systemic innate immunity in a cell-type-specific manner. Overall, these data reveal novel cell-type-specific changes in the innate immune system in response to acute stress, which in turn are impacted by the microbiota. In conclusion, the microbiota influences the priming and recovery of the innate immune system to an acute stressor and may inform future microbiota-targeted therapeutics aimed at modulating stress-induced immune activation in stress-related disorders.
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van de Wouw M, Boehme M, Dinan TG, Cryan JF. Monocyte mobilisation, microbiota & mental illness. Brain Behav Immun 2019; 81:74-91. [PMID: 31330299 DOI: 10.1016/j.bbi.2019.07.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/12/2019] [Accepted: 07/18/2019] [Indexed: 12/13/2022] Open
Abstract
The gastrointestinal microbiome has emerged as a key player in regulating brain and behaviour. This has led to the strategy of targeting the gut microbiota to ameliorate disorders of the central nervous system. Understanding the underlying signalling pathways in which the microbiota impacts these disorders is crucial for the development of future therapeutics for improving CNS functionality. One of the major pathways through which the microbiota influences the brain is the immune system, where there is an increasing appreciation for the role of monocyte trafficking in regulating brain homeostasis. In this review, we will shed light on the role of monocyte trafficking as a relay of microbiota signals in conditions where the central nervous system is in disorder, such as stress, peripheral inflammation, ageing, traumatic brain injury, stroke, multiple sclerosis, Alzheimer's disease and Parkinson's disease. We also cover how the gastrointestinal microbiota is implicated in these mental illnesses. In addition, we aim to discuss how the monocyte system can be modulated by the gut microbiota to mitigate disorders of the central nervous system, which will lead to novel microbiota-targeted strategies.
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Affiliation(s)
| | - Marcus Boehme
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Timothy G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Psychiatry and Neurobehavioral Science, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
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7
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Abstract
Childhood exposure to traumatic events, termed early life stress (ELS), is now widely recognized for causing long-term negative health effects that may not manifest until adulthood. Allostatic load (AL) describes the cumulative "wear-and-tear" effects of chronic stress on the body that may adversely affect human health by accelerating other disease processes. Recent epidemiological studies have reported higher stress levels in industrialized countries and trends of increasing prevalence in autoimmune diseases during recent decades. To elucidate mechanisms of stress-related immune dysregulation, most animal studies up to now have focused on AL and stress-triggered events occurring in adults but have not explored ELS in the context of autoimmune disorders. We have identified a current gap in understanding the impact of ELS on immune system ontogeny and its potential for priming genetically susceptible individuals who are at increased risk for autoimmune diseases later in life, through mechanisms involving neuroendocrine-immune cross talk. In this review, we highlight the intersection between stress and immune function, with a focus on ELS as consequential for increased autoimmune disorder risks later in life.
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Affiliation(s)
- Jamie Y. Choe
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Maya Nair
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Riyaz Basha
- Department of Pediatrics and Women’s Health, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas 76107
| | - Byung-Jin Kim
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Harlan P. Jones
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107
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8
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Habib G, Khazin F, Sakas F, Hakim G, Artul S. The impact of intra-articular injection of diprospan at the knee joint on blood glucose levels in diabetic patients. Eur J Rheumatol 2018; 5:96-99. [PMID: 30185356 DOI: 10.5152/eurjrheum.2018.17133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 11/06/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the effect of intra-articular (IA) corticosteroid injection (IACI) of betamethasone dipropionate/betamethasone sodium phosphate (Diprospan) on blood glucose levels in diabetic patients METHODS: Patients with type 2 diabetes and symptomatic osteoarthritis of the knee (OAK) in whom medical therapy failed were administered 1 mL Diprospan IACI (5 mg of betamethasone dipropionate +2 mg of betamethasone sodium phosphate). Patients were asked to monitor blood glucose levels before and 2 h after meals for 1 week before and 12 days after the injection was administered. A control group was administered an IA injection of hyaluronic acid. RESULTS Twelve patients from the Diprospan group and six from the control group were recruited for the study. Patients in the Diprospan group had significantly increased blood glucose levels with median initial and peak levels of 187.5 mg% and 310 mg%, respectively, at a median of 4 and 11.5 h following IACI, respectively. The last peak level was seen after a median of 45 h following IACI. There was no significant increase in blood glucose levels in the control group. CONCLUSION Diprospan IACI is associated with significantly increased blood glucose levels in all diabetic patients with OAK.
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Affiliation(s)
- George Habib
- Rheumatology Unit, Laniado Hospital, Netanya, Israel.,Rheumatology Clinic, Nazareth Hospital, Israel Institute of Technology School of Medicine, Haifa, Israel
| | - Fadi Khazin
- Department of Orthopedics, Carmel Medical Center, Haifa, Israel
| | - Fahed Sakas
- Department of Medicine, Rambam Medical Center, Haifa, Israel
| | - Geries Hakim
- Department of Orthopedics, Nazareth Hospital, Bar-Ilan University Gallile School of Medicine, Israel
| | - Suheil Artul
- Department of Radiology, Nazareth Hospital, Bar-Ilan University Gallile School of Medicine, Israel
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9
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Habib G, Sakas F, Artul S, Khazin F, Hakim G, Jabbour A, Jabaly-Habib H. The impact of intra-articular methylprednisolone acetate injection on fructosamine levels in diabetic patients with osteoarthritis of the knee, a case-control study. Clin Rheumatol 2016; 35:1609-14. [PMID: 26951257 DOI: 10.1007/s10067-016-3218-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/15/2016] [Accepted: 02/16/2016] [Indexed: 11/30/2022]
Abstract
Fructosamine is a glycated protein that reflects blood glucose control over the last 2-3 weeks. There are no studies that address the impact of intra-articular injection (IAI) of methylprednisolone acetate (MPA) on fructosamine levels among patients with type-2 diabetes and osteoarthritis of the knee (OAK). Non-selected patients attending the rheumatology or orthopedic clinic with type-2 diabetes and painful OAK, who failed non-steroidal anti-inflammatory drugs (NSAIDS) and physical therapy, were asked to participate in our study. After consent blood tests were drown for fructosamine, hemoglobin A1c (HbA1c) level, complete blood count, lipid profile, serum albumin, serum protein, c-reactive protein, and erythrocyte sedimentation rate. Demographic and different clinical parameters were also documented. Immediately after that, patients had IAI of 80 mg of MPA at the knee joint (group 1). Two to three weeks later, the same blood tests were repeated (except for HbA1c). Age- and sex-matched group of patients with type-2 diabetes and painful OAK attending the same clinics, but who were managed by NSAIDS were asked to participate as a control group (group 2) and had the same evaluation at enrollment and 2-3 weeks later, after consent. Eighteen patients from either group completed the study. Mean fructosamine level in group 1 patients was 263.7 ± 31.8 mg% prior to the IAI vs. 274.6 ± 39.3 mg% (p = 0.035), 2-3 weeks later, while mean fructosamine level in the control group (group 2) at enrollments was 274.2 ± 31.2 mg% vs. 269 ± 30.2 mg%, p = 0.509, 2-3 weeks later. There was no significant change in any other parameter tested at enrollment in either group, compared to those obtained 2-3 weeks afterwards. Body mass index was on the edge of significance as a predictor for a significant change in fructosamine level in group 1 patients. IAI of 80 mg of MPA in patients with type-2 diabetes and OAK had resulted in a significant, though mild increase in fructosamine levels 2-3 weeks later.
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Affiliation(s)
- George Habib
- Rheumatology Unit, Laniado Medical Center, Netanya, Israel. .,Faculty of Medicine, Technion, Haifa, Israel. .,Rheumatology Clinic, Nazareth Hospital, Nazareth, Israel.
| | - Fahed Sakas
- Department of Pediatrics, Rambam Medical Center, Haifa, Israel
| | - Suheil Artul
- Department of Radiology, Nazareth hospital, Nazareth, Gallile faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
| | - Fadi Khazin
- Department of Orthopedics, Carmel Medical Center, Haifa, Israel
| | - Geries Hakim
- Department of Orthopedics, Nazareth Hospital, Nazareth, Israel
| | - Adel Jabbour
- Central lab, Nazareth hospital, Nazareth, Israel
| | - Haneen Jabaly-Habib
- Ophthalmology Unit, Poryia Medical Center, Gallile Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
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Sumiyoshi M, Kimura Y. Effects of Eleutherococcus senticosus Cortex on Recovery from the Forced Swimming Test and Fatty Acid β-Oxidation in the Liver and Skeletal Muscle of mice. THE NATURAL PRODUCTS JOURNAL 2016; 6:49-55. [PMID: 28553575 PMCID: PMC5427804 DOI: 10.2174/2210315506999151207145020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/12/2015] [Accepted: 11/12/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The root and stem barks of Eleutherococcus senticosus have been used to treat emotional and physical fatigue in China, Russia, Korea, and Japan. The effects of E. senticosus on recovery from physical fatigue and the expenditure of energy currently remain unclear. We herein examined the effects of E. senticosus extract on recovery from physical fatigue after the forced swimming test as well as fatty acid β-oxidation in the liver and skeletal muscle of mice. METHODS 1) Physical fatigue; E. senticosus extract (500 and 1000 mg/kg, twice daily) was administered orally to ICR male mice for 7 consecutive days. After swimming had been performed for 15 min, each mouse was placed on the cover of a 100-mm culture plate, and the time for each mouse to move away from the cover was measured. 2) Fatty acid β-oxidation in the liver and skeletal muscle; E. senticosus extract (500 and 1000 mg/kg) was administered orally twice daily to C57BL/6J male mice for 21 consecutive days. The initial and final body and liver weight were measured, and then fatty acid β-oxidation activity in the liver and skeletal muscle was measured by methods using [1-14C] palmitic acid. KEY FINDINGS Recovery times after forced swimming were shorter in E. senticosus extract (500 and 1000 mg/kg)-treated mice than in vehicle-treated mice. The body and liver weight had no effect by the oral administration of E. senticosus extract, vitamin mixture and L-carnitine. Fatty acid β-oxidation activity in skeletal muscle was increased by E. senticosus extract (500 and 1000 mg/kg). CONCLUSION E. senticosus may enhance recovery from physical fatigue induced by forced swimming by accelerating energy changes through fatty acid β-oxidation in skeletal muscle.
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Affiliation(s)
- Maho Sumiyoshi
- Division of Biochemical Pharmacology, Department of Basic Medical Research, Ehime University Graduate School of Medicine, Shitsukawa, Toon City, Ehime 791-0295, Japan
| | - Yoshiyuki Kimura
- Division of Biochemical Pharmacology, Department of Basic Medical Research, Ehime University Graduate School of Medicine, Shitsukawa, Toon City, Ehime 791-0295, Japan
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11
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Mati VLT, Raso P, de Melo AL. Strongyloides stercoralis infection in marmosets: replication of complicated and uncomplicated human disease and parasite biology. Parasit Vectors 2014; 7:579. [PMID: 25499310 PMCID: PMC4287166 DOI: 10.1186/s13071-014-0579-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 11/28/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Strongyloides stercoralis can undergo an alternative autoinfective life cycle in the host, which, in some individuals can lead to a lethal infection. However, due to a number of factors, such as, the majority of those infected are from low-income backgrounds and the limitation in experimental models for studying human S. stercoralis, strongyloidiasis remains neglected. Improved knowledge of animal models that are susceptible to this parasite is needed in order to investigate the immunological mechanisms involved during infection and in particular to further understand the natural history of the autoinfective cycle. METHODS Callithrix penicillata were inoculated subcutaneously with 100 (n = 2), 300 (n = 4) or 500 (n = 9) third-stage infective larvae (L3i) of S. stercoralis of human origin. Three marmosets received smaller inocula (i.e., one received 100 and two received 300 L3i) to ensure a greater capacity to withstand the infection after immunosuppression, which was triggered by administration of dexamethasone during early patency. Qualitative faecal analyses began at 7 days post-infection (DPI), and semi-quantitative tests were also performed for the dexamethasone-treated primates and the three matched controls. During the necropsies, specimens of S. stercoralis were recovered and tissue fragments were processed for histopathology. RESULTS The mean prepatency and patency periods were 16.1 ± 3.0 and 161.1 ± 72.2 DPI, respectively. The marmosets typically tolerated the infection well, but immunosuppressed individuals exhibited higher numbers of larvae in the faeces and progressive clinical deterioration with late disseminated infection. In these cases, the number of females recovered was significantly higher than the number of inoculated L3i. Large quantities of larvae were observed migrating through the host tissues, and histopathology revealed pulmonary and intestinal injuries consistent with those observed in human strongyloidiasis. CONCLUSIONS Both complicated and uncomplicated strongyloidiasis occur in C. penicillata that is described as a susceptible small non-human primate model for S. stercoralis. This host permits the maintenance of a human strain of the parasite in the laboratory and can be useful for experimental investigations of strongyloidiasis. In parallel, we discuss data related to the autoinfective cycle that provides new insights into the biology of S. stercoralis.
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Affiliation(s)
| | - Pedro Raso
- Department of Pathological Anatomy and Legal Medicine, FM, UFMG, Belo Horizonte, Brazil.
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12
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Grailer JJ, Steeber DA. Vascular endothelial growth factor receptor inhibitor SU5416 suppresses lymphocyte generation and immune responses in mice by increasing plasma corticosterone. PLoS One 2013; 8:e75390. [PMID: 24066177 PMCID: PMC3774642 DOI: 10.1371/journal.pone.0075390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Accepted: 08/15/2013] [Indexed: 01/19/2023] Open
Abstract
Inhibitors of vascular endothelial growth factor and its receptors (VEGFRs) are attractive therapeutic candidates for cancer treatment. One such small molecule VEGFR inhibitor, SU5416, limits angiogenesis in vivo and is widely used for investigating VEGFR signaling in tumor pathophysiology. Herein, we describe novel actions of SU5416 on the immune system. Treatment of mice with SU5416 for 3 days induced significant reductions in size and cellularity of peripheral lymph nodes. Interestingly, SU5416 did not affect initial lymphocyte localization to peripheral lymph nodes but did reduce lymphocyte accumulation during long-term migration assays. Treatment with SU5416 also induced severe loss of double-positive thymocytes resulting in thymic atrophy and a reduction in peripheral B cells. Furthermore, immune responses following immunization were reduced in mice treated with SU5416. Findings of thymic atrophy and reduced weight gain during SU5416 treatment suggested elevated corticosterone levels. Indeed, a significant 5-fold increase in serum corticosterone was found 4 hours after treatment with SU5416. Importantly, adrenalectomy negated the effects of SU5416 treatment on primary immune tissues, and partial reversal of SU5416-induced changes was observed following blockade of glucocorticoid receptors. SU5416 has been reported to inhibit the activation of latent transforming growth factor (TGF)-β, a cytokine involved in the regulation of glucocorticoid release by the adrenal glands. Interestingly, treatment with a TGF-β receptor inhibitor, showed a similar phenotype as SU5416 treatment, including elevated serum corticosterone levels and thymic atrophy. Therefore, these results suggest that SU5416 induces glucocorticoid release directly from the adrenal glands, possibly by inhibition of TGF-β activation.
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Affiliation(s)
- Jamison J. Grailer
- Department of Biological Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
| | - Douglas A. Steeber
- Department of Biological Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
- * E-mail:
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13
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Álvarez-Rodríguez L, López-Hoyos M, Calvo-Alén J, Aurrecoechea E, Villa I, Martínez-Taboada VM. Phagocyte dysfunction in polymyalgia rheumatica and other age-related, chronic, inflammatory conditions. J Leukoc Biol 2013; 94:1071-8. [PMID: 23904438 DOI: 10.1189/jlb.0113034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study was conducted to evaluate phagocyte function in patients with age-related chronic inflammatory conditions. It included 95 patients with PMR, 17 with GCA, 40 with EORA, and 25 age-matched HCs. Serum IL-8 was determined with a bead array. The chemotactic capacity, phagocytic ability, and oxidative burst activity of circulating leukocytes were determined with flow cytometry kits. Patients with active chronic inflammatory diseases showed a significant increase in circulating levels of IL-8 that remained elevated in patients with PMR or EORA, despite treatment. No correlation was found between circulating IL-8 and the migratory capacity of neutrophils. Neutrophils from patients with active EORA without stimulus and after fMLP stimuli showed a higher capacity to migrate than those of the HCs (P=0.033). The phagocytic activity of granulocytes in the patients with GCA was significantly higher than in the HCs and the patients with PMR or EORA (P<0.05). The percentage and MFI of phagocytes that produce ROIs when stimulated with Escherichia coli was significantly reduced in neutrophils and monocytes from the patients with age-restricted inflammatory conditions. We concluded that the effector functions of phagocytes, determined to be chemotaxis, phagocytosis, and oxidative burst, are deregulated in age-restricted inflammatory disorders and may have a pathogenic role.
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Affiliation(s)
- Lorena Álvarez-Rodríguez
- 1.Facultad de Medicina. Universidad de Cantabria, Avda. Valdecilla s/n. 39008. Santander, Spain.
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14
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Jones HP. Immune cells listen to what stress is saying: neuroendocrine receptors orchestrate immune function. Methods Mol Biol 2012; 934:77-87. [PMID: 22933141 DOI: 10.1007/978-1-62703-071-7_4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Over the past three decades, the field of psychoneuroimmunology research has blossomed into a major field of study, gaining interests of researchers across all traditionally accepted disciplines of scientific research. This chapter provides an overview of our current understanding in defining neuroimmune interactions with a primary focus of discussing the neuroendocrine receptor activity by immune cells. This chapter highlights the necessity of neuroimmune responses as it relates to a better understanding of the pathophysiological mechanisms of health and disease.
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Affiliation(s)
- Harlan P Jones
- Department of Molecular Biology and Immunology, University of North Texas Health Science Center, Fort Worth, TX, USA.
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15
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Wolfrom CM, Lévy V, Deschatrette J. Neutropenia dynamics in a case of T-LGL lymphoproliferation illustrate rapid turnover of granulocyte progenitors. Cell Prolif 2010; 43:326-32. [PMID: 20546248 DOI: 10.1111/j.1365-2184.2010.00678.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To elucidate the natural history of T-cell large granular lymphocyte (T-LGL) lymphoproliferation, we followed changes in associated fluctuating neutropenia for 3 years in an untreated patient presenting with the disease. MATERIALS AND METHODS We report a nonlinear mathematical analysis of irregular neutrophil fluctuation, using iterative data maps, to detect long-term regulation of the neutrophil population. RESULTS This geometric analysis indicated that variations of this sequence of neutrophil counts followed bounded deterministic dynamics around a fixed low level equilibrium, a situation similar to that previously observed for cultured mouse early bone marrow progenitor cells. CONCLUSION These findings illustrate how the deleterious effect of T-LGL on neutrophils is balanced, over periods of years, by pulses of compensatory neutrophil production, potentially accounting for the commonly observed prolonged indolent course of the disease.
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Affiliation(s)
- C M Wolfrom
- CNRS-UMR 8080 'Développement et Evolution', Université Paris-Sud, Orsay Cedex, France.
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16
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Kimura Y, Sumiyoshi M, Suzuki T, Suzuki T, Sakanaka M. Effects of water-soluble low-molecular-weight β-1, 3-D-glucan (branch β-1, 6) isolated from Aureobasidium pullulans 1A1 strain black yeast on restraint stress in mice. J Pharm Pharmacol 2010; 59:1137-44. [PMID: 17725857 DOI: 10.1211/jpp.59.8.0012] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
It is well known that different stress paradigms are able to rapidly induce corticosterone production and immune function through the activation of the hypothalamic-pituitary-adrenal axis. It has been reported that glucocorticoids suppress natural killer (NK) activity and interleukin (IL)-1 production and, on the other hand, that IL-1 and IL-6 stimulate the release of corticotrophin-releasing-hormone from the rat hypothalamus. Moreover, it has been reported that IL-12 plays a central role in the initiation of cell-mediated immunity, directly and via its induction of interferon (IFN)-γ and activation of NK cells. In this study, we examined the effects of water-soluble low-molecular-weight β-glucan isolated from Aureobasidium pullulans 1A1 strain on the corticosterone levels and immune function, such as NK activity and IL-6 and IL-12 production, using a restraint stress-induced mouse model. The water-soluble low-molecular-weight β-glucan at a dose of 50 or 100 mg kg−1 inhibited the increases in the blood corticosterone level and the reduction of NK activity induced by restraint stress. Furthermore, the water-soluble low-molecular-weight β-glucan (100 mg kg−1) prevented the reduction of IL-6 and IL-12 production by splenocytes caused by restraint stress. These findings suggest that the inhibitory actions of water-soluble low-molecular-weight β-glucan on the increase in corticosterone level and reduction of NK activity induced by restraint stress may be associated with the abrogation of the IL-6 and IL-12 reduction caused by the stress. Thus, water-soluble low-molecular-weight β-glucan may be an effective dietary supplement for the prevention of stress.
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Affiliation(s)
- Yoshiyuki Kimura
- Division of Biochemical Pharmacology, Department of Basic Medical Research, Graduate School of Medicine, Ehime University, Shitsukawa, Toon City, Ehime 791-0295, Japan.
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17
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Habib GS. Systemic effects of intra-articular corticosteroids. Clin Rheumatol 2009; 28:749-56. [PMID: 19252817 DOI: 10.1007/s10067-009-1135-x] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Revised: 02/04/2009] [Accepted: 02/09/2009] [Indexed: 11/29/2022]
Abstract
The objective of this study was to review all the published articles in the English literature about the systemic effects of intra-articular corticosteroid injection (IACI) in humans. Reports were searched through Pubmed using the terms intraarticular or intra-articular and steroids, corticosteroids, or glucocorticosteroids up and including the year 2007. Reports were also located through references of articles. Only objective findings outside the injected joint were included. The overwhelming majority of the studies was done at the knee joint and in rheumatoid arthritis/juvenile idiopathic arthritis patients. Many of the studies were done on the hypothalamic-pituitary-adrenal axis. Serum cortisol decreased within hours with a nadir after usually 24-48 h following the IACI. Recovery to baseline takes 1-4 weeks and sometimes longer depending on the type and dose of IACI and on the number of injected joints. Serum cortisol levels were blunted following adrenocorticotropic hormone stimulation in a small proportion of patients following methylprednisolone acetate injection and more common following other preparations. IACI resulted in a transient increase in blood glucose levels over few days in controlled diabetic patients with knee osteoarthritis. Peak levels are around 300 mg%. IACIs are associated with reduction in inflammatory markers like C-reactive protein and erythrocyte sedimentation rate that start few days following the IACI and could last for months. The effect on inflammatory cytokines is immediate with significant decrease within hours. IACI may induce remission also in patients with oligo-/polyarthritis and/or in patients with extra-articular manifestations. Other metabolic, hematologic, vascular, allergic, visual, psychologic, and other effects were also reported.
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Affiliation(s)
- George S Habib
- Department of Medicine, Carmel Medical Center, Haifa, 34362, Israel.
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18
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MacKenzie S, Iliev D, Liarte C, Koskinen H, Planas JV, Goetz FW, Mölsä H, Krasnov A, Tort L. Transcriptional analysis of LPS-stimulated activation of trout (Oncorhynchus mykiss) monocyte/macrophage cells in primary culture treated with cortisol. Mol Immunol 2006; 43:1340-8. [PMID: 16239032 DOI: 10.1016/j.molimm.2005.09.005] [Citation(s) in RCA: 115] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2005] [Indexed: 11/16/2022]
Abstract
Primary immune responses to pathogen invasion are mediated by the innate immune system in which tissue macrophages play a key role. During infectious processes glucocorticoids generally may function to dampen inflammatory responses. In this study, the ability of cortisol to directly modulate the transcriptional response of rainbow trout macrophages to the cellular activator lipopolysaccharide (LPS) was investigated. The results indicate that cortisol significantly inhibits the well-described LPS-dependent induction of the expression of TNF-alpha2, a pro-inflammatory cytokine. In order to further characterize the molecular effects of LPS and the immunomodulatory role of cortisol, the in vitro macrophage response to LPS in the absence or presence of 12-h cortisol exposure was analyzed utilizing a salmonid-specific microarray platform. Genes that were stimulated or inhibited with LPS plus cortisol fell into several major functional groups. The first, a general "response" group comprising genes within ontology classes including the response to external stimuli, stress, humoral immunity and apoptosis, exhibited a significant increase after LPS stimulation, whereas suppression of this response was observed in the presence of cortisol. LPS stimulated other genes in a second group involved in cell signalling and also genes in a third group involved in the activation of transcription. Categories activated with cortisol were mainly related to various aspects of metabolism (including protein biosynthesis, binding and transport of ions) and structural proteins (mainly cytoskeleton and microtubules). The immunomodulatory action of cortisol on LPS-stimulated macrophages therefore appears more complex than simply the antagonism of LPS-induced transcriptional responses.
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Affiliation(s)
- S MacKenzie
- Unitat de Fisiologia Animal, Departament de Biologia Cel.lular, Fisiologia i d'Immunologia, Facultat de Ciencies, Universitat Autonoma de Barcelona, Bellaterra, Barcelona, Spain.
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Kasahara S, Cooper EL. Nervous, endocrine, immune systems as a target for complementary and alternative medicine. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2005; 546:405-23. [PMID: 15584388 DOI: 10.1007/978-1-4757-4820-8_27] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Affiliation(s)
- Shinji Kasahara
- Laboratory of Comparative Neuroimmunology, Department of Neurobiology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Box 951763, Los Angeles, California 90095-1763, USA.
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20
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Kimura Y, Sumiyoshi M. Effects of various Eleutherococcus senticosus cortex on swimming time, natural killer activity and corticosterone level in forced swimming stressed mice. JOURNAL OF ETHNOPHARMACOLOGY 2004; 95:447-453. [PMID: 15507373 DOI: 10.1016/j.jep.2004.08.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2004] [Revised: 08/18/2004] [Accepted: 08/30/2004] [Indexed: 05/24/2023]
Abstract
The cortex of Eleutherococcus senticosus (Rupr. & Maxim.) Maxim. has been used extensively in Russia, China, Korea and Japan as an adaptogen whose properties are the ability to increase as non-specific body resistance to stress and fatigue. Although it has been reported that Eleutherococcus senticosus has anti-fatigue and anti-stress actions, their actions are still unclear on the relationship between immune system, especially natural killer (NK) activity and endocrine system (corticosterone level). We compared the effects of the water extracts (A, B, C, D and E) of five Eleutherococcus senticosus cortex on the swimming time, NK activity and blood corticosterone level using forced swimming stressed mice. Among five kinds, C, D and E extracts significantly prolonged the swimming time. C and D extracts inhibited the reduction of NK activity and the corticosterone elevation induced by forced swimming. The contents of eleutheroside E, isoflaxidin and eleutherosides B plus E were in the order C > D > E > B > A and C > E > D > A > B extracts, respectively. Therefore, it is suggested that eleutheroside E may be contributed to the anti-fatigue action, the recovery of the reduction of NK activity and the inhibition of corticosterone elevation induced by swimming stress.
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Affiliation(s)
- Yoshiyuki Kimura
- Second Department of Medical Biochemistry, School of Medicine, Ehime University. Shigenobu-cho, Onsen-gun, Ehime 719-0295, Japan.
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21
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Mi W, Belyavskyi M, Johnson RR, Sieve AN, Storts R, Meagher MW, Welsh CJR. Alterations in chemokine expression following Theiler's virus infection and restraint stress. J Neuroimmunol 2004; 151:103-15. [PMID: 15145609 DOI: 10.1016/j.jneuroim.2004.02.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2003] [Revised: 02/23/2004] [Accepted: 02/23/2004] [Indexed: 11/26/2022]
Abstract
Restraint stress (RS) applied to mice during acute infection with Theiler's virus causes corticosterone-induced immunosuppression. This effect was further investigated by measuring chemokine changes in the spleen and central nervous system (CNS) using an RNase Protection Assay. mRNAs for lymphotactin (Ltn), interferon-induced protein-10 (IP-10), MIP-1 beta, monocyte chemoattractant protein-1 (MCP-1) and TCA-3 were detected in the spleen at day 2 pi, but not in the brain of CBA mice infected with Theiler's virus. Ltn, IP-10 and RANTES were elevated in both the spleen and the brain at day 7 pi, and were significantly decreased by RS in the brain. RS also resulted in decreased inflammation within the CNS.
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Affiliation(s)
- W Mi
- Department of Veterinary Anatomy and Public Health, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA
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22
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Flint MS, Depree KM, Rich BA, Tinkle SS. Differential regulation of sensitizer-induced inflammation and immunity by acute restraint stress in allergic contact dermatitis. J Neuroimmunol 2003; 140:28-40. [PMID: 12864969 DOI: 10.1016/s0165-5728(03)00163-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previously, we demonstrated that restraint stress applied before chemical sensitization modulates allergic contact dermatitis (ACD) differently than restraint applied before challenge. In this study, we asked if these dichotomous restraint-induced changes reflect modulation of the cutaneous microenvironment or changes in development of antigen-specific immunity in the lymph node (LN) of BALB/c mice. Our data confirm that restraint suppresses T cell-dependent immunity in ACD when applied prior to sensitization or prior to challenge and demonstrate that the stress-induced increase in ear swelling is due to heightened inflammation associated with ACD and is dependent upon the sensitization status of the mouse.
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MESH Headings
- Administration, Cutaneous
- Adoptive Transfer
- Animals
- Antigen-Presenting Cells/pathology
- Cell Division/immunology
- Cell Movement/genetics
- Cell Movement/immunology
- Dermatitis, Allergic Contact/genetics
- Dermatitis, Allergic Contact/immunology
- Dermatitis, Allergic Contact/pathology
- Dinitrofluorobenzene/administration & dosage
- Dinitrofluorobenzene/immunology
- Ear, External
- Edema/genetics
- Edema/immunology
- Edema/pathology
- Immunization
- Immunophenotyping
- Immunosuppression Therapy
- Langerhans Cells/pathology
- Lymph Nodes/immunology
- Lymph Nodes/pathology
- Male
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Restraint, Physical/methods
- Species Specificity
- Stress, Physiological/genetics
- Stress, Physiological/immunology
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/metabolism
- T-Lymphocyte Subsets/transplantation
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Affiliation(s)
- Melanie S Flint
- Toxicology and Molecular Biology Branch, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA
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Abstract
A reciprocal regulation exists between the central nervous and immune systems through which the CNS signals the immune system via hormonal and neuronal pathways and the immune system signals the CNS through cytokines. The primary hormonal pathway by which the CNS regulates the immune system is the hypothalamic-pituitary-adrenal axis, through the hormones of the neuroendocrine stress response. The sympathetic nervous system regulates the function of the immune system primarily via adrenergic neurotransmitters released through neuronal routes. Neuroendocrine regulation of immune function is essential for survival during stress or infection and to modulate immune responses in inflammatory disease. Glucocorticoids are the main effector end point of this neuroendocrine system and, through the glucocorticoid receptor, have multiple effects on immune cells and molecules. This review focuses on the regulation of the immune response via the neuroendocrine system. Particular details are presented on the effects of interruptions of this regulatory loop at multiple levels in predisposition and expression of immune diseases and on mechanisms of glucocorticoid effects on immune cells and molecules.
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Affiliation(s)
- Jeanette I Webster
- Section on Neuroimmune Immunology and Behavior, National Institute of Mental Health, Bldg 36, Room 1A 23 (MSC 4020), 36 Convent Drive, Bethesda, Maryland 20892-4020, USA.
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Reed CE, Milton DK. Endotoxin-stimulated innate immunity: A contributing factor for asthma. J Allergy Clin Immunol 2001; 108:157-66. [PMID: 11496229 DOI: 10.1067/mai.2001.116862] [Citation(s) in RCA: 143] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Exposure to airborne endotoxin in infancy may protect against asthma by promoting enhanced T(H)1 response and tolerance to allergens. On the other hand, later in life, it adversely affects patients with asthma. Endotoxin binding to receptors on macrophages and other cells generates IL-12, which inhibits IgE responses. It also generates cytokines like IL-1, TNF-alpha, and IL-8, which cause inflammation. These signal transduction pathways resemble those leading to the generation of cytokines, such as IL-4, IL-13, and IL-5, which are responsible for the inflammation of IgE-mediated allergic disease. The main difference seems to be that endotoxin recruits neutrophils, but IgE recruits eosinophils, and the details of the tissue injury from these granulocytes differ. Sources of airborne endotoxin include many agricultural dusts, aerosols from contaminated water in many industrial plants, contaminated heating and air-conditioning systems, mist-generating humidifiers, and damp or water-damaged homes. Acute inhalation of high concentrations of endotoxin can cause fever, cough, and dyspnea. Chronic inhalation of lesser amounts causes chronic bronchitis and emphysema and is associated with airway hyperresponsiveness. Airborne endotoxin adversely affects patients with asthma in 3 ways: (1) by increasing the severity of the airway inflammation; (2) by increasing the susceptibility to rhinovirus-induced colds; and (3) by causing chronic bronchitis and emphysema with development of irreversible airway obstruction after chronic exposure of adults. The most effective management is mitigating exposure. The potential of drug treatments requires further clinical investigation.
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Affiliation(s)
- C E Reed
- Allergic Disease Research Laboratory, Mayo Clinic, Rochester, MN, USA
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