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Zabot GC, Medeiros EB, Macarini BMN, Peruchi BB, Keller GS, Lídio AV, Boaventura A, de Jesus LC, de Bem Silveira G, Silveira PCL, Chede BC, Réus GZ, Budni J. The involvement of neuroinflammation in an animal model of dementia and depression. Prog Neuropsychopharmacol Biol Psychiatry 2024; 133:110999. [PMID: 38552774 DOI: 10.1016/j.pnpbp.2024.110999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/21/2024]
Abstract
Alzheimer's disease (AD) and depression are inflammatory pathologies, leading to increased inflammatory response and neurotoxicity. Therefore, this study aimed to evaluate the effect of the treatment with fluoxetine and/or galantamine and/or donepezil on the levels of proinflammatory and anti-inflammatory cytokines in a mixed animal model of depression and dementia. Adult male Wistar rats underwent chronic mild stress (CMS) protocol for 40 days and were subjected to stereotaxic surgery for intra-hippocampal administration of amyloid-beta (Aꞵ) peptide or artificial cerebrospinal fluid (ACSF) to mimic the dementia animal model. On the 42nd day, animals were treated with water, galantamine, donepezil, and/or fluoxetine, orally for 17 days. On the 57th and 58th days, the Splash and Y-maze tests for behavior analysis were performed. The frontal cortex and hippocampus were used to analyze the tumor necrosis factor alfa (TNF-α), interleukin 1 beta (IL-1ꞵ), IL-6, and IL-10 levels. The results of this study show that animals subjected to CMS and administration of Aꞵ had anhedonia, cognitive impairment, increased TNF-α and IL-1ꞵ levels in the frontal cortex, and reduced IL-10 levels in the hippocampus. All treatment groups were able to reverse the cognitive impairment. Only donepezil did not decrease the TNF-α levels in the hippocampus. Fluoxetine + galantamine and fluoxetine + donepezil reversed the anhedonia. Fluoxetine reversed the anhedonia and IL-1ꞵ levels in the frontal cortex. In addition, fluoxetine + donepezil reversed the reduction of IL-10 levels in the hippocampus. The results indicate a pathophysiological interaction between AD and depression, and the association of medications in the future may be a possible therapeutic strategy to reduce inflammation, especially the fluoxetine-associated treatments.
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Affiliation(s)
- Gabriel Casagrande Zabot
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Eduarda Behenck Medeiros
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Bárbara Machado Naspolini Macarini
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Bruno Búrigo Peruchi
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Gabriela Serafim Keller
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Adrielly Vargas Lídio
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Amanda Boaventura
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Laura Ceolin de Jesus
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Gustavo de Bem Silveira
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Paulo Cesar Lock Silveira
- Laboratory of Experimental Physiopathology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Beatriz Costa Chede
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Gislaine Zilli Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Josiane Budni
- Laboratory of Experimental Neurology, Graduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNESC), Criciúma, Brazil.
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Sarmin N, Roknuzzaman ASM, Sarker R, -Or-Rashid M, Qusar MS, Bachar SC, Kabir ER, Islam MR, Al Mahmud Z. Association of interleukin-2 and interleukin-10 with the pathophysiology and development of generalized anxiety disorder: a case-control study. BMC Psychiatry 2024; 24:462. [PMID: 38902708 PMCID: PMC11188505 DOI: 10.1186/s12888-024-05911-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 06/13/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a devastating mental health condition characterized by constant, uncontrolled worrying. Recent hypotheses indicate that pro-inflammatory cytokines and chemokines are potential contributors to the pathogenesis of GAD. Here, we aimed to assess the role of interleukin-2 (IL-2) and interleukin-10 (IL-10) in the pathophysiology and development of GAD. METHODS This study recruited 50 GAD patients diagnosed according to the DSM-5 criteria and 38 age-sex-matched healthy controls (HCs). A qualified psychiatrist evaluated all study subjects. The socio-demographic and clinical characteristics of the study population were determined using pre-structured questionnaires or interviews, and cytokine serum levels were estimated using commercially available ELISA kits. RESULTS We observed reduced serum IL-10 levels in GAD patients compared to HCs (33.69 ± 1.37 pg/ml vs. 44.12 ± 3.16 pg/ml). Also, we observed a significant negative correlation between altered IL-10 levels and GAD-7 scores (r=-0.315, p = 0.039). Moreover, IL-10 serum measurement exhibited good predictive value in receiver operating characteristics (ROC) analysis with an area under the curve (AUC) value of 0.793 (p < 0.001) with 80.65% sensitivity and 62.79% specificity at a cutoff value of 33.93 pg/ml. Conversely, we noticed elevated serum IL-2 levels in GAD patients than in HCs (14.81 ± 2.88 pg/ml vs. 8.08 ± 1.1 pg/ml); however, it failed to maintain any significant association with GAD-7 scores, implying that IL-2 might not be involved in GAD pathogenesis. The lower AUC value (0.640; p > 0.05) exhibited by IL-2 serum measurement in ROC analysis further supported that IL-2 might not be associated with GAD. CONCLUSION This study provides new insights into the complex interplay between anti-inflammatory cytokines and GAD pathogenesis. Based on the present findings, we can assume that IL-10 but not IL-2 may be associated with the pathophysiology and development of GAD. However, further research with a larger population size and longitudinal design is required to confirm the potential diagnostic efficacy of IL-10.
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Affiliation(s)
- Nisat Sarmin
- Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
| | - A S M Roknuzzaman
- Department of Pharmacy, University of Asia Pacific, Dhaka, 1205, Bangladesh
| | - Rapty Sarker
- Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mamun -Or-Rashid
- Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mma Shalahuddin Qusar
- Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Shahabagh, Dhaka, 1000, Bangladesh
| | - Sitesh Chandra Bachar
- Department of Pharmacy, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Eva Rahman Kabir
- School of Pharmacy, BRAC University, Kha 224 Bir Uttam Rafiqul Islam Avenue, Merul Badda, Dhaka, 1212, Bangladesh
| | - Md Rabiul Islam
- School of Pharmacy, BRAC University, Kha 224 Bir Uttam Rafiqul Islam Avenue, Merul Badda, Dhaka, 1212, Bangladesh.
| | - Zobaer Al Mahmud
- Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh.
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Simonnet B, Roffi R, Lehot H, Morin J, Druelle A, Daubresse L, Louge P, de Maistre S, Gempp E, Vallee N, Blatteau JE. Therapeutic management of severe spinal cord decompression sickness in a hyperbaric center. Front Med (Lausanne) 2023; 10:1172646. [PMID: 37746073 PMCID: PMC10514493 DOI: 10.3389/fmed.2023.1172646] [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: 02/24/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Spinal cord decompression sickness (scDCS) unfortunately has a high rate of long-term sequelae. The purpose of this study was to determine the best therapeutic management in a hyperbaric center and, in particular, the influence of hyperbaric treatment performed according to tables at 4 atm (Comex 30) or 2.8 atm abs (USNT5 or T6 equivalent). Methods This was a retrospective study that included scDCS with objective sensory or motor deficit affecting the limbs and/or sphincter impairment seen at a single hyperbaric center from 2010 to 2020. Information on dive, time to recompression, and in-hospital management (hyperbaric and medical treatments such as lidocaine) were analyzed as predictor variables, as well as initial clinical severity and clinical deterioration in the first 24 h after initial recompression. The primary endpoint was the presence or absence of sequelae at discharge as assessed by the modified Japanese Orthopaedic Association score. Results 102 divers (52 ± 16 years, 20 female) were included. In multivariate analysis, high initial clinical severity, deterioration in the first 24 h, and recompression tables at 4 atm versus 2.8 atm abs for both initial and additional recompression were associated with incomplete neurological recovery. Analysis of covariance comparing the effect of initial tables at 2.8 versus 4 atm abs as a function of initial clinical severity showed a significantly lower level of sequelae with tables at 2.8 atm. In studying correlations between exposure times to maximum or cumulative O2 dose and the degree of sequelae, the optimal initial treatment appears to be a balance between administration of a high partial pressure of O2 (2.8 atm) and a limited exposure duration that does not result in pulmonary oxygen toxicity. Further analysis suggests that additional tables in the first 24-48 h at 2.8 atm abs with a Heliox mixture may be beneficial, while the use of lidocaine does not appear to be relevant. Conclusion Our study shows that the risk of sequelae is related not only to initial severity but also to clinical deterioration in the first 24 h, suggesting the activation of biological cascades that can be mitigated by well-adapted initial and complementary hyperbaric treatment.
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Affiliation(s)
- Benjamin Simonnet
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Romain Roffi
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Henri Lehot
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Jean Morin
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Arnaud Druelle
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Lucille Daubresse
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Pierre Louge
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Sébastien de Maistre
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Emmanuel Gempp
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
| | - Nicolas Vallee
- Military Institute of Biomedical Research (IRBA), Subaquatic Operational Research Team (ERRSO), Toulon, France
| | - Jean-Eric Blatteau
- Department of Diving and Hyperbaric Medicine, Sainte-Anne Military Hospital, Toulon, France
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Loddé B, Giroux-Metges MA, Galinat H, Kerspern H, Pougnet R, Saliou P, Guerrero F, Lafère P. Does Decreased Diffusing Capacity of the Lungs for Carbon Monoxide Constitute a Risk of Decompression Sickness in Occupational Divers? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6516. [PMID: 37569056 PMCID: PMC10418885 DOI: 10.3390/ijerph20156516] [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: 02/18/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
Long-term alterations of pulmonary function (mainly decreased airway conductance and capacity of the lungs to diffuse carbon monoxide (DLCO)) have been described after hyperbaric exposures. However, whether these alterations convey a higher risk for divers' safety has never been investigated before. The purpose of the present pilot study was to assess whether decreased DLCO is associated with modifications of the physiological response to diving. In this case-control observational study, 15 "fit-to-dive" occupational divers were split into two groups according to their DLCO measurements compared to references values, either normal (control) or reduced (DLCO group). After a standardized 20 m/40 min dive in a sea water pool, the peak-flow, vascular gas emboli (VGE) grade, micro-circulatory reactivity, inflammatory biomarkers, thrombotic factors, and plasmatic aldosterone concentration were assessed at different times post-dive. Although VGE were recorded in all divers, no cases of decompression sickness (DCS) occurred. Compared to the control, the latency to VGE peak was increased in the DLCO group (60 vs. 30 min) along with a higher maximal VGE grade (p < 0.0001). P-selectin was higher in the DLCO group, both pre- and post-dive. The plasmatic aldosterone concentration was significantly decreased in the control group (-30.4 ± 24.6%) but not in the DLCO group. Apart from a state of hypocoagulability in all divers, other measured parameters remained unchanged. Our results suggest that divers with decreased DLCO might have a higher risk of DCS. Further studies are required to confirm these preliminary results.
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Affiliation(s)
- Brice Loddé
- ORPHY Laboratory, EA 4324, Western Brittany University (UBO), 29238 Brest, France
- Occupational Diseases Center, Brest University Hospital, 29609 Brest, France
| | - Marie-Agnès Giroux-Metges
- ORPHY Laboratory, EA 4324, Western Brittany University (UBO), 29238 Brest, France
- Respiratory Functional Exploration Unit, Brest University Hospital, 29609 Brest, France
| | - Hubert Galinat
- Department of Biological Hematology, Brest University Hospital, 29609 Brest, France
| | - Hèlène Kerspern
- Department of Biochemistry and Pharmaco-Toxicology, Brest University Hospital, 29609 Brest, France
| | - Richard Pougnet
- Occupational Diseases Center, Brest University Hospital, 29609 Brest, France
| | - Philippe Saliou
- ISERM, EFS, UMR 1078, GGB, Infection Control Unit, Western Brittany University (UBO), 29238 Brest, France
| | - François Guerrero
- ORPHY Laboratory, EA 4324, Western Brittany University (UBO), 29238 Brest, France
| | - Pierre Lafère
- ORPHY Laboratory, EA 4324, Western Brittany University (UBO), 29238 Brest, France
- Environmental, Occupational, Ageing (Integrative) Physiology Laboratory, HE2B, 1160 Brussels, Belgium
- DAN Europe Research Department, 1160 Brussels, Belgium
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Tsai MK, Sytwu HK, Hsieh TY, Chien WC, Lai CH, Chen HC. Association Between Depression or Anxiety and the Risk of Hepatitis B Flares: A Nationwide Population-Based Cohort Study. J Inflamm Res 2022; 15:2983-2993. [PMID: 35615105 PMCID: PMC9126231 DOI: 10.2147/jir.s355314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/30/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose Depression and anxiety have been reported to increase the risk of infectious diseases and reactivation of latent infection. We conducted a nationwide population-based retrospective cohort study to determine the relationship between hepatitis B flares and depression or anxiety, utilizing outpatient and inpatient data from the Taiwan National Health Insurance Research database collected from 2000 to 2015. Patients and Methods A total of 12,992 patients with chronic hepatitis B and newly diagnosed anxiety/depression, without advanced liver disease, were propensity score-matched for age, sex, and comorbidities in a 1:4 ratio to 51,968 controls with chronic hepatitis B without depression/anxiety or advanced liver disease. Both groups were followed-up until December 31, 2015. Cox proportional hazards regression was used to determine the risk factors for hepatitis B flares. The Log rank test and Kaplan-Meier analysis were performed to assess differences in the cumulative incidence of hepatitis B flares according to anxiety/depression status. Results The incidence of hepatitis B flares was higher in the depression/anxiety cohort than in the control cohort (log-rank; p < 0.001). Patients with depression/anxiety had a significantly higher incidence rate of hepatitis B flares than those without depression/anxiety (3017 per 105 person-years versus 2042 per 105 person-years, p = 0.003). After adjusting for age and comorbidities, anxiety/depression was independently associated with an increased risk of hepatitis B flares (hazard ratio, 1.173; 95% confidence interval, 1.033-1.277; p = 0.003). Conclusion This analysis suggests that in patients with chronic hepatitis B without advanced liver disease, those with concomitant depression or anxiety may be at higher risk of hepatitis B flares.
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Affiliation(s)
- Meng-Ko Tsai
- Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Institute of Medical Sciences, National Defense Medical Center, Taipei, 114, Taiwan
| | - Huey-Kang Sytwu
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
- Department and Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Tsai-Yuan Hsieh
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chao-Hung Lai
- Division of Cardiology, Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan
| | - Hsiang-Cheng Chen
- Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
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Desruelle AV, de Maistre S, Gaillard S, Richard S, Tardivel C, Martin JC, Blatteau JE, Boussuges A, Rives S, Risso JJ, Vallee N. Cecal Metabolomic Fingerprint of Unscathed Rats: Does It Reflect the Good Response to a Provocative Decompression? Front Physiol 2022; 13:882944. [PMID: 35655958 PMCID: PMC9152359 DOI: 10.3389/fphys.2022.882944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/27/2022] [Indexed: 11/23/2022] Open
Abstract
On one side, decompression sickness (DCS) with neurological disorders lead to a reshuffle of the cecal metabolome of rats. On the other side, there is also a specific and different metabolomic signature in the cecum of a strain of DCS-resistant rats, that are not exposed to hyperbaric protocol. We decide to study a conventional strain of rats that resist to an accident-provoking hyperbaric exposure, and we hypothesize that the metabolomic signature put forward may correspond to a physiological response adapted to the stress induced by diving. The aim is to verify and characterize whether the cecal compounds of rats resistant to the provocative dive have a cecal metabolomic signature different from those who do not dive. 35 asymptomatic diver rats are selected to be compared to 21 rats non-exposed to the hyperbaric protocol. Because our aim is essentially to study the differences in the cecal metabolome associated with the hyperbaric exposure, about half of the rats are fed soy and the other half of maize in order to better rule out the effect of the diet itself. Lower levels of IL-1β and glutathione peroxidase (GPX) activity are registered in blood of diving rats. No blood cell mobilization is noted. Conventional and ChemRICH approaches help the metabolomic interpretation of the 185 chemical compounds analyzed in the cecal content. Statistical analysis show a panel of 102 compounds diet related. 19 are in common with the hyperbaric protocol effect. Expression of 25 compounds has changed in the cecal metabolome of rats resistant to the provocative dive suggesting an alteration of biliary acids metabolism, most likely through actions on gut microbiota. There seem to be also weak changes in allocations dedicated to various energy pathways, including hormonal reshuffle. Some of the metabolites may also have a role in regulating inflammation, while some may be consumed for the benefit of oxidative stress management.
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Affiliation(s)
- Anne-Virginie Desruelle
- Institut de Recherche Biomédicale des Armées, Equipe de Recherche Subaquatique Opérationnelle, Toulon Cedex, France
| | - Sébastien de Maistre
- Service de Médecine Hyperbare Expertise Plongée, Hôpital d'Instruction des Armées Sainte-Anne, Toulon Cedex, France
| | | | | | - Catherine Tardivel
- C2VN, INRAE, INSERM, BIOMET, Aix Marseille University, Faculté de Médecine La Timone, Marseille, France
| | - Jean-Charles Martin
- C2VN, INRAE, INSERM, BIOMET, Aix Marseille University, Faculté de Médecine La Timone, Marseille, France
| | - Jean-Eric Blatteau
- Service de Médecine Hyperbare Expertise Plongée, Hôpital d'Instruction des Armées Sainte-Anne, Toulon Cedex, France
| | - Alain Boussuges
- Institut de Recherche Biomédicale des Armées, Equipe de Recherche Subaquatique Opérationnelle, Toulon Cedex, France
| | - Sarah Rives
- Institut de Recherche Biomédicale des Armées, Equipe de Recherche Subaquatique Opérationnelle, Toulon Cedex, France
| | - Jean-Jacques Risso
- Institut de Recherche Biomédicale des Armées, Equipe de Recherche Subaquatique Opérationnelle, Toulon Cedex, France
| | - Nicolas Vallee
- Institut de Recherche Biomédicale des Armées, Equipe de Recherche Subaquatique Opérationnelle, Toulon Cedex, France
- *Correspondence: Nicolas Vallee,
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Al-Hakeim HK, Twayej AJ, Al-Dujaili AH, Maes M. Plasma Indoleamine-2,3-Dioxygenase (IDO) is Increased in Drug-Naï ve Major Depressed Patients and Treatment with Sertraline and Ketoprofen Normalizes IDO in Association with Pro-Inflammatory and Immune- Regulatory Cytokines. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 19:44-54. [PMID: 31894751 DOI: 10.2174/1871527319666200102100307] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/17/2019] [Accepted: 11/20/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Major Depression Disorder (MDD) is accompanied by an immune response characterized by increased levels of inflammatory and immune-regulatory cytokines and stimulation of indoleamine-2,3-dioxygenase (IDO). There is also evidence that anti-inflammatory drugs may have clinical efficacy in MDD. METHODS This study examined a) IDO in association with interferon (IFN)-γ, Interleukin (IL)-4 and Transforming Growth Factor (TGF)-β1 in 140 drug-naïve MDD patients and 40 normal controls; and b) the effects of an eight-week treatment of sertraline with or without ketoprofen (a nonsteroidal antiinflammatory drug) on the same biomarkers in 44 MDD patients. RESULTS Baseline IDO, IFN-γ, TGF-β1 and IL-4 were significantly higher in MDD patients as compared with controls. Treatment with sertraline with or without ketoprofen significantly reduced the baseline levels of all biomarkers to levels which were in the normal range (IDO, TGF-β1, and IL-4) or still somewhat higher than in controls (IFN-γ). Ketoprofen add-on had a significantly greater effect on IDO as compared with placebo. The reductions in IDO, IL-4, and TGF-β1 during treatment were significantly associated with those in the BDI-II. CONCLUSION MDD is accompanied by activated immune-inflammatory pathways (including IDO) and the Compensatory Immune-Regulatory System (CIRS). The clinical efficacy of antidepressant treatment may be ascribed at least in part to decrements in IDO and the immune-inflammatory response. These treatments also significantly reduce the more beneficial properties of T helper-2 and T regulatory (Treg) subsets. Future research should develop immune treatments that target the immune-inflammatory response in MDD while enhancing the CIRS.
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Affiliation(s)
| | - Ahmed Jasim Twayej
- Pathological Analysis Department, College of Health and Medical, Al-Kafeel University, Najaf, Iraq
| | | | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.,Department of Psychiatry, Medical University Plovdiv, Plovdiv, Bulgaria.,IMPACT Research Center, Deakin University, Geelong, Australia
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8
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Desruelle AV, Louge P, Richard S, Blatteau JE, Gaillard S, De Maistre S, David H, Risso JJ, Vallée N. Demonstration by Infra-Red Imaging of a Temperature Control Defect in a Decompression Sickness Model Testing Minocycline. Front Physiol 2019; 10:933. [PMID: 31396102 PMCID: PMC6668502 DOI: 10.3389/fphys.2019.00933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/09/2019] [Indexed: 12/17/2022] Open
Abstract
The prevention, prognosis and resolution of decompression sickness (DCS) are not satisfactory. The etiology of DCS has highlighted thrombotic and inflammatory phenomena that could cause severe neurological disorders or even death. Given the immunomodulatory effects described for minocycline, an antibiotic in widespread use, we have decided to explore its effects in an experimental model for decompression sickness. 40 control mice (Ctrl) and 40 mice treated orally with 90 mg/kg of minocycline (MINO) were subjected to a protocol in a hyperbaric chamber, compressed with air. The purpose was to mimic a scuba dive to a depth of 90 msw and its pathogenic decompression phase. Clinical examinations and blood counts were conducted after the return to the surface. For the first time they were completed by a simple infrared (IR) imaging technique in order to assess feasibility and its clinical advantage in differentiating the sick mice (DCS) from the healthy mice (NoDCS). In this tudy, exposure to the hyperbaric protocol provoked a reduction in the number of circulating leukocytes. DCS in mice, manifesting itself by paralysis or convulsion for example, is also associated with a fall in platelets count. Cold areas ( < 25°C) were detected by IR in the hind paws and tail with significant differences (p < 0.05) between DCS and NoDCS. Severe hypothermia was also shown in the DCS mice. The ROC analysis of the thermograms has made it possible to determine that an average tail temperature below 27.5°C allows us to consider the animals to be suffering from DCS (OR = 8; AUC = 0.754, p = 0.0018). Minocycline modulates blood analysis and it seems to limit the mobilization of monocytes and granulocytes after the provocative dive. While a higher proportion of mice treated with minocycline experienced DCS symptoms, there is no significant difference. The infrared imaging has made it possible to show severe hypothermia. It suggests an modification of thermregulation in DCS animals. Surveillance by infrared camera is fast and it can aid the prognosis in the case of decompression sickness in mice.
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Affiliation(s)
- Anne-Virginie Desruelle
- Unité Environnements Extrêmes, Département Environnement Opérationnel, Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Toulon, France
| | - Pierre Louge
- Service de Médecine Hyperbare et Expertise Plongée, Hôpital d'Instruction des Armées, Toulon, France
| | | | - Jean-Eric Blatteau
- Unité Environnements Extrêmes, Département Environnement Opérationnel, Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Toulon, France.,Service de Médecine Hyperbare et Expertise Plongée, Hôpital d'Instruction des Armées, Toulon, France
| | | | - Sébastien De Maistre
- Service de Médecine Hyperbare et Expertise Plongée, Hôpital d'Instruction des Armées, Toulon, France
| | - Hélène David
- Apricot Inhalotherapeutics, Saint-Laurent-de-l'Île-d'Orléans, QC, Canada
| | - Jean-Jacques Risso
- Unité Environnements Extrêmes, Département Environnement Opérationnel, Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Toulon, France
| | - Nicolas Vallée
- Unité Environnements Extrêmes, Département Environnement Opérationnel, Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Toulon, France
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9
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Blatteau JE, Gaillard S, De Maistre S, Richard S, Louges P, Gempp E, Druelles A, Lehot H, Morin J, Castagna O, Abraini JH, Risso JJ, Vallée N. Reduction in the Level of Plasma Mitochondrial DNA in Human Diving, Followed by an Increase in the Event of an Accident. Front Physiol 2018; 9:1695. [PMID: 30555340 PMCID: PMC6282000 DOI: 10.3389/fphys.2018.01695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/09/2018] [Indexed: 01/02/2023] Open
Abstract
Circulating mitochondrial DNA (mtDNA) is receiving increasing attention as a danger-associated molecular pattern in conditions such as autoimmunity or trauma. In the context of decompression sickness (DCS), the course of which is sometimes erratic, we hypothesize that mtDNA plays a not insignificant role particularly in neurological type accidents. This study is based on the comparison of circulating mtDNA levels in humans presenting with various types of diving accidents, and punctured upon their admission at the hyperbaric facility. One hundred and fourteen volunteers took part in the study. According to the clinical criteria there were 12 Cerebro DCS, 57 Medullary DCS, 15 Vestibular DCS, 8 Ctrl+ (accident-free divers), and 22 Ctrl- (non-divers). This work demonstrates that accident-free divers have less mtDNA than non-divers, which leads to the assumption that hyperbaric exposure degrades the mtDNA. mtDNA levels are on average greater in divers with DCS compared with accident-free divers. On another hand, the amount of double strand DNA (dsDNA) is neither significantly different between controls, nor between the different DCS types. Initially the increase in circulating oligonucleotides was attributed to the destruction of cells by bubble abrasion following necrotic phenomena. If there really is a significant difference between the Medullary DCS and the Ctrl-, this difference is not significant between these same DCS and the Ctrl+. This refutes the idea of massive degassing and suggests the need for new research in order to verify that oxidative stress could be a key element without necessarily being sufficient for the occurrence of a neurological type of accident.
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Affiliation(s)
- Jean-Eric Blatteau
- Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Toulon, France
- Hôpital d’Instruction des Armées – Service de Médecine Hyperbare et Expertise Plongée, Toulon, France
| | | | - Sébastien De Maistre
- Hôpital d’Instruction des Armées – Service de Médecine Hyperbare et Expertise Plongée, Toulon, France
| | - Simone Richard
- Mediterranean Institute of Oceanography, Université de Toulon, Toulon, France
| | - Pierre Louges
- Hôpital d’Instruction des Armées – Service de Médecine Hyperbare et Expertise Plongée, Toulon, France
| | - Emmanuel Gempp
- Hôpital d’Instruction des Armées – Service de Médecine Hyperbare et Expertise Plongée, Toulon, France
| | - Arnaud Druelles
- Hôpital d’Instruction des Armées – Service de Médecine Hyperbare et Expertise Plongée, Toulon, France
| | - Henri Lehot
- Hôpital d’Instruction des Armées – Service de Médecine Hyperbare et Expertise Plongée, Toulon, France
| | - Jean Morin
- Hôpital d’Instruction des Armées – Service de Médecine Hyperbare et Expertise Plongée, Toulon, France
| | - Olivier Castagna
- Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Toulon, France
| | - Jacques H. Abraini
- Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Toulon, France
| | - Jean-Jacques Risso
- Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Toulon, France
| | - Nicolas Vallée
- Institut de Recherche Biomédicale des Armées, Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Toulon, France
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10
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Lambrechts K, de Maistre S, Abraini JH, Blatteau JE, Risso JJ, Vallée N. Tirofiban, a Glycoprotein IIb/IIIa Antagonist, Has a Protective Effect on Decompression Sickness in Rats: Is the Crosstalk Between Platelet and Leukocytes Essential? Front Physiol 2018; 9:906. [PMID: 30050468 PMCID: PMC6050390 DOI: 10.3389/fphys.2018.00906] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/21/2018] [Indexed: 12/18/2022] Open
Abstract
In its severest forms, decompression sickness (DCS) may extend systemically and/or induce severe neurological deficits, including paralysis or even death. It seems that the sterile and ischemic inflammatory phenomena are consecutive to the reaction of the bubbles with the organism and that the blood platelet activation plays a determinant role in the development of DCS. According to the hypotheses commonly put forward, the bubbles could either activate the platelets by direct contact or be the cause of abrasion of the vascular epithelium, which would expose the basal plate glycogen and then prompt the platelets to activate. The purpose of this study is to confirm anti-platelet drugs specific to GPIIb/IIIa integrin could prevent DCS, using a rat model. There is a significant difference concerning the incidence of the drug on the clinical status of the rats (p = 0.016), with a better clinical outcome for rats treated with tirofiban (TIR) compared with the control rats (p = 0.027), even if the three anti-GPIIb/IIIa agents used have limited respiratory distress. TIR limited the decrease in platelet counts following the hyperbaric exposure. TIR help to prevent from DCS. TIR is specific to GPIIb/IIIa whereas eptifibatide and abciximab could inhibit αVβ3 and αMβ2 involved in communication with the immune system. While inhibiting GPIIb/IIIa could highlight a platelet-dependent inflammatory pathway that improves DCS outcomes, we wonder whether inhibiting the αVβ3 and αMβ2 communications is not a wrong approach for limiting mortality in DCS.
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Affiliation(s)
- Kate Lambrechts
- Département Environnement Opérationnel, Unité Environnements Extrêmes, Institut de Recherche Biomédicale des Armées - Equipe Résidente de Recherche Subaquatique Opérationnelle (Armed Forces Biomedical Research Institute - Resident Operational Subaquatic Research Team), Toulon, France.,Laboratoire Motricité Humaine Expertise Sport Santé (LAMHESS - Human Motricity, Education, Sport and Health Laboratory), Université du Sud Toulon Var, La Garde, France
| | - Sébastien de Maistre
- Hôpital d'Instruction des Armées - Service de Médecine Hyperbare et Expertise Plongée (Military Teaching Hospital - Hyperbaric Medicine and Diving Expertise Department), Toulon, France
| | - Jacques H Abraini
- Département Environnement Opérationnel, Unité Environnements Extrêmes, Institut de Recherche Biomédicale des Armées - Equipe Résidente de Recherche Subaquatique Opérationnelle (Armed Forces Biomedical Research Institute - Resident Operational Subaquatic Research Team), Toulon, France.,Département d'Anesthésiologie, Université Laval, Laval, QC, Canada.,Faculté de Médecine, Université de Caen Normandie (UNICAEN), Caen, France
| | - Jean-Eric Blatteau
- Hôpital d'Instruction des Armées - Service de Médecine Hyperbare et Expertise Plongée (Military Teaching Hospital - Hyperbaric Medicine and Diving Expertise Department), Toulon, France
| | - Jean-Jacques Risso
- Département Environnement Opérationnel, Unité Environnements Extrêmes, Institut de Recherche Biomédicale des Armées - Equipe Résidente de Recherche Subaquatique Opérationnelle (Armed Forces Biomedical Research Institute - Resident Operational Subaquatic Research Team), Toulon, France
| | - Nicolas Vallée
- Département Environnement Opérationnel, Unité Environnements Extrêmes, Institut de Recherche Biomédicale des Armées - Equipe Résidente de Recherche Subaquatique Opérationnelle (Armed Forces Biomedical Research Institute - Resident Operational Subaquatic Research Team), Toulon, France
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11
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Abstract
Psychoactive drugs pose a risk to both the diver and his or her buddy. Little is known about the safety of diving with antidepressants. Amongst the potential interactions with the diving environment are: somnolence; convulsions; a bleeding tendency (potentially worsening decompression illness, DCI), alterations to glucose metabolism and psychiatric side effects. Fluoxetine may potentially reduce the inflammatory process associated with DCI. This article presents guidelines for recreational diving in combination with antidepressants. These guidelines were endorsed at a meeting of the Dutch Association for Diving Medicine in 2015 and are solely based on 'expert' opinion.
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12
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Abstract
A significant number of patients with major depression do not respond optimally to current antidepressant drugs. As depression is likely to be a heterogeneous disorder, it is possible that existing neurotransmitter-based antidepressant drugs do not fully address other pathologies that may exist in certain cases. Biological pathologies related to depression that have been proposed and studied extensively include inflammation and immunology, hypercortisolemia, oxidative stress, and impaired angiogenesis. Such pathologies may induce neurodegeneration, which in turn causes cognitive impairment, a symptom increasingly being recognized in depression. A neurotoxic brain hypothesis unifying all these factors may explain the heterogeneity of depression as well as cognitive decline and antidepressant drug resistance in some patients. Compared with neurotransmitter-based antidepressant drugs, many botanical compounds in traditional medicine used for the treatment of depression and its related symptoms have been discovered to be anti-inflammatory, immunoregulatory, anti-infection, antioxidative, and proangiogenic. Some botanical compounds also exert actions on neurotransmission. This multitarget nature of botanical medicine may act through the amelioration of the neurotoxic brain environment in some patients resistant to neurotransmitter-based antidepressant drugs. A multitarget multidimensional approach may be a reasonable solution for patients resistant to neurotransmitter-based antidepressant drugs.
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13
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Cosnard C, De Maistre S, Abraini JH, Chazalviel L, Blatteau JE, Risso JJ, Vallée N. Thirty-five Day Fluoxetine Treatment Limits Sensory-Motor Deficit and Biochemical Disorders in a Rat Model of Decompression Sickness. Front Physiol 2017; 8:604. [PMID: 28928667 PMCID: PMC5591790 DOI: 10.3389/fphys.2017.00604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/04/2017] [Indexed: 11/30/2022] Open
Abstract
According to the OECD statistical base for 2014, anti-depressants will, on average, be distributed at a rate of 62 daily doses per 1,000 inhabitants for the 25 countries surveyed (Health at a glance: Europe 2014; OECD Health Statistics; World Health Organization and OECD Health Statistics, 2014). Divers must be concerned. On another hand, divers are potentially exposed to decompression sickness including coagulation inflammation and ischemia, which can result in neurological lesions or even death. The purpose of this study is to assess whether chronic treatment with anti-depressants may represent a contraindication to the practice of an at-risk activity, such as, scuba diving, or even presents a benefit by attenuating the severity of the symptoms. We study for the first time the effect of a 35-day fluoxetine treatment (20 mg/kg) on the occurrence of decompression sickness in laboratory rats (n = 79). Following exposure to the hazardous protocol, there is a significant correlation between the type of treatment and the clinical status of the rats in favor of a better clinical prognosis for the rats treated with fluoxetine with a significantly higher number of No DCS status and a lower number of Severe DCS status in the Flux, compared to Controls. The treatment modifies the rat performances both significantly and favorably during the physical and behavioral tests, just like their biological and biochemical constants. After decompression, rats under treatment display lower sensory-motor deficit and lowers biochemical disorders. From a biological point of view, we conclude fluoxetine should not be seen as a contraindication for diving on the basis of anticipated increased physiological risk.
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Affiliation(s)
- Caroline Cosnard
- Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Institut de Recherche Biomédicale des Armées, Hopital d'instruction des Armées Sainte-AnneToulon, France
| | - Sébastien De Maistre
- Service de Médecine Hyperbare et Expertise Plongée, Hôpital d'Instruction des ArméesToulon, France
| | - Jacques H Abraini
- Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Institut de Recherche Biomédicale des Armées, Hopital d'instruction des Armées Sainte-AnneToulon, France.,Département d'Anesthésiologie, Université LavalLaval, QC, Canada.,Faculté de Médecine, Université de Caen Normandie (UNICAEN)Caen, France
| | | | - Jean-Eric Blatteau
- Service de Médecine Hyperbare et Expertise Plongée, Hôpital d'Instruction des ArméesToulon, France
| | - Jean-Jacques Risso
- Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Institut de Recherche Biomédicale des Armées, Hopital d'instruction des Armées Sainte-AnneToulon, France
| | - Nicolas Vallée
- Equipe Résidante de Recherche Subaquatique Opérationnelle, Département Environnement Opérationnel, Unité Environnements Extrêmes, Institut de Recherche Biomédicale des Armées, Hopital d'instruction des Armées Sainte-AnneToulon, France.,Université de ToulonLa Garde, France
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14
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Zhang K, Wang M, Wang H, Liu Y, Buzzacott P, Xu W. Time Course of Endothelial Dysfunction Induced by Decompression Bubbles in Rats. Front Physiol 2017; 8:181. [PMID: 28386238 PMCID: PMC5362629 DOI: 10.3389/fphys.2017.00181] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/08/2017] [Indexed: 12/14/2022] Open
Abstract
Decompression stress can cause endothelial injury, leading to systematic inflammation and prothrombotic phenomena. Our previous work found that endothelial injury following decompression correlated positively with bubble formation. This study aimed to investigate the time course of endothelial injury and the relationship with bubble amounts. Rats were subjected to a simulated air dive to 7 ATA for 90 min with rapid decompression. Bubbles were detected ultrasonically at the root of pulmonary arteries following decompression. Surviving rats were randomly divided into six groups according to sampling time following decompression (2, 6, 12, 24, 48, and 72 h). Three parameters, serum levels of malondialdehyde (MDA), endothelin-1 (ET-1), and intercellular cell adhesion molecule-1 (ICAM-1) were identified from our previous study and measured. The level of MDA reached a peak level at 12 h post decompression, and then decreased gradually to control level before 72 h. For both ET-1 and ICAM-1, the greatest expression appeared at 24 h following surfacing, and the increases lasted for more than 72 h. These changes correlated positively with bubble counts at most detection time points. This study reveals the progress of endothelial dysfunction following decompression which provides guidance for timing the determination at least for the current model. The results further verify that bubbles are the causative agents of decompression induced endothelial damage and bubble amounts are an objective and suitable parameter to predict endothelial dysfunction. Most importantly, levels of endothelial biomarkers post dive may serve as sensitive parameters for assessing bubble load and decompression stress.
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Affiliation(s)
- Kun Zhang
- Department of Diving and Hyperbaric Medicine, Faculty of Naval Medicine, Second Military Medical University Shanghai, China
| | - Mengmeng Wang
- Department of Diving and Hyperbaric Medicine, Faculty of Naval Medicine, Second Military Medical University Shanghai, China
| | - Haowen Wang
- Department of Diving and Hyperbaric Medicine, Faculty of Naval Medicine, Second Military Medical University Shanghai, China
| | - Yinuo Liu
- Department of Diving and Hyperbaric Medicine, Faculty of Naval Medicine, Second Military Medical University Shanghai, China
| | - Peter Buzzacott
- Department of Diving and Hyperbaric Medicine, Faculty of Naval Medicine, Second Military Medical UniversityShanghai, China; School of Sports Science, Exercise and Health, University of Western AustraliaPerth, WA, Australia
| | - Weigang Xu
- Department of Diving and Hyperbaric Medicine, Faculty of Naval Medicine, Second Military Medical University Shanghai, China
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