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Finnie JW. Clostridium perfringens Type D Epsilon Toxin Causes Blood-Retinal Barrier Microvascular Damage and Diffuse Retinal Vasogenic Oedema. Vet Sci 2023; 11:2. [PMID: 38275918 PMCID: PMC10818779 DOI: 10.3390/vetsci11010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
Clostridium perfringens type D epsilon toxin (ETX) causes severe retinal microvascular endothelial injury in the rat. The resulting blood-retinal barrier (BRB) breakdown leads to increased vascular permeability, which was detected immunohistochemically by the extravasation of plasma albumin as a vascular tracer, and ensuing severe, diffuse, vasogenic retinal oedema. This microvascular damage was also confirmed by a loss of endothelial barrier antigen, a marker of an intact BRB in rats. Since similar microvascular lesions are found in EXT-exposed laboratory rodent and sheep brains, and the BRB resembles the BBB, they are also likely to occur in the eyes of naturally epsilon-intoxicated sheep and goats, but this remains to be determined. Moreover, while retinal oedema is a common and important component of many human and veterinary ocular disorders, more effective treatments are required. Accordingly, the retinal vasogenic oedema reliably and reproducibly induced by ETX in rats provides a useful model in which to study the pathogenesis of retinal oedema development and evaluate its prevention or amelioration by putative pharmacological interventions.
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Affiliation(s)
- John W Finnie
- Division of Research and Innovation, School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
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2
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Titball RW, Lewis N, Nicholas R. Is Clostridium perfringens epsilon toxin associated with multiple sclerosis? Mult Scler 2023; 29:1057-1063. [PMID: 37480283 PMCID: PMC10413780 DOI: 10.1177/13524585231186899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 07/23/2023]
Abstract
Clostridium perfringens epsilon toxin is associated with enterotoxaemia in livestock. More recently, it is proposed to play a role in multiple sclerosis (MS) in humans. Compared to matched controls, strains of C. perfringens which produce epsilon toxin are significantly more likely to be isolated from the gut of MS patients and at significantly higher levels; similarly, sera from MS patients are significantly more likely to contain antibodies to epsilon toxin. Epsilon toxin recognises the myelin and lymphocyte (MAL) protein receptor, damaging the blood-brain barrier and brain cells expressing MAL. In the experimental autoimmune encephalomyelitis model of MS, the toxin enables infiltration of immune cells into the central nervous system, inducing an MS-like disease. These studies provide evidence that epsilon toxin plays a role in MS, but do not yet fulfil Koch's postulates in proving a causal role.
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Affiliation(s)
| | | | - Richard Nicholas
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
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3
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Pathology and Pathogenesis of Brain Lesions Produced by Clostridium perfringens Type D Epsilon Toxin. Int J Mol Sci 2022; 23:ijms23169050. [PMID: 36012315 PMCID: PMC9409160 DOI: 10.3390/ijms23169050] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/23/2022] Open
Abstract
Clostridium perfringens type D epsilon toxin (ETX) produces severe, and frequently fatal, neurologic disease in ruminant livestock. The disorder is of worldwide distribution and, although vaccination has reduced its prevalence, ETX still causes substantial economic loss in livestock enterprises. The toxin is produced in the intestine as a relatively inactive prototoxin, which is subsequently fully enzymatically activated to ETX. When changed conditions in the intestinal milieu, particularly starch overload, favor rapid proliferation of this clostridial bacterium, large amounts of ETX can be elaborated. When sufficient toxin is absorbed from the intestine into the systemic circulation and reaches the brain, two neurologic syndromes can develop from this enterotoxemia. If the brain is exposed to large amounts of ETX, the lesions are fundamentally vasculocentric. The neurotoxin binds to microvascular endothelial receptors and other brain cells, the resulting damage causing increased vascular permeability and extravasation of plasma protein and abundant fluid into the brain parenchyma. While plasma protein, particularly albumin, pools largely perivascularly, the vasogenic edema becomes widely distributed in the brain, leading to a marked rise in intracranial pressure, coma, sometimes cerebellar herniation, and, eventually, often death. When smaller quantities of ETX are absorbed into the bloodstream, or livestock are partially immune, a more protracted clinical course ensues. The resulting brain injury is characterized by bilaterally symmetrical necrotic foci in certain selectively vulnerable neuroanatomic sites, termed focal symmetrical encephalomalacia. ETX has also been internationally listed as a potential bioterrorism agent. Although there are no confirmed human cases of ETX intoxication, the relatively wide species susceptibility to this toxin and its high toxicity mean it is likely that human populations would also be vulnerable to its neurotoxic actions. While the pathogenesis of ETX toxicity in the brain is incompletely understood, the putative mechanisms involved in neural lesion development are discussed.
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4
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Finnie JW, Navarro MA, Uzal FA. Pathogenesis and diagnostic features of brain and ophthalmic damage produced by Clostridium perfringens type D epsilon toxin. J Vet Diagn Invest 2020; 32:282-286. [PMID: 31955669 DOI: 10.1177/1040638719900190] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Clostridium perfringens type D epsilon toxin (EXT) causes an important neurologic disorder of sheep, goats and, rarely, cattle. The disease can occur in peracute, acute, subacute, and chronic forms. High circulating levels of ETX produce vasculocentric brain lesions, in which microvascular endothelial injury results in diagnostically useful perivascular and intramural extravasations of plasma protein, especially in sheep, and less frequently in goats. With lower toxin doses, a more protracted clinical course tends to occur, particularly in sheep, leading to focal, bilaterally symmetrical, necrotic foci in certain brain regions. Although these morphologic features usually permit the diagnostic pathologist to make a definitive etiologic diagnosis, there are many aspects of the pathogenesis of these cerebral lesions that are not completely understood. ETX has also been shown to produce microvascular damage in the retina of rats, resulting in severe, diffuse vasogenic edema, similar to that found in brains exposed to this neurotoxin. The pathoclisis and vascular theories offer alternative explanations of the differential susceptibility of different brain regions to the same neurotoxic insult.
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Affiliation(s)
- John W Finnie
- Discipline of Anatomy and Pathology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia (Finnie).,California Animal Health and Food Safety Laboratory System-San Bernardino Branch, School of Veterinary Medicine, University of California-Davis, San Bernardino, CA (Navarro, Uzal)
| | - Mauricio A Navarro
- Discipline of Anatomy and Pathology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia (Finnie).,California Animal Health and Food Safety Laboratory System-San Bernardino Branch, School of Veterinary Medicine, University of California-Davis, San Bernardino, CA (Navarro, Uzal)
| | - Francisco A Uzal
- Discipline of Anatomy and Pathology, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia (Finnie).,California Animal Health and Food Safety Laboratory System-San Bernardino Branch, School of Veterinary Medicine, University of California-Davis, San Bernardino, CA (Navarro, Uzal)
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5
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Linden JR, Flores C, Schmidt EF, Uzal FA, Michel AO, Valenzuela M, Dobrow S, Vartanian T. Clostridium perfringens epsilon toxin induces blood brain barrier permeability via caveolae-dependent transcytosis and requires expression of MAL. PLoS Pathog 2019; 15:e1008014. [PMID: 31703116 PMCID: PMC6867657 DOI: 10.1371/journal.ppat.1008014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 11/20/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022] Open
Abstract
Clostridium perfringens epsilon toxin (ETX) is responsible for causing the economically devastating disease, enterotoxaemia, in livestock. It is well accepted that ETX causes blood brain barrier (BBB) permeability, however the mechanisms involved in this process are not well understood. Using in vivo and in vitro methods, we determined that ETX causes BBB permeability in mice by increasing caveolae-dependent transcytosis in brain endothelial cells. When mice are intravenously injected with ETX, robust ETX binding is observed in the microvasculature of the central nervous system (CNS) with limited to no binding observed in the vasculature of peripheral organs, indicating that ETX specifically targets CNS endothelial cells. ETX binding to CNS microvasculature is dependent on MAL expression, as ETX binding to CNS microvasculature of MAL-deficient mice was not detected. ETX treatment also induces extravasation of molecular tracers including 376Da fluorescein salt, 60kDA serum albumin, 70kDa dextran, and 155kDA IgG. Importantly, ETX-induced BBB permeability requires expression of both MAL and caveolin-1, as mice deficient in MAL or caveolin-1 did not exhibit ETX-induced BBB permeability. Examination of primary murine brain endothelial cells revealed an increase in caveolae in ETX-treated cells, resulting in dynamin and lipid raft-dependent vacuolation without cell death. ETX-treatment also results in a rapid loss of EEA1 positive early endosomes and accumulation of large, RAB7-positive late endosomes and multivesicular bodies. Based on these results, we hypothesize that ETX binds to MAL on the apical surface of brain endothelial cells, causing recruitment of caveolin-1, triggering caveolae formation and internalization. Internalized caveolae fuse with early endosomes which traffic to late endosomes and multivesicular bodies. We believe that these multivesicular bodies fuse basally, releasing their contents into the brain parenchyma. Clostridium perfringens epsilon toxin (ETX) is an extremely lethal bacterial toxin known to cause a devastating disease in livestock animals and may be a possible cause of multiple sclerosis in humans. ETX is well known to cause disruption of the blood-brain barrier (BBB), a critical structure necessary for proper brain function. Deterioration of this barrier allows entry of toxic blood-borne material to enter the brain. Although ETX-induced BBB dysfunction is well accepted, how this happens is unknown. Here, we demonstrate that ETX causes BBB permeability by inducing formation of cell-surface invaginations called caveolae in endothelial cells, the cells that line blood vessels. Importantly, only endothelial cells from the brain and other central nervous system organs appear to be a target of ETX, as the toxin only binds to blood vessels in these organs and not blood vessels from other organs. These ETX-induced caveolae fuse with other caveolae and specialized intracellular vesicles called endosomes. We predict that these endosomes engulf blood-borne material during their internalization, allowing material to travel from the blood, through the cell, and into brain tissue. We also show that expression of the protein MAL and caveolin-1 is necessary for ETX-induced BBB permeability.
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Affiliation(s)
- Jennifer R. Linden
- The Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, New York, New York, United States of America
| | - Claudia Flores
- The Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, New York, New York, United States of America
| | - Eric F. Schmidt
- Laboratory of Molecular Biology, The Rockefeller University, New York, New York, United States of America
| | - Francisco A. Uzal
- California Animal Health & Food Safety Laboratory System, San Bernardino Branch, University of California, Davis, San Bernardino, California, United States of America
| | - Adam O. Michel
- Laboratory of Comparative Pathology, Center of Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine, New York, New York, United States of America
| | - Marissa Valenzuela
- The Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, New York, New York, United States of America
| | - Sebastian Dobrow
- The Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, New York, New York, United States of America
| | - Timothy Vartanian
- The Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, New York, New York, United States of America
- * E-mail:
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6
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Mander KA, Uzal FA, Williams R, Finnie JW. Clostridium perfringens type D epsilon toxin produces a rapid and dose-dependent cytotoxic effect on cerebral microvascular endothelial cells in vitro. J Vet Diagn Invest 2019; 32:277-281. [PMID: 31608815 DOI: 10.1177/1040638719882745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Clostridium perfringens type D epsilon toxin (ETX) is responsible for a severe and frequently fatal neurologic disorder in ruminant livestock. Light microscopic, immunohistochemical, and ultrastructural studies have suggested that ETX injury to the cerebral microvasculature, with subsequent severe, generalized vasogenic edema and increased intracranial pressure, is critically important in producing neurologic dysfunction. However, the effect of ETX on brain capillary endothelial cells in vitro has not been examined previously, to our knowledge. We exposed a well-characterized human blood-brain barrier cell line to increasing concentrations of ETX, and demonstrated a direct and dose-dependent endotheliotoxic effect. Our findings are concordant with the primacy of vasculocentric brain lesions in the diagnosis of acute epsilon toxin enterotoxemia in ruminant livestock.
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Affiliation(s)
- Kimberley A Mander
- Adelaide Medical School, University of Adelaide, Adelaide South Australia, Australia (Mander, Williams, Finnie).,California Animal Health and Food Safety Laboratory System-San Bernardino Branch, School of Veterinary Medicine, University of California, Davis, CA (Uzal)
| | - Francisco A Uzal
- Adelaide Medical School, University of Adelaide, Adelaide South Australia, Australia (Mander, Williams, Finnie).,California Animal Health and Food Safety Laboratory System-San Bernardino Branch, School of Veterinary Medicine, University of California, Davis, CA (Uzal)
| | - Ruth Williams
- Adelaide Medical School, University of Adelaide, Adelaide South Australia, Australia (Mander, Williams, Finnie).,California Animal Health and Food Safety Laboratory System-San Bernardino Branch, School of Veterinary Medicine, University of California, Davis, CA (Uzal)
| | - John W Finnie
- Adelaide Medical School, University of Adelaide, Adelaide South Australia, Australia (Mander, Williams, Finnie).,California Animal Health and Food Safety Laboratory System-San Bernardino Branch, School of Veterinary Medicine, University of California, Davis, CA (Uzal)
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7
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Huang Y, Li SN, Zhou XY, Zhang LX, Chen GX, Wang TH, Xia QJ, Liang N, Zhang X. The Dual Role of AQP4 in Cytotoxic and Vasogenic Edema Following Spinal Cord Contusion and Its Possible Association With Energy Metabolism via COX5A. Front Neurosci 2019; 13:584. [PMID: 31258460 PMCID: PMC6587679 DOI: 10.3389/fnins.2019.00584] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 05/23/2019] [Indexed: 02/05/2023] Open
Abstract
Spinal cord edema, mainly including vasogenic and cytotoxic edema, influences neurological outcome after spinal cord contusion (SCC). Aquaporin 4 (AQP4) is the most ubiquitous water channel in the central nervous system (CNS), which is a rate-limiting factor in vasogenic edema expressing in brain injury, and it contributes to the formation of cytotoxic edema locating in astrocytes. However, little is known about the regulatory mechanism of AQP4 within vasogenic and cytotoxic edema in SCC, and whether the regulation mechanism of AQP4 is related to Cytochrome coxidase (COX5A) affecting energy metabolism. Therefore, the SCC model is established by Allen’s method, and the degree of edema and neuronal area is measured. The motor function of rats is evaluated by the Basso, Beattie, and Bresnahan (BBB) scoring system. Meanwhile, AQP4 and COX5A are detected by real-time quantitative PCR (qRT-PCR) and western blot (WB). The localization of targeted protein is exhibited by immunohistochemical staining (IHC) and immunofluorescence (IF). Additionally, the methodology of AQP4 lentivirus-mediated RNA interference (AQP4-RNAi) is used to reveal the effect on edema of SCC and the regulating molecular mechanism. Firstly, we observe that the tissue water content increases after SCC and decreases after the peak value of tissue water content at 3 days (P < 0.05) with abundant expression of AQP4 protein locating around vascular endothelial cells (VECs), which suggests that the increasing AQP4 promotes water reabsorption and improves vasogenic edema in the early stage of SCC. However, the neuronal area is larger than in the sham group in the 7 days (P < 0.05) with the total water content of spinal cord decrease. Meanwhile, AQP4 migrates from VECs to neuronal cytomembrane, which indicates that AQP4 plays a crucial role in aggravating the formation and development of cytotoxic edema in the middle stages of SCC. Secondly, AQP4-RNAi is used to elucidate the mechanism of AQP4 to edema of SCC. The neuronal area shrinks and the area of cytotoxic edema reduces after AQP4 downregulation. The BBB scores are significantly higher than in the vector group after AQP4-RNAi at 5, 7, and 14 (P < 0.05). There is a relationship between AQP4 and COX5A shown by bioinformatics analysis. After AQP4 inhibition, the expression of COX5A is significantly upregulated in the swelling astrocytes. Therefore, the inhibition of AQP4 expression reduces cytotoxic edema in SCC and improves motor function, which may be associated with upregulation of COX5A via affecting energy metabolism. Moreover, it is not clear how the inhibition of AQP4 directly causes the upregulation of COX5A.
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Affiliation(s)
- Yuan Huang
- Clinical Laboratory Medicine, Chengdu Medical College, Chengdu, China
| | - Sheng-Nan Li
- Center for Experimental Technology of Preclinical Medicine, Chengdu Medical College, Chengdu, China
| | - Xiu-Ya Zhou
- Center for Experimental Technology of Preclinical Medicine, Chengdu Medical College, Chengdu, China
| | | | - Gang-Xian Chen
- Center for Experimental Technology of Preclinical Medicine, Chengdu Medical College, Chengdu, China
| | - Ting-Hua Wang
- Institute of Neuroscience, Kunming Medical University, Kunming, China.,Institute of Neurological Diseases, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qing-Jie Xia
- Institute of Neurological Diseases, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Nan Liang
- Center for Experimental Technology of Preclinical Medicine, Chengdu Medical College, Chengdu, China
| | - Xiao Zhang
- Center for Experimental Technology of Preclinical Medicine, Chengdu Medical College, Chengdu, China
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8
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Adler D, Linden JR, Shetty SV, Ma Y, Bokori-Brown M, Titball RW, Vartanian T. Clostridium perfringens Epsilon Toxin Compromises the Blood-Brain Barrier in a Humanized Zebrafish Model. iScience 2019; 15:39-54. [PMID: 31030181 PMCID: PMC6487375 DOI: 10.1016/j.isci.2019.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/29/2018] [Accepted: 04/08/2019] [Indexed: 12/22/2022] Open
Abstract
Clostridium perfringens epsilon toxin (ETX) is hypothesized to mediate blood-brain barrier (BBB) permeability by binding to the myelin and lymphocyte protein (MAL) on the luminal surface of endothelial cells (ECs). However, the kinetics of this interaction and a general understanding of ETX's behavior in a live organism have yet to be appreciated. Here we investigate ETX binding and BBB breakdown in living Danio rerio (zebrafish). Wild-type zebrafish ECs do not bind ETX. When zebrafish ECs are engineered to express human MAL (hMAL), proETX binding occurs in a time-dependent manner. Injection of activated toxin in hMAL zebrafish initiates BBB leakage, hMAL downregulation, blood vessel stenosis, perivascular edema, and blood stasis. We propose a kinetic model of MAL-dependent ETX binding and neurovascular pathology. By generating a humanized zebrafish BBB model, this study contributes to our understanding of ETX-induced BBB permeability and strengthens the proposal that MAL is the ETX receptor.
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Affiliation(s)
- Drew Adler
- Brain and Mind Research Institute, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA; Department of Neurobiology and Behavior, Cornell University, Ithaca, NY 14850, USA
| | - Jennifer R Linden
- Brain and Mind Research Institute, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA
| | - Samantha V Shetty
- Brain and Mind Research Institute, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA
| | - Yinghua Ma
- Brain and Mind Research Institute, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA
| | | | - Richard W Titball
- Department of Biosciences, University of Exeter, Exeter, Devon EX4 4SB, UK
| | - Timothy Vartanian
- Brain and Mind Research Institute, Weill Cornell Medical College of Cornell University, New York, NY 10065, USA.
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9
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Zhang HM, Chen W, Liu RN, Zhao Y. Notch inhibitor can attenuate apparent diffusion coefficient and improve neurological function through downregulating NOX2-ROS in severe traumatic brain injury. DRUG DESIGN DEVELOPMENT AND THERAPY 2018; 12:3847-3854. [PMID: 30510400 PMCID: PMC6231429 DOI: 10.2147/dddt.s174037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Introduction Secondary brain injury is a major factor that affects the prognosis and outcome of traumatic brain injury (TBI) patients. Secondary brain edema is considered to be an initiating factor in secondary brain injury after TBI. A previous study has indicated that Notch signaling activation contributes to neuron death in mice affected by stroke; however, its role in neuronal oxidation stress for brain edema after TBI is not well established. Apparent diffusion coefficient (ADC) values can represent the brain edema after TBI. Methods We established a rat model of acute craniocerebral injury, using functional MRI to evaluate the ADC and cerebral blood flow values. The present study was designed to determine the effect of Notch inhibitor DAPT upon oxidation stress for brain edema after TBI. Rats were randomly distributed into five groups, control group, severe TBI group, severe TBI + vehicle group, severe TBI + DAPT group, and severe TBI + DPI group. All rats were sacrificed at 24 hours after TBI. Results Our data indicated that Notch signaling inhibitor DAPT significantly reduced the ADC values and improved the neurological function after TBI. In addition, DAPT decreased NOX2 levels and the ROS levels. Furthermore, DPI can decrease NOX2 levels and ROS levels. Conclusion This study indicated that DAPT Notch signal inhibitors can inhibit NOX2-ROS generation, reduce the ADC values, relieve cerebral edema, and improve nerve function.
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Affiliation(s)
- Hong-Mei Zhang
- Emergency Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, People's Republic of China, .,Emergency Department, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, People's Republic of China
| | - Wei Chen
- Department of Intensive Care Unit, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, People's Republic of China
| | - Rui-Ning Liu
- Emergency Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, People's Republic of China,
| | - Yan Zhao
- Emergency Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei, People's Republic of China,
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10
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Mander K, Finnie J. Loss of Endothelial Barrier Antigen Immunoreactivity in Rat Retinal Microvessels is Correlated with Clostridium perfringens Type D Epsilon Toxin-induced Damage to the Blood–Retinal Barrier. J Comp Pathol 2018; 158:51-55. [DOI: 10.1016/j.jcpa.2017.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/17/2017] [Accepted: 11/25/2017] [Indexed: 11/15/2022]
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11
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Chidlow G, Plunkett M, Casson RJ, Wood JP. Investigations into localized re-treatment of the retina with a 3-nanosecond laser. Lasers Surg Med 2016; 48:602-15. [DOI: 10.1002/lsm.22506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Glyn Chidlow
- Ophthalmic Research Laboratories; Hanson Institute Centre for Neurological Diseases; Frome Rd Adelaide SA 5000 Australia
- Discipline of Ophthalmology and Visual Sciences; University of Adelaide; Frome Rd Adelaide SA 5005 Australia
| | - Malcolm Plunkett
- Ophthalmic Research Laboratories; Hanson Institute Centre for Neurological Diseases; Frome Rd Adelaide SA 5000 Australia
| | - Robert J. Casson
- Ophthalmic Research Laboratories; Hanson Institute Centre for Neurological Diseases; Frome Rd Adelaide SA 5000 Australia
- Discipline of Ophthalmology and Visual Sciences; University of Adelaide; Frome Rd Adelaide SA 5005 Australia
| | - John P.M. Wood
- Ophthalmic Research Laboratories; Hanson Institute Centre for Neurological Diseases; Frome Rd Adelaide SA 5000 Australia
- Discipline of Ophthalmology and Visual Sciences; University of Adelaide; Frome Rd Adelaide SA 5005 Australia
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12
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Rumah KR, Ma Y, Linden JR, Oo ML, Anrather J, Schaeren-Wiemers N, Alonso MA, Fischetti VA, McClain MS, Vartanian T. The Myelin and Lymphocyte Protein MAL Is Required for Binding and Activity of Clostridium perfringens ε-Toxin. PLoS Pathog 2015; 11:e1004896. [PMID: 25993478 PMCID: PMC4439126 DOI: 10.1371/journal.ppat.1004896] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 04/19/2015] [Indexed: 12/18/2022] Open
Abstract
Clostridium perfringens ε-toxin (ETX) is a potent pore-forming toxin responsible for a central nervous system (CNS) disease in ruminant animals with characteristics of blood-brain barrier (BBB) dysfunction and white matter injury. ETX has been proposed as a potential causative agent for Multiple Sclerosis (MS), a human disease that begins with BBB breakdown and injury to myelin forming cells of the CNS. The receptor for ETX is unknown. Here we show that both binding of ETX to mammalian cells and cytotoxicity requires the tetraspan proteolipid Myelin and Lymphocyte protein (MAL). While native Chinese Hamster Ovary (CHO) cells are resistant to ETX, exogenous expression of MAL in CHO cells confers both ETX binding and susceptibility to ETX-mediated cell death. Cells expressing rat MAL are ~100 times more sensitive to ETX than cells expressing similar levels of human MAL. Insertion of the FLAG sequence into the second extracellular loop of MAL abolishes ETX binding and cytotoxicity. ETX is known to bind specifically and with high affinity to intestinal epithelium, renal tubules, brain endothelial cells and myelin. We identify specific binding of ETX to these structures and additionally show binding to retinal microvasculature and the squamous epithelial cells of the sclera in wild-type mice. In contrast, there is a complete absence of ETX binding to tissues from MAL knockout (MAL-/-) mice. Furthermore, MAL-/- mice exhibit complete resistance to ETX at doses in excess of 1000 times the symptomatic dose for wild-type mice. We conclude that MAL is required for both ETX binding and cytotoxicity.
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Affiliation(s)
- Kareem Rashid Rumah
- Brain and Mind Research Institute, Weill Cornell Medical College, New York City, New York, United States of America
- Laboratory of Bacterial Pathogenesis and Immunology, The Rockefeller University, New York City, New York, United States of America
| | - Yinghua Ma
- Brain and Mind Research Institute, Weill Cornell Medical College, New York City, New York, United States of America
| | - Jennifer R. Linden
- Brain and Mind Research Institute, Weill Cornell Medical College, New York City, New York, United States of America
| | - Myat Lin Oo
- Brain and Mind Research Institute, Weill Cornell Medical College, New York City, New York, United States of America
| | - Josef Anrather
- Brain and Mind Research Institute, Weill Cornell Medical College, New York City, New York, United States of America
| | - Nicole Schaeren-Wiemers
- Neurobiology, Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Miguel A. Alonso
- Centro de Biología Molecular Severo Ochoa, CSIC-UAM, Cantoblanco, Madrid, Spain
| | - Vincent A. Fischetti
- Laboratory of Bacterial Pathogenesis and Immunology, The Rockefeller University, New York City, New York, United States of America
| | - Mark S. McClain
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Timothy Vartanian
- Brain and Mind Research Institute, Weill Cornell Medical College, New York City, New York, United States of America
- * E-mail:
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