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Huitsing K, Tritsch T, Arias FJC, Collado F, Aenlle KK, Nathason L, Fletcher MA, Klimas NG, Craddock TJA. The potential role of ocular and otolaryngological mucus proteins in myalgic encephalomyelitis/chronic fatigue syndrome. Mol Med 2024; 30:1. [PMID: 38172662 PMCID: PMC10763106 DOI: 10.1186/s10020-023-00766-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating illness associated with a constellation of other symptoms. While the most common symptom is unrelenting fatigue, many individuals also report suffering from rhinitis, dry eyes and a sore throat. Mucin proteins are responsible for contributing to the formation of mucosal membranes throughout the body. These mucosal pathways contribute to the body's defense mechanisms involving pathogenic onset. When compromised by pathogens the epithelium releases numerous cytokines and enters a prolonged state of inflammation to eradicate any particular infection. Based on genetic analysis, and computational theory and modeling we hypothesize that mucin protein dysfunction may contribute to ME/CFS symptoms due to the inability to form adequate mucosal layers throughout the body, especially in the ocular and otolaryngological pathways leading to low grade chronic inflammation and the exacerbation of symptoms.
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Affiliation(s)
- Kaylin Huitsing
- Department of Psychology and Neuroscience, College of Psychology, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
| | - Tara Tritsch
- Department of Psychology and Neuroscience, College of Psychology, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
| | - Francisco Javier Carrera Arias
- Department of Psychology and Neuroscience, College of Psychology, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
| | - Fanny Collado
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
- Miami Veterans Affairs Medical Center, 1201 NW 16th St, Miami, FL, 33125-1624, USA
| | - Kristina K Aenlle
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
- Miami Veterans Affairs Medical Center, 1201 NW 16th St, Miami, FL, 33125-1624, USA
- Department of Clinical Immunology, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
| | - Lubov Nathason
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
- Department of Clinical Immunology, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
| | - Mary Ann Fletcher
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
- Miami Veterans Affairs Medical Center, 1201 NW 16th St, Miami, FL, 33125-1624, USA
- Department of Clinical Immunology, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
| | - Nancy G Klimas
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
- Miami Veterans Affairs Medical Center, 1201 NW 16th St, Miami, FL, 33125-1624, USA
- Department of Clinical Immunology, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA
| | - Travis J A Craddock
- Department of Psychology and Neuroscience, College of Psychology, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA.
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA.
- Miami Veterans Affairs Medical Center, 1201 NW 16th St, Miami, FL, 33125-1624, USA.
- Department of Clinical Immunology, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA.
- Department of Computer Science, College of Engineering and Computing, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA.
- Center for Collaborative Research, Room 440, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL, 33328-2004, USA.
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2
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Huitsing K, Tritsch T, Arias FJC, Collado F, Aenlle K, Nathason L, Fletcher MA, Klimas NG, Craddock T. The Potential Role of Ocular and Otolaryngological Mucus Proteins in Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome. RESEARCH SQUARE 2023:rs.3.rs-3171709. [PMID: 37546944 PMCID: PMC10402253 DOI: 10.21203/rs.3.rs-3171709/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating illness associated with a constellation of other symptoms. While the most common symptom is unrelenting fatigue, many individuals also report suffering from rhinitis, dry eyes and a sore throat. Mucin proteins are responsible for contributing to the formation of mucosal membranes throughout the body. These mucosal pathways contribute to the body's defense mechanisms involving pathogenic onset. When compromised by pathogens the epithelium releases numerous cytokines and enters a prolonged state of inflammation to eradicate any particular infection. Based on genetic analysis, and computational theory and modeling we hypothesize that mucin protein dysfunction may contribute to ME/CFS symptoms due to the inability to form adequate mucosal layers throughout the body, especially in the ocular and otolaryngological pathways leading to low grade chronic inflammation and the exacerbation of symptoms.
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Affiliation(s)
- Kaylin Huitsing
- Nova Southeastern University - Fort Lauderdale/Davie Campus: Nova Southeastern University
| | - Tara Tritsch
- Nova Southeastern University - Fort Lauderdale/Davie Campus: Nova Southeastern University
| | | | - Fanny Collado
- Bruce W Carter Department of Veterans Affairs Medical Center: Miami VA Healthcare System
| | - Kristina Aenlle
- Bruce W Carter Department of Veterans Affairs Medical Center: Miami VA Healthcare System
| | - Lubov Nathason
- Nova Southeastern University - Fort Lauderdale/Davie Campus: Nova Southeastern University
| | - Mary Ann Fletcher
- Nova Southeastern University - Fort Lauderdale/Davie Campus: Nova Southeastern University
| | - Nancy G Klimas
- Nova Southeastern University - Fort Lauderdale/Davie Campus: Nova Southeastern University
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3
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García-Diéguez L, Diaz-Tang G, Marin Meneses E, Cruise V, Barraza I, Craddock TJ, Smith RP. Periodically disturbing biofilms reduces expression of quorum sensing-regulated virulence factors in Pseudomonas aeruginosa. iScience 2023; 26:106843. [PMID: 37255658 PMCID: PMC10225924 DOI: 10.1016/j.isci.2023.106843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 06/01/2023] Open
Abstract
Pseudomonas aeruginosa uses quorum sensing to regulate the expression of virulence factors. In static environments, spatial structures, such as biofilms, can increase the expression of these virulence factors. However, in natural settings, biofilms are exposed to physical forces that disrupt spatial structure, which may affect the expression of virulence factors regulated by quorum sensing. We show that periodically disturbing biofilms composed of P. aeruginosa using a physical force reduces the expression of quorum sensing-regulated virulence factors. At an intermediate disturbance frequency, the expression of virulence factors in the las, rhl, and pqs regulons is reduced. Mathematical modeling suggests that perturbation of the pqsR receptor is critical for this reduction. Removing the lasR receptor enhances the reduction in the expression of virulence factors as a result of disturbance. Our results allow identification of environments where virulence is reduced and implicate the lasR receptor as having a buffering role against disturbance.
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Affiliation(s)
- Laura García-Diéguez
- Department of Biological Sciences, Halmos College of Arts and Science, Nova Southeastern University, Fort Lauderdale FL 33314, USA
| | - Gabriela Diaz-Tang
- Department of Biological Sciences, Halmos College of Arts and Science, Nova Southeastern University, Fort Lauderdale FL 33314, USA
| | - Estefania Marin Meneses
- Department of Biological Sciences, Halmos College of Arts and Science, Nova Southeastern University, Fort Lauderdale FL 33314, USA
| | - Vanessa Cruise
- Department of Biological Sciences, Halmos College of Arts and Science, Nova Southeastern University, Fort Lauderdale FL 33314, USA
| | - Ivana Barraza
- Department of Biological Sciences, Halmos College of Arts and Science, Nova Southeastern University, Fort Lauderdale FL 33314, USA
| | - Travis J.A. Craddock
- Clinical Systems Biology Group, Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale FL 33314, USA
- Department of Psychology & Neuroscience, College of Psychology, Nova Southeastern University, Fort Lauderdale FL 33314, USA
- Department of Computer Science, College of Engineering and Computing, Nova Southeastern University, Fort Lauderdale FL 33314, USA
- Department of Clinical Immunology, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale FL 33314, USA
| | - Robert P. Smith
- Department of Biological Sciences, Halmos College of Arts and Science, Nova Southeastern University, Fort Lauderdale FL 33314, USA
- Cell Therapy Institute, Kiran Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale FL 33314, USA
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4
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Michalovicz LT, Kelly KA, Craddock TJA, O'Callaghan JP. A Projectile Concussive Impact Model Produces Neuroinflammation in Both Mild and Moderate-Severe Traumatic Brain Injury. Brain Sci 2023; 13:brainsci13040623. [PMID: 37190590 DOI: 10.3390/brainsci13040623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
Traumatic brain injury (TBI) is a major cause of death and disability and is experienced by nearly 3 million people annually as a result of falls, vehicular accidents, or from being struck by or against an object. While TBIs can range in severity, the majority of injuries are considered to be mild. However, TBI of any severity has the potential to have long-lasting neurological effects, including headaches, cognitive/memory impairments, mood dysfunction, and fatigue as a result of neural damage and neuroinflammation. Here, we modified a projectile concussive impact (PCI) model of TBI to deliver a closed-head impact with variable severity dependent on the material of the ball-bearing projectile. Adult male Sprague Dawley rats were evaluated for neurobehavioral, neuroinflammatory, and neural damage endpoints both acutely and longer-term (up to 72 h) post-TBI following impact with either an aluminum or stainless-steel projectile. Animals that received TBI using the stainless-steel projectile exhibited outcomes strongly correlated to moderate-severe TBI, such as prolonged unconsciousness, impaired neurobehavior, increased risk for hematoma and death, as well as significant neuronal degeneration and neuroinflammation throughout the cortex, hippocampus, thalamus, and cerebellum. In contrast, rats that received TBI with the aluminum projectile exhibited characteristics more congruous with mild TBI, such as a trend for longer periods of unconsciousness in the absence of neurobehavioral deficits, a lack of neurodegeneration, and mild neuroinflammation. Moreover, alignment of cytokine mRNA expression from the cortex of these rats with a computational model of neuron-glia interaction found that the moderate-severe TBI produced by the stainless-steel projectile strongly associated with the neuroinflammatory state, while the mild TBI existed in a state between normal and inflammatory neuron-glia interactions. Thus, these modified PCI protocols are capable of producing TBIs that model the clinical and experimental manifestations associated with both moderate-severe and mild TBI producing relevant models for the evaluation of the potential underlying roles of neuroinflammation and other chronic pathophysiology in the long-term outcomes associated with TBI.
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Affiliation(s)
- Lindsay T Michalovicz
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26508, USA
| | - Kimberly A Kelly
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26508, USA
| | - Travis J A Craddock
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Department of Clinical Immunology, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Department of Psychology & Neuroscience, College of Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Department of Computer Science, College of Engineering and Computing, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - James P O'Callaghan
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26508, USA
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Stanculescu D, Bergquist J. Perspective: Drawing on Findings From Critical Illness to Explain Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Front Med (Lausanne) 2022; 9:818728. [PMID: 35345768 PMCID: PMC8957276 DOI: 10.3389/fmed.2022.818728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/11/2022] [Indexed: 12/15/2022] Open
Abstract
We propose an initial explanation for how myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) could originate and perpetuate by drawing on findings from critical illness research. Specifically, we combine emerging findings regarding (a) hypoperfusion and endotheliopathy, and (b) intestinal injury in these illnesses with our previously published hypothesis about the role of (c) pituitary suppression, and (d) low thyroid hormone function associated with redox imbalance in ME/CFS. Moreover, we describe interlinkages between these pathophysiological mechanisms as well as “vicious cycles” involving cytokines and inflammation that may contribute to explain the chronic nature of these illnesses. This paper summarizes and expands on our previous publications about the relevance of findings from critical illness for ME/CFS. New knowledge on diagnostics, prognostics and treatment strategies could be gained through active collaboration between critical illness and ME/CFS researchers, which could lead to improved outcomes for both conditions.
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Affiliation(s)
| | - Jonas Bergquist
- Division of Analytical Chemistry and Neurochemistry, Department of Chemistry - Biomedical Center, Uppsala University, Uppsala, Sweden.,The Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Collaborative Research Centre at Uppsala University, Uppsala, Sweden
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6
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Michalovicz LT, Kelly KA, Miller DB, Sullivan K, O'Callaghan JP. The β-adrenergic receptor blocker and anti-inflammatory drug propranolol mitigates brain cytokine expression in a long-term model of Gulf War Illness. Life Sci 2021; 285:119962. [PMID: 34563566 PMCID: PMC9047058 DOI: 10.1016/j.lfs.2021.119962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 12/03/2022]
Abstract
Aims: Growing evidence suggests that Gulf War Illness (GWI) is the result of underlying neuroimmune dysfunction. For example, previously we found that several GWI-relevant organophosphate acetylcholinesterase inhibitors produce heightened neuroinflammatory responses following subchronic exposure to stress hormone as a mimic of high physiological stress. The goal of the current study was to evaluate the potential for the β-adrenergic receptor inhibitor and anti-inflammatory drug, propranolol, to treat neuroinflammation in a novel long-term mouse model of GWI. Main methods: Adult male C57BL/6J mice received a subchronic exposure to corticosterone (CORT) at levels mimicking high physiological stress followed by exposure to the sarin surrogate, diisopropyl fluorophosphate (DFP). These mice were then re-exposed to CORT every other week for a total of five weeks, followed by a systemic immune challenge with lipopolysaccharide (LPS). Animals receiving the propranolol treatment were given a single dose (20 mg/kg, i.p.) either four or 11 days prior to the LPS challenge. The potential anti-neuroinflammatory effects of propranolol were interrogated by analysis of cytokine mRNA expression. Key findings: We found that our long-term GWI model produces a primed neuroinflammatory response to subsequent immune challenge that is dependent upon GWI-relevant organophosphate exposure. Propranolol treatment abrogated the elaboration of inflammatory cytokine mRNA expression in the brain instigated in our model, having no treatment effects in non-DFP exposed groups. Significance: Our results indicate that propranolol may be a promising therapy for GWI with the potential to treat the underlying neuroinflammation associated with the illness.
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Affiliation(s)
- Lindsay T Michalovicz
- Health Effects Laboratory Division, Centers for Disease Control and Prevention-National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Kimberly A Kelly
- Health Effects Laboratory Division, Centers for Disease Control and Prevention-National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Diane B Miller
- Health Effects Laboratory Division, Centers for Disease Control and Prevention-National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | | | - James P O'Callaghan
- Health Effects Laboratory Division, Centers for Disease Control and Prevention-National Institute for Occupational Safety and Health, Morgantown, WV, USA.
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7
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Carrera Arias FJ, Aenlle K, Abreu M, Holschbach MA, Michalovicz LT, Kelly KA, Klimas N, O’Callaghan JP, Craddock TJA. Modeling Neuroimmune Interactions in Human Subjects and Animal Models to Predict Subtype-Specific Multidrug Treatments for Gulf War Illness. Int J Mol Sci 2021; 22:ijms22168546. [PMID: 34445252 PMCID: PMC8395153 DOI: 10.3390/ijms22168546] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 01/03/2023] Open
Abstract
Gulf War Illness (GWI) is a persistent chronic neuroinflammatory illness exacerbated by external stressors and characterized by fatigue, musculoskeletal pain, cognitive, and neurological problems linked to underlying immunological dysfunction for which there is no known treatment. As the immune system and the brain communicate through several signaling pathways, including the hypothalamic–pituitary–adrenal (HPA) axis, it underlies many of the behavioral and physiological responses to stressors via blood-borne mediators, such as cytokines, chemokines, and hormones. Signaling by these molecules is mediated by the semipermeable blood–brain barrier (BBB) made up of a monocellular layer forming an integral part of the neuroimmune axis. BBB permeability can be altered and even diminished by both external factors (e.g., chemical agents) and internal conditions (e.g., acute or chronic stress, or cross-signaling from the hypothalamic–pituitary–gonadal (HPG) axis). Such a complex network of regulatory interactions that possess feed-forward and feedback connections can have multiple response dynamics that may include several stable homeostatic states beyond normal health. Here we compare immune and hormone measures in the blood of human clinical samples and mouse models of Gulf War Illness (GWI) subtyped by exposure to traumatic stress for subtyping this complex illness. We do this via constructing a detailed logic model of HPA–HPG–Immune regulatory behavior that also considers signaling pathways across the BBB to neuronal–glial interactions within the brain. We apply conditional interactions to model the effects of changes in BBB permeability. Several stable states are identified in the system beyond typical health. Following alignment of the human and mouse blood profiles in the context of the model, mouse brain sample measures were used to infer the neuroinflammatory state in human GWI and perform treatment simulations using a genetic algorithm to optimize the Monte Carlo simulations of the putative treatment strategies aimed at returning the ill system back to health. We identify several ideal multi-intervention strategies and potential drug candidates that may be used to treat chronic neuroinflammation in GWI.
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Affiliation(s)
- Francisco J. Carrera Arias
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; (F.J.C.A.); (K.A.); (M.A.); (N.K.)
| | - Kristina Aenlle
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; (F.J.C.A.); (K.A.); (M.A.); (N.K.)
- Department of Clinical Immunology, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Miami Veterans Affairs Healthcare System, Miami, FL 33125, USA
| | - Maria Abreu
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; (F.J.C.A.); (K.A.); (M.A.); (N.K.)
- Department of Clinical Immunology, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Miami Veterans Affairs Healthcare System, Miami, FL 33125, USA
| | - Mary A. Holschbach
- Department of Psychology & Neuroscience, College of Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA;
| | - Lindsay T. Michalovicz
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA; (L.T.M.); (K.A.K.); (J.P.O.)
| | - Kimberly A. Kelly
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA; (L.T.M.); (K.A.K.); (J.P.O.)
| | - Nancy Klimas
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; (F.J.C.A.); (K.A.); (M.A.); (N.K.)
- Department of Clinical Immunology, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Miami Veterans Affairs Healthcare System, Miami, FL 33125, USA
| | - James P. O’Callaghan
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA; (L.T.M.); (K.A.K.); (J.P.O.)
| | - Travis J. A. Craddock
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; (F.J.C.A.); (K.A.); (M.A.); (N.K.)
- Department of Clinical Immunology, College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Department of Psychology & Neuroscience, College of Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA;
- Department of Computer Science, College of Engineering and Computing, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Correspondence: ; Tel.: +1-954-262-2868
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8
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A randomized phase II remote study to assess Bacopa for Gulf War Illness associated cognitive dysfunction: Design and methods of a national study. Life Sci 2021; 282:119819. [PMID: 34256038 DOI: 10.1016/j.lfs.2021.119819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 12/31/2022]
Abstract
AIMS Gulf War Illness (GWI) is a chronic, debilitating, multi-symptom condition affecting as many as one-third of the nearly 700,000 U.S. troops deployed to the Middle East during the 1990-1991 Gulf War (GW). The treatment of GWI relies on symptom management. A common challenge in studying the efficacy of interventions for symptom management is participant recruitment related to factors such as the burden of travelling to study sites and the widespread dispersion of Veterans with GWI. The goal of this study is to assess the efficacy of a novel low-risk therapeutic agent, Bacopa monnieri, for cognitive function in Veterans with GWI and to evaluate the utility of a remote patient-centric study design developed to promote recruitment and minimize participant burden. MAIN METHODS To promote effective participant recruitment, we developed a remote patient-centric study design. Participants will be recruited online through social media and through a web-based research volunteer list of GW Veterans. An online assessment platform will be used, and laboratory blood draws will be performed at clinical laboratory sites that are local to participants. Furthermore, the assigned intervention will be mailed to each participant. SIGNIFICANCE These study design adaptations will open participation to Veterans nearly nationwide and reduce administrative costs while maintaining methodologic rigor and participant safety in a randomized, placebo-controlled phase II clinical trial.
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9
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Brown KA, Carpenter JM, Preston CJ, Ludwig HD, Clay KB, Harn DA, Norberg T, Wagner JJ, Filipov NM. Lacto-N-fucopentaose-III ameliorates acute and persisting hippocampal synaptic plasticity and transmission deficits in a Gulf War Illness mouse model. Life Sci 2021; 279:119707. [PMID: 34102195 DOI: 10.1016/j.lfs.2021.119707] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/19/2021] [Accepted: 06/01/2021] [Indexed: 12/12/2022]
Abstract
AIMS The present study investigated if treatment with the immunotherapeutic, lacto-N-fucopentaose-III (LNFPIII), resulted in amelioration of acute and persisting deficits in synaptic plasticity and transmission as well as trophic factor expression along the hippocampal dorsoventral axis in a mouse model of Gulf War Illness (GWI). MAIN METHODS Mice received either coadministered or delayed LNFPIII treatment throughout or following, respectively, exposure to a 15-day GWI induction paradigm. Subsets of animals were subsequently sacrificed 48 h, seven months, or 11 months post GWI-related (GWIR) exposure for hippocampal qPCR or in vitro electrophysiology experiments. KEY FINDINGS Progressively worsened impairments in hippocampal synaptic plasticity, as well as a biphasic effect on hippocampal synaptic transmission, were detected in GWIR-exposed animals. Dorsoventral-specific impairments in hippocampal synaptic responses became more pronounced over time, particularly in the dorsal hippocampus. Notably, delayed LNFPIII treatment ameliorated GWI-related aberrations in hippocampal synaptic plasticity and transmission seven and 11 months post-exposure, an effect that was consistent with enhanced hippocampal trophic factor expression and absence of increased interleukin 6 (IL-6) in animals treated with LNFPIII. SIGNIFICANCE Approximately a third of Gulf War Veterans have GWI; however, GWI therapeutics are presently limited to targeted and symptomatic treatments. As increasing evidence underscores the substantial role of persisting neuroimmune dysfunction in GWI, efficacious neuroactive immunotherapeutics hold substantial promise in yielding GWI remission. The findings in the present report indicate that LNFPIII may be an efficacious candidate for ameliorating persisting neurological abnormalities presented in GWI.
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Affiliation(s)
- Kyle A Brown
- Department of Physiology and Pharmacology, University of Georgia, Athens, GA, United States; Interdisciplinary Toxicology Program, University of Georgia, Athens, GA, United States
| | - Jessica M Carpenter
- Department of Physiology and Pharmacology, University of Georgia, Athens, GA, United States; Neuroscience Program, University of Georgia, Athens, GA, United States
| | - Collin J Preston
- Department of Physiology and Pharmacology, University of Georgia, Athens, GA, United States; Interdisciplinary Toxicology Program, University of Georgia, Athens, GA, United States
| | - Helaina D Ludwig
- Department of Physiology and Pharmacology, University of Georgia, Athens, GA, United States; Interdisciplinary Toxicology Program, University of Georgia, Athens, GA, United States
| | - Kendall B Clay
- Neuroscience Program, University of Georgia, Athens, GA, United States
| | - Donald A Harn
- Department of Infectious Diseases, University of Georgia, Athens, GA, United States; Center for Tropical and Emerging Diseases, University of Georgia, Athens, GA, United States
| | - Thomas Norberg
- Department of Chemistry, University of Uppsala, Uppsala, Sweden
| | - John J Wagner
- Department of Physiology and Pharmacology, University of Georgia, Athens, GA, United States; Interdisciplinary Toxicology Program, University of Georgia, Athens, GA, United States; Neuroscience Program, University of Georgia, Athens, GA, United States.
| | - Nikolay M Filipov
- Department of Physiology and Pharmacology, University of Georgia, Athens, GA, United States; Interdisciplinary Toxicology Program, University of Georgia, Athens, GA, United States; Neuroscience Program, University of Georgia, Athens, GA, United States.
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10
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Stanculescu D, Larsson L, Bergquist J. Theory: Treatments for Prolonged ICU Patients May Provide New Therapeutic Avenues for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Front Med (Lausanne) 2021; 8:672370. [PMID: 34026797 PMCID: PMC8137963 DOI: 10.3389/fmed.2021.672370] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/01/2021] [Indexed: 12/20/2022] Open
Abstract
We here provide an overview of treatment trials for prolonged intensive care unit (ICU) patients and theorize about their relevance for potential treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Specifically, these treatment trials generally target: (a) the correction of suppressed endocrine axes, notably through a "reactivation" of the pituitary gland's pulsatile secretion of tropic hormones, or (b) the interruption of the "vicious circle" between inflammation, oxidative and nitrosative stress (O&NS), and low thyroid hormone function. There are significant parallels in the treatment trials for prolonged critical illness and ME/CFS; this is consistent with the hypothesis of an overlap in the mechanisms that prevent recovery in both conditions. Early successes in the simultaneous reactivation of pulsatile pituitary secretions in ICU patients-and the resulting positive metabolic effects-could indicate an avenue for treating ME/CFS. The therapeutic effects of thyroid hormones-including in mitigating O&NS and inflammation and in stimulating the adreno-cortical axis-also merit further studies. Collaborative research projects should further investigate the lessons from treatment trials for prolonged critical illness for solving ME/CFS.
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Affiliation(s)
| | - Lars Larsson
- Basic and Clinical Muscle Biology, Department of Physiology and Pharmacology, Karolinska Institute, Solna, Sweden
| | - Jonas Bergquist
- Analytical Chemistry and Neurochemistry, Department of Chemistry–Biomedical Center, Uppsala University, Uppsala, Sweden
- The Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Collaborative Research Centre at Uppsala University, Uppsala, Sweden
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Lacto-N-fucopentaose-III (LNFPIII) ameliorates acute aberrations in hippocampal synaptic transmission in a Gulf War Illness animal model. Brain Res 2021; 1766:147513. [PMID: 33961896 DOI: 10.1016/j.brainres.2021.147513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 02/04/2023]
Abstract
Approximately one-third of Persian Gulf War veterans are afflicted by Gulf War Illness (GWI), a chronic multisymptom condition that fundamentally presents with cognitive deficits (i.e., learning and memory impairments) and neuroimmune dysfunction (i.e., inflammation). Factors associated with GWI include overexposures to neurotoxic pesticides and nerve agent prophylactics such as permethrin (PM) and pyridostigmine bromide (PB), respectively. GWI-related neurological impairments associated with PB-PM overexposures have been recapitulated in animal models; however, there is a paucity of studies assessing PB-PM-related aberrations in hippocampal synaptic plasticity and transmission that may underlie behavioral impairments. Importantly, FDA-approved neuroactive treatments are currently unavailable for GWI. In the present study, we assessed the efficacy of an immunomodulatory therapeutic, lacto-N-fucopentaose-III (LNFPIII), on ameliorating acute effects of in vivo PB-PM exposure on synaptic plasticity and transmission as well as trophic factor/cytokine expression along the hippocampal dorsoventral axis. PB-PM exposure resulted in hippocampal synaptic transmission deficits 48 h post-exposure, a response that was ameliorated by LNFPIII coadministration, particularly in the dorsal hippocampus (dH). LNFPIII coadministration also enhanced synaptic transmission in the dH and the ventral hippocampus (vH). Notably, LNFPIII coadministration elevated long-term potentiation in the dH. Further, PB-PM exposure and LNFPIII coadministration uniquely altered key inflammatory cytokine and trophic factor production in the dH and the vH. Collectively, these findings demonstrate that PB-PM exposure impaired hippocampal synaptic responses 48 h post-exposure, impairments that differentially manifested along the dorsoventral axis. Importantly, LNFPIII ameliorated GWI-related electrophysiological deficits, a beneficial effect indicating the potential efficacy of LNFPIII for treating GWI.
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12
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Stanculescu D, Larsson L, Bergquist J. Hypothesis: Mechanisms That Prevent Recovery in Prolonged ICU Patients Also Underlie Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Front Med (Lausanne) 2021; 8:628029. [PMID: 33585528 PMCID: PMC7876311 DOI: 10.3389/fmed.2021.628029] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/08/2021] [Indexed: 12/13/2022] Open
Abstract
Here the hypothesis is advanced that maladaptive mechanisms that prevent recovery in some intensive care unit (ICU) patients may also underlie Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Specifically, these mechanisms are: (a) suppression of the pituitary gland's pulsatile secretion of tropic hormones, and (b) a "vicious circle" between inflammation, oxidative and nitrosative stress (O&NS), and low thyroid hormone function. This hypothesis should be investigated through collaborative research projects.
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Affiliation(s)
| | - Lars Larsson
- Basic and Clinical Muscle Biology, Department of Physiology and Pharmacology, Karolinska Institute, Solna, Sweden
| | - Jonas Bergquist
- Analytical Chemistry and Neurochemistry, Department of Chemistry – Biomedical Center, Uppsala University, Uppsala, Sweden
- The Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Collaborative Research Centre at Uppsala University, Uppsala, Sweden
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13
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Vashishtha S, Broderick G, Craddock TJA, Barnes ZM, Collado F, Balbin EG, Fletcher MA, Klimas NG. Leveraging Prior Knowledge to Recover Characteristic Immune Regulatory Motifs in Gulf War Illness. Front Physiol 2020; 11:358. [PMID: 32411011 PMCID: PMC7198798 DOI: 10.3389/fphys.2020.00358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/27/2020] [Indexed: 11/13/2022] Open
Abstract
Potentially linked to the basic physiology of stress response, Gulf War Illness (GWI) is a debilitating condition presenting with complex immune, endocrine and neurological symptoms. Here we interrogate the immune response to physiological stress by measuring 16 blood-borne immune markers at 8 time points before, during and after maximum exercise challenge in n = 12 GWI veterans and n = 11 healthy veteran controls deployed to the same theater. Immune markers were combined into functional sets and the dynamics of their joint expression described as classical rate equations. These empirical networks were further informed structurally by projection onto prior knowledge networks mined from the literature. Of the 49 literature-informed immune signaling interactions, 21 were found active in the combined exercise response data. However, only 4 signals were common to both subject groups while 7 were uniquely active in GWI and 10 uniquely active in healthy veterans. Feedforward mediation of IL-23 and IL-17 by IL-6 and IL-10 emerged as distinguishing control elements that were characteristically active in GWI versus healthy subjects. Simulated restructuring of the regulatory circuitry in GWI as a result of applying an IL-6 receptor antagonist in combination with either a Th1 (IL-2, IFNγ, and TNFα) or IL-23 receptor antagonist predicted a partial rescue of immune response elements previously associated with illness severity. Overall, results suggest that pharmacologically altering the topology of the immune response circuitry identified as active in GWI can inform on strategies that while not curative, may nonetheless deliver a reduction in symptom burden. A lasting and more complete remission in GWI may therefore require manipulation of a broader physiology, namely one that includes endocrine oversight of immune function.
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Affiliation(s)
- Saurabh Vashishtha
- Department of Medicine, University of Alberta, Edmonton, AB, Canada.,Center for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, United States
| | - Gordon Broderick
- Center for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, United States.,Department of Biomedical Engineering, Kate Gleason College of Engineering, Rochester Institute of Technology, Rochester, NY, United States
| | - Travis J A Craddock
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States.,Departments of Psychology & Neuroscience, Computer Science and Clinical Immunology, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Zachary M Barnes
- Diabetes Research Institute, University of Miami, Miami, FL, United States.,Miami Veterans Affairs Medical Center, Miami, FL, United States
| | - Fanny Collado
- Miami Veterans Affairs Medical Center, Miami, FL, United States
| | - Elizabeth G Balbin
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States.,Miami Veterans Affairs Medical Center, Miami, FL, United States
| | - Mary Ann Fletcher
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States.,Departments of Psychology & Neuroscience, Computer Science and Clinical Immunology, Nova Southeastern University, Fort Lauderdale, FL, United States.,Miami Veterans Affairs Medical Center, Miami, FL, United States
| | - Nancy G Klimas
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States.,Departments of Psychology & Neuroscience, Computer Science and Clinical Immunology, Nova Southeastern University, Fort Lauderdale, FL, United States.,Miami Veterans Affairs Medical Center, Miami, FL, United States
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14
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Jaundoo R, Craddock TJA. DRUGPATH: The Drug Gene Pathway Meta-Database. Int J Mol Sci 2020; 21:E3171. [PMID: 32365960 PMCID: PMC7246871 DOI: 10.3390/ijms21093171] [Citation(s) in RCA: 2] [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: 02/29/2020] [Revised: 04/10/2020] [Accepted: 04/21/2020] [Indexed: 01/10/2023] Open
Abstract
The complexity of modern-day diseases often requires drug treatment therapies consisting of multiple pharmaceutical interventions, which can lead to adverse drug reactions for patients. A priori prediction of these reactions would not only improve the quality of life for patients but also save both time and money in regards to pharmaceutical research. Consequently, the drug-gene-pathway (DRUGPATH) meta-database was developed to map known interactions between drugs, genes, and pathways among other information in order to easily identify potential adverse drug events. DRUGPATH utilizes expert-curated sources such as PharmGKB, DrugBank, and the FDA's NDC database to identify known as well as previously unknown/overlooked relationships, and currently contains 12,940 unique drugs, 3933 unique pathways, 5185 unique targets, and 3662 unique genes. Moreover, there are 59,561 unique drug-gene interactions, 77,808 unique gene-pathway interactions, and over 1 million unique drug-pathway interactions.
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Affiliation(s)
- Rajeev Jaundoo
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Travis J. A. Craddock
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Fort Lauderdale, FL 33313, USA
- Departments of Psychology and Neuroscience, Computer Science, and Clinical Immunology, Nova Southeastern University, Fort Lauderdale, FL 33313, USA
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15
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Jaundoo R, Bohmann J, Gutierrez GE, Klimas N, Broderick G, Craddock TJA. Towards a Treatment for Gulf War Illness: A Consensus Docking Approach. Mil Med 2020; 185:554-561. [PMID: 32074351 PMCID: PMC7029833 DOI: 10.1093/milmed/usz299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 12/24/2022] Open
Abstract
Introduction Gulf War Illness (GWI) currently has no known cure and affects soldiers deployed during the Persian Gulf War. It is thought to originate from exposure to neurotoxicants combined with battlefield stress, and previous research indicates that treatment first involves inhibition of interleukin-2 and tumor necrosis factor alpha, followed by the glucocorticoid receptor. However, the off-target effects of pharmaceuticals hinder development of a drug treatment therapy. Materials and Methods AutoDock 4.2, AutoDock Vina, and Schrodinger’s Glide were used to perform consensus docking, a computational technique where pharmaceuticals are screened against targets using multiple scoring algorithms to obtain consistent binding affinities. FDA approved pharmaceuticals were docked against the above-mentioned immune and stress targets to determine a drug therapy for GWI. Additionally, the androgen and estrogen targets were screened to avoid pharmaceuticals with off-target interactions. Results While suramin bound to both immune targets with high affinity, top binders of the hormonal and glucocorticoid targets were non-specific towards their respective proteins, possibly due to high structure similarity between these proteins. Conclusions Development of a drug treatment therapy for GWI is threatened by the tight interplay between the immune and hormonal systems, often leading to drug interactions. Increasing knowledge of these interactions can lead to break-through therapies.
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Affiliation(s)
- Rajeev Jaundoo
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Department of Psychology & Neuroscience, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Department of Clinical Immunology, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796
| | - Jonathan Bohmann
- Pharmaceuticals and Bioengineering Department, Southwest Research Institute, 6220 Culebra Road, San Antonio, TX 78238-5166
| | - Gloria E Gutierrez
- Pharmaceuticals and Bioengineering, Chemistry and Chemical Engineering Division, Southwest Research Institute, 6220 Culebra Road, San Antonio, TX 78238-5166
| | - Nancy Klimas
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Department of Clinical Immunology, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Miami Veterans Affairs Medical Center, 1201 N.W. 16th Street, Miami, FL 33125
| | - Gordon Broderick
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Department of Psychology & Neuroscience, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Department of Clinical Immunology, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Rochester Institute of Technology, One Lomb Memorial Drive, Rochester, NY 14623-5603.,Centre for Clinical Systems Biology, Rochester General Hospital Research Institute, 100 Kings Highway South, Rochester, NY 14617
| | - Travis J A Craddock
- Institute for Neuro-Immune Medicine, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Department of Psychology & Neuroscience, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Department of Clinical Immunology, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796.,Department of Computer Science, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314-7796
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16
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Chester JE, Rowneki M, Van Doren W, Helmer DA. Progression of intervention-focused research for Gulf War illness. Mil Med Res 2019; 6:31. [PMID: 31627737 PMCID: PMC6798371 DOI: 10.1186/s40779-019-0221-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/11/2019] [Indexed: 01/06/2023] Open
Abstract
The Persian Gulf War of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle East. Deployment-related exposures to toxic substances such as pesticides, nerve agents, pyridostigmine bromide (PB), smoke from burning oil wells, and petrochemicals may have contributed to medical illness in as many as 250,000 of those American troops. The cluster of chronic symptoms, now referred to as Gulf War Illness (GWI), has been studied by many researchers over the past two decades. Although over $500 million has been spent on GWI research, to date, no cures or condition-specific treatments have been discovered, and the exact pathophysiology remains elusive.Using the 2007 National Institute of Health (NIH) Roadmap for Medical Research model as a reference framework, we reviewed studies of interventions involving GWI patients to assess the progress of treatment-related GWI research. All GWI clinical trial studies reviewed involved investigations of existing interventions that have shown efficacy in other diseases with analogous symptoms. After reviewing the published and ongoing registered clinical trials for cognitive-behavioral therapy, exercise therapy, acupuncture, coenzyme Q10, mifepristone, and carnosine in GWI patients, we identified only four treatments (cognitive-behavioral therapy, exercise therapy, CoQ10, and mifepristone) that have progressed beyond a phase II trial.We conclude that progress in the scientific study of therapies for GWI has not followed the NIH Roadmap for Medical Research model. Establishment of a standard case definition, prioritized GWI research funding for the characterization of the pathophysiology of the condition, and rapid replication and adaptation of early phase, single site clinical trials could substantially advance research progress and treatment discovery for this condition.
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Affiliation(s)
- Jeremy E Chester
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, 385 Tremont Avenue, East Orange, NJ, 07018, USA.
- War Related Illness and Injury Study Center, Veterans Affairs Medical Center, 50 Irving St., Washington, DC, NW, 20422, USA.
| | - Mazhgan Rowneki
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, 385 Tremont Avenue, East Orange, NJ, 07018, USA
| | - William Van Doren
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, 385 Tremont Avenue, East Orange, NJ, 07018, USA
| | - Drew A Helmer
- War Related Illness and Injury Study Center, Veterans Affairs New Jersey Healthcare System, 385 Tremont Avenue, East Orange, NJ, 07018, USA
- Rutgers University, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
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17
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Joshi U, Pearson A, Evans JE, Langlois H, Saltiel N, Ojo J, Klimas N, Sullivan K, Keegan AP, Oberlin S, Darcey T, Cseresznye A, Raya B, Paris D, Hammock B, Vasylieva N, Hongsibsong S, Stern LJ, Crawford F, Mullan M, Abdullah L. A permethrin metabolite is associated with adaptive immune responses in Gulf War Illness. Brain Behav Immun 2019; 81:545-559. [PMID: 31325531 PMCID: PMC7155744 DOI: 10.1016/j.bbi.2019.07.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/17/2019] [Accepted: 07/11/2019] [Indexed: 10/31/2022] Open
Abstract
Gulf War Illness (GWI), affecting 30% of veterans from the 1991 Gulf War (GW), is a multi-symptom illness with features similar to those of patients with autoimmune diseases. The objective of the current work is to determine if exposure to GW-related pesticides, such as permethrin (PER), activates peripheral and central nervous system (CNS) adaptive immune responses. In the current study, we focused on a PER metabolite, 3-phenoxybenzoic acid (3-PBA), as this is a common metabolite previously shown to form adducts with endogenous proteins. We observed the presence of 3-PBA and 3-PBA modified lysine of protein peptides in the brain, blood and liver of pyridostigmine bromide (PB) and PER (PB+PER) exposed mice at acute and chronic post-exposure timepoints. We tested whether 3-PBA-haptenated albumin (3-PBA-albumin) can activate immune cells since it is known that chemically haptenated proteins can stimulate immune responses. We detected autoantibodies against 3-PBA-albumin in plasma from PB + PER exposed mice and veterans with GWI at chronic post-exposure timepoints. We also observed that in vitro treatment of blood with 3-PBA-albumin resulted in the activation of B- and T-helper lymphocytes and that these immune cells were also increased in blood of PB + PER exposed mice and veterans with GWI. These immune changes corresponded with elevated levels of infiltrating monocytes in the brain and blood of PB + PER exposed mice which coincided with alterations in the markers of blood-brain barrier disruption, brain macrophages and neuroinflammation. These studies suggest that pesticide exposure associated with GWI may have resulted in the activation of the peripheral and CNS adaptive immune responses, possibly contributing to an autoimmune-type phenotype in veterans with GWI.
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Affiliation(s)
- Utsav Joshi
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,Open University, Milton Keynes, UK,James A. Haley VA Hospital, Tampa, FL, USA
| | - Andrew Pearson
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,Open University, Milton Keynes, UK,James A. Haley VA Hospital, Tampa, FL, USA
| | - James E. Evans
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,James A. Haley VA Hospital, Tampa, FL, USA
| | - Heather Langlois
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,James A. Haley VA Hospital, Tampa, FL, USA
| | - Nicole Saltiel
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,James A. Haley VA Hospital, Tampa, FL, USA
| | - Joseph Ojo
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,Open University, Milton Keynes, UK,James A. Haley VA Hospital, Tampa, FL, USA
| | - Nancy Klimas
- NOVA Southeastern University, Ft. Lauderdale, FL, USA,Miami VAMC, Miami, FL, USA
| | | | | | - Sarah Oberlin
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,James A. Haley VA Hospital, Tampa, FL, USA
| | - Teresa Darcey
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,James A. Haley VA Hospital, Tampa, FL, USA
| | - Adam Cseresznye
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,James A. Haley VA Hospital, Tampa, FL, USA
| | - Balaram Raya
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,James A. Haley VA Hospital, Tampa, FL, USA
| | - Daniel Paris
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,Open University, Milton Keynes, UK,James A. Haley VA Hospital, Tampa, FL, USA
| | - Bruce Hammock
- Department of Entomology and Nematology, UCD Comprehensive Cancer Center, University of California Davis, Davis, CA, USA
| | - Natalia Vasylieva
- Department of Entomology and Nematology, UCD Comprehensive Cancer Center, University of California Davis, Davis, CA, USA
| | - Surat Hongsibsong
- Environment and Health Research Unit, Research Institute for Health Science, Chiang Mai University, Chiang, Thailand
| | - Lawrence J. Stern
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, MA, USA,Department of Pathology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Fiona Crawford
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,Open University, Milton Keynes, UK,James A. Haley VA Hospital, Tampa, FL, USA
| | - Michael Mullan
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA,Open University, Milton Keynes, UK,James A. Haley VA Hospital, Tampa, FL, USA
| | - Laila Abdullah
- Roskamp Institute, 2040 Whitfield Ave, Sarasota, FL, USA; Open University, Milton Keynes, UK; James A. Haley VA Hospital, Tampa, FL, USA.
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18
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Sedghamiz H, Morris M, Whitley D, Craddock TJA, Pichichero M, Broderick G. Computation of Robust Minimal Intervention Sets in Multi-Valued Biological Regulatory Networks. Front Physiol 2019; 10:241. [PMID: 30941053 PMCID: PMC6433979 DOI: 10.3389/fphys.2019.00241] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/25/2019] [Indexed: 02/06/2023] Open
Abstract
Enabled by rapid advances in computational sciences, in silico logical modeling of complex and large biological networks is more and more feasible making it an increasingly popular approach among biologists. Automated high-throughput, drug target identification is one of the primary goals of this in silico network biology. Targets identified in this way are then used to mine a library of drug chemical compounds in order to identify appropriate therapies. While identification of drug targets is exhaustively feasible on small networks, it remains computationally difficult on moderate and larger models. Moreover, there are several important constraints such as off-target effects, efficacy and safety that should be integrated into the identification of targets if the intention is translation to the clinical space. Here we introduce numerical constraints whereby efficacy is represented by efficiency in response and robustness of outcome. This paper introduces an algorithm that relies on a Constraint Satisfaction (CS) technique to efficiently compute the Minimal Intervention Sets (MIS) within a set of often complex clinical safety constraints with the aim of identifying the smallest least invasive set of targets pharmacologically accessible for therapy that most efficiently and reliably achieve the desired outcome.
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Affiliation(s)
- Hooman Sedghamiz
- Center for Clinical Systems Biology, Rochester General Hospital Research Institute, Rochester, NY, United States
| | - Matthew Morris
- Center for Clinical Systems Biology, Rochester General Hospital Research Institute, Rochester, NY, United States
| | - Darrell Whitley
- School of Computer Science, Colorado State University, Fort Collins, CO, United States
| | - Travis J A Craddock
- Department of Psychology and Neuroscience, Nova Southeastern University, Fort Lauderdale, FL, United States.,Department of Computer Science, Nova Southeastern University, Fort Lauderdale, FL, United States.,Department of Clinical Immunology, Nova Southeastern University, Fort Lauderdale, FL, United States.,Clinical Systems Biology Group, Institute for NeuroImmune Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Michael Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY, United States
| | - Gordon Broderick
- Center for Clinical Systems Biology, Rochester General Hospital Research Institute, Rochester, NY, United States.,Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, NY, United States
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19
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Jeffrey MG, Nathanson L, Aenlle K, Barnes ZM, Baig M, Broderick G, Klimas NG, Fletcher MA, Craddock TJA. Treatment Avenues in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Split-gender Pharmacogenomic Study of Gene-expression Modules. Clin Ther 2019; 41:815-835.e6. [PMID: 30851951 DOI: 10.1016/j.clinthera.2019.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/09/2019] [Accepted: 01/18/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multisymptom illness impacting up to 1 million people in the United States. As the pathogenesis and etiology of this complex condition are unclear, prospective treatments are limited. Identifying US Food and Drug Administration-approved drugs that may be repositioned as treatments for ME/CFS may offer a rapid and cost-effective solution. METHODS Here we used gene-expression data from 33 patients with Fukuda-defined ME/CFS (23 females, 10 males) and 21 healthy demographically comparable controls (15 females, 6 males) to identify differential expression of predefined gene-module sets based on nonparametric statistics. Differentially expressed gene modules were then annotated via over-representation analysis using the Consensus Pathway database. Differentially expressed modules were then regressed onto measures of fatigue and cross-referenced with drug atlas and pharmacogenomics databases to identify putative treatment agents. FINDINGS The top 1% of modules identified in males indicated small effect sizes in modules associated with immune regulation and mitochondrial dysfunction. In females, modules identified included those related to immune factors and cardiac/blood factors, returning effect sizes ranging from very small to intermediate (0.147 < Cohen δ < 0.532). Regression analysis indicated that B-cell receptors, T-cell receptors, tumor necrosis factor α, transforming growth factor β, and metabolic and cardiac modules were strongly correlated with multiple composite measures of fatigue. Cross-referencing identified genes with pharmacogenomics data indicated immunosuppressants as potential treatments of ME/CFS symptoms. IMPLICATIONS The findings from our analysis suggest that ME/CFS symptoms are perpetuated by immune dysregulation that may be approached via immune modulation-based treatment strategies.
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Affiliation(s)
- Mary G Jeffrey
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; College of Psychology, Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Lubov Nathanson
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Kristina Aenlle
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, USA; Miami Veterans Affairs Medical Center, Miami, FL, USA
| | - Zachary M Barnes
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; Miami Veterans Affairs Medical Center, Miami, FL, USA; Miller School of Medicine, University of Miami, Miami, FL, USA; Diabetes Research Institute, University of Miami, Miami, FL, USA
| | - Mirza Baig
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Gordon Broderick
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; College of Psychology, Nova Southeastern University, Ft. Lauderdale, FL, USA; Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, USA; Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Center for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, USA
| | - Nancy G Klimas
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; College of Psychology, Nova Southeastern University, Ft. Lauderdale, FL, USA; Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Mary Ann Fletcher
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, USA; Miami Veterans Affairs Medical Center, Miami, FL, USA
| | - Travis J A Craddock
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; College of Psychology, Nova Southeastern University, Ft. Lauderdale, FL, USA; Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, USA; Department of Computer Science, Nova Southeastern University, Ft. Lauderdale, FL, USA.
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Michalovicz LT, Locker AR, Kelly KA, Miller JV, Barnes Z, Fletcher MA, Miller DB, Klimas NG, Morris M, Lasley SM, O'Callaghan JP. Corticosterone and pyridostigmine/DEET exposure attenuate peripheral cytokine expression: Supporting a dominant role for neuroinflammation in a mouse model of Gulf War Illness. Neurotoxicology 2019; 70:26-32. [PMID: 30339781 PMCID: PMC6533534 DOI: 10.1016/j.neuro.2018.10.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/24/2018] [Accepted: 10/11/2018] [Indexed: 01/16/2023]
Abstract
Gulf War Illness (GWI) is a chronic multi-symptom disorder experienced by as many as a third of the veterans of the 1991 Gulf War; the constellation of "sickness behavior" symptoms observed in ill veterans is suggestive of a neuroimmune involvement. Various chemical exposures and conditions in theater have been implicated in the etiology of the illness. Previously, we found that GW-related organophosphates (OPs), such as the sarin surrogate, DFP, and chlorpyrifos, cause neuroinflammation. The combination of these exposures with exogenous corticosterone (CORT), mimicking high physiological stress, exacerbates the observed neuroinflammation. The potential relationship between the effects of OPs and CORT on the brain versus inflammation in the periphery has not been explored. Here, using our established GWI mouse model, we investigated the effects of CORT and DFP exposure, with or without a chronic application of pyridostigmine bromide (PB) and N,N-diethyl-meta-toluamide (DEET), on cytokines in the liver and serum. While CORT primed DFP-induced neuroinflammation, this effect was largely absent in the periphery. Moreover, the changes found in the peripheral tissues do not correlate with the previously reported neuroinflammation. These results not only support GWI as a neuroimmune disorder, but also highlight the separation between central and peripheral effects of these exposures.
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Affiliation(s)
- Lindsay T Michalovicz
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Alicia R Locker
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Kimberly A Kelly
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Julie V Miller
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Zachary Barnes
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; Miami Veterans Affairs Medical Center, Miami, FL, USA
| | - Mary Ann Fletcher
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; Miami Veterans Affairs Medical Center, Miami, FL, USA
| | - Diane B Miller
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Nancy G Klimas
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA; Miami Veterans Affairs Medical Center, Miami, FL, USA
| | - Mariana Morris
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Stephen M Lasley
- Department of Cancer Biology & Pharmacology, University of Illinois College of Medicine at Peoria, Peoria, IL, USA
| | - James P O'Callaghan
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA.
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21
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Using a Consensus Docking Approach to Predict Adverse Drug Reactions in Combination Drug Therapies for Gulf War Illness. Int J Mol Sci 2018; 19:ijms19113355. [PMID: 30373189 PMCID: PMC6274917 DOI: 10.3390/ijms19113355] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/01/2018] [Accepted: 10/16/2018] [Indexed: 12/23/2022] Open
Abstract
Gulf War Illness (GWI) is a chronic multisymptom illness characterized by fatigue, musculoskeletal pain, and gastrointestinal and cognitive dysfunction believed to stem from chemical exposures during the 1990⁻1991 Persian Gulf War. There are currently no treatments; however, previous studies have predicted a putative multi-intervention treatment composed of inhibiting Th1 immune cytokines followed by inhibition of the glucocorticoid receptor (GCR) to treat GWI. These predictions suggest the use of specific monoclonal antibodies or suramin to target interleukin-2 and tumor necrosis factor α , followed by mifepristone to inhibit the GCR. In addition to this putative treatment strategy, there exist a variety of medications that target GWI symptomatology. As pharmaceuticals are promiscuous molecules, binding to multiple sites beyond their intended targets, leading to off-target interactions, it is key to ensure that none of these medications interfere with the proposed treatment avenue. Here, we used the drug docking programs AutoDock 4.2, AutoDock Vina, and Schrödinger's Glide to assess the potential off-target immune and hormone interactions of 43 FDA-approved drugs commonly used to treat GWI symptoms in order to determine their putative polypharmacology and minimize adverse drug effects in a combined pharmaceutical treatment. Several of these FDA-approved drugs were predicted to be novel binders of immune and hormonal targets, suggesting caution for their use in the proposed GWI treatment strategy symptoms.
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22
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Craddock TJA, Michalovicz LT, Kelly KA, Rice MA, Miller DB, Klimas NG, Morris M, O'Callaghan JP, Broderick G. A Logic Model of Neuronal-Glial Interaction Suggests Altered Homeostatic Regulation in the Perpetuation of Neuroinflammation. Front Cell Neurosci 2018; 12:336. [PMID: 30374291 PMCID: PMC6196274 DOI: 10.3389/fncel.2018.00336] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/12/2018] [Indexed: 11/21/2022] Open
Abstract
Aberrant inflammatory signaling between neuronal and glial cells can develop into a persistent sickness behavior-related disorders, negatively impacting learning, memory, and neurogenesis. While there is an abundance of literature describing these interactions, there still lacks a comprehensive mathematical model describing the complex feed-forward and feedback mechanisms of neural-glial interaction. Here we compile molecular and cellular signaling information from various studies and reviews in the literature to create a logically-consistent, theoretical model of neural-glial interaction in the brain to explore the role of neuron-glia homeostatic regulation in the perpetuation of neuroinflammation. Logic rules are applied to this connectivity diagram to predict the system's homeostatic behavior. We validate our model predicted homeostatic profiles against RNAseq gene expression profiles in a mouse model of stress primed neuroinflammation. A meta-analysis was used to calculate the significance of similarity between the inflammatory profiles of mice exposed to diisopropyl fluorophostphate (DFP) [with and without prior priming by the glucocorticoid stress hormone corticosterone (CORT)], with the equilibrium states predicted by the model, and to provide estimates of the degree of the neuroinflammatory response. Beyond normal homeostatic regulation, our model predicts an alternate self-perpetuating condition consistent with chronic neuroinflammation. RNAseq gene expression profiles from the cortex of mice exposed to DFP and CORT+DFP align with this predicted state of neuroinflammation, whereas the alignment to CORT alone was negligible. Simulations of putative treatment strategies post-exposure were shown to be theoretically capable of returning the system to a state of typically healthy regulation with broad-acting anti-inflammatory agents showing the highest probability of success. The results support a role for the brain's own homeostatic drive in perpetuating the chronic neuroinflammation associated with exposure to the organophosphate DFP, with and without CORT priming. The deviation of illness profiles from exact model predictions suggests the presence of additional factors or of lasting changes to the brain's regulatory circuitry specific to each exposure.
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Affiliation(s)
- Travis J A Craddock
- Department of Psychology & Neuroscience, Nova Southeastern University, Ft. Lauderdale, FL, United States.,Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States.,Department of Computer Science, Nova Southeastern University, Ft. Lauderdale, FL, United States.,Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Lindsay T Michalovicz
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Kimberly A Kelly
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Mark A Rice
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Diane B Miller
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Nancy G Klimas
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States.,Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, United States.,Miami Veterans Affairs Medical Center, Miami, FL, United States
| | - Mariana Morris
- Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States.,Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - James P O'Callaghan
- Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, United States
| | - Gordon Broderick
- Department of Psychology & Neuroscience, Nova Southeastern University, Ft. Lauderdale, FL, United States.,Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States.,Center for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, United States
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23
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Oleoylethanolamide treatment reduces neurobehavioral deficits and brain pathology in a mouse model of Gulf War Illness. Sci Rep 2018; 8:12921. [PMID: 30150699 PMCID: PMC6110778 DOI: 10.1038/s41598-018-31242-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 08/15/2018] [Indexed: 12/12/2022] Open
Abstract
There are nearly 250,000 Gulf War (GW) veterans who suffer from Gulf War Illness (GWI), a multi-symptom condition that remains untreatable. The main objective was to determine if targeting peroxisomal function could be of therapeutic value in GWI. We performed a pilot study that showed accumulation of very long chain fatty acids (VLCFA), which are metabolized in peroxisomes, in plasma from veterans with GWI. We then examined if targeting peroxisomal β-oxidation with oleoylethanolamide (OEA) restores these lipids to the normal levels and mitigates neuroinflammation and neurobehavioral deficits in a well-established mouse model of GWI. In GWI mice, treatment with OEA corresponded with cognitive benefits and reduced fatigue and disinhibition-like behavior in GWI mice. Biochemical and molecular analysis of the brain tissue showed reduced astroglia and microglia staining, decreased levels of chemokines and cytokines, and decreased NFκB phosphorylation. Treatment with OEA reduced accumulation of peroxisome specific VLCFA in the brains of GWI mice. These studies further support the translational value of targeting peroxisomes. We expect that OEA may be a potential therapy for treating neurobehavioral symptoms and the underlying lipid dysfunction and neuroinflammation associated with GWI. Oleoylethanolamide is available as a dietary supplement, making it appealing for human translational studies.
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O'Callaghan JP, Michalovicz LT, Miller JV, Kelly KA. Advancing the Role of Neuroimmunity and Genetic Susceptibility in Gulf War Illness. EBioMedicine 2017; 26:11-12. [PMID: 29239837 PMCID: PMC5832621 DOI: 10.1016/j.ebiom.2017.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 11/21/2017] [Indexed: 11/28/2022] Open
Affiliation(s)
- James P O'Callaghan
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Morgantown, WV, United States.
| | - Lindsay T Michalovicz
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Morgantown, WV, United States
| | - Julie V Miller
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Morgantown, WV, United States
| | - Kimberly A Kelly
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Morgantown, WV, United States
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25
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Johnson GJ, Slater BCS, Leis LA, Rector TS, Bach RR. Blood Biomarkers of Chronic Inflammation in Gulf War Illness. PLoS One 2016; 11:e0157855. [PMID: 27352030 PMCID: PMC4924830 DOI: 10.1371/journal.pone.0157855] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 06/06/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND More than twenty years following the end of the 1990-1991 Gulf War it is estimated that approximately 300,000 veterans of this conflict suffer from an unexplained chronic, multi-system disorder known as Gulf War Illness (GWI). The etiology of GWI may be exposure to chemical toxins, but it remains only partially defined, and its case definition is based only on symptoms. Objective criteria for the diagnosis of GWI are urgently needed for diagnosis and therapeutic research. OBJECTIVE This study was designed to determine if blood biomarkers could provide objective criteria to assist diagnosis of GWI. DESIGN A surveillance study of 85 Gulf War Veteran volunteers identified from the Department of Veterans Affairs Minnesota Gulf War registry was performed. All subjects were deployed to the Gulf War. Fifty seven subjects had GWI defined by CDC criteria, and 28 did not have symptomatic criteria for a diagnosis of GWI. Statistical analyses were performed on peripheral blood counts and assays of 61 plasma proteins using the Mann-Whitney rank sum test to compare biomarker distributions and stepwise logistic regression to formulate a diagnostic model. RESULTS Lymphocyte, monocyte, neutrophil, and platelet counts were higher in GWI subjects. Six serum proteins associated with inflammation were significantly different in GWI subjects. A diagnostic model of three biomarkers-lymphocytes, monocytes, and C reactive protein-had a predicted probability of 90% (CI 76-90%) for diagnosing GWI when the probability of having GWI was above 70%. SIGNIFICANCE The results of the current study indicate that inflammation is a component of the pathobiology of GWI. Analysis of the data resulted in a model utilizing three readily measurable biomarkers that appears to significantly augment the symptom-based case definition of GWI. These new observations are highly relevant to the diagnosis of GWI, and to therapeutic trials.
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Affiliation(s)
- Gerhard J. Johnson
- Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, 55417, United States of America
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, 55455, United States of America
| | - Billie C. S. Slater
- Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, 55417, United States of America
| | - Linda A. Leis
- Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, 55417, United States of America
| | - Thomas S. Rector
- Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, 55417, United States of America
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, 55455, United States of America
| | - Ronald R. Bach
- Department of Veterans Affairs Health Care System, Minneapolis, Minnesota, 55417, United States of America
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, 55455, United States of America
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