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Tyus D, Leslie JL, Naz F, Uddin MJ, Thompson B, Petri WA. The sympathetic nervous system drives hyperinflammatory responses to Clostridioides difficile infection. Cell Rep Med 2024:101771. [PMID: 39368481 DOI: 10.1016/j.xcrm.2024.101771] [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: 05/31/2024] [Revised: 07/30/2024] [Accepted: 09/13/2024] [Indexed: 10/07/2024]
Abstract
Clostridioides difficile infection (CDI) is a leading cause of hospital-acquired infections in the United States, known for triggering severe disease by hyperactivation of the host response. In this study, we determine the impact of the sympathetic nervous system (SNS) on CDI disease severity. Mouse models of CDI are administered inhibitors of SNS activity prior to CDI. Chemical sympathectomy or pharmacological inhibition of norepinephrine synthesis greatly reduces mortality and disease severity in the CDI model. Pharmacological blockade or genetic ablation of the alpha 2 adrenergic receptor ameliorates intestinal inflammation, disease severity, and mortality rate. These results underscore the role of the SNS and the alpha 2 adrenergic receptor in CDI pathogenesis and suggest that targeting neural systems could be a promising approach to therapy in severe disease.
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Affiliation(s)
- David Tyus
- Neuroscience Graduate Program, University of Virginia Health System, Charlottesville, VA 22908, USA
| | - Jhansi L Leslie
- Division of Infectious Disease and International Health, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Farha Naz
- Division of Infectious Disease and International Health, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Md Jashim Uddin
- Division of Infectious Disease and International Health, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Brandon Thompson
- Departments of Medicine, Pathology, Microbiology, Immunology and Cancer Biology, University of Virginia Health System, Charlottesville, VA 22908, USA; Division of Infectious Disease and International Health, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - William A Petri
- Neuroscience Graduate Program, University of Virginia Health System, Charlottesville, VA 22908, USA; Departments of Medicine, Pathology, Microbiology, Immunology and Cancer Biology, University of Virginia Health System, Charlottesville, VA 22908, USA; Division of Infectious Disease and International Health, University of Virginia School of Medicine, Charlottesville, VA 22908, USA.
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2
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Hamilton JL, Baccile R, Best TJ, Desai P, Landay A, Rojas JC, Wimmer MA, Balk RA. Association between Dexmedetomidine Use and Mortality in Patients with COVID-19 Receiving Invasive Mechanical Ventilation: A U.S. National COVID Cohort Collaborative (N3C) Study. J Clin Med 2024; 13:3429. [PMID: 38929961 PMCID: PMC11204330 DOI: 10.3390/jcm13123429] [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: 04/16/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background/Objectives: Dexmedetomidine is a sedative for patients receiving invasive mechanical ventilation (IMV) that previous single-site studies have found to be associated with improved survival in patients with COVID-19. The reported clinical benefits include dampened inflammatory response, reduced respiratory depression, reduced agitation and delirium, improved preservation of responsiveness and arousability, and improved hypoxic pulmonary vasoconstriction and ventilation-perfusion ratio. Whether improved mortality is evident in large, multi-site COVID-19 data is understudied. (2) Methods: The association between dexmedetomidine use and mortality in patients with COVID-19 receiving IMV was assessed. This retrospective multi-center cohort study utilized patient data in the United States from health systems participating in the National COVID Cohort Collaborative (N3C) from 1 January 2020 to 3 November 2022. The primary outcome was 28-day mortality rate from the initiation of IMV. Propensity score matching adjusted for differences between the group with and without dexmedetomidine use. Adjusted hazard ratios (aHRs) for 28-day mortality were calculated using multivariable Cox proportional hazards models with dexmedetomidine use as a time-varying covariate. (3) Results: Among the 16,357,749 patients screened, 3806 patients across 17 health systems met the study criteria. Mortality was lower with dexmedetomidine use (aHR, 0.81; 95% CI, 0.73-0.90; p < 0.001). On subgroup analysis, mortality was lower with earlier dexmedetomidine use-initiated within the median of 3.5 days from the start of IMV-(aHR, 0.67; 95% CI, 0.60-0.76; p < 0.001) as well as use prior to standard, widespread use of dexamethasone for patients on respiratory support (prior to 30 July 2020) (aHR, 0.54; 95% CI, 0.42-0.69; p < 0.001). In a secondary model that was restricted to 576 patients across six health system sites with available PaO2/FiO2 data, mortality was not lower with dexmedetomidine use (aHR 0.95, 95% CI, 0.72-1.25; p = 0.73); however, on subgroup analysis, mortality was lower with dexmedetomidine use initiated earlier than the median dexmedetomidine start time after IMV (aHR, 0.72; 95% CI, 0.53-0.98; p = 0.04) and use prior to 30 July 2020 (aHR, 0.22; 95% CI, 0.06-0.78; p = 0.02). (4) Conclusions: Dexmedetomidine use was associated with reduced mortality in patients with COVID-19 receiving IMV, particularly when initiated earlier, rather than later, during the course of IMV as well as use prior to the standard, widespread usage of dexamethasone during respiratory support. These particular findings might suggest that the associated mortality benefit with dexmedetomidine use is tied to immunomodulation. However, further research including a large randomized controlled trial is warranted to evaluate the potential mortality benefit of DEX use in COVID-19 and evaluate the physiologic changes influenced by DEX that may enhance survival.
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Affiliation(s)
- John L. Hamilton
- Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA; (P.D.); (A.L.); (J.C.R.); (M.A.W.)
| | - Rachel Baccile
- Center for Health and the Social Sciences, University of Chicago, Chicago, IL 60637, USA; (R.B.); (T.J.B.)
| | - Thomas J. Best
- Center for Health and the Social Sciences, University of Chicago, Chicago, IL 60637, USA; (R.B.); (T.J.B.)
| | - Pankaja Desai
- Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA; (P.D.); (A.L.); (J.C.R.); (M.A.W.)
| | - Alan Landay
- Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA; (P.D.); (A.L.); (J.C.R.); (M.A.W.)
| | - Juan C. Rojas
- Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA; (P.D.); (A.L.); (J.C.R.); (M.A.W.)
| | - Markus A. Wimmer
- Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA; (P.D.); (A.L.); (J.C.R.); (M.A.W.)
| | - Robert A. Balk
- Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA; (P.D.); (A.L.); (J.C.R.); (M.A.W.)
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3
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Alexa AL, Sargarovschi S, Ionescu D. Neutrophils and Anesthetic Drugs: Implications in Onco-Anesthesia. Int J Mol Sci 2024; 25:4033. [PMID: 38612841 PMCID: PMC11012681 DOI: 10.3390/ijms25074033] [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: 02/12/2024] [Revised: 03/24/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
Apart from being a significant line of defense in the host defense system, neutrophils have many immunological functions. Although there are not many publications that accurately present the functions of neutrophils in relation to oncological pathology, their activity and implications have been studied a lot recently. This review aims to extensively describe neutrophils functions'; their clinical implications, especially in tumor pathology; the value of clinical markers related to neutrophils; and the implications of neutrophils in onco-anesthesia. This review also aims to describe current evidence on the influence of anesthetic drugs on neutrophils' functions and their potential influence on perioperative outcomes.
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Affiliation(s)
- Alexandru Leonard Alexa
- Department of Anesthesia and Intensive Care I, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (S.S.); (D.I.)
- Association for Research in Anesthesia and Intensive Care (ACATI), 400162 Cluj-Napoca, Romania
- Onco-Anaesthesia Research Group, ESAIC, 1000 Brussels, Belgium
| | - Sergiu Sargarovschi
- Department of Anesthesia and Intensive Care I, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (S.S.); (D.I.)
- Association for Research in Anesthesia and Intensive Care (ACATI), 400162 Cluj-Napoca, Romania
| | - Daniela Ionescu
- Department of Anesthesia and Intensive Care I, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (S.S.); (D.I.)
- Association for Research in Anesthesia and Intensive Care (ACATI), 400162 Cluj-Napoca, Romania
- Onco-Anaesthesia Research Group, ESAIC, 1000 Brussels, Belgium
- Outcome Research Consortium, Cleveland, OH 44195, USA
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Mauro AK, Clemente L, Khurshid N, Shah DM, Zheng J, Boeldt DS. Src kinase partially mediates cytokine-induced endothelial dysfunction. Pregnancy Hypertens 2023; 34:83-89. [PMID: 37864990 PMCID: PMC10873000 DOI: 10.1016/j.preghy.2023.10.004] [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: 05/11/2023] [Revised: 08/24/2023] [Accepted: 10/06/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES Endothelial dysfunction is known to be a key characteristic of preeclampsia (PE) and can contribute to progression of symptoms and injury to multiple organ systems. Delivery is the only treatment for progression of PE, but development of an endothelial-based therapy for PE presents a promising strategy. Growth factors and cytokines are dysregulated in PE and can impact endothelial function, manifesting changes in Ca2+ signaling and interruptions in monolayer barrier function that contribute to symptoms of hypertension, proteinuria, and edema. In this study, we highlight Src kinase as a partial mediator of growth factor and cytokine mediated endothelial dysfunction. STUDY DESIGN Fura-2 Ca2+ imaging and Electrical Cell Impedance Sensing (ECIS) assays are performed on growth factor or cytokine exposed human umbilical vein endothelial cells (HUVECs). Inhibitors to MEK/ERK (U0126) or Src (PP2) are used to determine the contribution of kinase signaling pathways. MAIN OUTCOME MEASURES Decreases in HUVEC Ca2+ signaling or monolayer resistance measure endothelial dysfunction. Reversal of endothelial dysfunction by kinase inhibitors reveals the respective contibutions of MEK/ERK and Src kinase. RESULTS We show that Src inhibition protects Ca2+ signaling responses against insults induced by VEGF165, bFGF, PlGF, TNFα, and IL-1β. Additionally, we show that Src inhibition protects the endothelial monolayer from the full impact of TNFα insult. Further, we find that MEK/ERK inhibition does not offer protection from growth factor-mediated endothelial dysfunction. CONCLUSIONS The results of this study suggest cytokine and growth factor-stimulated Src kinase plays a partial role on promoting endothelial dysfunction in HUVECs.
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Affiliation(s)
- Amanda K Mauro
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI 53715, USA
| | - Luca Clemente
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI 53715, USA
| | - Nauman Khurshid
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI 53715, USA; Division of Reproductive Sciences, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI 53715, USA
| | - Dinesh M Shah
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI 53715, USA; Division of Reproductive Sciences, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI 53715, USA
| | - Jing Zheng
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI 53715, USA
| | - Derek S Boeldt
- Perinatal Research Laboratories, Department of Obstetrics & Gynecology, University of Wisconsin - Madison, School Medicine and Public Health, Madison, WI 53715, USA.
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Layton R, Layton D, Beggs D, Fisher A, Mansell P, Stanger KJ. The impact of stress and anesthesia on animal models of infectious disease. Front Vet Sci 2023; 10:1086003. [PMID: 36816193 PMCID: PMC9933909 DOI: 10.3389/fvets.2023.1086003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Stress and general anesthesia have an impact on the functional response of the organism due to the detrimental effects on cardiovascular, immunological, and metabolic function, which could limit the organism's response to an infectious event. Animal studies have formed an essential step in understanding and mitigating infectious diseases, as the complexities of physiology and immunity cannot yet be replicated in vivo. Using animals in research continues to come under increasing societal scrutiny, and it is therefore crucial that the welfare of animals used in disease research is optimized to meet both societal expectations and improve scientific outcomes. Everyday management and procedures in animal studies are known to cause stress, which can not only cause poorer welfare outcomes, but also introduces variables in disease studies. Whilst general anesthesia is necessary at times to reduce stress and enhance animal welfare in disease research, evidence of physiological and immunological disruption caused by general anesthesia is increasing. To better understand and quantify the effects of stress and anesthesia on disease study and welfare outcomes, utilizing the most appropriate animal monitoring strategies is imperative. This article aims to analyze recent scientific evidence about the impact of stress and anesthesia as uncontrolled variables, as well as reviewing monitoring strategies and technologies in animal models during infectious diseases.
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Affiliation(s)
- Rachel Layton
- Australian Centre for Disease Preparedness, CSIRO, Geelong, VIC, Australia,*Correspondence: Rachel Layton ✉
| | - Daniel Layton
- Australian Centre for Disease Preparedness, CSIRO, Geelong, VIC, Australia
| | - David Beggs
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, VIC, Australia
| | - Andrew Fisher
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, VIC, Australia
| | - Peter Mansell
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, VIC, Australia
| | - Kelly J. Stanger
- Australian Centre for Disease Preparedness, CSIRO, Geelong, VIC, Australia
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6
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Ren B, Cheng M, Liu C, Zheng H, Zhang J, Chen W, Song J, Zhuang J, Liu T, Wang R, Wang Z. Perioperative lidocaine and dexmedetomidine intravenous infusion reduce the serum levels of NETs and biomarkers of tumor metastasis in lung cancer patients: A prospective, single-center, double-blinded, randomized clinical trial. Front Oncol 2023; 13:1101449. [PMID: 36910600 PMCID: PMC10003334 DOI: 10.3389/fonc.2023.1101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/14/2023] [Indexed: 03/14/2023] Open
Abstract
Background Neutrophil extracellular traps (NETs) can enhance the metastasis of non-small cell lung cancer (NSCLC). As biomarkers of tumor metastasis, metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) together with NETs are essential to endothelial-to-mesenchymal transition (EMT). We hypothesized that intravenous infusion of lidocaine and dexmedetomidine could reduce the production of NETs and biomarkers of tumor metastasis after video-assisted thoracic surgery (VATS) in NSCLC patients. Method The trial included 132 NSCLC patients undergoing VATS. The patients were equally randomized to a placebo group (Group C), a lidocaine group (Group L, intravenous lidocaine 8 mg/kg/h for 15 minutes before anesthesia, 2 mg/kg/h during surgery, and 1 mg/kg/h until 24 hours after surgery), a dexmedetomidine group (Group D, intravenous dexmedetomidine 2 μg/kg/h for 15 minutes before anesthesia, 0.5 μg/kg/h during surgery, and 0.25 μg/kg/h until 24 hours after surgery), and a dexmedetomidine plus lidocaine group (Group LD, combination use of lidocaine and dexmedetomidine). The primary outcome was the production of myeloperoxidase (MPO) and citrullinated histone-3 (H3Cit), biomarkers of NETs, on postoperative day (POD) 1. MMP-3, MMP-9, and VEGF-α, as biomarkers of tumor metastasis, were also evaluated on POD 1. Results The baseline patient characteristics and perioperative data did not differ between the study groups. MPO was significantly decreased in Groups L, D, and LD (-197.08 ± 34.01, -137.37 ± 32.41, and -189.45 ± 33.73 U/ml, P<0.001, respectively) compared with Group C (-106.51 ± 25.44 U/ml). H3Cit was also lessened in Groups L, D, and LD (-49.51 ± 9.11, -34.80 ± 10.37, and -51.82 ± 8.98 ng/ml, P<0.001, respectively) compared with Group C (-24.73 ± 7.65 ng/ml). Lidocaine and dexmedetomidine also reduced MMP-3 (-69.08 ± 13.22, -52.84 ± 13.78, -85.34 ± 12.59 vs. -40.55 ± 10.71 ng/ml in Group L, D, LD vs. Group C, P<0.001, respectively), MMP-9 (-8.46 ± 1.68, -6.07 ± 1.82, -9.67 ± 1.43 vs. -4.28 ± 1.29 ng/ml in Group L, D, LD vs. Group C, P<0.001, respectively), and VEGF-α (-95.55 ± 22.53, -71.65 ± 18.77, -104.89 ± 15.49 vs. -51.73 ± 16.27 pg/ml in Group L, D, LD vs. Group C, P<0.001, respectively) on POD 1. Conclusion In NSCLC patients, continuous perioperative intravenous infusion of lidocaine and dexmedetomidine significantly reduced the production of NETs and tumor metastasis biomarkers on POD 1. Meanwhile, it also decreased inflammation, protected cellular immune function, reduced pain and opioid consumption, and improved the quality of postoperative recovery. Clinical trial registration chictr.org.cn, identifier: 187049.
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Affiliation(s)
- Baiqing Ren
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Muqiao Cheng
- Department of Anesthesiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Liu
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Huiwen Zheng
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Jingyue Zhang
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Wei Chen
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Jie Song
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Jingwen Zhuang
- Department of Anesthesiology, The First People's Hospital of Changde City, Changde, China
| | - Tianya Liu
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Rui Wang
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Zhiping Wang
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China
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Abouelfetouh MM, Salah E, Liu L, Ding M, Ding Y. Intrathecal adenosine enhances the antinociception of Xylazine in goats. BMC Vet Res 2022; 18:105. [PMID: 35300701 PMCID: PMC8928627 DOI: 10.1186/s12917-022-03193-9] [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: 06/19/2021] [Accepted: 02/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background The role of adenosine (AD) in neuromodulation of nociceptive signaling at the level of the spinal cord has been established in both preclinical and clinical models. Recently, the signaling pathway that involves adenosine 5-monophosphate activated protein kinase has been reported to mediate the antinociceptive effects of xylazine (XYL). The objective of this study was to investigate the antinociceptive, cardiorespiratory and hematological effects of intrathecal administration of combined XYL-AD in goats as compared to XYL alone. Six clinically healthy adult goats weighing 25 ± 2 kg were randomly assigned to one of three groups in a cross-over design. Goats were sedated with XYL (0.05 mg/kg, IM) in all groups. Ten min later, 0.9% saline solution [SAL group], XYL (0.05 mg/kg) [XYL group] or a combination of XYL (0.05 mg/kg) and AD (2000 µg) [XYL-AD group] was injected intrathecally. Antinociception scores and both cardiorespiratory and hematological parameters were measured before XYL sedation and intrathecal injection (baseline), and at 5, 10, 15, 30, 60, 90, 120 and 150 min thereafter. Results The XYL-AD group showed significantly earlier onset of antinociception [5 (5–7) min] than XYL [13 (12–14.25] min (P = 0.031). The duration of complete antinociception in goats that received XYL-AD was significantly longer (P = 0.031) than that received XYL alone [65 (58.75–66.25) and 47.5 (43.75–51.25) min, respectively]. In both XYL and XYL-AD groups, heart rate (HR), arterial blood pressure (SAP, MAP and DAP) were significantly decreased (P < 0.05) compared to the baseline. Compared to the SAL group, a statistically significant reduction in HR from 10 to 150 min (P < 0.05) was detected in the XYL group contrary to the XYL-AD group. Differences in the hematological parameters among different groups were insignificant. Conclusions AD injected intrathecally interacts synergistically with XYL to promote antinociception in goats. This discovery supports the use of AD in combination with XYL in clinical trials.
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Affiliation(s)
- Mahmoud M Abouelfetouh
- College of Veterinary Medicine, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, 430070, Hubei Province, China.,Department of Surgery, Radiology and Anaesthesiology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, 13736, Egypt
| | - Eman Salah
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, 430070, Hubei Province, China.,Department of Pharmacology, Faculty of Veterinary Medicine, Benha University, Moshtohor, Toukh, 13736, Egypt
| | - Lingling Liu
- College of Veterinary Medicine, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, 430070, Hubei Province, China.,Clinical Veterinary Laboratory, College of Veterinary Medicine, Henan University of Animal Husbandry and Economy, Zhengzhou, 450046, Henan Province, China
| | - Mingxing Ding
- College of Veterinary Medicine, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, 430070, Hubei Province, China
| | - Yi Ding
- College of Veterinary Medicine, Huazhong Agricultural University, No.1, Shizishan Street, Hongshan District, Wuhan, 430070, Hubei Province, China.
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8
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Dahdah A, Johnson J, Gopalkrishna S, Jaggers RM, Webb D, Murphy AJ, Hanssen NMJ, Hanaoka BY, Nagareddy PR. Neutrophil Migratory Patterns: Implications for Cardiovascular Disease. Front Cell Dev Biol 2022; 10:795784. [PMID: 35309915 PMCID: PMC8924299 DOI: 10.3389/fcell.2022.795784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/18/2022] [Indexed: 12/31/2022] Open
Abstract
The body's inflammatory response involves a series of processes that are necessary for the immune system to mitigate threats from invading pathogens. Leukocyte migration is a crucial process in both homeostatic and inflammatory states. The mechanisms involved in immune cell recruitment to the site of inflammation are numerous and require several cascades and cues of activation. Immune cells have multiple origins and can be recruited from primary and secondary lymphoid, as well as reservoir organs within the body to generate an immune response to certain stimuli. However, no matter the origin, an important aspect of any inflammatory response is the web of networks that facilitates immune cell trafficking. The vasculature is an important organ for this trafficking, especially during an inflammatory response, mainly because it allows cells to migrate towards the source of insult/injury and serves as a reservoir for leukocytes and granulocytes under steady state conditions. One of the most active and vital leukocytes in the immune system's arsenal are neutrophils. Neutrophils exist under two forms in the vasculature: a marginated pool that is attached to the vessel walls, and a demarginated pool that freely circulates within the blood stream. In this review, we seek to present the current consensus on the mechanisms involved in leukocyte margination and demargination, with a focus on the role of neutrophil migration patterns during physio-pathological conditions, in particular diabetes and cardiovascular disease.
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Affiliation(s)
- Albert Dahdah
- Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Jillian Johnson
- Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Sreejit Gopalkrishna
- Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Robert M. Jaggers
- Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Darren Webb
- Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Andrew J. Murphy
- Division of Immunometabolism, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Nordin M. J. Hanssen
- Amsterdam Diabetes Centrum, Internal and Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Beatriz Y. Hanaoka
- Department of Internal Medicine, Division of Rheumatology, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Prabhakara R. Nagareddy
- Department of Surgery, Division of Cardiac Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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9
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Hamilton JL, Vashi M, Kishen EB, Fogg LF, Wimmer MA, Balk RA. The Association of an Alpha-2 Adrenergic Receptor Agonist and Mortality in Patients With COVID-19. Front Med (Lausanne) 2022; 8:797647. [PMID: 35059419 PMCID: PMC8764306 DOI: 10.3389/fmed.2021.797647] [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: 10/19/2021] [Accepted: 11/29/2021] [Indexed: 12/15/2022] Open
Abstract
There is a need for treatments to reduce coronavirus disease 2019 (COVID-19) mortality. Alpha-2 adrenergic receptor (α2 AR) agonists can dampen immune cell and inflammatory responses as well as improve oxygenation through physiologic respiratory parameters. Therefore, α2 AR agonists may be effective in reducing mortality related to hyperinflammation and acute respiratory failure in COVID-19. Dexmedetomidine (DEX) is an α2 AR agonist used for sedation. We performed a retrospective analysis of adults at Rush University System for Health hospitals between March 1, 2020 and July 30, 2020 with COVID-19 requiring invasive mechanical ventilation and sedation (n = 214). We evaluated the association of DEX use and 28-day mortality from time of intubation. Overall, 28-day mortality in the cohort receiving DEX was 27.0% as compared to 64.5% in the cohort that did not receive DEX (relative risk reduction 58.2%; 95% CI 42.4–69.6). Use of DEX was associated with reduced 28-day mortality on multivariable Cox regression analysis (aHR 0.19; 95% CI 0.10–0.33; p < 0.001). Adjusting for time-varying exposure to DEX also demonstrated that DEX was associated with reduced 28-day mortality (aHR 0.51; 95% CI 0.28–0.95; p = 0.03). Earlier DEX use, initiated <3.4 days from intubation, was associated with reduced 28-day mortality (aHR 0.25; 95% CI 0.13–0.50; p < 0.001) while later DEX use was not (aHR 0.64; 95% CI 0.27–1.50; p = 0.30). These results suggest an α2 AR agonist might reduce mortality in patients with COVID-19. Randomized controlled trials are needed to confirm this observation.
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Affiliation(s)
- John L Hamilton
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Mona Vashi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Ekta B Kishen
- Bioinformatics and Biostatistics Core, Rush University Medical Center, Chicago, IL, United States
| | - Louis F Fogg
- Department of Community, Systems and Mental Health Nursing, Rush University Medical Center, Chicago, IL, United States
| | - Markus A Wimmer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Robert A Balk
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
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10
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Yuki K. The immunomodulatory mechanism of dexmedetomidine. Int Immunopharmacol 2021; 97:107709. [PMID: 33933842 DOI: 10.1016/j.intimp.2021.107709] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
Dexmedetomidine has been increasingly introduced into the perioperative care of surgical patients. Because a subset of anesthetics/sedatives are immunomodulatory, it is critical to understand the role of dexmedetomidine in our host immune functions. Here we reviewed the role of dexmedetomidine in different immune cells. We also reviewed published clinical articles that described the role of dexmedetomidine in organ injury, cancer surgery, and infection. In animal studies, dexmedetomidine attenuated organ injury. In clinical studies, dexmedetomidine was associated with an improvement in outcomes in cardiac surgery and transplant surgery. However, there is a paucity in research examining how dexmedetomidine is associated with these outcomes. Further studies are needed to understand its clinical application from immunological standpoints.
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Affiliation(s)
- Koichi Yuki
- Department of Anesthesiology, Critical Care and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, USA; Department of Anaesthesia, Harvard Medical School, USA; Department of Immunology, Harvard Medical School, USA.
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11
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Yang P, Tian H, Zou YR, Chambon P, Ichinose H, Honig G, Diamond B, Kim SJ. Epinephrine Production in Th17 Cells and Experimental Autoimmune Encephalitis. Front Immunol 2021; 12:616583. [PMID: 33692790 PMCID: PMC7937652 DOI: 10.3389/fimmu.2021.616583] [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: 10/12/2020] [Accepted: 01/05/2021] [Indexed: 12/17/2022] Open
Abstract
Epinephrine is a hormone secreted primarily by medullary cells of the adrenal glands which regulates permeability of blood–brain barrier (BBB). Recent studies showed signaling by epinephrine/epinephrine receptor in T cells is involved in autoimmune diseases. Nevertheless, the production of epinephrine by T cells and its pathogenic function in T cells are not well investigated. Our results show that phenylethanol N-methyltransferase (PNMT), a rate-limiting enzyme of epinephrine synthesis, is specifically expressed in vitro in differentiated TH17 cells and in tissue-resident TH17 cells. Indeed, expression levels of enzymes involved in epinephrine production are higher in TH17 cells from animals after EAE induction. The induction of PNMT was not observed in other effector T cell subsets or regulatory T cells. Epinephrine producing TH17 cells exhibit co-expression of GM-CSF, suggesting they are pathogenic TH17 cells. To delineate the function of epinephrine-production in TH17 cells, we generated a TH17-specific knockout of tyrosine hydroxylase (Th) by breeding a Th-flox and a ROR-gt-CRE mouse (Th-CKO). Th-CKO mice are developmentally normal with an equivalent T lymphocyte number in peripheral lymphoid organs. Th-CKO mice also show an equivalent number of TH17 cells in vivo and following in vitro differentiation. To test whether epinephrine-producing TH17 cells are key for breaching the BBB, migration of T cells through mouse brain endothelial cells was investigated in vitro. Both epi+ wild-type and epi- TH17 cells migrate through an endothelial cell barrier. Mice were immunized with MOG peptide to induce experimental autoimmune encephalitis (EAE) and disease progression was monitored. Although there is a reduced infiltration of CD4+ T cells in Th-CKO mice, no difference in clinical score was observed between Th-CKO and wild-type control mice. Increased neutrophils were observed in the central nervous system of Th-CKO mice, suggesting an alternative pathway to EAE progression in the absence of TH17 derived epinephrine.
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Affiliation(s)
- Pinguang Yang
- Center of Autoimmune and Hematopoietic and Musculoskeletal diseases, The Feinstein Institute for Medical Research, Manhasset, NY, United States.,Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, Hempstead, NY, United States
| | - Hong Tian
- Center of Autoimmune and Hematopoietic and Musculoskeletal diseases, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| | - Yong-Rui Zou
- Center of Autoimmune and Hematopoietic and Musculoskeletal diseases, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| | - Pierre Chambon
- Institute for Genetics and Cellular and Molecular Biology, Institute of Advanced Study of the University of Strasbourg, Strasbourg, France
| | - Hiroshi Ichinose
- Department of Life Science, Graduate School of bioscience and Biotechnology, Tokyo Institute of Technology, Yokohama, Japan
| | - Gerard Honig
- Crohn's & Colitis Foundation, National Headquarters, New York, NY, United States
| | - Betty Diamond
- Center of Autoimmune and Hematopoietic and Musculoskeletal diseases, The Feinstein Institute for Medical Research, Manhasset, NY, United States
| | - Sun Jung Kim
- Center of Autoimmune and Hematopoietic and Musculoskeletal diseases, The Feinstein Institute for Medical Research, Manhasset, NY, United States
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12
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Abstract
Anesthetics are widely used drugs administered in a multitude of clinical settings. Their impacts on various functions of the immune system have been studied but are still not fully understood. Neutrophil granulocytes are a critical first-line host defense mechanism against infections and contribute to the inflammatory phase of wound healing, but dysregulated neutrophil activation can also precipitate perioperative organ injury. A better understanding of the interactions between common anesthetics and neutrophils may reveal considerations toward optimizing treatment of our most vulnerable patients in the intensive care unit and in the perioperative setting.
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Affiliation(s)
- Angela Meier
- From the Department of Anesthesiology, Division of Critical Care, University of San Diego, San Diego, California
| | - Victor Nizet
- Department of Pediatrics, Division of Host-Microbe Systems & Therapeutics, Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California San Diego, San Diego, California
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13
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Kanashiro A, Hiroki CH, da Fonseca DM, Birbrair A, Ferreira RG, Bassi GS, Fonseca MD, Kusuda R, Cebinelli GCM, da Silva KP, Wanderley CW, Menezes GB, Alves-Fiho JC, Oliveira AG, Cunha TM, Pupo AS, Ulloa L, Cunha FQ. The role of neutrophils in neuro-immune modulation. Pharmacol Res 2019; 151:104580. [PMID: 31786317 DOI: 10.1016/j.phrs.2019.104580] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/07/2019] [Accepted: 11/27/2019] [Indexed: 01/10/2023]
Abstract
Neutrophils are peripheral immune cells that represent the first recruited innate immune defense against infections and tissue injury. However, these cells can also induce overzealous responses and cause tissue damage. Although the role of neutrophils activating the immune system is well established, only recently their critical implications in neuro-immune interactions are becoming more relevant. Here, we review several aspects of neutrophils in the bidirectional regulation between the nervous and immune systems. First, the role of neutrophils as a diffuse source of acetylcholine and catecholamines is controversial as well as the effects of these neurotransmitters in neutrophil's functions. Second, neutrophils contribute for the activation and sensitization of sensory neurons, and thereby, in events of nociception and pain. In addition, nociceptor activation promotes an axon reflex triggering a local release of neural mediators and provoking neutrophil activation. Third, the recruitment of neutrophils in inflammatory responses in the nervous system suggests these immune cells as innovative targets in the treatment of central infectious, neurological and neurodegenerative disorders. Multidisciplinary studies involving immunologists and neuroscientists are required to define the role of the neurons-neutrophils communication in the pathophysiology of infectious, inflammatory, and neurological disorders.
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Affiliation(s)
- Alexandre Kanashiro
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil; Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Carlos Hiroji Hiroki
- Department of Immunology and Biochemistry, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Denise Morais da Fonseca
- Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - Alexander Birbrair
- Department of Pathology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Raphael Gomes Ferreira
- Araguaína Medical School, Federal University of Tocantins, Avenida Paraguai s/n, 77824-838, Araguaína, TO, Brazil
| | - Gabriel Shimizu Bassi
- Center for Perioperative Organ Protection, Department of Anesthesiology, Duke University, Durham, NC, 27710, USA
| | - Mirian D Fonseca
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Ricardo Kusuda
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Katiussia Pinho da Silva
- Department of Pharmacology, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Carlos Wagner Wanderley
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - José Carlos Alves-Fiho
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - André Gustavo Oliveira
- Department of Physiology and Biophysics, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thiago M Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - André Sampaio Pupo
- Department of Pharmacology, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Luis Ulloa
- Center for Perioperative Organ Protection, Department of Anesthesiology, Duke University, Durham, NC, 27710, USA.
| | - Fernando Queiroz Cunha
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
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14
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Liu Y, Sun J, Wu T, Lu X, Du Y, Duan H, Yu W, Su D, Lu J, Tian J. Effects of serum from breast cancer surgery patients receiving perioperative dexmedetomidine on breast cancer cell malignancy: A prospective randomized controlled trial. Cancer Med 2019; 8:7603-7612. [PMID: 31663690 PMCID: PMC6912063 DOI: 10.1002/cam4.2654] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/24/2019] [Accepted: 10/14/2019] [Indexed: 12/31/2022] Open
Abstract
Adrenergic receptors (ARs) have gained attention for their involvement in breast cancer (BC) progression. Dexmedetomidine, a selective α2 -AR agonist, has been reported to increase the malignancy of BC cells in vitro or stimulate tumor growth in mice. However, clinical evidence is lacking. Clinical research in this area is important as dexmedetomidine is widely used in BC surgery patients. Here we allocated 24 women with primary BC to the dexmedetomidine group (who received a total dose of 2 μg kg-1 dexmedetomidine perioperatively) or to the control group (who received the same volume of normal saline). Venous blood was obtained from all patients immediately upon entering the operating room and 24 hours postoperatively. Serum was then exposed to MCF-7 cells at a concentration of 10% for 24 hours. Cell proliferation, migration, and invasion were analyzed using EdU, Transwell, and Matrigel methods, respectively. We found that postoperative serum from those who received dexmedetomidine was associated with significantly increased cell proliferation, migration, and invasion compared with preoperative serum when used to culture MCF-7 cells. The mean percentage change from post to preoperative values in these cell functions was significantly larger in the dexmedetomidine group than in the control group (proliferation, 30.44% vs 8.45%, P = .0024; migration, 15.90% vs 3.25%, P = .0015; invasion, 8.17% vs 2.13%, P = .04). In conclusion, these findings suggest that in patients undergoing surgery for primary BC, perioperative administration of dexmedetomidine might influence the serum milieu in a way that favors the malignancy of MCF-7 cells. Clinical trial registration: NCT03108937.
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Affiliation(s)
- Yan Liu
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaxin Sun
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Wu
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoying Lu
- Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Yueyao Du
- Department of Breast, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongwei Duan
- Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Weifeng Yu
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Diansan Su
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinsong Lu
- Department of Breast, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Tian
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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15
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Ince LM, Weber J, Scheiermann C. Control of Leukocyte Trafficking by Stress-Associated Hormones. Front Immunol 2019; 9:3143. [PMID: 30687335 PMCID: PMC6336915 DOI: 10.3389/fimmu.2018.03143] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/19/2018] [Indexed: 01/13/2023] Open
Abstract
Leukocyte migration is a crucial process in both homeostatic and inflammatory conditions. The spatiotemporal distribution of immune cells is balanced between processes of cellular mobilization into the bloodstream, their adhesion to vascular beds and trafficking into tissues. Systemic regulation of leukocyte mobility is achieved by different signals including neuronal and hormonal cues, of which the catecholamines and glucocorticoids have been most extensively studied. These hormones are often associated with a stress response, however they regulate immune cell trafficking also in steady state, with effects dependent upon cell type, location, time-of-day, concentration, and duration of signal. Systemic administration of catecholamines, such as the sympathetic neurotransmitters adrenaline and noradrenaline, increases neutrophil numbers in the bloodstream but has different effects on other leukocyte populations. In contrast, local, endogenous sympathetic tone has been shown to be crucial for dynamic daily changes in adhesion molecule expression in the bone marrow and skeletal muscle, acting as a key signal to the endothelium and stromal cells to regulate immune cell trafficking. Conversely, glucocorticoids are often reported as anti-inflammatory, although recent data shows a more complex role, particularly under steady-state conditions. Endogenous changes in circulating glucocorticoid concentration induce redistribution of cells and potentiate inflammatory responses, and in many paradigms glucocorticoid action is strongly influenced by time of day. In this review, we discuss the current knowledge of catecholamine and glucocorticoid regulation of leukocyte migration under homeostatic and stimulated conditions.
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Affiliation(s)
- Louise M Ince
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jasmin Weber
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany
| | - Christoph Scheiermann
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Walter-Brendel-Centre of Experimental Medicine, University Hospital, Ludwig-Maximilians-University Munich, BioMedical Centre, Planegg-Martinsried, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
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16
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Bertino B, Blanchet‐Réthoré S, Thibaut de Ménonville S, Reynier P, Méhul B, Bogouch A, Gamboa B, Dugaret AS, Zugaj D, Petit L, Roquet M, Piwnica D, Vial E, Bourdès V, Voegel JJ, Nonne C. Brimonidine displays anti‐inflammatory properties in the skin through the modulation of the vascular barrier function. Exp Dermatol 2018; 27:1378-1387. [DOI: 10.1111/exd.13793] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/01/2018] [Indexed: 12/16/2022]
Affiliation(s)
| | | | | | | | - Bruno Méhul
- GALDERMA R&D‐Nestlé Skin Health Sophia Antipolis France
| | | | | | | | - Didier Zugaj
- GALDERMA R&D‐Nestlé Skin Health Sophia Antipolis France
| | - Laurent Petit
- GALDERMA R&D‐Nestlé Skin Health Sophia Antipolis France
| | - Manon Roquet
- GALDERMA R&D‐Nestlé Skin Health Sophia Antipolis France
| | - David Piwnica
- GALDERMA R&D‐Nestlé Skin Health Sophia Antipolis France
| | - Emmanuel Vial
- GALDERMA R&D‐Nestlé Skin Health Sophia Antipolis France
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17
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Maaliki D, Issa K, Al Shehabi T, El-Yazbi A, Eid AH. The role of α2-adrenergic receptors in hypertensive preeclampsia: A hypothesis. Microcirculation 2018; 26:e12511. [PMID: 30383326 DOI: 10.1111/micc.12511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/18/2018] [Accepted: 10/29/2018] [Indexed: 02/06/2023]
Abstract
Preeclampsia, a major disorder of human pregnancy, manifests as persistent hypertension and proteinuria presenting after 20 weeks of pregnancy. Multiple systemic symptoms might be associated with preeclampsia including thrombocytopenia, liver impairment, pulmonary edema, and cerebral disturbances. However, vascular dysfunction remains the core pathological driver of preeclampsia. Defective placental implantation followed by dysfunctional placental spiral artery development promotes a hypoxic environment. Massive endothelial dysfunction characterized by reduced vasodilation, augmented vasoconstriction, and increased vascular permeability and inflammation ensues. Interestingly, the same signaling and inflammatory pathways implicated in preeclampsia appear to be shared with other vascular disorders involving alteration of α2 -AR function. The role of α2 -ARs in the regulation of microcirculatory function has long been recognized, thus raising the question of whether they are involved in the pathogenesis of vascular dysfunction in preeclampsia. Here, we review possible interplay between signaling and inflammatory pathways common to preeclampsia and α2 -AR function/regulation. We speculate on the potential contribution of these receptors to the observed phenotype and the potential role for their pharmacological modulators as therapeutic interventions with preeclampsia.
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Affiliation(s)
- Dina Maaliki
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
| | - Khodr Issa
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon
| | - Tuqa Al Shehabi
- Department of Biological and Environmental Sciences, Qatar University, Doha, Qatar
| | - Ahmed El-Yazbi
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Ali H Eid
- Department of Pharmacology and Toxicology, American University of Beirut, Beirut, Lebanon.,Department of Biological and Environmental Sciences, Qatar University, Doha, Qatar.,Department of Biomedical Sciences, Qatar University, Doha, Qatar
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18
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Dong W, He B, Qian H, Liu Q, Wang D, Li J, Wei Z, Wang Z, Xu Z, Wu G, Qian G, Wang G. RAB26-dependent autophagy protects adherens junctional integrity in acute lung injury. Autophagy 2018; 14:1677-1692. [PMID: 29965781 DOI: 10.1080/15548627.2018.1476811] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Microvascular barrier dysfunction is the central pathophysiological feature of acute lung injury (ALI). RAB26 is a newly identified small GTPase involved in the regulation of endothelial cell (EC) permeability. However, the mechanism behind this protection has not been clearly elucidated. Here we found that RAB26 promoted the integrity of adherens junctions (AJs) in a macroautophagy/autophagy-dependent manner in ALI. RAB26 is frequently downregulated in mouse lungs after LPS treatment. Mice lacking Rab26 exhibited phosphorylated SRC expression and increased CDH5/VE-cadherin phosphorylation, leading to AJ destruction. rab26-null mice showed further aggravation of the effects of endotoxin insult on lung vascular permeability and water content. Depletion of RAB26 resulted in upregulation of phosphorylated SRC, enhancement of CDH5 phosphorylation, and aggravation of CDH5 internalization, thereby weakening AJ integrity and endothelial barrier function in human pulmonary microvascular endothelial cells (HPMECs). RAB26 overexpression caused active interaction between SRC and the autophagy marker LC3-II and promoted degradation of phosphorylated SRC. Furthermore, RAB26 was involved in a direct and activation-dependent manner in autophagy induction through interaction with ATG16L1 in its GTP-bound form. These findings demonstrate that RAB26 exerts a protective effect on endothelial cell (EC) permeability, which is in part dependent on autophagic targeting of active SRC, and the resultant CDH5 dephosphorylation maintains AJ stabilization. Thus, RAB26-mediated autophagic targeting of phosphorylated SRC can maintain barrier integrity when flux through the RAB26-SRC pathway is protected. These findings suggest that activation of RAB26-SRC signaling provides a new therapeutic opportunity to prevent vascular leakage in ALI. ABBREVIATIONS AJs: adherens junctions; ALI: acute lung injury; ARDS: acute respiratory distress syndrome; ATG5: autophagy related 5; ATG12: autophagy related 12; ATG 16L1: autophagy related 16 like; 1 BALF: bronchoalveolar lavage fluidCQ: chloroquine; Ctrl: control; EC: endothelial cell; GFP: green fluorescent protein; HA-tagged; RAB26WT: HA-tagged wild-type; RAB26 HA-tagged; RAB26QL: HA-tagged; RAB26Q123LHA-tagged; RAB26NI: HA-tagged; RAB26N177IHPMECs: human pulmonary microvascular endothelial cells; H&E: hematoxylin & eosin; IgG: immunoglobulin; GIF: immunofluorescence; IP: immunoprecipitationi;. p.: intraperitoneal; LPS: lipopolysaccharide; PBS: phosphate-buffered salinesi; RNA: small interfering;RNASQSTM1/p62, sequestosome; 1TBS: Tris-buffered saline; VEGF: vascular endothelial growth factor; WB: western blot; WT: wild-type.
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Affiliation(s)
- Weijie Dong
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Binfeng He
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Hang Qian
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Qian Liu
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Dong Wang
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Jin Li
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Zhenghua Wei
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Zi Wang
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Zhi Xu
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Guangyu Wu
- b Department of Pharmacology and Toxicology , Georgia Regents University , Augusta , Georgia , USA
| | - Guisheng Qian
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
| | - Guansong Wang
- a Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University , Chongqing , China
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19
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Nissinen J, Andrade P, Natunen T, Hiltunen M, Malm T, Kanninen K, Soares JI, Shatillo O, Sallinen J, Ndode-Ekane XE, Pitkänen A. Disease-modifying effect of atipamezole in a model of post-traumatic epilepsy. Epilepsy Res 2017; 136:18-34. [DOI: 10.1016/j.eplepsyres.2017.07.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/30/2017] [Accepted: 07/06/2017] [Indexed: 12/25/2022]
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20
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Inada T, Sumi C, Hirota K, Shingu K, Okamoto A, Matsuo Y, Kamibayashi T. Mitigation of inflammation using the intravenous anesthetic dexmedetomidine in the mouse air pouch model. Immunopharmacol Immunotoxicol 2017; 39:225-232. [PMID: 28555511 DOI: 10.1080/08923973.2017.1327964] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Dexmedetomidine, an α2-adrenergic/imidazoline receptor agonist, is a widely used intravenous anesthetic. Its primary current usage is for sedation of patients in the intensive care unit. The mouse air pouch model is versatile in studying the anti-inflammatory effect of a drug on a local inflammation, which is induced by a variety of substances. In the present study, using the carrageenan-induced air pouch inflammation model, we tested whether dexmedetomidine mitigates inflammation occurring locally in the mouse air pouch. We found that dexmedetomidine dose-dependently inhibited the production of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in the pouch and decreased the number of white blood cells (WBC) recruited into the pouch. Dexmedetomidine also dose-dependently inhibited the production of neutrophil chemokines, cxcl1 and cxcl2. Furthermore, the dexmedetomidine-induced decreased recruitment of WBC into the pouch was successfully reversed with intra-pouch administration of cxcl1/cxcl2, but not TNF-α or IL-6. Lastly, the inhibition of the production of the cytokines and chemokines with dexmedetomidine was reversed by the treatment of yohimbine, suggesting that dexmedetomidine's anti-inflammatory effect is primarily via the stimulation of the α2-adrenergic receptor. We conclude that dexmedetomidine has an anti-inflammatory property in the carrageenan-induced mouse air pouch inflammation model, and that the dexmedetomidine-induced inhibition of production of the neutrophil chemokines, cxcl1 and cxcl2, may be related, at least in part, to the inhibition of WBC intra-pouch recruitment.
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Affiliation(s)
- Takefumi Inada
- a Department of Anesthesiology , Kansai Medical University , Osaka , Japan
| | - Chisato Sumi
- a Department of Anesthesiology , Kansai Medical University , Osaka , Japan
| | - Kiichi Hirota
- a Department of Anesthesiology , Kansai Medical University , Osaka , Japan
| | - Koh Shingu
- a Department of Anesthesiology , Kansai Medical University , Osaka , Japan
| | - Akihisa Okamoto
- a Department of Anesthesiology , Kansai Medical University , Osaka , Japan
| | - Yoshiyuki Matsuo
- a Department of Anesthesiology , Kansai Medical University , Osaka , Japan
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21
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Holmes AD, Steinhoff M. Integrative concepts of rosacea pathophysiology, clinical presentation and new therapeutics. Exp Dermatol 2016; 26:659-667. [DOI: 10.1111/exd.13143] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2016] [Indexed: 12/13/2022]
Affiliation(s)
| | - Martin Steinhoff
- Department of Dermatology; UCD Charles Institute for Translational Dermatology; University College Dublin; Dublin Ireland
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22
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Stewart JM, Tarantal AF, Hawthorne WJ, Salvaris EJ, O'Connell PJ, Nottle MB, d'Apice AJF, Cowan PJ, Kearns-Jonker M. Clonidine inhibits anti-non-Gal IgM xenoantibody elicited in multiple pig-to-primate models. Xenotransplantation 2015; 22:413-26. [PMID: 26490547 DOI: 10.1111/xen.12199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 08/25/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Survival of vascularized xenografts is dependent on pre-emptive inhibition of the xenoantibody response against galactosyltransferase knockout (GTKO) porcine organs. Our analysis in multiple GTKO pig-to-primate models of xenotransplantation has demonstrated that the anti-non-gal-α-1,3-gal (anti-non-Gal) xenoantibody response displays limited structural diversity. This allowed our group to identify an experimental compound which selectively inhibited induced anti-non-Gal IgM xenoantibodies. However, because this compound had an unknown safety profile, we extended this line of research to include screening small molecules with known safety profiles allowing rapid advancement to large animal models. METHODS The NIH clinical collections of small molecules were screened by ELISA for their ability to inhibit xenoantibody binding to GTKO pig endothelial cells. Serum collected from non-immunosuppressed rhesus monkeys at day 14 post-injection with GTKO pig endothelial cells was utilized as a source of elicited xenoantibody for initial screening. Virtual small molecule screening based on xenoantibody structure was used to assess the likelihood that the identified small molecules bound xenoantibody directly. As a proxy for selectivity, ELISAs against tetanus toxoid and the natural antigens laminin, thyroglobulin, and single-stranded DNA (ssDNA) were utilized to assess the ability of the identified reagents to inhibit additional antibody responses. The identified inhibitory small molecules were further tested for their ability to inhibit xenoantibody elicited in multiple settings, including rhesus monkeys pre-treated with an anti-non-Gal selective anti-idiotypic antibody, non-immunosuppressed rhesus monkeys immunized with wild-type fetal pig isletlike cell clusters, and non-immunosuppressed baboons transplanted with GTKO multiple transgenic pig kidneys. RESULTS Four clinically relevant small molecules inhibited anti-non-Gal IgM binding to GTKO pig endothelial cells in vitro. Three of these drugs displayed a limited region of structural similarity suggesting they may inhibit xenoantibody by a similar mechanism. One of these, the anti-hypertensive agent clonidine, displayed only minimal inhibition of antibodies elicited by vaccination against tetanus toxoid or pre-existing natural antibodies against laminin, thyroglobulin, or ssDNA. Furthermore, clonidine inhibited elicited anti-non-Gal IgM from all animals that demonstrated a xenoantibody response in each experimental setting. CONCLUSIONS Clinically relevant small molecule drugs with known safety profiles can inhibit xenoantibody elicited against non-Gal antigens in diverse experimental xenotransplantation settings. These molecules are ready to be tested in large animal models. However, it will first be necessary to optimize the timing and dosing required to inhibit xenoantibodies in vivo.
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Affiliation(s)
- John M Stewart
- Department of Human Anatomy, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Alice F Tarantal
- Departments of Pediatrics and Cell Biology and Human Anatomy, and California National Primate Research Center, University of California, Davis, CA, USA
| | - Wayne J Hawthorne
- Centre for Transplant and Renal Research, Westmead Millennium Institute, Westmead, NSW, Australia.,National Pancreas Transplant Unit, University of Sydney at Westmead Hospital, Westmead, NSW, Australia
| | - Evelyn J Salvaris
- Immunology Research Centre, St. Vincent's Hospital Melbourne, Melbourne, Vic., Australia
| | - Philip J O'Connell
- Centre for Transplant and Renal Research, Westmead Millennium Institute, Westmead, NSW, Australia.,National Pancreas Transplant Unit, University of Sydney at Westmead Hospital, Westmead, NSW, Australia
| | - Mark B Nottle
- Discipline of Obstetrics and Gynaecology, University of Adelaide, Adelaide, SA, Australia
| | - Anthony J F d'Apice
- Immunology Research Centre, St. Vincent's Hospital Melbourne, Melbourne, Vic., Australia.,Department of Medicine, University of Melbourne, Melbourne, Vic., Australia
| | - Peter J Cowan
- Immunology Research Centre, St. Vincent's Hospital Melbourne, Melbourne, Vic., Australia.,Department of Medicine, University of Melbourne, Melbourne, Vic., Australia
| | - Mary Kearns-Jonker
- Department of Human Anatomy, Loma Linda University School of Medicine, Loma Linda, CA, USA
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23
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Scanzano A, Schembri L, Rasini E, Luini A, Dallatorre J, Legnaro M, Bombelli R, Congiu T, Cosentino M, Marino F. Adrenergic modulation of migration, CD11b and CD18 expression, ROS and interleukin-8 production by human polymorphonuclear leukocytes. Inflamm Res 2015; 64:127-35. [PMID: 25561369 DOI: 10.1007/s00011-014-0791-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/24/2014] [Accepted: 11/27/2014] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Adrenergic modulation of immunity has been extensively characterized, however, few information exist regarding polymorphonuclear leukocytes (PMN), despite their key role in immunity and inflammation. We investigated the effect of adrenergic agents on human PMN migration, CD11b and CD18 expression, reactive oxygen species (ROS) and interleukin (IL)-8 production, and on adrenoceptor (AR) expression. METHODS Migration was measured by the Boyden chamber assay, CD11b/CD18 expression was assessed by flow cytometry, intracellular ROS were detected by spectrofluorimetry, and IL-8 was quantitated by standard ELISA assay. AR mRNA levels were measured by real-time PCR and PMN morphology was studied by scanning electron microscopy. RESULTS Adrenaline(A), noradrenaline and the β-AR agonist isoprenaline reduced N-formyl-Met-Leu-Phe (fMLP)-induced migration, CD11b/CD18 expression, and ROS production, without affecting IL-8. The effect of A on CD11b was antagonized by yohimbine and propranolol, and increased by prazosin. The effect on ROS production was completely abolished by propranolol. PMN expressed α(1A)-, α(1B)-, α(1D)-, α(2A)-, α(2C)-, β(1)-, β(2)-, and β(3)-AR mRNA. A prevented fMLP-induced morphological changes of PMN. CONCLUSIONS Adrenergic agents reduced PMN responses mainly through β-AR, although α-AR may contribute at least to CD11b expression. AR-operated pathways in PMN should be investigated in disease conditions and in the response to therapeutic agents.
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Affiliation(s)
- Angela Scanzano
- Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n.9, 21100, Varese VA, Italy,
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