Persistent neuroinflammation and functional deficits in a murine model of decompression sickness

We hypothesized that early intra-CNS responses in a murine model of decompression sickness (DCS) would be reflected by changes in the microparticles (MPs) that exit the brain via the glymphatic system, and due to systemic responses the MPs would cause inflammatory changes lasting for many days leading to functional neurological deficits. Elevations on the order of 3-fold of blood-borne inflammatory MPs, neutrophil activation, glymphatic flow and neuroinflammation in cerebral cortex and hippocampus were found in mice at 12 days after exposure to 760 kPa of air for 2 hours. Mice also exhibited a significant decline in memory and locomotor activity, as assessed by novel object recognition and rotarod testing. Similar inflammatory changes in blood, neuroinflammation and functional impairments were initiated in naïve mice by injection of filamentous (F-) actin-positiveMPs, but not F-actin-negative MPs,obtained from decompressed mice. We conclude that high pressure/decompression stress establishes a systemic inflammatory process that results in prolonged neuroinflammation and functional impairments in the mouse decompression model.

Innovative Wound Healing Hydrogel Containing Chicken Feather Keratin and Soy Isoflavone Genistein: In Vivo Studies

The current study was performed to isolate keratin from chicken feathers with an intention to develop a keratin-genistein wound-healing hydrogel, along with its in vivo analysis. Pre-formulation aspects were analysed by using FTIR; SEM; HPTLC, while gel was characterized for gel strength, viscosity, spreadability, drug content, etc. Additionally, an in vivo study along with biochemical factors against pro-inflammatory factors and histopathological studies were conducted to determine possible wound-healing and anti-inflammatory effects. Pre-formulation studies revealed the presence of amide bonds with region of dense fibrous keratin and an internal porous network in extracted keratin, which corresponds with standard keratin. Evaluation of optimised keratin-genistein hydrogel indicated the development of neutral, non-sticky hydrogel which spread evenly on the skin. In vivo studies in rats indicate higher degrees of wound-healing in combined hydrogel (94.65%) for a duration of 14 days as compared to an individual hydrogel formulation with the development of the epidermis and excessive proliferation of fibrous connective tissue indicating wound repair. Furthermore, the hydrogel inhibited the overexpression of IL-6 gene along with other pro-inflammatory factors, indicating its anti-inflammatory effects. In order to find out the possibility of closure of wounds and anti-inflammatory properties of the novel product, an in vivo investigation into the healing of wounds in laboratory animals was carried out through biochemical (ELISA and qRT-PCR) analyses against inflammatory markers (IL-2, IL-6, IL-1, IL-10, and COX-2) and histopathological (liver, skin, and the kidneys) investigations. Based on the results, we conclude that keratin-genistein hydrogel is a promising therapeutic molecule for the management of wound repair.

DOE-Assisted Formulation, Optimization, and Characterization of Tioconazole-Loaded Transferosomal Hydrogel for the Effective Treatment of Atopic Dermatitis: In Vitro and In Vivo Evaluation

The present study was performed to determine the therapeutic effects of tioconazole (Tz)-loaded novel transferosome carriers (TFs) for the treatment of atopic dermatitis (AD). Method: Tioconazole transferosomes suspension (TTFs) was formulated and optimized using a 32 factorial design. After that, the optimized batch of TTFs loaded into Carbopol 934 and sodium CMC was prepared with hydrogel and noted as TTFsH. Subsequently, it was evaluated for pH, spread ability, drug content, in vitro drug release, viscosity, in vivo scratching and erythema score, skin irritation, and histopathology study. Result: The optimized batch of TTFs (B4) showed the values of vesicle size, flux, and entrapment efficiency to be 171.40 ± 9.03 nm, 48.23 ± 0.42, and 93.89 ± 2.41, respectively. All batches of TTFsH showed sustained drug release for up to 24 h. The F2 optimized batch released Tz in an amount of 94.23 ± 0.98% with a flux of 47.23 ± 0.823 and followed the Higuchi kinetic model. The in vivo studies provided evidence that the F2 batch of TTFsH was able to treat atopic dermatitis (AD) by reducing the erythema and the scratching score compared to that of the marketed formulation (Candiderm cream, Glenmark). The histopathology study supported the result of the erythema and scratching score study with intact skin structure. It showed that a formulated low dose of TTFsH was safe and biocompatible to both the dermis and the epidermis layer of skin. Conclusion: Thus, a low dose of F2-TTFsH is a promising tool that effectively targeted the skin for the topical delivery of Tz to treat atopic dermatitis symptoms.

Elevations of Extracellular Vesicles and Inflammatory Biomarkers in Closed Circuit SCUBA Divers

Blood-borne extracellular vesicles and inflammatory mediators were evaluated in divers using a closed circuit rebreathing apparatus and custom-mixed gases to diminish some diving risks. "Deep" divers (n = 8) dove once to mean (±SD) 102.5 ± 1.2 m of sea water (msw) for 167.3 ± 11.5 min. "Shallow" divers (n = 6) dove 3 times on day 1, and then repetitively over 7 days to 16.4 ± 3.7 msw, for 49.9 ± 11.9 min. There were statistically significant elevations of microparticles (MPs) in deep divers (day 1) and shallow divers at day 7 that expressed proteins specific to microglia, neutrophils, platelets, and endothelial cells, as well as thrombospondin (TSP)-1 and filamentous (F-) actin. Intra-MP IL-1β increased by 7.5-fold (p < 0.001) after day 1 and 41-fold (p = 0.003) at day 7. Intra-MP nitric oxide synthase-2 (NOS2) increased 17-fold (p < 0.001) after day 1 and 19-fold (p = 0.002) at day 7. Plasma gelsolin (pGSN) levels decreased by 73% (p < 0.001) in deep divers (day 1) and 37% in shallow divers by day 7. Plasma samples containing exosomes and other lipophilic particles increased from 186% to 490% among the divers but contained no IL-1β or NOS2. We conclude that diving triggers inflammatory events, even when controlling for hyperoxia, and many are not proportional to the depth of diving.

Neuroinflammation with increased glymphatic flow in a murine model of decompression sickness

This project investigated glial-based lymphatic (glymphatic) function and its role in a murine model of decompression sickness (DCS). DCS pathophysiology is traditionally viewed as being related to gas bubble formation from insoluble gas on decompression. However, a body of work implicates a role for a subset of inflammatory extracellular vesicles, 0.1 to 1 µm microparticles (MPs) that are elevated in human and rodent models in response to high gas pressure and rise further after decompression. Herein, we describe immunohistochemical and Western blot evidence showing that following high air pressure exposure, there are elevations of astrocyte NF-κB and microglial-ionized calcium-binding adaptor protein-1 (IBA-1) along with fluorescence contrast and MRI findings of an increase in glymphatic flow. Concomitant elevations of central nervous system-derived MPs coexpressing thrombospondin-1 (TSP) drain to deep cervical nodes and then to blood where they cause neutrophil activation. A new set of blood-borne MPs are generated that express filamentous actin at the surface that exacerbate neutrophil activation. Blood-brain barrier integrity is disrupted due to activated neutrophil sequestration that causes further astrocyte and microglial perturbation. When postdecompression node or blood MPs are injected into naïve mice, the same spectrum of abnormalities occur and they are blocked with coadministration of antibody to TSP. We conclude that high pressure/decompression causes neuroinflammation with an increased glymphatic flow. The resulting systemic liberation of TSP-expressing MPs sustains the neuroinflammatory cycle lasting for days.NEW & NOTEWORTHY A murine model of central nervous system (CNS) decompression sickness demonstrates that high gas pressure activates astrocytes and microglia triggering inflammatory microparticle (MP) production. Thrombospondin-expressing MPs are released from the CNS via enhanced glymphatic flow to the systemic circulation where they activate neutrophils. Secondary production of neutrophil-derived MPs causes further cell activation and neutrophil adherence to the brain microvasculature establishing a feed-forward neuroinflammatory cycle.

Blood-Borne Microparticles Are an Inflammatory Stimulus in Type 2 Diabetes Mellitus

The proinflammatory state associated with diabetes mellitus (DM) remains poorly understood. We found patients with DM have 3- to 14-fold elevations of blood-borne microparticles (MPs) that bind phalloidin (Ph; Ph positive [+] MPs), indicating the presence of F-actin on their surface. We hypothesized that F-actin-coated MPs were an unrecognized cause for DM-associated proinflammatory status. Ph+MPs, but not Ph-negative MPs, activate human and murine (Mus musculus) neutrophils through biophysical attributes of F-actin and membrane expression of phosphatidylserine (PS). Neutrophils respond to Ph+MPs via a linked membrane array, including the receptor for advanced glycation end products and CD36, PS-binding membrane receptors. These proteins in conjunction with TLR4 are coupled to NO synthase 1 adaptor protein (NOS1AP). Neutrophil activation occurs because of Ph+MPs causing elevations of NF-κB and Src kinase (SrcK) via a concurrent increased association of NO synthase 2 and SrcK with NOS1AP, resulting in SrcK S-nitrosylation. We conclude that NOS1AP links PS-binding receptors with intracellular regulatory proteins. Ph+MPs are alarmins present in normal human plasma and are increased in those with DM and especially those with DM and a lower-extremity ulcer.

Cystic Hygroma of Wrist

Cystic hygroma is the rare congenital lesion. This is a cystic variety of lymphangioma. Cystic hygroma arising outside of the cervicofacial, thoracic, and abdominal areas are extremely rare. Wrist is a very rare site for occurrence of cystic hygroma. Presentation depends on site of location of cystic hygroma. A case of cystic hygroma of wrist in a child is reported. This child presented with painless swelling of left wrist. Excision of cyst was done. This is first case report of literature reporting occurrence of cystic hygroma on wrist. J Nepal Paediatr Soc 2012;32(2):166-168 doi: http://dx.doi.org/10.3126/jnps.v32i2.5465

Antiinflammatory, analgesic and antipyretic activity of certain thiazolidinones

The thiazolidin-4-one derivatives and the corresponding spiro compounds were synthesized from sulphanilamide and were evaluated for anti-inflammatory and analgesic activity in acute and sub acute models. Compounds were also evaluated for antipyretic and cyclooxygenase enzyme inhibitory activity. All the compounds showed significant antiinflammatory, analgesic and antipyretic activity at 100 mg/kg in all the models. The compounds B1, B2, B5, B6, and B8 showed maximum inhibition of COX-2 activity without inhibiting the COX-1 activity. The nimesulide was used as standard drug for comparison. The substitution at R, R₁ and R₂ with the functional groups Cl, OCH₃, NO₂ and OH in the aromatic ring resulted in increased activity as compared to unsubstituted thiazolidin-4-ones. However the substitution at R₃ with spiro group did not improve the activity. The study suggests that COX-2 binding site may not be a rigid structure but might adopt to various related molecules.

Head injury in children due to cricket ball scenario in developing countries

OBJECTIVES

The aim of the study was the assessment of head injury caused by cricket ball injury in children. In underdeveloped countries, this is particularly important due to the absence of safety precautions. The study was undertaken to increase the public awareness of the need to reduce the morbidity related to this sport.

METHODS

This was a prospective study in which all the children <18 years who had sustained head injury due to cricket balls were enrolled.

RESULTS

The study included 27 children, 26 males and 1 female. Out of these 21 cases of head injury were due to hard plastic cricket balls and the rest were due to conventional cricket balls. In 25 patients, CT scan was done, which revealed a lesion in 21 of them. Six patients required surgery, 3 for extradural hematoma, 1 for acute subdural hematoma, 1 for contusion and 1 for compound depressed fracture. One death occurred in our series. There was no significant difference in the nature of injury sustained by either plastic or conventional cricket balls.

CONCLUSION

Head injury due to cricket balls can lead to serious consequences even if an innocuous plastic ball is used in place of a conventional cricket ball. Public awareness apart from safety measures is required so that helmets are worn during playing. Change in the nature of the balls may bring a reduction in the severity of head injury.

Synthesis and in-vitro antimicrobial activity of new 1,2,4-triazoles

We have described the synthesis of new 1,2,4-triazoles and have evaluated their antimicrobial profile. Antitubercular activity was determined in triplicate using the Lowenstein-Jensen medium. A loopful of Mycobacterium tuberculosis suspension was inoculated on the surface of each Lowenstein-Jensen media containing the test compounds (100, 10 or 1 microg mL(-1)). To evaluate in-vitro antibacterial activity, compounds (50, 5 or 0.5 microg) were evaluated against B. subtilis, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Staphylococcus typhi by the disc diffusion method. To evaluate antifungal activity Sabourauds Dextrose agar medium was used. Some of the compounds (5, 0.5 or 0.05 microg mL(-1)) were screened for activity against Aspergillus niger 88 and Aspergillus niger 90 and others were screened for activity against T. rubrum TR1, T. rubrum R6, T. rubrum R7 and T. mentagrophyte M1, using the cup plate method. Our results show that the triazoles with a pyrazine moiety at position 3 were more active as antitubercular and antifungal agents compared with the triazoles which had a pyrazine moiety at position 4 of the molecule.

Acute psychosis following cervical myelography with iohexol

We report a young man who developed transient acute psychosis following uneventful cervical myelography with iohexol. This complication has not been described previously.

Protease inhibitors in serum and urine of snakebite victims

In victims of poisonous snakebites, serum total antichymotryptic activity but not the antitryptic activity was found to be increased. In addition, urinary antitryptic activity was found to be markedly elevated. In nonpoisonous snakebite cases, no such differences were noted. Ion-exchange chromatographic analysis of serum protease inhibitors revealed the absence of inhibitory activity in the alpha 2-macroglobulin fraction and elevation of alpha 1-antichymotrypsin in poisonous bite cases. In addition, there was a significant increase in the ratio of cationic to anionic fraction of alpha 1-protease inhibitor compared to normals. Urinary antitryptic activity could serve as a reliable index in assessing clinical improvement in snakebite victims during treatment and in differentiating poisonous from nonpoisonous cases.

Comparative study of proteinase inhibitors in human amniotic fluid and maternal serum

Serum and amniotic fluid samples from five pregnant women were analyzed for different proteinase inhibitors by ion-exchange chromatography on DEAE-cellulose. Alpha-2 macroglobulin was found to be absent in amniotic fluid. Even though alpha-1 antichymotrypsin was identified in amniotic fluid, its concentration gradient between serum and amniotic fluid (20--60) was much higher than that of alpha-1 antitrypsin (8--20). Two forms of alpha-1 antitrypsin were identified in both the fluids. In pregnancy, the ratio of the two forms was altered in favour of the less anionic form compared to normal sera. The contribution of the heat stable proteinase inhibitor for total antitryptic activity in amniotic fluid was more than in serum. The observation that urine samples from immature infants had higher heat stable inhibitory activity than urine samples from normal infants suggests that the heat stable inhibitor in amniotic fluid may arise from fetal kidney.

Protease inhibitors in serum and amniotic fluid during pregnancy

Antitryptic and antichymotryptic activities in amniotic fluid and maternal serum were measured at various stages of pregnancy using the caseinolytic assay method for proteases. The inhibitory activities increased up to 20 weeks in amniotic fluid and remained in the same range up to 30 weeks; a sharp fall was observed at term. In serum, there was a gradual rise of activities with peak values around 30 weeks. The decrease with further advance of pregnancy was not as sharp as in amniotic fluid. The ratios of antitryptic to antichymotryptic activities remained fairly constant (1.54 +/- 0.07) in amniotic fluid throughout pregnancy. In maternal serum the ratio varied over a range of 1.28 to 2.67 and the increase in antichymotryptic activity was relatively greater between 16 and 30 weeks resulting in a lower ratio between the two activities. Amniotic fluid was found to contain a higher proportion of a heat stable inhibitor compared to serum and its contribution to total antitryptic activity varied from 8.7 to 15.6 per cent.