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Stukas S, Cooper J, Higgins V, Holmes D, Adeli K, Wellington CL. Pediatric reference intervals for serum neurofilament light and glial fibrillary acidic protein using the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort. Clin Chem Lab Med 2024; 62:698-705. [PMID: 37882772 PMCID: PMC10895925 DOI: 10.1515/cclm-2023-0660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES Blood biomarkers have the potential to transform diagnosis and prognosis for multiple neurological indications. Establishing normative data is a critical benchmark in the analytical validation process. Normative data are important in children as little is known about how brain development may impact potential biomarkers. The objective of this study is to generate pediatric reference intervals (RIs) for serum neurofilament light (NfL), an axonal marker, and glial fibrillary acidic protein (GFAP), an astrocytic marker. METHODS Serum from healthy children and adolescents aged 1 to <19 years were obtained from the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort. Serum NfL (n=300) and GFAP (n=316) were quantified using Simoa technology, and discrete RI (2.5th and 97.5th percentiles) and continuous RI (5th and 95th percentiles) were generated. RESULTS While there was no association with sex, there was a statistically significant (p<0.0001) negative association between age and serum NfL (Rho -0.400) and GFAP (Rho -0.749). Two statistically significant age partitions were generated for NfL: age 1 to <10 years (lower, upper limit; 3.13, 20.6 pg/mL) and 10 to <19 years (1.82, 7.44 pg/mL). For GFAP, three statistically significant age partitions were generated: age 1 to <3.5 years (80.4, 601 pg/mL); 3.5 to <11 years (50.7, 224 pg/mL); and 11 to <19 years (26.2, 119 pg/mL). CONCLUSIONS Taken together with the literature on adults, NfL and GFAP display U-shaped curves with high levels in infants, decreasing levels during childhood, a plateau during adolescence and early adulthood and increasing levels in seniors. These normative data are expected to inform future pediatric studies on the importance of age on neurological blood biomarkers.
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Affiliation(s)
- Sophie Stukas
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Cooper
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Victoria Higgins
- CALIPER Program, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daniel Holmes
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, Providence Health, Vancouver, BC, Canada
| | - Khosrow Adeli
- CALIPER Program, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Cheryl L. Wellington
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Center, University of British Columbia, Vancouver, BC, Canada
- School of Biomedical Engineering (SBME), University of British Columbia, Vancouver, BC, Canada
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Criado-Marrero M, Ravi S, Bhaskar E, Barroso D, Pizzi MA, Williams L, Wellington CL, Febo M, Abisambra JF. Age dictates brain functional connectivity and axonal integrity following repetitive mild traumatic brain injuries. bioRxiv 2024:2024.01.25.577316. [PMID: 38328104 PMCID: PMC10849649 DOI: 10.1101/2024.01.25.577316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Traumatic brain injuries (TBI) present a major public health challenge, demanding an in-depth understanding of age-specific signs and vulnerabilities. Aging not only significantly influences brain function and plasticity but also elevates the risk of hospitalizations and death following repetitive mild traumatic brain injuries (rmTBIs). In this study, we investigate the impact of age on brain network changes and white matter properties following rmTBI employing a multi-modal approach that integrates resting-state functional magnetic resonance imaging (rsfMRI), graph theory analysis, diffusion tensor imaging (DTI), and Neurite Orientation Dispersion and Density Imaging (NODDI). Utilizing the CHIMERA model, we conducted rmTBIs or sham (control) procedures on young (2.5-3 months old) and aged (22-month-old) male and female mice to model high risk groups. Functional and structural imaging unveiled age-related reductions in communication efficiency between brain regions, while injuries induced opposing effects on the small-world index across age groups, influencing network segregation. Functional connectivity analysis also identified alterations in 79 out of 148 brain regions by age, treatment (sham vs. rmTBI), or their interaction. Injuries exerted pronounced effects on sensory integration areas, including insular and motor cortices. Age-related disruptions in white matter integrity were observed, indicating alterations in various diffusion directions (mean, radial, axial diffusivity, fractional anisotropy) and density neurite properties (dispersion index, intracellular and isotropic volume fraction). Inflammation, assessed through Iba-1 and GFAP markers, correlated with higher dispersion in the optic tract, suggesting a neuroinflammatory response in aged animals. These findings provide a comprehensive understanding of the intricate interplay between age, injuries, and brain connectivity, shedding light on the long-term consequences of rmTBIs.
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Poliakova T, Wellington CL. Roles of peripheral lipoproteins and cholesteryl ester transfer protein in the vascular contributions to cognitive impairment and dementia. Mol Neurodegener 2023; 18:86. [PMID: 37974180 PMCID: PMC10652636 DOI: 10.1186/s13024-023-00671-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023] Open
Abstract
This narrative review focuses on the role of cholesteryl ester transfer protein (CETP) and peripheral lipoproteins in the vascular contributions to cognitive impairment and dementia (VCID). Humans have a peripheral lipoprotein profile where low-density lipoproteins (LDL) represent the dominant lipoprotein fraction and high-density lipoproteins (HDL) represent a minor lipoprotein fraction. Elevated LDL-cholesterol (LDL-C) levels are well-established to cause cardiovascular disease and several LDL-C-lowering therapies are clinically available to manage this vascular risk factor. The efficacy of LDL-C-lowering therapies to reduce risk of all-cause dementia and AD is now important to address as recent studies demonstrate a role for LDL in Alzheimer's Disease (AD) as well as in all-cause dementia. The LDL:HDL ratio in humans is set mainly by CETP activity, which exchanges cholesteryl esters for triglycerides across lipoprotein fractions to raise LDL and lower HDL as CETP activity increases. Genetic and pharmacological studies support the hypothesis that CETP inhibition reduces cardiovascular risk by lowering LDL, which, by extension, may also lower VCID. Unlike humans, wild-type mice do not express catalytically active CETP and have HDL as their major lipoprotein fraction. As HDL has potent beneficial effects on endothelial cells, the naturally high HDL levels in mice protect them from vascular disorders, likely including VCID. Genetic restoration of CETP expression in mice to generate a more human-like lipid profile may increase the relevance of murine models for VCID studies. The therapeutic potential of existing and emerging LDL-lowering therapies for VCID will be discussed. Figure Legend. Cholesteryl Ester Transfer Protein in Alzheimer's Disease. CETP is mainly produced by the liver, and exchanges cholesteryl esters for triglycerides across lipoprotein fractions to raise circulating LDL and lower HDL as CETP activity increases. Low CETP activity is associated with better cardiovascular health, due to decreased LDL and increased HDL, which may also improve brain health. Although most peripheral lipoproteins cannot enter the brain parenchyma due to the BBB, it is increasingly appreciated that direct access to the vascular endothelium may enable peripheral lipoproteins to have indirect effects on brain health. Thus, lipoproteins may affect the cerebrovasculature from both sides of the BBB. Recent studies show an association between elevated plasma LDL, a well-known cardiovascular risk factor, and a higher risk of AD, and considerable evidence suggests that high HDL levels are associated with reduced CAA and lower neuroinflammation. Considering the potential detrimental role of LDL in AD and the importance of HDL's beneficial effects on endothelial cells, high CETP activity may lead to compromised BBB integrity, increased CAA deposits and greater neuroinflammation. Abbreviations: CETP - cholesteryl transfer ester protein; LDL - low-density lipoproteins; HDL - high-density lipoproteins; BBB - blood-brain barrier; CAA - cerebral amyloid angiopathy, SMC - smooth muscle cells, PVM - perivascular macrophages, RBC - red blood cells.
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Affiliation(s)
- Tetiana Poliakova
- Department of Pathology and Laboratory Medicine, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
- Djavad Mowafagian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
- Djavad Mowafagian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
- International Collaboration On Repair Discoveries, Vancouver, BC, Canada.
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada.
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Cooper JG, Stukas S, Ghodsi M, Ahmed N, Diaz-Arrastia R, Holmes DT, Wellington CL. Age specific reference intervals for plasma biomarkers of neurodegeneration and neurotrauma in a Canadian population. Clin Biochem 2023; 121-122:110680. [PMID: 37884086 DOI: 10.1016/j.clinbiochem.2023.110680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION In this study, we aimed to create reference intervals (RI) using a large Canadian population-based cohort, for plasma protein biomarkers with potential utility to screen, diagnosis, prognosticate and manage a variety of neurological diseases and disorders. RIs were generated for: the ratio of amyloid beta 42 over 40 (Aβ42/40), phosphorylated tau-181 (p-tau-181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). METHODS 900 plasma specimens from male and female participants aged 3-79 years old were obtained from the Statistics Canada Biobank, which holds specimens from the Canadian Health Measures Survey. Analysis of Aβ42/40, p-tau-181, NfL and GFAP was performed on the Quanterix Simoa HD-X analyzer using the Neurology 4-plex E and p-tau-181 assays. Discrete RIs were produced according to Clinical Laboratory Standards Institute guidelines (EP28-A3c). Continuous RIs were created using quantile regression. RESULTS For discrete RIs, significant age partitions were determined for each biomarker. No significant sex partitions were found. The following ranges and age partitions were determined: Aβ42/40: 3-<55y = 0.053-0.098, 55-<80y = 0.040-0.090; p-tau-181: 3-<12y = 1.4-5.6 pg/ml, 12-<60y = 0.8-3.1 pg/ml, 60-<80y = 0.9-4.0 pg/ml; NfL: 3-<40y = 2.6-11.3 pg/ml, 40-<60y = 4.6-17.7 pg/ml, 60-<80y = 8.1-47.1 pg/ml; GFAP; 3-<10y = 47.0-226 pg/ml, 10-<60y = 21.2-91.9 pg/ml, 60-<80y = 40.7-228 pg/ml. Continuous RIs produced smooth centile curves across the age range, from which point estimates for each year of age were calculated. CONCLUSIONS Discrete and continuous RIs for neurological plasma biomarkers will help refine normative cut-offs across the lifespan and improve the precision of interpretating biomarker levels. Continuous RIs are recommended for use in age groups, such as pediatrics and older adults, that experience rapid concentration changes by age.
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Affiliation(s)
- Jennifer G Cooper
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Sophie Stukas
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Mohammad Ghodsi
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Nyra Ahmed
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Ramon Diaz-Arrastia
- Clinical TBI Research Center, Penn Presbyterian Medical Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Daniel T Holmes
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, Providence Health, 1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - Cheryl L Wellington
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada; School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada.
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Tabor JB, Galarneau JM, Penner LC, Cooper J, Ghodsi M, Fraser DD, Wellington CL, Debert CT, Emery CA. Use of Biostatistical Models to Manage Replicate Error in Concussion Biomarker Research. JAMA Netw Open 2023; 6:e2339733. [PMID: 37870831 PMCID: PMC10594140 DOI: 10.1001/jamanetworkopen.2023.39733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/13/2023] [Indexed: 10/24/2023] Open
Abstract
Importance Advancing research on fluid biomarkers associated with sport-related concussion (SRC) highlights the importance of detecting low concentrations using ultrasensitive platforms. However, common statistical practices may overlook replicate errors and specimen exclusion, emphasizing the need to explore robust modeling approaches that consider all available replicate data for comprehensive understanding of sample variation and statistical inferences. Objective To evaluate the impact of replicate error and different biostatistical modeling approaches on SRC biomarker interpretation. Design, Setting, and Participants This cross-sectional study within the Surveillance in High Schools to Reduce the Risk of Concussions and Their Consequences study used data from healthy youth athletes (ages 11-18 years) collected from 3 sites across Canada between September 2019 and November 2021. Data were analyzed from November 2022 to February 2023. Exposures Demographic variables included age, sex, and self-reported history of previous concussion. Main Outcomes and Measures Outcomes of interest were preinjury plasma glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), neurofilament-light (NFL), total tau (t-tau) and phosphorylated-tau-181 (p-tau-181) assayed in duplicate. Bland-Altman analysis determined the 95% limits of agreement (LOAs) for each biomarker. The impact of replicate error was explored using 3 biostatistical modeling approaches assessing the associations of age, sex, and previous concussion on biomarker concentrations: multilevel regression using all available replicate data, single-level regression using the means of replicate data, and single-level regression with replicate means, excluding specimens demonstrating more than 20% coefficient variation (CV). Results The sample included 149 healthy youth athletes (78 [52%] male; mean [SD] age, 15.74 [1.41] years; 51 participants [34%] reporting ≥1 previous concussions). Wide 95% LOAs were observed for GFAP (-17.74 to 18.20 pg/mL), UCH-L1 (-13.80 to 14.77 pg/mL), and t-tau (65.27% to 150.03%). GFAP and UCH-L1 were significantly associated with sex in multilevel regression (GFAP: effect size, 15.65%; β = -0.17; 95% CI, -0.30 to -0.04]; P = .02; UCH-L1: effect size, 17.24%; β = -0.19; 95% CI, -0.36 to -0.02]; P = .03) and single-level regression using the means of replicate data (GFAP: effect size, 15.56%; β = -0.17; 95% CI, -0.30 to -0.03]; P = .02; UCH-L1: effect size, 18.02%; β = -0.20; 95% CI, -0.37 to -0.03]; P = .02); however, there was no association for UCH-L1 after excluding specimens demonstrating more than 20% CV. Excluding specimens demonstrating more than 20% CV resulted in decreased differences associated with sex in GFAP (effect size, 12.29%; β = -0.14; 95% CI, -0.273 to -0.004]; P = .04) and increased sex differences in UCH-L1 (effect size, 23.59%; β = -0.27; 95% CI, -0.55 to 0.01]; P = .06), with the widest 95% CIs (ie, least precision) found in UCH-L1. Conclusions and Relevance In this cross-sectional study of healthy youth athletes, varying levels of agreement between SRC biomarker technical replicates suggested that means of measurements may not optimize precision for population values. Multilevel regression modeling demonstrated how incorporating all available biomarker data could capture replicate variation, avoiding challenges associated with means and percentage of CV exclusion thresholds to produce more representative estimates of association.
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Affiliation(s)
- Jason B. Tabor
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jean-Michel Galarneau
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Linden C. Penner
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer Cooper
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ghodsi
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Douglas D. Fraser
- Department of Pediatrics and Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Cheryl L. Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chantel T. Debert
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn A. Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Iadecola C, Smith EE, Anrather J, Gu C, Mishra A, Misra S, Perez-Pinzon MA, Shih AY, Sorond FA, van Veluw SJ, Wellington CL. The Neurovasculome: Key Roles in Brain Health and Cognitive Impairment: A Scientific Statement From the American Heart Association/American Stroke Association. Stroke 2023; 54:e251-e271. [PMID: 37009740 PMCID: PMC10228567 DOI: 10.1161/str.0000000000000431] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
BACKGROUND Preservation of brain health has emerged as a leading public health priority for the aging world population. Advances in neurovascular biology have revealed an intricate relationship among brain cells, meninges, and the hematic and lymphatic vasculature (the neurovasculome) that is highly relevant to the maintenance of cognitive function. In this scientific statement, a multidisciplinary team of experts examines these advances, assesses their relevance to brain health and disease, identifies knowledge gaps, and provides future directions. METHODS Authors with relevant expertise were selected in accordance with the American Heart Association conflict-of-interest management policy. They were assigned topics pertaining to their areas of expertise, reviewed the literature, and summarized the available data. RESULTS The neurovasculome, composed of extracranial, intracranial, and meningeal vessels, as well as lymphatics and associated cells, subserves critical homeostatic functions vital for brain health. These include delivering O2 and nutrients through blood flow and regulating immune trafficking, as well as clearing pathogenic proteins through perivascular spaces and dural lymphatics. Single-cell omics technologies have unveiled an unprecedented molecular heterogeneity in the cellular components of the neurovasculome and have identified novel reciprocal interactions with brain cells. The evidence suggests a previously unappreciated diversity of the pathogenic mechanisms by which disruption of the neurovasculome contributes to cognitive dysfunction in neurovascular and neurodegenerative diseases, providing new opportunities for the prevention, recognition, and treatment of these conditions. CONCLUSIONS These advances shed new light on the symbiotic relationship between the brain and its vessels and promise to provide new diagnostic and therapeutic approaches for brain disorders associated with cognitive dysfunction.
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Cheng WH, Cheung H, Kang A, Fan J, Cooper J, Anwer M, Barron C, Wilkinson A, Hu G, Yue J, Cripton PA, Vocadlo DJ, Wellington CL. Altered Tau Kinase Activity in rTg4510 Mice after a Single Interfaced CHIMERA Traumatic Brain Injury. Int J Mol Sci 2023; 24:ijms24119439. [PMID: 37298388 DOI: 10.3390/ijms24119439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Traumatic brain injury (TBI) is an established risk factor for neurodegenerative diseases. In this study, we used the Closed Head Injury Model of Engineered Rotational Acceleration (CHIMERA) to investigate the effects of a single high-energy TBI in rTg4510 mice, a mouse model of tauopathy. Fifteen male rTg4510 mice (4 mo) were impacted at 4.0 J using interfaced CHIMERA and were compared to sham controls. Immediately after injury, the TBI mice showed significant mortality (7/15; 47%) and a prolonged duration of loss of the righting reflex. At 2 mo post-injury, surviving mice displayed significant microgliosis (Iba1) and axonal injury (Neurosilver). Western blotting indicated a reduced p-GSK-3β (S9):GSK-3β ratio in TBI mice, suggesting chronic activation of tau kinase. Although longitudinal analysis of plasma total tau suggested that TBI accelerates the appearance of tau in the circulation, there were no significant differences in brain total or p-tau levels, nor did we observe evidence of enhanced neurodegeneration in TBI mice compared to sham mice. In summary, we showed that a single high-energy head impact induces chronic white matter injury and altered GSK-3β activity without an apparent change in post-injury tauopathy in rTg4510 mice.
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Affiliation(s)
- Wai Hang Cheng
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Honor Cheung
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Amy Kang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jianjia Fan
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jennifer Cooper
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Mehwish Anwer
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Carlos Barron
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Anna Wilkinson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Grace Hu
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jefferey Yue
- Department of Chemistry, Simon Fraser University, Vancouver, BC V5A 1S6, Canada
| | - Peter A Cripton
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- International Collaboration on Repair Discoveries, Vancouver, BC V5Z 1M9, Canada
| | - David J Vocadlo
- Department of Chemistry, Simon Fraser University, Vancouver, BC V5A 1S6, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- International Collaboration on Repair Discoveries, Vancouver, BC V5Z 1M9, Canada
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Stukas S, Cooper J, Gill J, Fallah N, Skinnider MA, Belanger L, Ritchie L, Tsang A, Dong K, Streijger F, Street J, Paquette S, Ailon T, Dea N, Charest-Morin R, Fisher CG, Bailey CS, Dhall S, Mac-Thiong JM, Wilson JR, Christie S, Dvorak MF, Wellington CL, Kwon BK. Association of CSF and Serum Neurofilament Light and Glial Fibrillary Acidic Protein, Injury Severity, and Outcome in Spinal Cord Injury. Neurology 2023; 100:e1221-e1233. [PMID: 36599698 PMCID: PMC10033160 DOI: 10.1212/wnl.0000000000206744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/15/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Traumatic spinal cord injury (SCI) is highly heterogeneous, and tools to better delineate pathophysiology and recovery are needed. Our objective was to profile the response of 2 biomarkers, neurofilament light (NF-L) and glial fibrillary acidic protein (GFAP), in the serum and CSF of patients with acute SCI to evaluate their ability to objectively characterize injury severity and predict neurologic recovery. METHODS Blood and CSF samples were obtained from prospectively enrolled patients with acute SCI through days 1-4 postinjury, and the concentration of NF-L and GFAP was quantified using Simoa technology. Neurologic assessments defined the ASIA Impairment Scale (AIS) grade and motor score (MS) at presentation and 6 months postinjury. RESULTS One hundred eighteen patients with acute SCI (78 AIS A, 20 AIS B, and 20 AIS C) were enrolled, with 113 (96%) completing 6-month follow-up. NF-L and GFAP levels were strongly associated between paired serum and CSF specimens, were both increased with injury severity, and distinguished among baseline AIS grades. Serum NF-L and GFAP were significantly (p = 0.02 to <0.0001) higher in AIS A patients who did not improve at 6 months, predicting AIS grade conversion with a sensitivity and specificity (95% CI) of 76% (61, 87) and 77% (55, 92) using NF-L and 72% (57, 84) and 77% (55, 92) using GFAP at 72 hours, respectively. Independent of clinical baseline assessment, a serum NF-L threshold of 170 pg/mL at 72 hours predicted those patients who would be classified as motor complete (AIS A/B) compared with motor incomplete (AIS C/D) at 6 months with a sensitivity of 87% (76, 94) and specificity of 84% (69, 94); a serum GFAP threshold of 13,180 pg/mL at 72 hours yielded a sensitivity of 90% (80, 96) and specificity of 84% (69, 94). DISCUSSION The potential for NF-L and GFAP to classify injury severity and predict outcome after acute SCI will be useful for patient stratification and prognostication in clinical trials and inform communication of prognosis. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that higher serum NF-L and GFAP are associated with worse neurological outcome after acute SCI. TRIAL REGISTRATION INFORMATION Registered on ClinicalTrials.gov: NCT00135278 (March 2006) and NCT01279811 (January 2012).
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Affiliation(s)
- Sophie Stukas
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Jennifer Cooper
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Jasmine Gill
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Nader Fallah
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Michael A Skinnider
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Lise Belanger
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Leanna Ritchie
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Angela Tsang
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Kevin Dong
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Femke Streijger
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - John Street
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Scott Paquette
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Tamir Ailon
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Nicolas Dea
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Raphaele Charest-Morin
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Charles G Fisher
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Christopher S Bailey
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Sanjay Dhall
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Jean-Marc Mac-Thiong
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Jefferson R Wilson
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Sean Christie
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Marcel F Dvorak
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Cheryl L Wellington
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Brian K Kwon
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada.
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9
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Cooper JG, Stukas SK, Grey R, Ghodsi M, Ahmed N, Hoiland R, Thiara S, Foster D, Harper M, Panenka WJ, Silverberg NN, Stoessl JA, Sossi V, Sekhon MS, Wellington CL. The Utility of Blood Based Biomarkers in Detecting Neurological Complications of COVID‐19 in Critically Ill Patients. Alzheimers Dement 2022. [DOI: 10.1002/alz.069086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - Rebecca Grey
- University of British Columbia Vancouver BC Canada
| | | | - Nyra Ahmed
- University of British Columbia Vancouver BC Canada
| | - Ryan Hoiland
- University of British Columbia Vancouver BC Canada
| | - Sonny Thiara
- University of British Columbia Vancouver BC Canada
| | | | - Megan Harper
- University of British Columbia Vancouver BC Canada
| | | | | | | | - Vesna Sossi
- Physics and Astronomy Department and DM Center for Brain Health, University of British Columbia Vancouver BC Canada
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10
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Cooper JG, Stukas SK, Ghodsi M, Ahmed N, Holmes D, Wellington CL. Reference Intervals for Plasma Biomarkers of Alzheimer’s Disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.064762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | - Nyra Ahmed
- University of British Columbia Vancouver BC Canada
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11
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Messing M, Sekhon MS, Hughes MR, Stukas S, Hoiland RL, Cooper J, Ahmed N, Hamer MS, Li Y, Shin SB, Tung LW, Wellington CL, Sin DD, Leslie KB, McNagny KM. Prognostic peripheral blood biomarkers at ICU admission predict COVID-19 clinical outcomes. Front Immunol 2022; 13:1010216. [DOI: 10.3389/fimmu.2022.1010216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic continues to challenge the capacities of hospital ICUs which currently lack the ability to identify prospectively those patients who may require extended management. In this study of 90 ICU COVID-19 patients, we evaluated serum levels of four cytokines (IL-1β, IL-6, IL-10 and TNFα) as well as standard clinical and laboratory measurements. On 42 of these patients (binned into Initial and Replication Cohorts), we further performed CyTOF-based deep immunophenotyping of peripheral blood mononuclear cells with a panel of 38 antibodies. All measurements and patient samples were taken at time of ICU admission and retrospectively linked to patient clinical outcomes through statistical approaches. These analyses resulted in the definition of a new measure of patient clinical outcome: patients who will recover after short ICU stays (< 6 days) and those who will subsequently die or recover after long ICU stays (≥6 days). Based on these clinical outcome categories, we identified blood prognostic biomarkers that, at time of ICU admission, prospectively distinguish, with 91% sensitivity and 91% specificity (positive likelihood ratio 10.1), patients in the two clinical outcome groups. This is achieved through a tiered evaluation of serum IL-10 and targeted immunophenotyping of monocyte subsets, specifically, CD11clow classical monocytes. Both immune biomarkers were consistently elevated ( ≥15 pg/ml and ≥2.7 x107/L for serum IL-10 and CD11clow classical monocytes, respectively) in those patients who will subsequently die or recover after long ICU stays. This highly sensitive and specific prognostic test could prove useful in guiding clinical resource allocation.
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12
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Cameron TC, Randhawa A, Grist SM, Bennet T, Hua J, Alde LG, Caffrey TM, Wellington CL, Cheung KC. PDMS Organ-On-Chip Design and Fabrication: Strategies for Improving Fluidic Integration and Chip Robustness of Rapidly Prototyped Microfluidic In Vitro Models. Micromachines (Basel) 2022; 13:mi13101573. [PMID: 36295926 PMCID: PMC9609846 DOI: 10.3390/mi13101573] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/07/2022] [Accepted: 09/15/2022] [Indexed: 05/31/2023]
Abstract
The PDMS-based microfluidic organ-on-chip platform represents an exciting paradigm that has enjoyed a rapid rise in popularity and adoption. A particularly promising element of this platform is its amenability to rapid manufacturing strategies, which can enable quick adaptations through iterative prototyping. These strategies, however, come with challenges; fluid flow, for example, a core principle of organs-on-chip and the physiology they aim to model, necessitates robust, leak-free channels for potentially long (multi-week) culture durations. In this report, we describe microfluidic chip fabrication methods and strategies that are aimed at overcoming these difficulties; we employ a subset of these strategies to a blood-brain-barrier-on-chip, with others applied to a small-airway-on-chip. Design approaches are detailed with considerations presented for readers. Results pertaining to fabrication parameters we aimed to improve (e.g., the thickness uniformity of molded PDMS), as well as illustrative results pertaining to the establishment of cell cultures using these methods will also be presented.
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Affiliation(s)
- Tiffany C. Cameron
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Avineet Randhawa
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Samantha M. Grist
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Dream Photonics Inc., Vancouver, BC V6T 0A7, Canada
| | - Tanya Bennet
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Jessica Hua
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Luis G. Alde
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Chemistry, University of British Columbia, Vancouver, BC V6T 1Z1, Canada
| | - Tara M. Caffrey
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Cheryl L. Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Karen C. Cheung
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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13
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Stukas S, Goshua G, Kinkade A, Grey R, Mah G, Biggs CM, Jamal S, Thiara S, Lau TT, Piszczek J, Partovi N, Sweet DD, Lee AY, Wellington CL, Sekhon MS, Chen LY. Reduced fixed dose tocilizumab 400 mg IV compared to weight-based dosing in critically ill patients with COVID-19: A before-after cohort study. The Lancet Regional Health - Americas 2022; 11:100228. [PMID: 35345649 PMCID: PMC8941850 DOI: 10.1016/j.lana.2022.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Interleukin-6 inhibitors reduce mortality in severe COVID-19. British Columbia began using tocilizumab 8 mg/kg (maximum 800 mg) in January 2021 in critically ill patients with COVID-19, but due to drug shortages, decreased dosing to 400 mg IV fixed dose in April 2021. The aims of this study were twofold: to compare physiological responses and clinical outcomes of these two strategies, and examine the cost-effectiveness of treating all patients with 400 mg versus half the patients with 8 mg/kg and the other half without tocilizumab. Methods This was a single-centre, before-after cohort study of critically ill COVID-19 patients treated with tocilizumab, and a control cohort treated with dexamethasone only. Physiological responses and clinical outcomes were compared between patients receiving both doses of tocilizumab and those receiving dexamethasone only. We built a decision tree model to examine cost-effectiveness. Findings 152 patients were included; 40 received tocilizumab 8 mg/kg, 59 received 400 mg and 53 received dexamethasone only. Median CRP fell from 103 mg/L to 5.2 mg/L, 96 mg/L to 6.8 mg/L and from 81.3 mg/L to 48 mg/L in the 8 mg/kg, 400 mg tocilizumab, and dexamethasone only groups, respectively. 28-day mortality was 5% (n=2) vs 8% (n=5) vs 13% (n=7), with no significant difference in all pair-wise comparison. At an assumed willingness-to-pay threshold of $50,000 Canadian per life-year, utilizing 400 mg for all patients rather than 8 mg/kg for half the patients is cost-effective in 51.6% of 10,000 Monte Carlo simulations. Interpretation Both doses of tocilizumab demonstrated comparable reduction of inflammation with similar 28-day mortality. Without consideration of equity, the net monetary benefits of providing 400 mg tocilizumab to all patients are comparable to 8 mg/kg to half the patients. In the context of ongoing drug shortages, fixed-dose 400 mg tocilizumab may be a practical, feasible and economical option. Funding This work was supported by a gift donation from Hsu & Taylor Family to the VGH Foundation, and the Yale Bernard G. Forget Scholarship.
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14
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Hoiland RL, Rikhraj KJK, Thiara S, Fordyce C, Kramer AH, Skrifvars MB, Wellington CL, Griesdale DE, Fergusson NA, Sekhon MS. Neurologic Prognostication After Cardiac Arrest Using Brain Biomarkers: A Systematic Review and Meta-analysis. JAMA Neurol 2022; 79:390-398. [PMID: 35226054 PMCID: PMC8886448 DOI: 10.1001/jamaneurol.2021.5598] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Brain injury biomarkers released into circulation from the injured neurovascular unit are important prognostic tools in patients with cardiac arrest who develop hypoxic ischemic brain injury (HIBI) after return of spontaneous circulation (ROSC). OBJECTIVE To assess the neuroprognostic utility of bloodborne brain injury biomarkers in patients with cardiac arrest with HIBI. DATA SOURCES Studies in electronic databases from inception to September 15, 2021. These databases included MEDLINE, Embase, Evidence-Based Medicine Reviews, CINAHL, Cochrane Database of Systematic Reviews, and the World Health Organization Global Health Library. STUDY SELECTION Articles included in this systmatic review and meta-analysis were independently assessed by 2 reviewers. We included studies that investigated neuron-specific enolase, S100 calcium-binding protein β, glial fibrillary acidic protein, neurofilament light, tau, or ubiquitin carboxyl hydrolase L1 in patients with cardiac arrest aged 18 years and older for neurologic prognostication. We excluded studies that did not (1) dichotomize neurologic outcome as favorable vs unfavorable, (2) specify the timing of blood sampling or outcome determination, or (3) report diagnostic test accuracy or biomarker concentration. DATA EXTRACTION AND SYNTHESIS Data on the study design, inclusion and exclusion criteria, brain biomarkers levels, diagnostic test accuracy, and neurologic outcome were recorded. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. MAIN OUTCOMES AND MEASURES Summary receiver operating characteristic curve analysis was used to calculate the area under the curve, sensitivity, specificity, and optimal thresholds for each biomarker. Risk of bias and concerns of applicability were assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. RESULTS We identified 2953 studies, of which 86 studies with 10 567 patients (7777 men [73.6] and 2790 women [26.4]; pooled mean [SD] age, 62.8 [10.2] years) were included. Biomarker analysis at 48 hours after ROSC demonstrated that neurofilament light had the highest predictive value for unfavorable neurologic outcome, with an area under the curve of 0.92 (95% CI, 0.84-0.97). Subgroup analyses of patients treated with targeted temperature management and those who specifically had an out-of-hospital cardiac arrest showed similar results (targeted temperature management, 0.92 [95% CI, 0.86-0.95] and out-of-hospital cardiac arrest, 0.93 [95% CI, 0.86-0.97]). CONCLUSIONS AND RELEVANCE Neurofilament light, which reflects white matter damage and axonal injury, yielded the highest accuracy in predicting neurologic outcome in patients with HIBI at 48 hours after ROSC. TRIAL REGISTRATION PROSPERO Identifier: CRD42020157366.
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Affiliation(s)
- Ryan L. Hoiland
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada,Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, British Columbia, Canada,Department of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Kiran J. K. Rikhraj
- Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sharanjit Thiara
- Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher Fordyce
- Division of Cardiology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andreas H. Kramer
- Department of Critical Care Medicine, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | - Markus B. Skrifvars
- Department of Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Cheryl L. Wellington
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada,Department of Pathology and Laboratory Medicine, Faculty of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Donald E. Griesdale
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada,Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada,Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas A. Fergusson
- Faculty of Medicine, University of British Columbia, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mypinder S. Sekhon
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada,Division of Critical Care Medicine, Department of Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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15
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Leatherdale A, Stukas S, Lei V, West HE, Campbell CJ, Hoiland RL, Cooper J, Wellington CL, Sekhon MS, Pryzdial ELG, Conway EM. Persistently elevated complement alternative pathway biomarkers in COVID-19 correlate with hypoxemia and predict in-hospital mortality. Med Microbiol Immunol 2022; 211:37-48. [PMID: 35034207 PMCID: PMC8761108 DOI: 10.1007/s00430-021-00725-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023]
Abstract
Mechanisms underlying the SARS-CoV-2-triggered hyperacute thrombo-inflammatory response that causes multi-organ damage in coronavirus disease 2019 (COVID-19) are poorly understood. Several lines of evidence implicate overactivation of complement. To delineate the involvement of complement in COVID-19, we prospectively studied 25 ICU-hospitalized patients for up to 21 days. Complement biomarkers in patient sera and healthy controls were quantified by enzyme-linked immunosorbent assays. Correlations with respiratory function and mortality were analyzed. Activation of complement via the classical/lectin pathways was variably increased. Strikingly, all patients had increased activation of the alternative pathway (AP) with elevated levels of activation fragments, Ba and Bb. This was associated with a reduction of the AP negative regulator, factor (F) H. Correspondingly, terminal pathway biomarkers of complement activation, C5a and sC5b-9, were significantly elevated in all COVID-19 patient sera. C5a and AP constituents Ba and Bb, were significantly associated with hypoxemia. Ba and FD at the time of ICU admission were strong independent predictors of mortality in the following 30 days. Levels of all complement activation markers were sustained throughout the patients’ ICU stays, contrasting with the varying serum levels of IL-6, C-reactive protein, and ferritin. Severely ill COVID-19 patients have increased and persistent activation of complement, mediated strongly via the AP. Complement activation biomarkers may be valuable measures of severity of lung disease and the risk of mortality. Large-scale studies will reveal the relevance of these findings to thrombo-inflammation in acute and post-acute COVID-19.
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Affiliation(s)
- Alexander Leatherdale
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Victor Lei
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Henry E West
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Ryan L Hoiland
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia Okanagan, Vancouver, BC, Canada
| | - Jennifer Cooper
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Mypinder S Sekhon
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Edward L G Pryzdial
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Canadian Blood Services, Centre for Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Edward M Conway
- Centre for Blood Research, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada.
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
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16
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Vavasour IM, Becquart P, Gill J, Zhao G, Yik JT, Traboulsee A, Carruthers RL, Kolind SH, Schabas AJ, Sayao AL, Devonshire V, Tam R, Moore GRW, Stukas S, Wellington CL, Quandt JA, Li DKB, Laule C. Diffusely abnormal white matter in clinically isolated syndrome is associated with parenchymal loss and elevated neurofilament levels. Mult Scler Relat Disord 2021; 57:103422. [PMID: 34871858 DOI: 10.1016/j.msard.2021.103422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/23/2021] [Accepted: 11/20/2021] [Indexed: 11/19/2022]
Abstract
We characterized the frequency of diffusely abnormal white matter (DAWM) across a broad spectrum of multiple sclerosis (MS) participants. 35% of clinically isolated syndrome (CIS), 57% of relapsing remitting and 64% of secondary progressive MS participants demonstrated DAWM. CIS with DAWM had decreased cortical thickness, higher lesion load and a higher concentration of serum neurofilament light chain compared to CIS without DAWM. DAWM may be useful in identifying CIS patients with greater injury to their brains. Larger and longitudinal studies are warranted.
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Affiliation(s)
- I M Vavasour
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.
| | - P Becquart
- Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - J Gill
- Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - G Zhao
- MS/MRI Research Group, University of British Columbia, Vancouver, British Columbia, Canada
| | - J T Yik
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - A Traboulsee
- MS/MRI Research Group, University of British Columbia, Vancouver, British Columbia, Canada; Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - R L Carruthers
- Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - S H Kolind
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; MS/MRI Research Group, University of British Columbia, Vancouver, British Columbia, Canada; Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - A J Schabas
- Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - A L Sayao
- Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - V Devonshire
- Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - R Tam
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada; MS/MRI Research Group, University of British Columbia, Vancouver, British Columbia, Canada; School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - G R W Moore
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - S Stukas
- Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - C L Wellington
- Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - J A Quandt
- Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - D K B Li
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada; MS/MRI Research Group, University of British Columbia, Vancouver, British Columbia, Canada; Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - C Laule
- Radiology, University of British Columbia, Vancouver, British Columbia, Canada; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
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17
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Hoiland RL, Ainslie PN, Wellington CL, Cooper J, Stukas S, Thiara S, Foster D, Fergusson N, Conway EM, Menon DK, Gooderham PA, Hirsch-Reinshagen V, Griesdale D, Sekhon M. Brain Hypoxia Is Associated With Neuroglial Injury in Humans Post-Cardiac Arrest. Circ Res 2021; 129:583-597. [PMID: 34287000 PMCID: PMC8376277 DOI: 10.1161/circresaha.121.319157] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Supplemental Digital Content is available in the text. Secondary brain hypoxia portends significant mortality in ischemic brain diseases; yet, our understanding of hypoxic ischemic brain injury (HIBI) pathophysiology in humans remains rudimentary.
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Affiliation(s)
- Ryan L Hoiland
- Health and Exercise Sciences, University of British Columbia Okanagan, CANADA
| | | | | | | | - Sophie Stukas
- Pathology and Laboratory Medicine, University of British Columbia, CANADA
| | - Sonny Thiara
- Critical Care Medicine, University of British Columbia
| | - Denise Foster
- Critical Care Medicine, University of British Columbia, CANADA
| | | | - Edward M Conway
- Centre for Blood Research, University of British Columbia, CANADA
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18
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Chen LYC, Biggs CM, Jamal S, Stukas S, Wellington CL, Sekhon MS. Soluble interleukin-6 receptor in the COVID-19 cytokine storm syndrome. Cell Rep Med 2021; 2:100269. [PMID: 33899032 PMCID: PMC8055165 DOI: 10.1016/j.xcrm.2021.100269] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Data suggest that interleukin (IL)-6 blockade could reduce mortality in severe COVID-19, yet IL-6 is only modestly elevated in most patients. Chen et al. describe the role of soluble interleukin-6 receptor (sIL-6R) in IL-6 trans-signaling and how understanding the IL-6:sIL-6R axis might help define and treat COVID-19 cytokine storm syndrome.
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Affiliation(s)
- Luke Y C Chen
- Division of Hematology, University of British Columbia, Vancouver, BC V5Z1M9, Canada.,Centre for Health Education Scholarship, University of British Columbia, Vancouver, BC V6T1Z3, Canada
| | - Catherine M Biggs
- Division of Allergy and Immunology, University of British Columbia, Vancouver, BC V5Z1M9, Canada
| | - Shahin Jamal
- Division of Rheumatology, University of British Columbia, Vancouver, BC V5Z1M9, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V5Z1M9, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T1Z3, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V5Z1M9, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T1Z3, Canada
| | - Mypinder S Sekhon
- Division of Critical Care Medicine, University of British Columbia, Vancouver, BC V5Z1M9, Canada
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19
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Cameron T, Bennet T, Rowe EM, Anwer M, Wellington CL, Cheung KC. Review of Design Considerations for Brain-on-a-Chip Models. Micromachines (Basel) 2021; 12:441. [PMID: 33921018 PMCID: PMC8071412 DOI: 10.3390/mi12040441] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023]
Abstract
In recent years, the need for sophisticated human in vitro models for integrative biology has motivated the development of organ-on-a-chip platforms. Organ-on-a-chip devices are engineered to mimic the mechanical, biochemical and physiological properties of human organs; however, there are many important considerations when selecting or designing an appropriate device for investigating a specific scientific question. Building microfluidic Brain-on-a-Chip (BoC) models from the ground-up will allow for research questions to be answered more thoroughly in the brain research field, but the design of these devices requires several choices to be made throughout the design development phase. These considerations include the cell types, extracellular matrix (ECM) material(s), and perfusion/flow considerations. Choices made early in the design cycle will dictate the limitations of the device and influence the end-point results such as the permeability of the endothelial cell monolayer, and the expression of cell type-specific markers. To better understand why the engineering aspects of a microfluidic BoC need to be influenced by the desired biological environment, recent progress in microfluidic BoC technology is compared. This review focuses on perfusable blood-brain barrier (BBB) and neurovascular unit (NVU) models with discussions about the chip architecture, the ECM used, and how they relate to the in vivo human brain. With increased knowledge on how to make informed choices when selecting or designing BoC models, the scientific community will benefit from shorter development phases and platforms curated for their application.
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Affiliation(s)
- Tiffany Cameron
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.C.); (T.B.)
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Tanya Bennet
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.C.); (T.B.)
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Elyn M. Rowe
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (E.M.R.); (M.A.); (C.L.W.)
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Mehwish Anwer
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (E.M.R.); (M.A.); (C.L.W.)
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Cheryl L. Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (E.M.R.); (M.A.); (C.L.W.)
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Karen C. Cheung
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; (T.C.); (T.B.)
- Centre for Blood Research, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Department of Electrical & Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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20
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England JT, Abdulla A, Biggs CM, Lee AYY, Hay KA, Hoiland RL, Wellington CL, Sekhon M, Jamal S, Shojania K, Chen LYC. Weathering the COVID-19 storm: Lessons from hematologic cytokine syndromes. Blood Rev 2021; 45:100707. [PMID: 32425294 PMCID: PMC7227559 DOI: 10.1016/j.blre.2020.100707] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A subset of patients with severe COVID-19 develop profound inflammation and multi-organ dysfunction consistent with a "Cytokine Storm Syndrome" (CSS). In this review we compare the clinical features, diagnosis, and pathogenesis of COVID-CSS with other hematological CSS, namely secondary hemophagocytic lymphohistiocytosis (sHLH), idiopathic multicentric Castleman disease (iMCD), and CAR-T cell therapy associated Cytokine Release Syndrome (CRS). Novel therapeutics targeting cytokines or inhibiting cell signaling pathways have now become the mainstay of treatment in these CSS. We review the evidence for cytokine blockade and attenuation in these known CSS as well as the emerging literature and clinical trials pertaining to COVID-CSS. Established markers of inflammation as well as cytokine levels are compared and contrasted between these four entities in order to establish a foundation for future diagnostic criteria of COVID-CSS.
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Affiliation(s)
- James T England
- Division of Hematology, University of British Columbia, Canada
| | - Alym Abdulla
- Division of Hematology, University of British Columbia, Canada
| | - Catherine M Biggs
- Division of Allergy and Immunology, University of British Columbia, Canada
| | - Agnes Y Y Lee
- Division of Hematology, University of British Columbia, Canada
| | - Kevin A Hay
- Division of Hematology, University of British Columbia, Canada
| | - Ryan L Hoiland
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | - Mypinder Sekhon
- Division of Critical Care Medicine, University of British Columbia, Canada
| | - Shahin Jamal
- Division of Rheumatology, University of British Columbia, Canada
| | - Kamran Shojania
- Division of Rheumatology, University of British Columbia, Canada
| | - Luke Y C Chen
- Division of Hematology, University of British Columbia, Canada
- Centre for Health Education Scholarship, University of British Columbia, Canada
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21
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Cooper J, Stukas SK, Hoiland R, Thiara S, Foster D, Mitra A, Panenka WJ, Sekhon MS, Wellington CL. Quantification of neurological blood‐based biomarkers in critically ill patients with COVID‐19. Alzheimers Dement 2020. [PMCID: PMC7883192 DOI: 10.1002/alz.047682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Ryan Hoiland
- University of British Columbia Vancouver BC Canada
| | - Sonny Thiara
- University of British Columbia Vancouver BC Canada
| | | | - Anish Mitra
- University of British Columbia Vancouver BC Canada
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22
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Button EB, Boyce GK, Wilkinson A, Stukas SK, Hayat A, Cheng WH, Wadsworth BJ, Fan J, Robert J, Martens KM, Wellington CL. The effects of peripheral lipoprotein metabolism on cerebrovascular inflammation in APP/PS1 mice. Alzheimers Dement 2020. [DOI: 10.1002/alz.045613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | | | - Arooj Hayat
- University of British Columbia Vancouver BC Canada
| | | | | | - Jianjia Fan
- University of British Columbia Vancouver BC Canada
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23
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Robert J, Button EB, Martin E, McAlary L, Gidden Z, Gilmore M, Boyce GK, Caffrey TM, Agbay A, Clark A, Silverman JM, Cashman NR, Wellington CL. Cerebrovascular amyloid angiopathy in bioengineered vessels is reduced by high‐density lipoprotein particles enriched in apolipoprotein E. Alzheimers Dement 2020. [DOI: 10.1002/alz.043473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - Emma Martin
- University of British Columbia Vancouver BC Canada
| | - Luke McAlary
- University of British Columbia Vancouver BC Canada
| | - Zoe Gidden
- University of British Columbia Vancouver BC Canada
| | | | | | | | - Andrew Agbay
- University of British Columbia Vancouver BC Canada
| | - Amanda Clark
- University of British Columbia Vancouver BC Canada
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24
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Cheng WH, Wilkinson A, Cheung H, Barron CJ, Cripton PA, Wellington CL. Chimera traumatic brain injury induces tauopathy in the RTG4510 mice. Alzheimers Dement 2020. [DOI: 10.1002/alz.047179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Honor Cheung
- University of British Columbia Vancouver BC Canada
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25
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Robert J, Weilinger NL, Cao LP, Cataldi S, Button EB, Stukas S, Martin EM, Seibler P, Gilmour M, Caffrey TM, Rowe EM, Fan J, MacVicar B, Farrer MJ, Wellington CL. An in vitro bioengineered model of the human arterial neurovascular unit to study neurodegenerative diseases. Mol Neurodegener 2020; 15:70. [PMID: 33213497 PMCID: PMC7678181 DOI: 10.1186/s13024-020-00418-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 11/03/2020] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION The neurovascular unit (NVU) - the interaction between the neurons and the cerebrovasculature - is increasingly important to interrogate through human-based experimental models. Although advanced models of cerebral capillaries have been developed in the last decade, there is currently no in vitro 3-dimensional (3D) perfusible model of the human cortical arterial NVU. METHOD We used a tissue-engineering technique to develop a scaffold-directed, perfusible, 3D human NVU that is cultured in native-like flow conditions that mimics the anatomy and physiology of cortical penetrating arteries. RESULTS This system, composed of primary human vascular cells (endothelial cells, smooth muscle cells and astrocytes) and induced pluripotent stem cell (iPSC) derived neurons, demonstrates a physiological multilayer organization of the involved cell types. It reproduces key characteristics of cortical neurons and astrocytes and enables formation of a selective and functional endothelial barrier. We provide proof-of-principle data showing that this in vitro human arterial NVU may be suitable to study neurovascular components of neurodegenerative diseases such as Alzheimer's disease (AD), as endogenously produced phosphorylated tau and beta-amyloid accumulate in the model over time. Finally, neuronal and glial fluid biomarkers relevant to neurodegenerative diseases are measurable in our arterial NVU model. CONCLUSION This model is a suitable research tool to investigate arterial NVU functions in healthy and disease states. Further, the design of the platform allows culture under native-like flow conditions for extended periods of time and yields sufficient tissue and media for downstream immunohistochemistry and biochemistry analyses.
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Affiliation(s)
- Jerome Robert
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
- Institute of Clinical Chemistry, University hospital Zurich, 8000 Zurich, Wagistrasse 14, CH-8952 Schlieren, Switzerland
| | - Nicholas L. Weilinger
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Li-Ping Cao
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
- Centre for Applied Neurogenetics, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
| | - Stefano Cataldi
- Centre for Applied Neurogenetics, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
| | - Emily B. Button
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Emma M. Martin
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Philip Seibler
- Institute of Neurogenetics, University of Luebeck, 23562 Luebeck, Germany
| | - Megan Gilmour
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Tara M. Caffrey
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Elyn M. Rowe
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Jianjia Fan
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Brian MacVicar
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
| | - Matthew J. Farrer
- Centre for Applied Neurogenetics, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Laboratory for Neurogenetics & Neuroscience, McKnight and Fixel Institutes, University of Florida, Gainesville, 32610 USA
| | - Cheryl L. Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3 Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia V6T 1Z3 Canada
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia V5Z 1M9 Canada
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26
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Hoiland RL, Fergusson NA, Mitra AR, Griesdale DEG, Devine DV, Stukas S, Cooper J, Thiara S, Foster D, Chen LYC, Lee AYY, Conway EM, Wellington CL, Sekhon MS. The association of ABO blood group with indices of disease severity and multiorgan dysfunction in COVID-19. Blood Adv 2020; 4:4981-4989. [PMID: 33057633 PMCID: PMC7594392 DOI: 10.1182/bloodadvances.2020002623] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/17/2020] [Indexed: 02/06/2023] Open
Abstract
Studies on severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) suggest a protective effect of anti-A antibodies against viral cell entry that may hold relevance for SARS-CoV-2 infection. Therefore, we aimed to determine whether ABO blood groups are associated with different severities of COVID-19. We conducted a multicenter retrospective analysis and nested prospective observational substudy of critically ill patients with COVID-19. We collected data pertaining to age, sex, comorbidities, dates of symptom onset, hospital admission, intensive care unit (ICU) admission, mechanical ventilation, continuous renal replacement therapy (CRRT), standard laboratory parameters, and serum inflammatory cytokines. National (N = 398 671; P = .38) and provincial (n = 62 246; P = .60) ABO blood group distributions did not differ from our cohort (n = 95). A higher proportion of COVID-19 patients with blood group A or AB required mechanical ventilation (P = .02) and CRRT (P = .004) and had a longer ICU stay (P = .03) compared with patients with blood group O or B. Blood group A or AB also had an increased probability of requiring mechanical ventilation and CRRT after adjusting for age, sex, and presence of ≥1 comorbidity. Inflammatory cytokines did not differ between patients with blood group A or AB (n = 11) vs O or B (n = 14; P > .10 for all cytokines). Collectively, our data indicate that critically ill COVID-19 patients with blood group A or AB are at increased risk for requiring mechanical ventilation, CRRT, and prolonged ICU admission compared with patients with blood group O or B. Further work is needed to understand the underlying mechanisms.
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Affiliation(s)
- Ryan L Hoiland
- Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, BC, Canada
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia-Okanagan, Kelowna, BC, Canada
| | - Nicholas A Fergusson
- MD Undergraduate Program, University of British Columbia, Vancouver, BC, Canada
- Medicine, Quality, and Safety, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Anish R Mitra
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Donald E G Griesdale
- Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, BC, Canada
- Medicine, Quality, and Safety, Vancouver Coastal Health, Vancouver, BC, Canada
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Center for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Dana V Devine
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Canadian Blood Services, Ottawa, ON, Canada; and
- Centre for Blood Research, Life Sciences Institute
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Cooper
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sonny Thiara
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Denise Foster
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Edward M Conway
- Centre for Blood Research, Life Sciences Institute
- Division of Hematology, Department of Medicine
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health
- School of Biomedical Engineering, and
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, Canada
| | - Mypinder S Sekhon
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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27
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Zlokovic BV, Gottesman RF, Bernstein KE, Seshadri S, McKee A, Snyder H, Greenberg SM, Yaffe K, Schaffer CB, Yuan C, Hughes TM, Daemen MJ, Williamson JD, González HM, Schneider J, Wellington CL, Katusic ZS, Stoeckel L, Koenig JI, Corriveau RA, Fine L, Galis ZS, Reis J, Wright JD, Chen J. Vascular contributions to cognitive impairment and dementia (VCID): A report from the 2018 National Heart, Lung, and Blood Institute and National Institute of Neurological Disorders and Stroke Workshop. Alzheimers Dement 2020; 16:1714-1733. [PMID: 33030307 DOI: 10.1002/alz.12157] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022]
Abstract
Vascular contributions to cognitive impairment and dementia (VCID) are characterized by the aging neurovascular unit being confronted with and failing to cope with biological insults due to systemic and cerebral vascular disease, proteinopathy including Alzheimer's biology, metabolic disease, or immune response, resulting in cognitive decline. This report summarizes the discussion and recommendations from a working group convened by the National Heart, Lung, and Blood Institute and the National Institute of Neurological Disorders and Stroke to evaluate the state of the field in VCID research, identify research priorities, and foster collaborations. As discussed in this report, advances in understanding the biological mechanisms of VCID across the wide spectrum of pathologies, chronic systemic comorbidities, and other risk factors may lead to potential prevention and new treatment strategies to decrease the burden of dementia. Better understanding of the social determinants of health that affect risks for both vascular disease and VCID could provide insight into strategies to reduce racial and ethnic disparities in VCID.
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Affiliation(s)
| | | | | | - Sudha Seshadri
- University of Texas Health Science Center, San Antonio and Boston University, San Antonio, Texas, USA
| | - Ann McKee
- VA Boston Healthcare System and Boston University, Boston, Massachusetts, USA
| | | | - Steven M Greenberg
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kristine Yaffe
- University of California, San Francisco, San Francisco, California, USA
| | | | - Chun Yuan
- University of Washington, Seattle, Washington, USA
| | - Timothy M Hughes
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mat J Daemen
- Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | | | | | | | - Luke Stoeckel
- National Institute on Aging, Bethesda, Maryland, USA
| | - James I Koenig
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Roderick A Corriveau
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Lawrence Fine
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Zorina S Galis
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | - Jared Reis
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
| | | | - Jue Chen
- National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA
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28
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Chen LYC, Hoiland RL, Stukas S, Wellington CL, Sekhon MS. Confronting the controversy: interleukin-6 and the COVID-19 cytokine storm syndrome. Eur Respir J 2020; 56:2003006. [PMID: 32883678 PMCID: PMC7474149 DOI: 10.1183/13993003.03006-2020] [Citation(s) in RCA: 141] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 08/24/2020] [Indexed: 12/15/2022]
Abstract
The concept of coronavirus disease 2019 (COVID-19)-related cytokine storm syndrome (COVID-CSS) emerged early in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic to explain why some patients exposed to this virus become critically ill with acute respiratory distress syndrome, multi-organ failure, and death. A seminal study from Wuhan, China reported higher serum concentrations of inflammatory cytokines in patients requiring critical care compared to those with milder disease, and the authors postulated that “cytokine storm was associated with disease severity” [1]. Hypercytokinaemic immune dysregulation in COVID-19 is known as cytokine storm syndrome. Interleukin-6 levels ≥80 pg·mL−1 predict an increased risk of respiratory failure and death, and immunomodulatory therapy is an area of urgent investigation. https://bit.ly/3jq3uJ4
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Affiliation(s)
- Luke Y C Chen
- Division of Hematology, Dept of Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Education Scholarship, University of British Columbia, Vancouver, BC, Canada
| | - Ryan L Hoiland
- Dept of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
- Dept of Cellular and Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sophie Stukas
- Dept of Pathology and Laboratory Medicine, International Collaboration on Repair Discoveries, School of Biomedical Engineering, Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Cheryl L Wellington
- Dept of Pathology and Laboratory Medicine, International Collaboration on Repair Discoveries, School of Biomedical Engineering, Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Mypinder S Sekhon
- Division of Critical Care Medicine, Dept of Medicine, University of British Columbia, Vancouver, BC, Canada
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29
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Hoiland RL, Stukas S, Cooper J, Thiara S, Chen LYC, Biggs CM, Hay K, Lee AYY, Shojania K, Abdulla A, Wellington CL, Sekhon MS. Amelioration of COVID-19-related cytokine storm syndrome: parallels to chimeric antigen receptor-T cell cytokine release syndrome. Br J Haematol 2020; 190:e150-e154. [PMID: 32584416 PMCID: PMC7361645 DOI: 10.1111/bjh.16961] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Ryan L Hoiland
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.,Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, BC, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, International Collaboration on Repair Discoveries, School of Biomedical Engineering, Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Cooper
- Department of Pathology and Laboratory Medicine, International Collaboration on Repair Discoveries, School of Biomedical Engineering, Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sonny Thiara
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Luke Y C Chen
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Catherine M Biggs
- Division of Allergy and Immunology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kevin Hay
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Agnes Y Y Lee
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kamran Shojania
- Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Alym Abdulla
- Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, International Collaboration on Repair Discoveries, School of Biomedical Engineering, Djavad Mowafaghian Centre for Brain Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Mypinder S Sekhon
- Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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30
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McInnes KA, Abebe ZA, Whyte T, Bashir A, Barron C, Wellington CL, Cripton PA. An Automated Kinematic Measurement System for Sagittal Plane Murine Head Impacts. J Biomech Eng 2020; 142:1074130. [PMID: 32006027 DOI: 10.1115/1.4046202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Indexed: 12/22/2022]
Abstract
Mild traumatic brain injuries are typically caused by nonpenetrating head impacts that accelerate the skull and result in deformation of the brain within the skull. The shear and compressive strains caused by these deformations damage neural and vascular structures and impair their function. Accurate head acceleration measurements are necessary to define the nature of the insult to the brain. A novel murine head tracking system was developed to improve the accuracy and efficiency of kinematic measurements obtained with high-speed videography. A three-dimensional (3D)-printed marker carrier was designed for rigid fixation to the upper jaw and incisors with an elastic strap around the snout. The system was evaluated by impacting cadaveric mice with the closed head impact model of engineered rotational acceleration (CHIMERA) system using an energy of 0.7 J (5.29 m/s). We compared the performance of the head-marker system to the previously used skin-tracking method and documented significant improvements in measurement repeatability (aggregate coefficient of variation (CV) within raters from 15.8 to 1.5 and between raters from 15.5 to 1.5), agreement (aggregate percentage error from 24.9 to 8.7), and temporal response (aggregate temporal curve agreement from 0.668 to 0.941). Additionally, the new system allows for automated software tracking, which dramatically decreases the analysis time required (74% reduction). This novel head tracking system for mice offers an efficient, reliable, and real-time method to measure head kinematics during high-speed impacts using CHIMERA or other rodent or small mammal head impact models.
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Affiliation(s)
- Kurt A McInnes
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC V6T 1Z4, Canada; International Collaboration on Repair Discoveries, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Zelalem A Abebe
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC V6T 1Z4, Canada; International Collaboration on Repair Discoveries, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Thomas Whyte
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC V6T 1Z4, Canada; International Collaboration on Repair Discoveries, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Asma Bashir
- Department of Pathology and Laboratory Medicine, University of British Columbia, Rm. G227 - 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Carlos Barron
- Department of Pathology and Laboratory Medicine, University of British Columbia, Rm. G227 - 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Rm. G227 - 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada; International Collaboration on Repair Discoveries, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Peter A Cripton
- Department of Mechanical Engineering, University of British Columbia, 2054-6250 Applied Science Lane, Vancouver, BC V6T 1Z4, Canada; International Collaboration on Repair Discoveries, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada; Department of Orthopaedics, University of British Columbia, 11th Floor - 2775 Laurel Street Vancouver, BC V5Z 1M9, Canada; School of Biomedical Engineering, University of British Columbia, 251 - 2222 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
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31
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Cable J, Holtzman DM, Hyman BT, Tansey MG, Colonna M, Kellis M, Brinton RD, Albert M, Wellington CL, Sisodia SS, Tanzi RE. Alternatives to amyloid for Alzheimer's disease therapies-a symposium report. Ann N Y Acad Sci 2020; 1475:3-14. [PMID: 32472577 DOI: 10.1111/nyas.14371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
For decades, Alzheimer's disease research has focused on amyloid as the primary pathogenic agent. This focus has driven the development of numerous amyloid-targeting therapies; however, with one possible exception, none of these therapies have been effective in preventing or delaying cognitive decline in patients, and there are no approved disease-modifying agents. It is becoming more apparent that alternative drug targets are needed to address this complex disease. An increased understanding of Alzheimer's disease pathology has highlighted the need to target the appropriate disease pathology at the appropriate time in the disease course. Preclinical and early clinical studies have focused on targets, including inflammation, tau, vascular health, and the microbiome. This report summarizes the presentations from a New York Academy of Sciences' one-day symposium entitled "Alzheimer's Disease Therapeutics: Alternatives to Amyloid," held on November 20, 2019.
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Affiliation(s)
| | - David M Holtzman
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri
| | - Bradley T Hyman
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Malú Gámez Tansey
- Department of Neuroscience, Center for Translational Research in Neurodegenerative Disease, University of Florida College of Medicine, McKnight Brain Institute, Gainesville, Florida
| | - Marco Colonna
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Manolis Kellis
- MIT Computer Science and Artificial Intelligence Laboratory, Cambridge, Massachusetts.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Roberta D Brinton
- Departments of Pharmacology and Neurology, College of Medicine, the University of Arizona, Tucson, Arizona
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, International Collaboration on Repair Discoveries, School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sangram S Sisodia
- Department of Neurobiology, the University of Chicago, Chicago, Illinois.,The Microbiome Center, the University of Chicago, Chicago, Illinois
| | - Rudolph E Tanzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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32
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Zhao W, Fan J, Kulic I, Koh C, Clark A, Meuller J, Engkvist O, Barichievy S, Raynoschek C, Hicks R, Maresca M, Wang Q, Brown DG, Lok A, Parro C, Robert J, Chou HY, Zuhl AM, Wood MW, Brandon NJ, Wellington CL. Axl receptor tyrosine kinase is a regulator of apolipoprotein E. Mol Brain 2020; 13:66. [PMID: 32366277 PMCID: PMC7197143 DOI: 10.1186/s13041-020-00609-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 04/24/2020] [Indexed: 12/13/2022] Open
Abstract
Alzheimer's disease (AD), the leading cause of dementia, is a chronic neurodegenerative disease. Apolipoprotein E (apoE), which carries lipids in the brain in the form of lipoproteins, plays an undisputed role in AD pathophysiology. A high-throughput phenotypic screen was conducted using a CCF-STTG1 human astrocytoma cell line to identify small molecules that could upregulate apoE secretion. AZ7235, a previously discovered Axl kinase inhibitor, was identified to have robust apoE activity in brain microglia, astrocytes and pericytes. AZ7235 also increased expression of ATP-binding cassette protein A1 (ABCA1), which is involved in the lipidation and secretion of apoE. Moreover, AZ7235 did not exhibit Liver-X-Receptor (LXR) activity and stimulated apoE and ABCA1 expression in the absence of LXR. Target validation studies using AXL-/- CCF-STTG1 cells showed that Axl is required to mediate AZ7235 upregulation of apoE and ABCA1. Intriguingly, apoE expression and secretion was significantly attenuated in AXL-deficient CCF-STTG1 cells and reconstitution of Axl or kinase-dead Axl significantly restored apoE baseline levels, demonstrating that Axl also plays a role in maintaining apoE homeostasis in astrocytes independent of its kinase activity. Lastly, these effects may require human apoE regulatory sequences, as AZ7235 exhibited little stimulatory activity toward apoE and ABCA1 in primary murine glia derived from neonatal human APOE3 targeted-replacement mice. Collectively, we identified a small molecule that exhibits robust apoE and ABCA1 activity independent of the LXR pathway in human cells and elucidated a novel relationship between Axl and apoE homeostasis in human astrocytes.
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Affiliation(s)
- Wenchen Zhao
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Jianjia Fan
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Iva Kulic
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Cheryl Koh
- Mechanistic Biology & Profiling, Discovery Sciences, R&D, AstraZeneca, Boston, USA
| | - Amanda Clark
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Johan Meuller
- Mechanistic Biology & Profiling, Discovery Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Ola Engkvist
- Hit Discovery, Discovery Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Carina Raynoschek
- Discovery Biology, Discovery Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Ryan Hicks
- Discovery Biology, Discovery Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Marcello Maresca
- Discovery Biology, Discovery Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Qi Wang
- Neuroscience, BioPharmaceuticals R&D, AstraZeneca, Boston, USA
| | - Dean G Brown
- Hit Discovery, Discovery Sciences, R&D, AstraZeneca, Boston, USA
| | - Alvin Lok
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Cameron Parro
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Jerome Robert
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Hsien-Ya Chou
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Andrea M Zuhl
- Discovery Biology, Discovery Sciences, R&D, AstraZeneca, Boston, USA
| | - Michael W Wood
- Neuroscience, BioPharmaceuticals R&D, AstraZeneca, Boston, USA
| | | | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.
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33
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Robert J, Button EB, Martin EM, McAlary L, Gidden Z, Gilmour M, Boyce G, Caffrey TM, Agbay A, Clark A, Silverman JM, Cashman NR, Wellington CL. Cerebrovascular amyloid Angiopathy in bioengineered vessels is reduced by high-density lipoprotein particles enriched in Apolipoprotein E. Mol Neurodegener 2020; 15:23. [PMID: 32213187 PMCID: PMC7093966 DOI: 10.1186/s13024-020-00366-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/13/2020] [Indexed: 12/21/2022] Open
Abstract
Background Several lines of evidence suggest that high-density lipoprotein (HDL) reduces Alzheimer’s disease (AD) risk by decreasing vascular beta-amyloid (Aβ) deposition and inflammation, however, the mechanisms by which HDL improve cerebrovascular functions relevant to AD remain poorly understood. Methods Here we use a human bioengineered model of cerebral amyloid angiopathy (CAA) to define several mechanisms by which HDL reduces Aβ deposition within the vasculature and attenuates endothelial inflammation as measured by monocyte binding. Results We demonstrate that HDL reduces vascular Aβ accumulation independently of its principal binding protein, scavenger receptor (SR)-BI, in contrast to the SR-BI-dependent mechanism by which HDL prevents Aβ-induced vascular inflammation. We describe multiple novel mechanisms by which HDL acts to reduce CAA, namely: i) altering Aβ binding to collagen-I, ii) forming a complex with Aβ that maintains its solubility, iii) lowering collagen-I protein levels produced by smooth-muscle cells (SMC), and iv) attenuating Aβ uptake into SMC that associates with reduced low density lipoprotein related protein 1 (LRP1) levels. Furthermore, we show that HDL particles enriched in apolipoprotein (apo)E appear to be the major drivers of these effects, providing new insights into the peripheral role of apoE in AD, in particular, the fraction of HDL that contains apoE. Conclusion The findings in this study identify new mechanisms by which circulating HDL, particularly HDL particles enriched in apoE, may provide vascular resilience to Aβ and shed new light on a potential role of peripherally-acting apoE in AD.
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Affiliation(s)
- Jerome Robert
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada. .,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada. .,Present address: Institute of Clinical Chemistry, University Hospital Zurich, 8000, Zurich, Switzerland.
| | - Emily B Button
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Emma M Martin
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Luke McAlary
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, V6T 1Z1, Canada
| | - Zoe Gidden
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Megan Gilmour
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Guilaine Boyce
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Tara M Caffrey
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Andrew Agbay
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Amanda Clark
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Judith M Silverman
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Department of Neurology, University of British Columbia, Vancouver, British Columbia, V6T 2B5, Canada
| | - Neil R Cashman
- Department of Neurology, University of British Columbia, Vancouver, British Columbia, V6T 2B5, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,School of Biomedical Engineering, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada.,International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, V5Z 1M9, Canada
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Bashir A, Abebe ZA, McInnes KA, Button EB, Tatarnikov I, Cheng WH, Haber M, Wilkinson A, Barron C, Diaz-Arrastia R, Stukas S, Cripton PA, Wellington CL. Increased severity of the CHIMERA model induces acute vascular injury, sub-acute deficits in memory recall, and chronic white matter gliosis. Exp Neurol 2019; 324:113116. [PMID: 31734317 DOI: 10.1016/j.expneurol.2019.113116] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/03/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
Traumatic brain injury (TBI) is a leading cause of death and disability in modern societies. Diffuse axonal and vascular injury are nearly universal consequences of mechanical energy impacting the head and contribute to disability throughout the injury severity spectrum. CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration) is a non-surgical, impact-acceleration model of rodent TBI that reliably produces diffuse axonal injury characterized by white matter gliosis and axonal damage. At impact energies up to 0.7 joules, which result in mild TBI in mice, CHIMERA does not produce detectable vascular or grey matter injury. This study was designed to expand CHIMERA's capacity to induce more severe injuries, including vascular damage and grey matter gliosis. This was made possible by designing a physical interface positioned between the piston and animal's head to allow higher impact energies to be transmitted to the head without causing skull fracture. Here, we assessed interface-assisted single CHIMERA TBI at 2.5 joules in wild-type mice using a study design that spanned 6 h-60 d time points. Injured animals displayed robust acute neurological deficits, elevated plasma total tau and neurofilament-light levels, transiently increased proinflammatory cytokines in brain tissue, blood-brain barrier (BBB) leakage and microstructural vascular abnormalities, and grey matter microgliosis. Memory deficits were evident at 30 d and resolved by 60 d. Intriguingly, white matter injury was not remarkable at acute time points but evolved over time, with white matter gliosis being most extensive at 60 d. Interface-assisted CHIMERA thus enables experimental modeling of distinct endophenotypes of TBI that include acute vascular and grey matter injury in addition to chronic evolution of white matter damage, similar to the natural history of human TBI.
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Affiliation(s)
- Asma Bashir
- Djavad Mowafaghian Centre for Brain Health, Department of Pathology and Laboratory Medicine, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada; Graduate Program in Neuroscience, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada.
| | - Zelalem A Abebe
- International Centre On Repair Discoveries, Department of Mechanical Engineering and School of Biomedical Engineering, University of British Columbia, Vancouver V5Z 1M9, BC, Canada
| | - Kurt A McInnes
- International Centre On Repair Discoveries, Department of Mechanical Engineering and School of Biomedical Engineering, University of British Columbia, Vancouver V5Z 1M9, BC, Canada
| | - Emily B Button
- Djavad Mowafaghian Centre for Brain Health, Department of Pathology and Laboratory Medicine, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada.
| | - Igor Tatarnikov
- Graduate Program in Neuroscience, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada; Centre for Applied Neurogenetics, Department of Medical Genetics, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada
| | - Wai Hang Cheng
- Djavad Mowafaghian Centre for Brain Health, Department of Pathology and Laboratory Medicine, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada
| | - Margalit Haber
- Department of Neurology, University of Pennsylvania, 51 N 39th Street, Philadelphia, PA, USA
| | - Anna Wilkinson
- Djavad Mowafaghian Centre for Brain Health, Department of Pathology and Laboratory Medicine, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada.
| | - Carlos Barron
- Djavad Mowafaghian Centre for Brain Health, Department of Pathology and Laboratory Medicine, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada.
| | - Ramon Diaz-Arrastia
- Department of Neurology, University of Pennsylvania, 51 N 39th Street, Philadelphia, PA, USA.
| | - Sophie Stukas
- Djavad Mowafaghian Centre for Brain Health, Department of Pathology and Laboratory Medicine, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada.
| | - Peter A Cripton
- International Centre On Repair Discoveries, Department of Mechanical Engineering and School of Biomedical Engineering, University of British Columbia, Vancouver V5Z 1M9, BC, Canada.
| | - Cheryl L Wellington
- Djavad Mowafaghian Centre for Brain Health, Department of Pathology and Laboratory Medicine, University of British Columbia, 2215 Wesbrook Mall, Vancouver V6T 1Z3, BC, Canada.
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Sandsmark DK, Bashir A, Wellington CL, Diaz-Arrastia R. Cerebral Microvascular Injury: A Potentially Treatable Endophenotype of Traumatic Brain Injury-Induced Neurodegeneration. Neuron 2019; 103:367-379. [PMID: 31394062 PMCID: PMC6688649 DOI: 10.1016/j.neuron.2019.06.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/10/2019] [Accepted: 06/03/2019] [Indexed: 02/08/2023]
Abstract
Traumatic brain injury (TBI) is one the most common human afflictions, contributing to long-term disability in survivors. Emerging data indicate that functional improvement or deterioration can occur years after TBI. In this regard, TBI is recognized as risk factor for late-life neurodegenerative disorders. TBI encompasses a heterogeneous disease process in which diverse injury subtypes and multiple molecular mechanisms overlap. To develop precision medicine approaches where specific pathobiological processes are targeted by mechanistically appropriate therapies, techniques to identify and measure these subtypes are needed. Traumatic microvascular injury is a common but relatively understudied TBI endophenotype. In this review, we describe evidence of microvascular dysfunction in human and animal TBI, explore the role of vascular dysfunction in neurodegenerative disease, and discuss potential opportunities for vascular-directed therapies in ameliorating TBI-related neurodegeneration. We discuss the therapeutic potential of vascular-directed therapies in TBI and the use and limitations of preclinical models to explore these therapies.
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Affiliation(s)
| | - Asma Bashir
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Graduate Program in Neuroscience, University of British Columbia, Vancouver, BC, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
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Gibbs E, Silverman JM, Zhao B, Peng X, Wang J, Wellington CL, Mackenzie IR, Plotkin SS, Kaplan JM, Cashman NR. A Rationally Designed Humanized Antibody Selective for Amyloid Beta Oligomers in Alzheimer's Disease. Sci Rep 2019; 9:9870. [PMID: 31285517 PMCID: PMC6614461 DOI: 10.1038/s41598-019-46306-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 06/25/2019] [Indexed: 11/29/2022] Open
Abstract
Advances in the understanding of Alzheimer’s disease (AD) suggest that pathogenesis is not directly related to plaque burden, but rather to soluble toxic amyloid-beta oligomers (AßO). Therapeutic antibodies targeting Aß monomers and/or plaque have shown limited efficacy and dose-limiting adverse events in clinical trials. These findings suggest that antibodies capable of selectively neutralizing toxic AßO may achieve improved efficacy and safety. To this end, we generated monoclonal antibodies against a conformational Aß epitope predicted by computational modeling to be presented on toxic AßO but not monomers or fibrils. The resulting lead antibody, PMN310, showed the desired AßO-selective binding profile. In vitro, PMN310 inhibited AßO propagation and toxicity. In vivo, PMN310 prevented AßO-induced loss of memory formation and reduced synaptic loss and inflammation. A humanized version (huPMN310) compared favorably to other Aß-directed antibodies showing a lack of adverse event-associated binding to Aß deposits in AD brains, and greater selective binding to AßO-enriched AD brain fractions that contain synaptotoxic Aß species. Systemic administration of huPMN310 in mice resulted in brain exposure and kinetics comparable to those of other therapeutic human monoclonal antibodies. Greater selectivity for AßO and the potential to safely administer high doses of huPMN310 are expected to result in enhanced safety and therapeutic potency.
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Affiliation(s)
- Ebrima Gibbs
- University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, V6T 2B5, Canada
| | - Judith M Silverman
- University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, V6T 2B5, Canada
| | - Beibei Zhao
- University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, V6T 2B5, Canada
| | - Xubiao Peng
- University of British Columbia, Department of Physics and Astronomy, Vancouver, BC, V6T 1Z1, Canada
| | - Jing Wang
- University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, V6T 2B5, Canada
| | - Cheryl L Wellington
- University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, V6T 2B5, Canada
| | - Ian R Mackenzie
- University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, V6T 2B5, Canada
| | - Steven S Plotkin
- University of British Columbia, Department of Physics and Astronomy and Genome Sciences and Technology Program, Vancouver, BC, V6T 1Z1, Canada.,ProMIS Neurosciences, Cambridge, MA, 02142, USA
| | | | - Neil R Cashman
- University of British Columbia, Djavad Mowafaghian Centre for Brain Health, Vancouver, BC, V6T 2B5, Canada. .,ProMIS Neurosciences, Cambridge, MA, 02142, USA.
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Vonder Haar C, Martens KM, Bashir A, McInnes KA, Cheng WH, Cheung H, Stukas S, Barron C, Ladner T, Welch KA, Cripton PA, Winstanley CA, Wellington CL. Repetitive closed-head impact model of engineered rotational acceleration (CHIMERA) injury in rats increases impulsivity, decreases dopaminergic innervation in the olfactory tubercle and generates white matter inflammation, tau phosphorylation and degeneration. Exp Neurol 2019; 317:87-99. [DOI: 10.1016/j.expneurol.2019.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/15/2019] [Accepted: 02/20/2019] [Indexed: 01/20/2023]
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Button EB, Boyce GK, Wilkinson A, Stukas SK, Robert J, Button EB, Fan J, Martens KM, Wellington CL. P4-164: APOA-I DEFICIENCY INCREASES CORTICAL AMYLOID DEPOSITION, CEREBRAL AMYLOID ANGIOPATHY, CORTICAL AND HIPPOCAMPAL ASTROGLIOSIS AND AMYLOID-ASSOCIATED ASTROCYTE REACTIVITY IN APP/PS1 MICE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | | | | | | | - Jianjia Fan
- University of British Columbia; Vancouver BC Canada
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Cheng WH, Martens KM, Bashir A, Cheung H, Stukas SK, Gibbs E, Namjoshi D, Button EB, Wilkinson A, Barron CJ, Kent BA, Nygaard HB, Cashman NR, Cripton PA, Wellington CL. O3-01-02: CHIMERA REPETITIVE MILD TRAUMATIC BRAIN INJURY INDUCES CHRONIC BEHAVIORAL AND NEUROPATHOLOGICAL PHENOTYPES IN WILD-TYPE AND APP/PS1 MICE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | - Asma Bashir
- University of British Columbia; Vancouver BC Canada
| | - Honor Cheung
- University of British Columbia; Vancouver BC Canada
| | | | - Ebrima Gibbs
- University of British Columbia; Vancouver BC Canada
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Abstract
PURPOSE OF REVIEW We review current knowledge regarding HDL and Alzheimer's disease, focusing on HDL's vasoprotective functions and potential as a biomarker and therapeutic target for the vascular contributions of Alzheimer's disease. RECENT FINDINGS Many epidemiological studies have observed that circulating HDL levels associate with decreased Alzheimer's disease risk. However, it is now understood that the functions of HDL may be more informative than levels of HDL cholesterol (HDL-C). Animal model studies demonstrate that HDL protects against memory deficits, neuroinflammation, and cerebral amyloid angiopathy (CAA). In-vitro studies using state-of-the-art 3D models of the human blood-brain barrier (BBB) confirm that HDL reduces vascular Aβ accumulation and attenuates Aβ-induced endothelial inflammation. Although HDL-based therapeutics have not been tested in clinical trials for Alzheimer's disease , several HDL formulations are in advanced phase clinical trials for coronary artery disease and atherosclerosis and could be leveraged toward Alzheimer's disease . SUMMARY Evidence from human studies, animal models, and bioengineered arteries supports the hypothesis that HDL protects against cerebrovascular dysfunction in Alzheimer's disease. Assays of HDL functions relevant to Alzheimer's disease may be desirable biomarkers of cerebrovascular health. HDL-based therapeutics may also be of interest for Alzheimer's disease, using stand-alone or combination therapy approaches.
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Affiliation(s)
- Emily B. Button
- Department of Pathology and Laboratory Medicine
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jérôme Robert
- Department of Pathology and Laboratory Medicine
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tara M. Caffrey
- Department of Pathology and Laboratory Medicine
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jianjia Fan
- Department of Pathology and Laboratory Medicine
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wenchen Zhao
- Department of Pathology and Laboratory Medicine
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cheryl L. Wellington
- Department of Pathology and Laboratory Medicine
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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41
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Button EB, Boyce GK, Wilkinson A, Stukas S, Hayat A, Fan J, Wadsworth BJ, Robert J, Martens KM, Wellington CL. ApoA-I deficiency increases cortical amyloid deposition, cerebral amyloid angiopathy, cortical and hippocampal astrogliosis, and amyloid-associated astrocyte reactivity in APP/PS1 mice. Alzheimers Res Ther 2019; 11:44. [PMID: 31084613 PMCID: PMC6515644 DOI: 10.1186/s13195-019-0497-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/22/2019] [Indexed: 12/22/2022]
Abstract
Background Alzheimer’s disease (AD) is defined by amyloid beta (Aβ) plaques and neurofibrillary tangles and characterized by neurodegeneration and memory loss. The majority of AD patients also have Aβ deposition in cerebral vessels known as cerebral amyloid angiopathy (CAA), microhemorrhages, and vascular co-morbidities, suggesting that cerebrovascular dysfunction contributes to AD etiology. Promoting cerebrovascular resilience may therefore be a promising therapeutic or preventative strategy for AD. Plasma high-density lipoproteins (HDL) have several vasoprotective functions and are associated with reduced AD risk in some epidemiological studies and with reduced Aβ deposition and Aβ-induced inflammation in 3D engineered human cerebral vessels. In mice, deficiency of apoA-I, the primary protein component of HDL, increases CAA and cognitive dysfunction, whereas overexpression of apoA-I from its native promoter in liver and intestine has the opposite effect and lessens neuroinflammation. Similarly, acute peripheral administration of HDL reduces soluble Aβ pools in the brain and some studies have observed reduced CAA as well. Here, we expand upon the known effects of plasma HDL in mouse models and in vitro 3D artery models to investigate the interaction of amyloid, astrocytes, and HDL on the cerebrovasculature in APP/PS1 mice. Methods APP/PS1 mice deficient or hemizygous for Apoa1 were aged to 12 months. Plasma lipids, amyloid plaque deposition, Aβ protein levels, protein and mRNA markers of neuroinflammation, and astrogliosis were assessed using ELISA, qRT-PCR, and immunofluorescence. Contextual and cued fear conditioning were used to assess behavior. Results In APP/PS1 mice, complete apoA-I deficiency increased total and vascular Aβ deposition in the cortex but not the hippocampus compared to APP/PS1 littermate controls hemizygous for apoA-I. Markers of both general and vascular neuroinflammation, including Il1b mRNA, ICAM-1 protein, PDGFRβ protein, and GFAP protein, were elevated in apoA-I-deficient APP/PS1 mice. Additionally, apoA-I-deficient APP/PS1 mice had elevated levels of vascular-associated ICAM-1 in the cortex and hippocampus and vascular-associated GFAP in the cortex. A striking observation was that astrocytes associated with cerebral vessels laden with Aβ or associated with Aβ plaques showed increased reactivity in APP/PS1 mice lacking apoA-I. No behavioral changes were observed. Conclusions ApoA-I-containing HDL can reduce amyloid pathology and astrocyte reactivity to parenchymal and vascular amyloid in APP/PS1 mice. Electronic supplementary material The online version of this article (10.1186/s13195-019-0497-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Emily B Button
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.,Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Guilaine K Boyce
- Department of Surgery, Providence Health Care Research Institute, Vancouver, BC, V6Z 1Y6, Canada
| | - Anna Wilkinson
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.,Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.,Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Arooj Hayat
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Jianjia Fan
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.,Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Brennan J Wadsworth
- Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Jerome Robert
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.,Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Kris M Martens
- Department of Psychology, West Virginia University, Morgantown, WV, 26506, USA
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada. .,Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada.
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Cheng WH, Martens KM, Bashir A, Cheung H, Stukas S, Gibbs E, Namjoshi DR, Button EB, Wilkinson A, Barron CJ, Cashman NR, Cripton PA, Wellington CL. CHIMERA repetitive mild traumatic brain injury induces chronic behavioural and neuropathological phenotypes in wild-type and APP/PS1 mice. Alzheimers Res Ther 2019; 11:6. [PMID: 30636629 PMCID: PMC6330571 DOI: 10.1186/s13195-018-0461-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 12/19/2018] [Indexed: 12/14/2022]
Abstract
Background The annual incidence of traumatic brain injury (TBI) in the United States is over 2.5 million, with approximately 3–5 million people living with chronic sequelae. Compared with moderate-severe TBI, the long-term effects of mild TBI (mTBI) are less understood but important to address, particularly for contact sport athletes and military personnel who have high mTBI exposure. The purpose of this study was to determine the behavioural and neuropathological phenotypes induced by the Closed-Head Impact Model of Engineered Rotational Acceleration (CHIMERA) model of mTBI in both wild-type (WT) and APP/PS1 mice up to 8 months post-injury. Methods Male WT and APP/PS1 littermates were randomized to sham or repetitive mild TBI (rmTBI; 2 × 0.5 J impacts 24 h apart) groups at 5.7 months of age. Animals were assessed up to 8 months post-injury for acute neurological deficits using the loss of righting reflex (LRR) and Neurological Severity Score (NSS) tasks, and chronic behavioural changes using the passive avoidance (PA), Barnes maze (BM), elevated plus maze (EPM) and rotarod (RR) tasks. Neuropathological assessments included white matter damage; grey matter inflammation; and measures of Aβ levels, deposition, and aducanumab binding activity. Results The very mild CHIMERA rmTBI conditions used here produced no significant acute neurological or motor deficits in WT and APP/PS1 mice, but they profoundly inhibited extinction of fear memory specifically in APP/PS1 mice over the 8-month assessment period. Spatial learning and memory were affected by both injury and genotype. Anxiety and risk-taking behaviour were affected by injury but not genotype. CHIMERA rmTBI induced chronic white matter microgliosis, axonal injury and astrogliosis independent of genotype in the optic tract but not the corpus callosum, and it altered microgliosis in APP/PS1 amygdala and hippocampus. Finally, rmTBI did not alter long-term tau, Aβ or amyloid levels, but it increased aducanumab binding activity. Conclusions CHIMERA is a useful model to investigate the chronic consequences of rmTBI, including behavioural abnormalities consistent with features of post-traumatic stress disorder and inflammation of both white and grey matter. The presence of human Aβ greatly modified extinction of fear memory after rmTBI. Electronic supplementary material The online version of this article (10.1186/s13195-018-0461-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wai Hang Cheng
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Kris M Martens
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Asma Bashir
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Honor Cheung
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Ebrima Gibbs
- Department of Neurology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Dhananjay R Namjoshi
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Emily B Button
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Anna Wilkinson
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Carlos J Barron
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Neil R Cashman
- Department of Neurology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Peter A Cripton
- Department of Mechanical Engineering, International Collaboration on Repair Discoveries, University of British Columbia, 6250 Applied Sciences Lane, Vancouver, BC, V6T 1Z4, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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Sweeney MD, Montagne A, Sagare AP, Nation DA, Schneider LS, Chui HC, Harrington MG, Pa J, Law M, Wang DJJ, Jacobs RE, Doubal FN, Ramirez J, Black SE, Nedergaard M, Benveniste H, Dichgans M, Iadecola C, Love S, Bath PM, Markus HS, Al-Shahi Salman R, Allan SM, Quinn TJ, Kalaria RN, Werring DJ, Carare RO, Touyz RM, Williams SCR, Moskowitz MA, Katusic ZS, Lutz SE, Lazarov O, Minshall RD, Rehman J, Davis TP, Wellington CL, González HM, Yuan C, Lockhart SN, Hughes TM, Chen CLH, Sachdev P, O'Brien JT, Skoog I, Pantoni L, Gustafson DR, Biessels GJ, Wallin A, Smith EE, Mok V, Wong A, Passmore P, Barkof F, Muller M, Breteler MMB, Román GC, Hamel E, Seshadri S, Gottesman RF, van Buchem MA, Arvanitakis Z, Schneider JA, Drewes LR, Hachinski V, Finch CE, Toga AW, Wardlaw JM, Zlokovic BV. Vascular dysfunction-The disregarded partner of Alzheimer's disease. Alzheimers Dement 2019; 15:158-167. [PMID: 30642436 PMCID: PMC6338083 DOI: 10.1016/j.jalz.2018.07.222] [Citation(s) in RCA: 421] [Impact Index Per Article: 84.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/31/2018] [Indexed: 12/30/2022]
Abstract
Increasing evidence recognizes Alzheimer's disease (AD) as a multifactorial and heterogeneous disease with multiple contributors to its pathophysiology, including vascular dysfunction. The recently updated AD Research Framework put forth by the National Institute on Aging-Alzheimer's Association describes a biomarker-based pathologic definition of AD focused on amyloid, tau, and neuronal injury. In response to this article, here we first discussed evidence that vascular dysfunction is an important early event in AD pathophysiology. Next, we examined various imaging sequences that could be easily implemented to evaluate different types of vascular dysfunction associated with, and/or contributing to, AD pathophysiology, including changes in blood-brain barrier integrity and cerebral blood flow. Vascular imaging biomarkers of small vessel disease of the brain, which is responsible for >50% of dementia worldwide, including AD, are already established, well characterized, and easy to recognize. We suggest that these vascular biomarkers should be incorporated into the AD Research Framework to gain a better understanding of AD pathophysiology and aid in treatment efforts.
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Affiliation(s)
- Melanie D Sweeney
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Axel Montagne
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Abhay P Sagare
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- Department of Psychology, University of Southern California, Los Angeles, CA, USA; Alzheimer's Disease Research Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
| | - Lon S Schneider
- Alzheimer's Disease Research Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Helena C Chui
- Alzheimer's Disease Research Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Judy Pa
- Laboratory of Neuro Imaging (LONI), Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Meng Law
- Alzheimer's Disease Research Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA; Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Danny J J Wang
- Laboratory of Neuro Imaging (LONI), Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Russell E Jacobs
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Fergus N Doubal
- Neuroimaging Sciences and Brain Research Imaging Center, Division of Neuroimaging Sciences, Center for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, UK
| | - Joel Ramirez
- LC Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Sandra E Black
- Department of Medicine (Neurology), Hurvitz Brain Sciences Program, Canadian Partnership for Stroke Recovery, and LC Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto Dementia Research Alliance, University of Toronto, Toronto, Canada
| | - Maiken Nedergaard
- Section for Translational Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Division of Glia Disease and Therapeutics, Center for Translational Neuromedicine, University of Rochester Medical School, Rochester, NY, USA
| | - Helene Benveniste
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), Ludwing-Maximilians-University Munich, Munich, Germany
| | - Costantino Iadecola
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
| | - Seth Love
- Institute of Clinical Neurosciences, University of Bristol, School of Medicine, Level 2 Learning and Research, Southmead Hospital, Bristol, UK
| | - Philip M Bath
- Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Nottingham, UK; Stroke, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, UK
| | - Hugh S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Rustam Al-Shahi Salman
- Neuroimaging Sciences and Brain Research Imaging Center, Division of Neuroimaging Sciences, Center for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, UK
| | - Stuart M Allan
- Faculty of Biology, Medicine and Health, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Rajesh N Kalaria
- Neurovascular Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - David J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London, UK
| | - Roxana O Carare
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rhian M Touyz
- British Heart Foundation, Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Steve C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael A Moskowitz
- Stroke and Neurovascular Regulation Laboratory, Departments of Radiology and Neurology Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Zvonimir S Katusic
- Department of Anesthesiology and Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Sarah E Lutz
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - Orly Lazarov
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL, USA
| | - Richard D Minshall
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA; Department of Pharmacology, University of Illinois at Chicago, Chicago, IL, USA
| | - Jalees Rehman
- Department of Pharmacology, The Center for Lung and Vascular Biology, The University of Illinois College of Medicine, Chicago, IL, USA; Department of Medicine, The Center for Lung and Vascular Biology, The University of Illinois College of Medicine, Chicago, IL, USA
| | - Thomas P Davis
- Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hector M González
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Chun Yuan
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Samuel N Lockhart
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA; Alzheimer's Disease Research Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA; Alzheimer's Disease Research Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Christopher L H Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Memory Aging and Cognition Centre, National University Health System, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Memory Aging and Cognition Centre, National University Health System, Singapore
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Australia, Sydney, Australia
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Leonardo Pantoni
- "L. Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Deborah R Gustafson
- Department of Neurology, State University of New York-Downstate Medical Center, Brooklyn, NY, USA
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anders Wallin
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenberg, Sweden
| | - Eric E Smith
- Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
| | - Vincent Mok
- Department of Medicine and Therapeutics, Therese Pei Fong Chow Research Centre for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong SAR, China; Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Adrian Wong
- Department of Medicine and Therapeutics, Therese Pei Fong Chow Research Centre for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Peter Passmore
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Frederick Barkof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands; Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Majon Muller
- Section of Geriatrics, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Monique M B Breteler
- Department of Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Gustavo C Román
- Department of Neurology, Methodist Neurological Institute, Houston, TX, USA
| | - Edith Hamel
- Laboratory of Cerebrovascular Research, Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Sudha Seshadri
- The Framingham Heart Study, Framingham, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Rebecca F Gottesman
- Departments of Neurology and Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Zoe Arvanitakis
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Lester R Drewes
- Laboratory of Cerebral Vascular Biology, Department of Biomedical Sciences, University of Minnesota Medical School Duluth, Duluth, MN, USA
| | - Vladimir Hachinski
- Division of Neurology, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Caleb E Finch
- Leonard Davis School of Gerontology, Dornsife College, University of Southern California, Los Angeles, CA, USA
| | - Arthur W Toga
- Alzheimer's Disease Research Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA; Laboratory of Neuro Imaging (LONI), Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Joanna M Wardlaw
- Neuroimaging Sciences and Brain Research Imaging Center, Division of Neuroimaging Sciences, Center for Clinical Brain Sciences, UK Dementia Research Institute at the University of Edinburgh, UK
| | - Berislav V Zlokovic
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Alzheimer's Disease Research Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA.
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Silverman JM, Gibbs E, Peng X, Martens KM, Balducci C, Wang J, Yousefi M, Cowan CM, Lamour G, Louadi S, Ban Y, Robert J, Stukas S, Forloni G, Hsiung GYR, Plotkin SS, Wellington CL, Cashman NR. A Rational Structured Epitope Defines a Distinct Subclass of Toxic Amyloid-beta Oligomers. ACS Chem Neurosci 2018; 9:1591-1606. [PMID: 29614860 DOI: 10.1021/acschemneuro.7b00469] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Oligomers of amyloid-β (AβO) are deemed key in synaptotoxicity and amyloid seeding of Alzheimer's disease (AD). However, the heterogeneous and dynamic nature of AβO and inadequate markers for AβO subtypes have stymied effective AβO identification and therapeutic targeting in vivo. We identified an AβO-subclass epitope defined by differential solvent orientation of the lysine 28 side chain in a constrained loop of serine-asparagine-lysine (cSNK), rarely displayed in molecular dynamics simulations of monomer and fibril ensembles. A mouse monoclonal antibody targeting AβOcSNK recognizes ∼50-60 kDa SDS-resistant soluble Aβ assemblages in AD brain and prolongs the lag phase of Aβ aggregation in vitro. Acute peripheral infusion of a murine IgG1 anti-AβOcSNK in two AD mouse models reduced soluble brain Aβ aggregates by 20-30%. Chronic cSNK peptide immunization of APP/PS1 mice engendered an anti-AβOcSNK IgG1 response without epitope spreading to Aβ monomers or fibrils and was accompanied by preservation of global PSD95 expression and improved cued fear memory. Our data indicate that the oligomer subtype AβOcSNK participates in synaptotoxicity and propagation of Aβ aggregation in vitro and in vivo.
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Affiliation(s)
- Judith M. Silverman
- Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Ebrima Gibbs
- Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Xubiao Peng
- Department of Physics and Astronomy, Genome Sciences and Technology Program, Bioinformatics, Institute for Applied Math, University of British Columbia, Room
311, 6356 Agricultural Road, Vancouver, BC V6T 1Z2, Canada
| | - Kris M. Martens
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Claudia Balducci
- IRCCS, Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Via La Masa, 19, 20156 Milano, Italy
| | - Jing Wang
- Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Masoud Yousefi
- Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Catherine M. Cowan
- Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Guillaume Lamour
- Chemistry Department, University of British Columbia, Rm D223, 2036 Main Mall, Vancouver, BC V6T 1Z1, Canada
| | - Sarah Louadi
- Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Yuxin Ban
- Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Jerome Robert
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Gianluigi Forloni
- IRCCS, Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Via La Masa, 19, 20156 Milano, Italy
| | - Ging-Yuek R. Hsiung
- UBC Hospital Clinic for Alzheimer Disease and Related Disorders, Department of Medicine, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Steven S. Plotkin
- Department of Physics and Astronomy, Genome Sciences and Technology Program, Bioinformatics, Institute for Applied Math, University of British Columbia, Room
311, 6356 Agricultural Road, Vancouver, BC V6T 1Z2, Canada
| | - Cheryl L. Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Neil R. Cashman
- Department of Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
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45
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Fan J, Zhao RQ, Parro C, Zhao W, Chou HY, Robert J, Deeb TZ, Raynoschek C, Barichievy S, Engkvist O, Maresca M, Hicks R, Meuller J, Moss SJ, Brandon NJ, Wood MW, Kulic I, Wellington CL. Small molecule inducers of ABCA1 and apoE that act through indirect activation of the LXR pathway. J Lipid Res 2018; 59:830-842. [PMID: 29563219 DOI: 10.1194/jlr.m081851] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/13/2018] [Indexed: 01/01/2023] Open
Abstract
apoE is the primary lipid carrier within the CNS and the strongest genetic risk factor for late onset Alzheimer's disease (AD). apoE is primarily lipidated via ABCA1, and both are under transcriptional regulation by the nuclear liver X receptor (LXR). Considerable evidence from genetic (using ABCA1 overexpression) and pharmacological (using synthetic LXR agonists) studies in AD mouse models suggests that increased levels of lipidated apoE can improve cognitive performance and, in some strains, can reduce amyloid burden. However, direct synthetic LXR ligands have hepatotoxic side effects that limit their clinical use. Here, we describe a set of small molecules, previously annotated as antagonists of the purinergic receptor, P2X7, which enhance ABCA1 expression and activity as well as apoE secretion, and are not direct LXR ligands. Furthermore, P2X7 is not required for these molecules to induce ABCA1 upregulation and apoE secretion, demonstrating that the ABCA1 and apoE effects are mechanistically independent of P2X7 inhibition. Hence, we have identified novel dual activity compounds that upregulate ABCA1 across multiple CNS cell types, including human astrocytes, pericytes, and microglia, through an indirect LXR mechanism and that also independently inhibit P2X7 receptor activity.
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Affiliation(s)
- Jianjia Fan
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rui Qi Zhao
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cameron Parro
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wenchen Zhao
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hsien-Ya Chou
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jerome Robert
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tarek Z Deeb
- Tufts-AstraZeneca Laboratory for Basic and Translational Neuroscience, Boston, MA
| | - Carina Raynoschek
- Discovery Sciences, Innovative Medicines and Early Development (IMED) Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Samantha Barichievy
- Discovery Sciences, Innovative Medicines and Early Development (IMED) Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Ola Engkvist
- Discovery Sciences, Innovative Medicines and Early Development (IMED) Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Marcello Maresca
- Discovery Sciences, Innovative Medicines and Early Development (IMED) Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Ryan Hicks
- Discovery Sciences, Innovative Medicines and Early Development (IMED) Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Johan Meuller
- Discovery Sciences, Innovative Medicines and Early Development (IMED) Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Stephen J Moss
- Tufts-AstraZeneca Laboratory for Basic and Translational Neuroscience, Boston, MA.,Department of Neuroscience, Tufts University School of Medicine, Boston, MA and Department of Neuroscience, Physiology, and Pharmacology, University College London, London, United Kingdom
| | - Nicholas J Brandon
- Neuroscience, Innovative Medicines and Early Development (IMED) Biotech Unit, AstraZeneca, Boston, MA
| | - Michael W Wood
- Neuroscience, Innovative Medicines and Early Development (IMED) Biotech Unit, AstraZeneca, Boston, MA
| | - Iva Kulic
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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46
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Cheng WH, Stukas S, Martens KM, Namjoshi DR, Button EB, Wilkinson A, Bashir A, Robert J, Cripton PA, Wellington CL. Age at injury and genotype modify acute inflammatory and neurofilament-light responses to mild CHIMERA traumatic brain injury in wild-type and APP/PS1 mice. Exp Neurol 2017; 301:26-38. [PMID: 29269117 DOI: 10.1016/j.expneurol.2017.12.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/11/2017] [Accepted: 12/15/2017] [Indexed: 12/14/2022]
Abstract
Peak incidence of traumatic brain injury (TBI) occurs in both young and old individuals, and older age at injury is associated with worse outcome and poorer recovery. Moderate-severe TBI is a reported risk factor for dementia, including Alzheimer's disease (AD), but whether mild TBI (mTBI) alters AD pathogenesis is not clear. To delineate how age at injury and predisposition to amyloid formation affect the acute response to mTBI, we used the Closed Head Impact Model of Engineered Rotational Acceleration (CHIMERA) model of TBI to induce two mild injuries in wild-type (WT) and APP/PS1 mice at either 6 or 13months of age and assessed behavioural, histological and biochemical changes up to 14days post-injury. Age at injury did not alter acute behavioural responses to mTBI, including measures of neurological status, motor performance, spatial memory, fear, or anxiety, in either strain. Young APP/PS1 mice showed a subtle and transient increase in diffuse Aβ deposits after injury, whereas old APP/PS1 mice showed decreased amyloid deposits, without significant alterations in total soluble or insoluble Aβ levels at either age. Age at injury and genotype showed complex responses with respect to microglial and cytokine outcomes, where post-injury neuroinflammation is increased in old WT mice but attenuated in old APP/PS1 mice. Intriguingly, silver staining confirmed axonal damage in both strains and ages, yet only young WT and APP/PS1 mice showed neurofilament-positive axonal swellings after mTBI, as this response was almost entirely attenuated in old mice. Plasma neurofilament-light levels were significantly elevated after injury only in young APP/PS1 mice. This study suggests that mild TBI has minimal effects on Aβ metabolism, but that age and genotype can each modify acute outcomes related to white matter injury.
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Affiliation(s)
- Wai Hang Cheng
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Kris M Martens
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Dhananjay R Namjoshi
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Emily B Button
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Anna Wilkinson
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Asma Bashir
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Jerome Robert
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Peter A Cripton
- Department of Mechanical Engineering, International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3, Canada.
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47
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Robert J, Button EB, Yuen B, Gilmour M, Kang K, Bahrabadi A, Stukas S, Zhao W, Kulic I, Wellington CL. Clearance of beta-amyloid is facilitated by apolipoprotein E and circulating high-density lipoproteins in bioengineered human vessels. eLife 2017; 6. [PMID: 28994390 PMCID: PMC5634784 DOI: 10.7554/elife.29595] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/03/2017] [Indexed: 12/11/2022] Open
Abstract
Amyloid plaques, consisting of deposited beta-amyloid (Aβ), are a neuropathological hallmark of Alzheimer’s Disease (AD). Cerebral vessels play a major role in AD, as Aβ is cleared from the brain by pathways involving the cerebrovasculature, most AD patients have cerebrovascular amyloid (cerebral amyloid angiopathy (CAA), and cardiovascular risk factors increase dementia risk. Here we present a notable advance in vascular tissue engineering by generating the first functional 3-dimensioinal model of CAA in bioengineered human vessels. We show that lipoproteins including brain (apoE) and circulating (high-density lipoprotein, HDL) synergize to facilitate Aβ transport across bioengineered human cerebral vessels. These lipoproteins facilitate Aβ42 transport more efficiently than Aβ40, consistent with Aβ40 being the primary species that accumulates in CAA. Moreover, apoE4 is less effective than apoE2 in promoting Aβ transport, also consistent with the well-established role of apoE4 in Aβ deposition in AD. Alzheimer’s disease causes gradual loss of memory and difficulties in learning. The brains of patients with the disease show several abnormalities including deposits of a peptide molecule called beta-amyloid that is known to be toxic to nerve cells. This peptide can also cause damage to the brain by accumulating within the muscular walls of large blood vessels, a condition known as cerebral amyloid angiopathy (CAA) and is present in most Alzheimer’s disease patients. A group of molecules known as lipoproteins, which transport fats throughout body fluids, are thought to be involved in the process by which beta-amyloid leaves the brain. Apolipoprotein E (apoE) is one such molecule and it is made in the brain by cells called astrocytes. There are three different versions of apoE that are associated with different levels of risk of developing Alzheimer’s disease. Other lipoproteins, such as high-density lipoprotein, which is present in the blood, may also play a role in clearing beta-amyloid proteins from the brain. However, it has been difficult to investigate the roles of these lipoproteins in Alzheimer’s disease because current test-tube models do not fully mimic the composition of human brain blood vessels or show how they work. Robert et al. have used a tissue engineering approach to generate the first three-dimensional model of human brain blood vessels that can reproduce cerebral amyloid angiopathy. To make the model, different types of human cells similar to those found in real blood vessels and astrocytes were grown under conditions that resemble real-life conditions, including mimicking blood flow through the engineered vessels. Having established that the engineered vessels behaved similarly to normal blood vessels, Robert et al. used them to test whether lipoproteins helped to clear beta-amyloid proteins from the vessels. These experiments showed that a form of apoE that protects against Alzheimer’s disease was more effective in transporting beta-amyloid proteins across the walls of blood vessels than other forms of apoE. Further experiments showed that high-density lipoprotein in the blood and apoE on the brain side of the vessel work together to help transport beta-amyloid into the vessels. Together, these findings show that the model of CAA developed by Robert et al. provides a valuable new tool for exploring how this condition develops. The model could also be used more widely in the future, for example, to study how to deliver new drugs that could help treat Alzheimer’s disease into the brain.
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Affiliation(s)
- Jerome Robert
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Emily B Button
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Brian Yuen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Megan Gilmour
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Kevin Kang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Arvin Bahrabadi
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Wenchen Zhao
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Iva Kulic
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Cheryl L Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
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Robert J, Button EB, Stukas S, Boyce GK, Gibbs E, Cowan CM, Gilmour M, Cheng WH, Soo SK, Yuen B, Bahrabadi A, Kang K, Kulic I, Francis G, Cashman N, Wellington CL. High-density lipoproteins suppress Aβ-induced PBMC adhesion to human endothelial cells in bioengineered vessels and in monoculture. Mol Neurodegener 2017; 12:60. [PMID: 28830501 PMCID: PMC5568306 DOI: 10.1186/s13024-017-0201-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 08/07/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Alzheimer's Disease (AD), characterized by accumulation of beta-amyloid (Aβ) plaques in the brain, can be caused by age-related failures to clear Aβ from the brain through pathways that involve the cerebrovasculature. Vascular risk factors are known to increase AD risk, but less is known about potential protective factors. We hypothesize that high-density lipoproteins (HDL) may protect against AD, as HDL have vasoprotective properties that are well described for peripheral vessels. Epidemiological studies suggest that HDL is associated with reduced AD risk, and animal model studies support a beneficial role for HDL in selectively reducing cerebrovascular amyloid deposition and neuroinflammation. However, the mechanism by which HDL may protect the cerebrovascular endothelium in the context of AD is not understood. METHODS We used peripheral blood mononuclear cell adhesion assays in both a highly novel three dimensional (3D) biomimetic model of the human vasculature composed of primary human endothelial cells (EC) and smooth muscle cells cultured under flow conditions, as well as in monolayer cultures of ECs, to study how HDL protects ECs from the detrimental effects of Aβ. RESULTS Following Aβ addition to the abluminal (brain) side of the vessel, we demonstrate that HDL circulated within the lumen attenuates monocyte adhesion to ECs in this biofidelic vascular model. The mechanism by which HDL suppresses Aβ-mediated monocyte adhesion to ECs was investigated using monotypic EC cultures. We show that HDL reduces Aβ-induced PBMC adhesion to ECs independent of nitric oxide (NO) production, miR-233 and changes in adhesion molecule expression. Rather, HDL acts through scavenger receptor (SR)-BI to block Aβ uptake into ECs and, in cell-free assays, can maintain Aβ in a soluble state. We confirm the role of SR-BI in our bioengineered human vessel. CONCLUSION Our results define a novel activity of HDL that suppresses Aβ-mediated monocyte adhesion to the cerebrovascular endothelium.
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Affiliation(s)
- Jérôme Robert
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Emily B. Button
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Sophie Stukas
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Guilaine K. Boyce
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Ebrima Gibbs
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
- Department of Neurology, University of British Columbia, Vancouver, BC V6T 2B5 Canada
| | - Catherine M. Cowan
- Department of Zoology, University of British Columbia, Vancouver, BC V6T 2B5 Canada
| | - Megan Gilmour
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Wai Hang Cheng
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Sonja K. Soo
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Brian Yuen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Arvin Bahrabadi
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Kevin Kang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Iva Kulic
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
| | - Gordon Francis
- Department of Medicine, University of British Columbia, Vancouver, BC V6Z 1Y6 Canada
| | - Neil Cashman
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
- Department of Neurology, University of British Columbia, Vancouver, BC V6T 2B5 Canada
| | - Cheryl L. Wellington
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z3 Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3 Canada
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Namjoshi DR, Cheng WH, Bashir A, Wilkinson A, Stukas S, Martens KM, Whyte T, Abebe ZA, McInnes KA, Cripton PA, Wellington CL. Defining the biomechanical and biological threshold of murine mild traumatic brain injury using CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration). Exp Neurol 2017; 292:80-91. [DOI: 10.1016/j.expneurol.2017.03.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 02/18/2017] [Accepted: 03/03/2017] [Indexed: 01/05/2023]
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Vonder Haar C, Martens KM, Riparip LK, Rosi S, Wellington CL, Winstanley CA. Frontal Traumatic Brain Injury Increases Impulsive Decision Making in Rats: A Potential Role for the Inflammatory Cytokine Interleukin-12. J Neurotrauma 2017; 34:2790-2800. [PMID: 28376700 DOI: 10.1089/neu.2016.4813] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Traumatic brain injury (TBI) is associated with the development of numerous psychiatric diseases. Of particular concern for TBI patients is the impact of chronic impulsivity on daily functioning. Despite the scope of the human problem, little has been done to address impulsivity in animal models of brain injury. In the current study, we examined the effects of either a severe or a milder bilateral frontal controlled cortical impact injury on impulsivity using the Delay Discounting Task (DDT), in which preference for smaller-sooner over larger-later rewards is indicative of greater impulsive choice. Both milder and severe TBI caused a significant, chronic increase in impulsive decision making. Despite these pronounced changes in performance of the DDT, memory function, as assessed by the Morris Water Maze, was not impaired in more mildly injured rats and only transiently impacted in the severe TBI group. Whereas a significant lesion was only evident in severely injured rats, analysis of cytokine levels within the frontal cortex revealed a selective increase in interleukin (IL)-12 that was associated with the magnitude of the change in impulsive choice caused by both milder and severe TBI. These findings suggest that tissue loss alone cannot explain the increased impulsivity observed, and that inflammatory pathways mediated by IL-12 may be a contributing factor. The findings from this study highlight the sensitivity of sophisticated behavioral measures designed to assess neuropsychiatric dysfunction in the detection of TBI-induced cognitive impairments and their utility in identifying potential mechanistic pathways and therapeutic targets.
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Affiliation(s)
- Cole Vonder Haar
- 1 Djavad Mowafaghian Centre for Brain Health, University of British Columbia , Vancouver, British Columbia, Canada
| | - Kris M Martens
- 1 Djavad Mowafaghian Centre for Brain Health, University of British Columbia , Vancouver, British Columbia, Canada
| | - Lara-Kirstie Riparip
- 2 Brain and Spinal Injury Center, Departments of Physical Therapy Rehabilitation Science and Neurological Surgery, University of California San Francisco , San Francisco, California
| | - Susanna Rosi
- 2 Brain and Spinal Injury Center, Departments of Physical Therapy Rehabilitation Science and Neurological Surgery, University of California San Francisco , San Francisco, California
| | - Cheryl L Wellington
- 1 Djavad Mowafaghian Centre for Brain Health, University of British Columbia , Vancouver, British Columbia, Canada
| | - Catharine A Winstanley
- 1 Djavad Mowafaghian Centre for Brain Health, University of British Columbia , Vancouver, British Columbia, Canada
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