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O'Carroll R, Reynolds JP, Al-Roqi M, Aiyegbusi ED, Dooley D. ThermoCyte: an inexpensive open-source temperature control system for in vitro live-cell imaging. R Soc Open Sci 2023; 10:231037. [PMID: 38034122 PMCID: PMC10685113 DOI: 10.1098/rsos.231037] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023]
Abstract
Live-cell imaging is a common technique in microscopy to investigate dynamic cellular behaviour and permits the accurate and relevant analysis of a wide range of cellular and tissue parameters, such as motility, cell division, wound healing responses and calcium (Ca2+) signalling in cell lines, primary cell cultures and ex vivo preparations. Furthermore, this can occur under many experimental conditions, making live-cell imaging indispensable for biological research. Systems which maintain cells at physiological conditions outside of a CO2 incubator are often bulky, expensive and use proprietary components. Here we present an inexpensive, open-source temperature control system for in vitro live-cell imaging. Our system 'ThermoCyte', which is constructed from standard electronic components, enables precise tuning, control and logging of a temperature 'set point' for imaging cells at physiological temperature. We achieved stable thermal dynamics, with reliable temperature cycling and a standard deviation of 0.42°C over 1 h. Furthermore, the device is modular in nature and is adaptable to the researcher's specific needs. This represents simple, inexpensive and reliable tool for laboratories to carry out custom live-cell imaging protocols, on a standard laboratory bench, at physiological temperature.
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Affiliation(s)
- Ross O'Carroll
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin D04 V1W8, Ireland
| | - James P. Reynolds
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin D04 V1W8, Ireland
- Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin D04 V1W8, Ireland
| | - Mazen Al-Roqi
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin D04 V1W8, Ireland
| | - Emmanuelle Damilola Aiyegbusi
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin D04 V1W8, Ireland
- Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin D04 V1W8, Ireland
| | - Dearbhaile Dooley
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin D04 V1W8, Ireland
- Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin D04 V1W8, Ireland
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2
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Walsh CM, Wychowaniec JK, Costello L, Brougham DF, Dooley D. An In Vitro and Ex Vivo Analysis of the Potential of GelMA Hydrogels as a Therapeutic Platform for Preclinical Spinal Cord Injury. Adv Healthc Mater 2023; 12:e2300951. [PMID: 37114899 DOI: 10.1002/adhm.202300951] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 03/24/2023] [Indexed: 04/29/2023]
Abstract
Spinal cord injury (SCI) is a devastating condition with no curative therapy currently available. Immunomodulation can be applied as a therapeutic strategy to drive alternative immune cell activation and promote a proregenerative injury microenvironment. Locally injected hydrogels carrying immunotherapeutic cargo directly to injured tissue offer an encouraging treatment approach from an immunopharmacological perspective. Gelatin methacrylate (GelMA) hydrogels are promising in this regard, however, detailed analysis on the immunogenicity of GelMA in the specific context of the SCI microenvironment is lacking. Here, the immunogenicity of GelMA hydrogels formulated with a translationally relevant photoinitiator is analyzed in vitro and ex vivo. 3% (w/v) GelMA, synthesized from gelatin type-A, is first identified as the optimal hydrogel formulation based on mechanical properties and cytocompatibility. Additionally, 3% GelMA-A does not alter the expression profile of key polarization markers in BV2 microglia or RAW264.7 macrophages after 48 h. Finally, it is shown for the first time that 3% GelMA-A can support the ex vivo culture of primary murine organotypic spinal cord slices for 14 days with no direct effect on glial fibrillary acidic protein (GFAP+ ) astrocyte or ionized calcium-binding adaptor molecule 1 (Iba-1+ ) microglia reactivity. This provides evidence that GelMA hydrogels can act as an immunotherapeutic hydrogel-based platform for preclinical SCI.
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Affiliation(s)
- Ciara M Walsh
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
- UCD Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
| | - Jacek K Wychowaniec
- School of Chemistry, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
- AO Research Institute Davos, Clavadelerstrasse 8, Davos, 7270, Switzerland
| | - Louise Costello
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
| | - Dermot F Brougham
- School of Chemistry, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
| | - Dearbhaile Dooley
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
- UCD Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin, D04 V1W8, Ireland
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3
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Vangansewinkel T, Lemmens S, Tiane A, Geurts N, Dooley D, Vanmierlo T, Pejler G, Hendrix S. Therapeutic administration of mouse mast cell protease 6 improves functional recovery after traumatic spinal cord injury in mice by promoting remyelination and reducing glial scar formation. FASEB J 2023; 37:e22939. [PMID: 37130013 DOI: 10.1096/fj.202201942rr] [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: 11/26/2022] [Revised: 04/06/2023] [Accepted: 04/14/2023] [Indexed: 05/03/2023]
Abstract
Traumatic spinal cord injury (SCI) most often leads to permanent paralysis due to the inability of axons to regenerate in the adult mammalian central nervous system (CNS). In the past, we have shown that mast cells (MCs) improve the functional outcome after SCI by suppressing scar tissue formation at the lesion site via mouse mast cell protease 6 (mMCP6). In this study, we investigated whether recombinant mMCP6 can be used therapeutically to improve the functional outcome after SCI. Therefore, we applied mMCP6 locally via an intrathecal catheter in the subacute phase after a spinal cord hemisection injury in mice. Our findings showed that hind limb motor function was significantly improved in mice that received recombinant mMCP6 compared with the vehicle-treated group. In contrast to our previous findings in mMCP6 knockout mice, the lesion size and expression levels of the scar components fibronectin, laminin, and axon-growth-inhibitory chondroitin sulfate proteoglycans were not affected by the treatment with recombinant mMCP6. Surprisingly, no difference in infiltration of CD4+ T cells and reactivity of Iba-1+ microglia/macrophages at the lesion site was observed between the mMCP6-treated mice and control mice. Additionally, local protein levels of the pro- and anti-inflammatory mediators IL-1β, IL-2, IL-4, IL-6, IL-10, TNF-α, IFNγ, and MCP-1 were comparable between the two treatment groups, indicating that locally applied mMCP6 did not affect inflammatory processes after injury. However, the increase in locomotor performance in mMCP6-treated mice was accompanied by reduced demyelination and astrogliosis in the perilesional area after SCI. Consistently, we found that TNF-α/IL-1β-astrocyte activation was decreased and that oligodendrocyte precursor cell (OPC) differentiation was increased after recombinant mMCP6 treatment in vitro. Mechanistically, this suggests effects of mMCP6 on reducing astrogliosis and improving (re)myelination in the spinal cord after injury. In conclusion, these data show for the first time that recombinant mMCP6 is therapeutically active in enhancing recovery after SCI.
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Affiliation(s)
- Tim Vangansewinkel
- Cardio and Organ Systems, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
- VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Stefanie Lemmens
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Assia Tiane
- Department of Neuroscience, Faculty of Medicine and Life Sciences, Biomedical Research Institute, Hasselt University, Hasselt, Belgium
- Department Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- University MS Center (UMSC) Hasselt-Pelt, Hasselt, Belgium
| | - Nathalie Geurts
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Dearbhaile Dooley
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Ireland
- UCD Conway Institute of Biomolecular & Biomedical Research University College Dublin, Belfield, Ireland
| | - Tim Vanmierlo
- Department of Neuroscience, Faculty of Medicine and Life Sciences, Biomedical Research Institute, Hasselt University, Hasselt, Belgium
- Department Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- University MS Center (UMSC) Hasselt-Pelt, Hasselt, Belgium
| | - Gunnar Pejler
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Sven Hendrix
- Institute for Translational Medicine, Medical School Hamburg, Hamburg, Germany
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4
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Frantsuzov R, Mondal S, Walsh CM, Reynolds JP, Dooley D, MacManus DB. A finite element model of contusion spinal cord injury in rodents. J Mech Behav Biomed Mater 2023; 142:105856. [PMID: 37087955 DOI: 10.1016/j.jmbbm.2023.105856] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/02/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
Traumatic spinal cord injuries result from high impact forces acting on the spine and are proceeded by an extensive secondary inflammatory response resulting in motor, sensory, and autonomic dysfunction. Experimental in vivo traumatic spinal cord injuries in rodents using a contusion model have been extremely useful in elucidating the underlying pathophysiology of these injuries. However, the relationship between the pathophysiology and the biomechanical factors is still not well understood. Therefore, the aim of this research is to provide a comprehensive analysis of the biomechanics of traumatic spinal cord injury in a rat contusion model. This is achieved through the development and validation of a finite element model of the thoracic rat spinal cord and subsequently simulating controlled cortical impact-induced traumatic spinal cord injury. The effects of impactor velocity, depth, and geometry on the resulting stresses and strains within the spinal cord are investigated. Our results show that increasing impactor depth results in larger stresses and strains within the spinal cord tissue as expected. Further, for the first time ever our results show that impactor geometry (spherical versus cylindrical) plays an important role in the distribution and magnitude of stresses and strains within the cord. Therefore, finite element modelling can be a powerful tool used to predict stresses and strains that occur in spinal cord tissue during trauma.
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Affiliation(s)
- Roman Frantsuzov
- School of Mechanical & Manufacturing Engineering, Dublin City University, Dublin, Ireland
| | - Subrata Mondal
- School of Mechanical & Manufacturing Engineering, Dublin City University, Dublin, Ireland
| | - Ciara M Walsh
- School of Medicine, University College Dublin, Dublin, Ireland; Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - James P Reynolds
- School of Medicine, University College Dublin, Dublin, Ireland; Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - Dearbhaile Dooley
- School of Medicine, University College Dublin, Dublin, Ireland; Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Ireland
| | - David B MacManus
- School of Mechanical & Manufacturing Engineering, Dublin City University, Dublin, Ireland; MEDeng Research Centre, Dublin City University, Dublin, Ireland; Biodesign Europe, Dublin City University, Dublin, Ireland; School of Mechanical & Materials Engineering, University College Dublin, Dublin, Ireland.
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5
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Walsh CM, Gull K, Dooley D. Motor rehabilitation as a therapeutic tool for spinal cord injury: New perspectives in immunomodulation. Cytokine Growth Factor Rev 2023; 69:80-89. [PMID: 36114092 DOI: 10.1016/j.cytogfr.2022.08.005] [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: 08/02/2022] [Accepted: 08/27/2022] [Indexed: 02/07/2023]
Abstract
Traumatic spinal cord injury (SCI) is a devastating condition that significantly impacts motor, sensory and autonomic function in patients. Despite advances in therapeutic approaches, there is still no curative therapy currently available. Neuroinflammation is a persisting event of the secondary injury phase of SCI that affects functional recovery, and modulation of the inflammatory response towards a beneficial anti-inflammatory state can improve recovery in preclinical SCI models. In human SCI patients, rehabilitative exercise, or motor rehabilitation as we will refer to it from here on out, remains the cornerstone of treatment to increase functional capacity and prevent secondary health implications. Motor rehabilitation is known to have anti-inflammatory effects; however, current literature is lacking in the description of the effect of motor rehabilitation on inflammation in the context of SCI. Understanding the effect on different inflammatory markers after SCI should enable the optimization of motor rehabilitation as a therapeutic regime. This review extensively describes the effect of motor rehabilitation on selected inflammatory mediators in both preclinical and human SCI studies. Additionally, we summarize how the type, duration, and intensity of motor rehabilitation can affect the inflammatory response after SCI. In doing so, we introduce a new perspective on how motor rehabilitation can be optimized as an immunomodulatory therapy to improve patient outcome after SCI.
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Affiliation(s)
- Ciara M Walsh
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland; UCD Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland
| | - Khadija Gull
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Dearbhaile Dooley
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland; UCD Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland.
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6
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Van Broeckhoven J, Erens C, Sommer D, Scheijen E, Sanchez S, Vidal PM, Dooley D, Van Breedam E, Quarta A, Ponsaerts P, Hendrix S, Lemmens S. Macrophage-based delivery of interleukin-13 improves functional and histopathological outcomes following spinal cord injury. J Neuroinflammation 2022; 19:102. [PMID: 35488301 PMCID: PMC9052547 DOI: 10.1186/s12974-022-02458-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/22/2021] [Accepted: 04/07/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Spinal cord injury (SCI) elicits a robust neuroinflammatory reaction which, in turn, exacerbates the initial mechanical damage. Pivotal players orchestrating this response are macrophages (Mφs) and microglia. After SCI, the inflammatory environment is dominated by pro-inflammatory Mφs/microglia, which contribute to secondary cell death and prevent regeneration. Therefore, reprogramming Mφ/microglia towards a more anti-inflammatory and potentially neuroprotective phenotype has gained substantial therapeutic interest in recent years. Interleukin-13 (IL-13) is a potent inducer of such an anti-inflammatory phenotype. In this study, we used genetically modified Mφs as carriers to continuously secrete IL-13 (IL-13 Mφs) at the lesion site. METHODS Mφs were genetically modified to secrete IL-13 (IL-13 Mφs) and were phenotypically characterized using qPCR, western blot, and ELISA. To analyze the therapeutic potential, the IL-13 Mφs were intraspinally injected at the perilesional area after hemisection SCI in female mice. Functional recovery and histopathological improvements were evaluated using the Basso Mouse Scale score and immunohistochemistry. Neuroprotective effects of IL-13 were investigated using different cell viability assays in murine and human neuroblastoma cell lines, human neurospheroids, as well as murine organotypic brain slice cultures. RESULTS In contrast to Mφs prestimulated with recombinant IL-13, perilesional transplantation of IL-13 Mφs promoted functional recovery following SCI in mice. This improvement was accompanied by reduced lesion size and demyelinated area. The local anti-inflammatory shift induced by IL-13 Mφs resulted in reduced neuronal death and fewer contacts between dystrophic axons and Mφs/microglia, suggesting suppression of axonal dieback. Using IL-4Rα-deficient mice, we show that IL-13 signaling is required for these beneficial effects. Whereas direct neuroprotective effects of IL-13 on murine and human neuroblastoma cell lines or human neurospheroid cultures were absent, IL-13 rescued murine organotypic brain slices from cell death, probably by indirectly modulating the Mφ/microglia responses. CONCLUSIONS Collectively, our data suggest that the IL-13-induced anti-inflammatory Mφ/microglia phenotype can preserve neuronal tissue and ameliorate axonal dieback, thereby promoting recovery after SCI.
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Affiliation(s)
- Jana Van Broeckhoven
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, 3590, Diepenbeek, Belgium
| | - Céline Erens
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, 3590, Diepenbeek, Belgium
| | - Daniela Sommer
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, 3590, Diepenbeek, Belgium
| | - Elle Scheijen
- Department of Neurosciences, Biomedical Research Institute, Hasselt University, 3590, Diepenbeek, Belgium
| | - Selien Sanchez
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, 3590, Diepenbeek, Belgium
| | - Pia M Vidal
- Neuroimmunology and Regeneration of the Central Nervous System Unit, Biomedical Science Research Laboratory, Basic Sciences Department, Faculty of Medicine, Universidad Católica de la Santísima Concepción, 4090541, Concepción, Chile
| | - Dearbhaile Dooley
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.,UCD Conway Institute of Biomolecular & Biomedical Research University College Dublin, Belfield, Dublin 4, Ireland
| | - Elise Van Breedam
- Laboratory of Experimental Hematology, University of Antwerp, 2610, Wilrijk, Belgium.,Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, 2610, Wilrijk, Belgium
| | - Alessandra Quarta
- Laboratory of Experimental Hematology, University of Antwerp, 2610, Wilrijk, Belgium.,Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, 2610, Wilrijk, Belgium
| | - Peter Ponsaerts
- Laboratory of Experimental Hematology, University of Antwerp, 2610, Wilrijk, Belgium.,Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, 2610, Wilrijk, Belgium
| | - Sven Hendrix
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, 3590, Diepenbeek, Belgium. .,Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Stefanie Lemmens
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, 3590, Diepenbeek, Belgium
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7
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Walsh CM, Wychowaniec JK, Brougham DF, Dooley D. Functional hydrogels as therapeutic tools for spinal cord injury: New perspectives on immunopharmacological interventions. Pharmacol Ther 2021; 234:108043. [PMID: 34813862 DOI: 10.1016/j.pharmthera.2021.108043] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 10/06/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 02/06/2023]
Abstract
Spinal cord injury (SCI) is a complex medical and psychological challenge for which there is no curative therapy currently available. Despite major progress in pharmacological and surgical approaches, clinical trials for SCI patients have been uniformly disappointing thus far as there are many practical and biological issues yet to be resolved. Neuroinflammation is a critical event of the secondary injury phase after SCI, and recent research strategies have focused on modulating the immune response after injury to provide a more favorable recovery environment. Biomaterials can serve this purpose by providing physical and trophic support to the injured spinal cord after SCI. Of all potential biomaterials, functional hydrogels are emerging as a key component in novel treatment strategies for SCI, including controlled and localized delivery of immunomodulatory therapies to drive polarization of immune cells towards a pro-regenerative phenotype. Here, we extensively review recent developments in the use of functional hydrogels as immunomodulatory therapies for SCI. We briefly describe physicochemical properties of hydrogels and demonstrate how advanced fabrication methods lead to the required heterogeneity and hierarchical arrangements that increasingly mimic complex spinal cord tissue. We then summarize potential SCI therapeutic modalities including: (i) hydrogels alone; (ii) hydrogels as cellular or (iii) bioactive molecule delivery vehicles, and; (iv) combinatorial approaches. By linking the structural properties of hydrogels to their functions in treatment with particular focus on immunopharmacological stimuli, this may accelerate further development of functional hydrogels for SCI, and indeed next-generation central nervous system regenerative therapies.
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Affiliation(s)
- Ciara M Walsh
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland; UCD Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland
| | - Jacek K Wychowaniec
- School of Chemistry, University College Dublin, Belfield, Dublin 4, Ireland; AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, Switzerland
| | - Dermot F Brougham
- School of Chemistry, University College Dublin, Belfield, Dublin 4, Ireland
| | - Dearbhaile Dooley
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland; UCD Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland.
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8
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Van Broeckhoven J, Sommer D, Dooley D, Hendrix S, Franssen AJPM. Macrophage phagocytosis after spinal cord injury: when friends become foes. Brain 2021; 144:2933-2945. [PMID: 34244729 DOI: 10.1093/brain/awab250] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [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: 03/17/2021] [Revised: 06/12/2021] [Accepted: 06/20/2021] [Indexed: 11/14/2022] Open
Abstract
After spinal cord injury (SCI), macrophages can exert either beneficial or detrimental effects depending on their phenotype. Aside from their critical role in inflammatory responses, macrophages are also specialized in the recognition, engulfment, and degradation of pathogens, apoptotic cells, and tissue debris. They promote remyelination and axonal regeneration by removing inhibitory myelin components and cellular debris. However, excessive intracellular presence of lipids and dysregulated intracellular lipid homeostasis result in the formation of foamy macrophages. These develop a pro-inflammatory phenotype that may contribute to further neurological decline. Additionally, myelin-activated macrophages play a crucial role in axonal dieback and retraction. Here, we review the opposing functional consequences of phagocytosis by macrophages in SCI, including remyelination and regeneration versus demyelination, degeneration, and axonal dieback. Furthermore, we discuss how targeting the phagocytic ability of macrophages may have therapeutic potential for the treatment of SCI.
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Affiliation(s)
- Jana Van Broeckhoven
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Daniela Sommer
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Dearbhaile Dooley
- School of Medicine, Health Sciences Centre, University College Dublin, Belfield Dublin 4, Ireland.,UCD Conway Institute of Biomolecular & Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland
| | - Sven Hendrix
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium.,Medical School Hamburg, Hamburg, Germany
| | - Aimée J P M Franssen
- Department of Immunology and Infection, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
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9
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Sommer D, Corstjens I, Sanchez S, Dooley D, Lemmens S, Van Broeckhoven J, Bogie J, Vanmierlo T, Vidal PM, Rose-John S, Gou-Fabregas M, Hendrix S. ADAM17-deficiency on microglia but not on macrophages promotes phagocytosis and functional recovery after spinal cord injury. Brain Behav Immun 2019; 80:129-145. [PMID: 30851378 DOI: 10.1016/j.bbi.2019.02.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/12/2019] [Accepted: 02/27/2019] [Indexed: 12/26/2022] Open
Abstract
A disintegrin and metalloproteinase 17 (ADAM17) is the major sheddase involved in the cleavage of a plethora of cytokines, cytokine receptors and growth factors, thereby playing a substantial role in inflammatory and regenerative processes after central nervous system trauma. By making use of a hypomorphic ADAM17 knockin mouse model as well as pharmacological ADAM10/ADAM17 inhibitors, we showed that ADAM17-deficiency or inhibition significantly increases clearance of apoptotic cells, promotes axon growth and improves functional recovery after spinal cord injury (SCI) in mice. Microglia-specific ADAM17-knockout (ADAM17flox+/+-Cx3Cr1 Cre+/-) mice also showed improved functional recovery similar to hypomorphic ADAM17 mice. In contrast, endothelial-specific (ADAM17flox+/+-Cdh5Pacs Cre+/-) and macrophage-specific (ADAM17flox+/+-LysM Cre+/-) ADAM17-knockout mice or bone marrow chimera with transplanted ADAM17-deficient macrophages, displayed no functional improvement compared to wild type mice. These data indicate that ADAM17 expression on microglia cells (and not on macrophages or endothelial cells) plays a detrimental role in inflammation and functional recovery after SCI.
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Affiliation(s)
- Daniela Sommer
- Biomedical Research Institute, Hasselt University, 3500 Hasselt, Belgium
| | - Inge Corstjens
- Biomedical Research Institute, Hasselt University, 3500 Hasselt, Belgium
| | - Selien Sanchez
- Biomedical Research Institute, Hasselt University, 3500 Hasselt, Belgium
| | - Dearbhaile Dooley
- Health Science Centre, School of Medicine, University College Dublin, Dublin 4, Ireland
| | - Stefanie Lemmens
- Biomedical Research Institute, Hasselt University, 3500 Hasselt, Belgium
| | | | - Jeroen Bogie
- Biomedical Research Institute, Hasselt University, 3500 Hasselt, Belgium
| | - Tim Vanmierlo
- Biomedical Research Institute, Hasselt University, 3500 Hasselt, Belgium; Division of Translational Neuroscience, MHeNs, Maastricht University, 6229ER Maastricht, the Netherlands
| | - Pia M Vidal
- Laboratory of Neuroimmunology, Fundación Ciencia & Vida, 7780272 Santiago, Chile
| | - Stefan Rose-John
- Institute of Biochemistry, Christian-Albrechts University Kiel, 24098 Kiel, Germany
| | | | - Sven Hendrix
- Biomedical Research Institute, Hasselt University, 3500 Hasselt, Belgium.
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10
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Lemmens S, Nelissen S, Dooley D, Geurts N, Peters EMJ, Hendrix S. Stress Pathway Modulation Is Detrimental or Ineffective for Functional Recovery after Spinal Cord Injury in Mice. J Neurotrauma 2019; 37:564-571. [PMID: 31210094 DOI: 10.1089/neu.2018.6211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/15/2023] Open
Abstract
A mounting body of evidence suggests that stress plays a major role in the injury progression after spinal cord injury (SCI). Injury activates the stress systems; this in turn may augment the generation of pro-inflammatory cytokines, stimulate pro-inflammatory immune cells, and alter the balance between the pro- and anti-inflammatory immune response. As a result, it is suggested that stress pathways may augment neuronal damage and loss after SCI. Considering these potential detrimental effects of stress after SCI, we hypothesized that inhibition of stress pathways immediately after SCI may offer protection from damage and improve recovery. To investigate the relevance of stress responses in SCI recovery, we investigated the effects of blocking three well-studied stress response axes in a mouse model of SCI. Propranolol, RU-486, and CP-99994 were administered to inhibit the sympathetic axis, the hypothalamus-pituitary-adrenal axis, and the neuropeptide axis, respectively. Surprisingly, assessing functional recovery by the Basso Mouse Scale revealed that RU-486 and CP-99994 did not affect functional outcome, indicating that these pathways are dispensable for neuroprotection or repair after SCI. Moreover, the beta-blocker propranolol worsened functional outcome in the mouse SCI model. In conclusion, immediate inhibition of three major stress axes has no beneficial effects on functional recovery after SCI in mice. These results suggest that injury-induced stress responses do not interfere with the healing process and hence, pharmacological targeting of stress responses is not a recommended treatment option for SCI. These findings are of great importance for other researchers to avoid unnecessary and potentially futile animal experiments.
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Affiliation(s)
- Stefanie Lemmens
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Sofie Nelissen
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Dearbhaile Dooley
- Health Science Centre, School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Nathalie Geurts
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Eva Milena Johanne Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine, Justus Liebig University and Charité Berlin, Germany
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
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11
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Sanchez S, Lemmens S, Baeten P, Sommer D, Dooley D, Hendrix S, Gou Fabregas M. HDAC3 Inhibition Promotes Alternative Activation of Macrophages but Does Not Affect Functional Recovery after Spinal Cord Injury. Exp Neurobiol 2018; 27:437-452. [PMID: 30429652 PMCID: PMC6221838 DOI: 10.5607/en.2018.27.5.437] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 07/04/2018] [Revised: 09/07/2018] [Accepted: 09/28/2018] [Indexed: 12/31/2022] Open
Abstract
After spinal cord injury (SCI), monocyte derived macrophages play a detrimental role. Histone deacetylases (HDACs) are central epigenetic regulators of macrophage-polarization. We hypothesized that HDAC3 inhibition suppresses the pro-inflammatory macrophage phenotype (M1), promotes the anti-inflammatory phenotype (M2) and improves functional recovery after SCI. Therefore, two inhibitors of HDAC3 were selected, namely scriptaid and RGFP966. The impact on macrophage polarization was studied by investigating the effect on gene and protein expression of selected M1 and M2 markers. We show that scriptaid differentially influences M1 and M2 markers. It increases CD86 and iNOS gene expression and decreases GPR18, CD38, FPR2 and Arg-1 gene expression as well as the production of IL-6 and NO. RGFP966 primarily increased the expression of the M2 markers Arg-1 and Ym1 and reduced the production of IL-6 (M1). RGFP966 and scriptaid reduced the formation of foamy macrophages. Finally, to investigate the impact of HDAC3 inhibition on functional recovery after SCI, we studied the effects of RGFP966 and scriptaid in an in vivo T-cut hemisection SCI model. Histological analyses were performed on spinal cord sections to determine lesion size and astrogliosis, demyelinated area and selected infiltrating immune cells. RGFP966 and scriptaid did not affect functional recovery or histopathological outcome after SCI. In conclusion, these results indicate that specific HDAC3 inhibition with RGFP966 promotes alternative activation of macrophages and reduces the formation of foamy macrophages, but does not lead to a better functional recovery after SCI.
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Affiliation(s)
- Selien Sanchez
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek BE3590, Belgium
| | - Stefanie Lemmens
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek BE3590, Belgium
| | - Paulien Baeten
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek BE3590, Belgium
| | - Daniela Sommer
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek BE3590, Belgium
| | - Dearbhaile Dooley
- Health Science Centre, School of Medicine, University College Dublin, Dublin D04 V1W8, Ireland
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek BE3590, Belgium
| | - Myriam Gou Fabregas
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek BE3590, Belgium
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12
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Schönfeld LM, Dooley D, Jahanshahi A, Temel Y, Hendrix S. Evaluating rodent motor functions: Which tests to choose? Neurosci Biobehav Rev 2017; 83:298-312. [PMID: 29107829 DOI: 10.1016/j.neubiorev.2017.10.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 06/22/2017] [Revised: 09/18/2017] [Accepted: 10/23/2017] [Indexed: 01/11/2023]
Abstract
Damage to the motor cortex induced by stroke or traumatic brain injury (TBI) can result in chronic motor deficits. For the development and improvement of therapies, animal models which possess symptoms comparable to the clinical population are used. However, the use of experimental animals raises valid ethical and methodological concerns. To decrease discomfort by experimental procedures and to increase the quality of results, non-invasive and sensitive rodent motor tests are needed. A broad variety of rodent motor tests are available to determine deficits after stroke or TBI. The current review describes and evaluates motor tests that fall into three categories: Tests to evaluate fine motor skills and grip strength, tests for gait and inter-limb coordination and neurological deficit scores. In this review, we share our thoughts on standardized data presentation to increase data comparability between studies. We also critically evaluate current methods and provide recommendations for choosing the best behavioral test for a new research line.
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Affiliation(s)
- Lisa-Maria Schönfeld
- Comparative Psychology, Institute of Experimental Psychology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
| | - Dearbhaile Dooley
- Health Science Centre, School of Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Ali Jahanshahi
- Department of Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Yasin Temel
- Department of Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute (BIOMED), Hasselt University, Hasselt, Belgium.
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13
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Fazekas B, Moreno-Olivera A, Kelly Y, O'Hara P, Murray S, Kennedy A, Conlon N, Scott J, Melo AM, Hickey FB, Dooley D, O'Brien EC, Moran S, Doherty DG, Little MA. Alterations in circulating lymphoid cell populations in systemic small vessel vasculitis are non-specific manifestations of renal injury. Clin Exp Immunol 2017; 191:180-188. [PMID: 28960271 DOI: 10.1111/cei.13058] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2017] [Indexed: 02/06/2023] Open
Abstract
Innate lymphocyte populations, such as innate lymphoid cells (ILCs), γδ T cells, invariant natural killer T (iNK T) cells and mucosal-associated invariant T (MAIT) cells are emerging as important effectors of innate immunity and are involved in various inflammatory and autoimmune diseases. The aim of this study was to assess the frequencies and absolute numbers of innate lymphocytes as well as conventional lymphocytes and monocytes in peripheral blood from a cohort of anti-neutrophil cytoplasm autoantibody (ANCA)-associated vasculitis (AAV) patients. Thirty-eight AAV patients and 24 healthy and disease controls were included in the study. Patients with AAV were sampled both with and without immunosuppressive treatment, and in the setting of both active disease and remission. The frequencies of MAIT and ILC2 cells were significantly lower in patients with AAV and in the disease control group compared to healthy controls. These reductions in the AAV patients remained during remission. B cell count and frequencies were significantly lower in AAV in remission compared to patients with active disease and disease controls. Despite the strong T helper type 2 (Th) preponderance of eosinophilic granulomatosis with polyangiitis, we did not observe increased ILC2 frequency in this cohort of patients. The frequencies of other cell types were similar in all groups studied. Reductions in circulating ILC2 and MAIT cells reported previously in patients with AAV are not specific for AAV, but are more likely to be due to non-specific manifestations of renal impairment and chronic illness. Reduction in B cell numbers in AAV patients experiencing remission is probably therapy-related.
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Affiliation(s)
- B Fazekas
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | | | - Y Kelly
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - P O'Hara
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - S Murray
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - A Kennedy
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - N Conlon
- Department of Immunology, Trinity College, Dublin, Ireland
| | - J Scott
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - A M Melo
- Department of Immunology, Trinity College, Dublin, Ireland
| | - F B Hickey
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - D Dooley
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - E C O'Brien
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - S Moran
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland
| | - D G Doherty
- Department of Immunology, Trinity College, Dublin, Ireland
| | - M A Little
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute, Dublin, Ireland.,Irish Centre for Vascular Biology, Trinity College, Dublin, Ireland
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14
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Schönfeld LM, Jahanshahi A, Lemmens E, Schipper S, Dooley D, Joosten E, Temel Y, Hendrix S. Long-Term Motor Deficits after Controlled Cortical Impact in Rats Can Be Detected by Fine Motor Skill Tests but Not by Automated Gait Analysis. J Neurotrauma 2017; 34:505-516. [DOI: 10.1089/neu.2016.4440] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Lisa-Maria Schönfeld
- Department of Morphology, Biomedical Research Institute (BIOMED), Hasselt University, Hasselt, Belgium
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ali Jahanshahi
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Evi Lemmens
- Department of Morphology, Biomedical Research Institute (BIOMED), Hasselt University, Hasselt, Belgium
| | - Sandra Schipper
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Dearbhaile Dooley
- Department of Morphology, Biomedical Research Institute (BIOMED), Hasselt University, Hasselt, Belgium
| | - Elbert Joosten
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Yasin Temel
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute (BIOMED), Hasselt University, Hasselt, Belgium
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15
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Le Blon D, Guglielmetti C, Hoornaert C, Quarta A, Daans J, Dooley D, Lemmens E, Praet J, De Vocht N, Reekmans K, Santermans E, Hens N, Goossens H, Verhoye M, Van der Linden A, Berneman Z, Hendrix S, Ponsaerts P. Intracerebral transplantation of interleukin 13-producing mesenchymal stem cells limits microgliosis, oligodendrocyte loss and demyelination in the cuprizone mouse model. J Neuroinflammation 2016; 13:288. [PMID: 27829467 PMCID: PMC5103449 DOI: 10.1186/s12974-016-0756-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 09/06/2016] [Accepted: 10/31/2016] [Indexed: 12/22/2022] Open
Abstract
Background Promoting the neuroprotective and repair-inducing effector functions of microglia and macrophages, by means of M2 polarisation or alternative activation, is expected to become a new therapeutic approach for central nervous system (CNS) disorders in which detrimental pro-inflammatory microglia and/or macrophages display a major contribution to the neuropathology. In this study, we present a novel in vivo approach using intracerebral grafting of mesenchymal stem cells (MSC) genetically engineered to secrete interleukin 13 (IL13-MSC). Methods In the first experimental setup, control MSC and IL13-MSC were grafted in the CNS of eGFP+ bone marrow chimaeric C57BL/6 mice to histologically evaluate IL13-mediated expression of several markers associated with alternative activation, including arginase1 and Ym1, on MSC graft-recognising microglia and MSC graft-infiltrating macrophages. In the second experimental setup, IL13-MSC were grafted on the right side (or on both the right and left sides) of the splenium of the corpus callosum in wild-type C57BL/6 mice and in C57BL/6 CX3CR1eGFP/+CCR2RFP/+ transgenic mice. Next, CNS inflammation and demyelination was induced by means of a cuprizone-supplemented diet. The influence of IL13-MSC grafting on neuropathological alterations was monitored by non-invasive T2-weighted magnetic resonance imaging (MRI) and quantitative histological analyses, as compared to cuprizone-treated mice with control MSC grafts and/or cuprizone-treated mice without MSC injection. Results In the first part of this study, we demonstrate that MSC graft-associated microglia and MSC graft-infiltrating macrophages are forced into alternative activation upon grafting of IL13-MSC, but not upon grafting of control MSC. In the second part of this study, we demonstrate that grafting of IL13-MSC, in addition to the recruitment of M2 polarised macrophages, limits cuprizone-induced microgliosis, oligodendrocyte death and demyelination. Furthermore, we here demonstrate that injection of IL13-MSC at both sides of the splenium leads to a superior protective effect as compared to a single injection at one side of the splenium. Conclusions Controlled and localised production of IL13 by means of intracerebral MSC grafting has the potential to modulate cell graft- and pathology-associated microglial/macrophage responses, and to interfere with oligodendrocyte death and demyelinating events in the cuprizone mouse model.
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Affiliation(s)
- Debbie Le Blon
- Laboratory of Experimental Hematology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Caroline Guglielmetti
- Bio-Imaging Laboratory, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Chloé Hoornaert
- Laboratory of Experimental Hematology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Alessandra Quarta
- Laboratory of Experimental Hematology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Jasmijn Daans
- Laboratory of Experimental Hematology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Dearbhaile Dooley
- Department of Morphology, Biomedical Research Institute, Hasselt University, Agoralaan building C, 3590, Diepenbeek, Belgium
| | - Evi Lemmens
- Department of Morphology, Biomedical Research Institute, Hasselt University, Agoralaan building C, 3590, Diepenbeek, Belgium
| | - Jelle Praet
- Bio-Imaging Laboratory, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Nathalie De Vocht
- Laboratory of Experimental Hematology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Kristien Reekmans
- Laboratory of Experimental Hematology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Eva Santermans
- Center for Statistics, I-Biostat, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium
| | - Niel Hens
- Center for Statistics, I-Biostat, Hasselt University, Agoralaan building D, 3590, Diepenbeek, Belgium.,Centre for Health Economic Research and Modeling Infectious Diseases (Chermid), University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Herman Goossens
- Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Marleen Verhoye
- Bio-Imaging Laboratory, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Annemie Van der Linden
- Bio-Imaging Laboratory, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Zwi Berneman
- Laboratory of Experimental Hematology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute, Hasselt University, Agoralaan building C, 3590, Diepenbeek, Belgium
| | - Peter Ponsaerts
- Laboratory of Experimental Hematology, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. .,Vaccine and Infectious Disease Institute, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. .,Experimental Cell Transplantation Group, Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, Campus Drie Eiken (CDE-S6.51), Universiteitsplein 1, 2610, Antwerp, Wilrijk, Belgium.
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16
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Dooley D, Lemmens E, Ponsaerts P, Hendrix S. Interleukin-25 is detrimental for recovery after spinal cord injury in mice. J Neuroinflammation 2016; 13:101. [PMID: 27154002 PMCID: PMC4858907 DOI: 10.1186/s12974-016-0566-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 12/10/2015] [Accepted: 04/28/2016] [Indexed: 01/15/2023] Open
Abstract
Background The cytokine, interleukin (IL)-25, is thought to be critically involved in inducing a type 2 immune response which may contribute to regeneration after central nervous system (CNS) trauma. We investigated whether applying recombinant IL-25, locally or systemically, in a mouse model of spinal cord injury (SCI) improves functional and histological recovery. Findings Repeated systemic administration of IL-25 did not influence functional recovery following SCI. In contrast, a single local administration of IL-25 significantly worsened locomotor outcome, which was evident from a decreased Basso mouse scale (BMS) score compared with phosphate-buffered saline (PBS)-treated controls. This was accompanied by a significant increase in lesion size, demyelination, and T helper cell infiltration. Conclusions These data show for the first time that IL-25 is either ineffective when applied systemically or detrimental to spinal cord recovery when applied locally. Our findings question the potential neuroprotective role of IL-25 following CNS trauma. Electronic supplementary material The online version of this article (doi:10.1186/s12974-016-0566-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dearbhaile Dooley
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium.,Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, Antwerp, Belgium
| | - Evi Lemmens
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Peter Ponsaerts
- Laboratory of Experimental Hematology, Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, Antwerp, Belgium
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium.
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17
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Hoornaert CJ, Luyckx E, Reekmans K, Dhainaut M, Guglielmetti C, Le Blon D, Dooley D, Fransen E, Daans J, Verbeeck L, Quarta A, De Vocht N, Lemmens E, Goossens H, Van der Linden A, Roobrouck VD, Verfaillie C, Hendrix S, Moser M, Berneman ZN, Ponsaerts P. In Vivo Interleukin-13-Primed Macrophages Contribute to Reduced Alloantigen-Specific T Cell Activation and Prolong Immunological Survival of Allogeneic Mesenchymal Stem Cell Implants. Stem Cells 2016; 34:1971-84. [PMID: 26992046 DOI: 10.1002/stem.2360] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 06/26/2015] [Accepted: 02/12/2016] [Indexed: 12/11/2022]
Abstract
Transplantation of mesenchymal stem cells (MSCs) into injured or diseased tissue-for the in situ delivery of a wide variety of MSC-secreted therapeutic proteins-is an emerging approach for the modulation of the clinical course of several diseases and traumata. From an emergency point-of-view, allogeneic MSCs have numerous advantages over patient-specific autologous MSCs since "off-the-shelf" cell preparations could be readily available for instant therapeutic intervention following acute injury. Although we confirmed the in vitro immunomodulatory capacity of allogeneic MSCs on antigen-presenting cells with standard coculture experiments, allogeneic MSC grafts were irrevocably rejected by the host's immune system upon either intramuscular or intracerebral transplantation. In an attempt to modulate MSC allograft rejection in vivo, we transduced MSCs with an interleukin-13 (IL13)-expressing lentiviral vector. Our data clearly indicate that prolonged survival of IL13-expressing allogeneic MSC grafts in muscle tissue coincided with the induction of an alternatively activated macrophage phenotype in vivo and a reduced number of alloantigen-reactive IFNγ- and/or IL2-producing CD8(+) T cells compared to nonmodified allografts. Similarly, intracerebral IL13-expressing MSC allografts also exhibited prolonged survival and induction of an alternatively activated macrophage phenotype, although a peripheral T cell component was absent. In summary, this study demonstrates that both innate and adaptive immune responses are effectively modulated in vivo by locally secreted IL13, ultimately resulting in prolonged MSC allograft survival in both muscle and brain tissue. Stem Cells 2016;34:1971-1984.
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Affiliation(s)
- Chloé J Hoornaert
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Evi Luyckx
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Kristien Reekmans
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Maxime Dhainaut
- Laboratory of Immunobiology, Department of Molecular Biology, Université Libre de Bruxelles, Gosselies, Belgium
| | | | - Debbie Le Blon
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Dearbhaile Dooley
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Erik Fransen
- StatUa Centre for Statistics, University of Antwerp, Antwerp, Belgium
| | - Jasmijn Daans
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Louca Verbeeck
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Alessandra Quarta
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Nathalie De Vocht
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Evi Lemmens
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Herman Goossens
- Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | | | - Valerie D Roobrouck
- Stem Cell Institute, Stem Cell Biology and Embryology Unit, KU Leuven, Leuven, Belgium
| | - Catherine Verfaillie
- Stem Cell Institute, Stem Cell Biology and Embryology Unit, KU Leuven, Leuven, Belgium
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Muriel Moser
- Laboratory of Immunobiology, Department of Molecular Biology, Université Libre de Bruxelles, Gosselies, Belgium
| | - Zwi N Berneman
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Peter Ponsaerts
- Laboratory of Experimental Hematology, University of Antwerp, Antwerp, Belgium.,Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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18
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Vangansewinkel T, Geurts N, Quanten K, Nelissen S, Lemmens S, Geboes L, Dooley D, Vidal PM, Pejler G, Hendrix S. Mast cells promote scar remodeling and functional recovery after spinal cord injury via mouse mast cell protease 6. FASEB J 2016; 30:2040-57. [PMID: 26917739 DOI: 10.1096/fj.201500114r] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 10/16/2015] [Accepted: 01/28/2016] [Indexed: 12/12/2022]
Abstract
An important barrier for axon regeneration and recovery after traumatic spinal cord injury (SCI) is attributed to the scar that is formed at the lesion site. Here, we investigated the effect of mouse mast cell protease (mMCP) 6, a mast cell (MC)-specific tryptase, on scarring and functional recovery after a spinal cord hemisection injury. Functional recovery was significantly impaired in both MC-deficient and mMCP6-knockout (mMCP6(-/-)) mice after SCI compared with wild-type control mice. This decrease in locomotor performance was associated with an increased lesion size and excessive scarring at the injury site. Axon growth-inhibitory chondroitin sulfate proteoglycans and the extracellular matrix components fibronectin, laminin, and collagen IV were significantly up-regulated in MC-deficient and mMCP6(-/-) mice, with an increase in scar volume between 23 and 32%. A degradation assay revealed that mMCP6 directly cleaves fibronectin and collagen IV in vitro In addition, gene expression levels of the scar components fibronectin, aggrecan, and collagen IV were increased up to 6.8-fold in mMCP6(-/-) mice in the subacute phase after injury. These data indicate that endogenous mMCP6 has scar-suppressing properties after SCI via indirect cleavage of axon growth-inhibitory scar components and alteration of the gene expression profile of these factors.-Vangansewinkel, T., Geurts, N., Quanten, K., Nelissen, S., Lemmens, S., Geboes, L., Dooley, D., Vidal, P. M., Pejler, G., Hendrix, S. Mast cells promote scar remodeling and functional recovery after spinal cord injury via mouse mast cell protease 6.
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Affiliation(s)
- Tim Vangansewinkel
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Nathalie Geurts
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Kirsten Quanten
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Sofie Nelissen
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Stefanie Lemmens
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Lies Geboes
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Dearbhaile Dooley
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Pia M Vidal
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Gunnar Pejler
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden; and Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium;
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Lemmens S, Brône B, Dooley D, Hendrix S, Geurts N. Alpha-adrenoceptor modulation in central nervous system trauma: pain, spasms, and paralysis--an unlucky triad. Med Res Rev 2014; 35:653-77. [PMID: 25546087 DOI: 10.1002/med.21337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 12/23/2022]
Abstract
Many researchers have attempted to pharmacologically modulate the adrenergic system to control locomotion, pain, and spasms after central nervous system (CNS) trauma, although such efforts have led to conflicting results. Despite this, multiple studies highlight that α-adrenoceptors (α-ARs) are promising therapeutic targets because in the CNS, they are involved in reactivity to stressors and regulation of locomotion, pain, and spasms. These functions can be activated by direct modulation of these receptors on neuronal networks in the brain and the spinal cord. In addition, these multifunctional receptors are also broadly expressed on immune cells. This suggests that they might play a key role in modulating immunological responses, which may be crucial in treating spinal cord injury and traumatic brain injury as both diseases are characterized by a strong inflammatory component. Reducing the proinflammatory response will create a more permissive environment for axon regeneration and may support neuromodulation in combination therapies. However, pharmacological interventions are hindered by adrenergic system complexity and the even more complicated anatomical and physiological changes in the CNS after trauma. This review is the first concise overview of the pros and cons of α-AR modulation in the context of CNS trauma.
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Affiliation(s)
- Stefanie Lemmens
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Bert Brône
- Department of Physiology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Dearbhaile Dooley
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Nathalie Geurts
- Department of Morphology, Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
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Dooley D, Lemmens E, Vangansewinkel T, Lemmens S, De Vocht N, Le Blon D, Ponsaerts P, Hendrix S. Mesenchymal stem cells overexpressing IL-13 decrease lesion size and demyelination after spinal cord injury. J Neuroimmunol 2014. [DOI: 10.1016/j.jneuroim.2014.08.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nelissen S, Vangansewinkel T, Geurts N, Geboes L, Lemmens E, Vidal PM, Lemmens S, Willems L, Boato F, Dooley D, Pehl D, Pejler G, Maurer M, Metz M, Hendrix S. Mast cells protect from post-traumatic spinal cord damage in mice by degrading inflammation-associated cytokines via mouse mast cell protease 4. Neurobiol Dis 2013; 62:260-72. [PMID: 24075853 DOI: 10.1016/j.nbd.2013.09.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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: 01/12/2013] [Revised: 08/23/2013] [Accepted: 09/17/2013] [Indexed: 12/16/2022] Open
Abstract
Mast cells (MCs) are found abundantly in the central nervous system and play a complex role in neuroinflammatory diseases such as multiple sclerosis and stroke. In the present study, we show that MC-deficient Kit(W-sh/W-sh) mice display significantly increased astrogliosis and T cell infiltration as well as significantly reduced functional recovery after spinal cord injury compared to wildtype mice. In addition, MC-deficient mice show significantly increased levels of MCP-1, TNF-α, IL-10 and IL-13 protein levels in the spinal cord. Mice deficient in mouse mast cell protease 4 (mMCP4), an MC-specific chymase, also showed increased MCP-1, IL-6 and IL-13 protein levels in spinal cord samples and a decreased functional outcome after spinal cord injury. A degradation assay using supernatant from MCs derived from either mMCP4(-/-) mice or controls revealed that mMCP4 cleaves MCP-1, IL-6, and IL-13 suggesting a protective role for MC proteases in neuroinflammation. These data show for the first time that MCs may be protective after spinal cord injury and that they may reduce CNS damage by degrading inflammation-associated cytokines via the MC-specific chymase mMCP4.
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Affiliation(s)
- Sofie Nelissen
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Tim Vangansewinkel
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Nathalie Geurts
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Lies Geboes
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Evi Lemmens
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Pia M Vidal
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Stefanie Lemmens
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Leen Willems
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Francesco Boato
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Dearbhaile Dooley
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Debora Pehl
- Dept. of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Germany
| | - Gunnar Pejler
- Dept. of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Marcus Maurer
- Dept. of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Germany
| | - Martin Metz
- Dept. of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Germany
| | - Sven Hendrix
- Dept. of Morphology & Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium.
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Dooley D, Vidal P, Hendrix S. Immunopharmacological intervention for successful neural stem cell therapy: New perspectives in CNS neurogenesis and repair. Pharmacol Ther 2013; 141:21-31. [PMID: 23954656 DOI: 10.1016/j.pharmthera.2013.08.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [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: 07/25/2013] [Accepted: 07/26/2013] [Indexed: 12/11/2022]
Abstract
The pharmacological support and stimulation of endogenous and transplanted neural stem cells (NSCs) is a major challenge in brain repair. Trauma to the central nervous system (CNS) results in a distinct inflammatory response caused by local and infiltrating immune cells. This makes NSC-supported regeneration difficult due to the presence of inhibitory immune factors which are upregulated around the lesion site. The continual and dual role of the neuroinflammatory response leaves it difficult to decipher upon a single modulatory strategy. Therefore, understanding the influence of cytokines upon regulation of NSC self-renewal, proliferation and differentiation is crucial when designing therapies for CNS repair. There is a plethora of partially conflicting data in vitro and in vivo on the role of cytokines in modulating the stem cell niche and the milieu around NSC transplants. This is mainly due to the pleiotropic role of many factors. In order for cell-based therapy to thrive, treatment must be phase-specific to the injury and also be personalized for each patient, i.e. taking age, sex, neuroimmune and endocrine status as well as other key parameters into consideration. In this review, we will summarize the most relevant information concerning interleukin (IL)-1, IL-4, IL-10, IL-15, IFN-γ, the neuropoietic cytokine family and TNF-α in order to extract promising therapeutic approaches for further research. We will focus on the consequences of neuroinflammation on endogenous brain stem cells and the transplantation environment, the effects of the above cytokines on NSCs, as well as immunopharmacological manipulation of the microenvironment for potential therapeutic use.
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Affiliation(s)
- Dearbhaile Dooley
- Dep. of Morphology & Biomedical Research Institute, Hasselt University, Belgium
| | - Pia Vidal
- Dep. of Morphology & Biomedical Research Institute, Hasselt University, Belgium
| | - Sven Hendrix
- Dep. of Morphology & Biomedical Research Institute, Hasselt University, Belgium.
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Vidal PM, Lemmens E, Dooley D, Hendrix S. The role of “anti-inflammatory” cytokines in axon regeneration. Cytokine Growth Factor Rev 2013; 24:1-12. [DOI: 10.1016/j.cytogfr.2012.08.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 08/20/2012] [Indexed: 11/25/2022]
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Migliori A, Pantea C, Ledbetter H, Stroe I, Betts JB, Mitchell JN, Ramos M, Freibert F, Dooley D, Harrington S, Mielke CH. Alpha-plutonium's polycrystalline elastic moduli over its full temperature range. J Acoust Soc Am 2007; 122:1994-2001. [PMID: 17902836 DOI: 10.1121/1.2767419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
alpha-plutonium's volume-corrected polycrystal elastic moduli were measured between 18 K and the upper limit of its occurrence, near 400 K. The two independent moduli for a polycrystal-bulk and shear-behave smoothly, indicating no phase transition. Both moduli show the same 50% increase on cooling, an order of magnitude larger than in other metals. The Debye temperature obtained from low-temperature elastic moduli, 207 K, significantly exceeds most previous estimates. The Gruneisen parameter gamma=5.3, obtained from the temperature dependence of the bulk modulus, is intermediate among previous estimates using other approaches, alpha-plutonium's Poisson ratio nu is low: 0.18, nearly temperature independent, and its small decrease on warming opposes usual behavior. The high gamma, large but equal bulk modulus and shear modulus fractional stiffening on cooling, and near-temperature-invariant nu are attributed to a single mechanism: 5-f electron localization-delocalization.
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Affiliation(s)
- A Migliori
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA.
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Knowles P, Kurtis C, Murray J, Saysell C, Tambyrajah W, Wilmot C, McPherson M, Phillips S, Dooley D, Brown D, Rogers M, Mure M. Hydrazine and amphetamine binding to amine oxidases: old drugs with new prospects. J Neural Transm (Vienna) 2007; 114:743-6. [PMID: 17406963 DOI: 10.1007/s00702-007-0681-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Accepted: 11/01/2006] [Indexed: 12/24/2022]
Abstract
Tranylcypromine (TCP), an amphetamine, is a reversible inhibitor of copper-containing amine oxidases. We have solved the structure of the complex of TCP with the amine oxidase from E. coli (ECAO) and shown that only the (+)-enantiomer of TCP binds. Kinetic studies on 2-phenylethylamine and TCP binding to wild-type ECAO and mutational variants fully support the model in which binding of the protonated amine is the first step in the catalytic cycle. Hydrazines are irreversible inhibitors of copper-containing amine oxidases. Binding of hydrazines leads to an adduct ("Adduct 1") with a chromophore at 430 nm which converts at higher pH to another adduct ("Adduct 2") with a chromophore at 520 nm. We have determined the structures of Adduct 1 and 2 for 2-hydrazinopyridine reacted with ECAO. It has been found that Adduct 1 corresponds to the hydrazone and azo tautomers whilst Adduct 2 corresponds to the azo tautomer coordinated to the active site copper. The implications of these results in developing more specific drugs are discussed.
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Affiliation(s)
- P Knowles
- Astbury Centre for Structural Biology, University of Leeds, Leeds, UK.
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Abstract
A wide range of interventions has been devised to address health hazards in the social and physical environment. The authors propose a 2-dimensional matrix to organize these interventions. The timing of interventions is divided into 4 stages: preventing exposure to hazard (proactive primary prevention), preventing symptoms from appearing (reactive primary prevention), preventing early symptoms from becoming chronic or leading to disease (secondary prevention), and managing the disease (tertiary prevention). The level at which the intervention is targeted is divided into 2 categories: micro (individual or family) and macro (more aggregate social level). Large-scale interventions such as media campaigns can target either individual health behaviors (microlevel) or the environment (macrolevel). This typology is illustrated with interventions designed to prevent or ameliorate the health consequences of adverse employment changes such as job loss. The analysis concludes that behavioral medicine and public health approaches are differentially suited to different intervention types.
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Affiliation(s)
- D Dooley
- Department of Psychology and Social Behavior, School of Social Ecology, University of California, Irvine, USA.
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Abstract
We conceptualize employment status not as a dichotomy of working versus not working but as a continuum ranging from adequate employment to inadequate employment (involuntary part-time or low wage) to unemployment. Will shifts from adequate to inadequate employment increase depression as do shifts from employment to unemployment, and to what extent does prior depression select workers into such adverse employment change? We analyze panel data from the National Longitudinal Survey of Youth for the years 1992-1994 for the 5,113 respondents who were adequately employed in 1992. Controlling for prior depression, both types of adverse employment change resulted in similar, significant increases in depression. These direct effects persisted despite inclusion of such potential mediators as changes in income, job satisfaction, and marital status. Marital status buffered the depressive effect of both types of adverse change, but education and job dissatisfaction amplified the effect of unemployment on depression. Prior depression did not predict higher risk of becoming inadequately employed but did predict increased risk of unemployment, particularly for those with less education. These results confirm that both unemployment and inadequate employment affect mental health, and they invite greater efforts to monitor the extent and impact of underemployment.
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Affiliation(s)
- D Dooley
- Department of Psychology and Social Behavior, School of Social Ecology, University of California, Irvine, CA 92697, USA
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Abstract
We purified a secreted fungal laccase from filtrates of Gaeumannomyces graminis var. tritici cultures induced with copper and xylidine. The active protein had an apparent molecular mass of 190 kDa and yielded subunits with molecular masses of 60 kDa when denatured and deglycosylated. This laccase had a pI of 5.6 and an optimal pH of 4.5 with 2,6-dimethoxyphenol as its substrate. Like other, previously purified laccases, this one contained several copper atoms in each subunit, as determined by inductively coupled plasma spectroscopy. The active enzyme catalyzed the oxidation of 2, 6-dimethoxyphenol (Km = 2.6 x 10(-5) +/- 7 x 10(-6) M), catechol (Km = 2.5 x 10(-4) +/- 1 x 10(-5) M), pyrogallol (Km = 3.1 x 10(-4) +/- 4 x 10(-5) M), and guaiacol (Km = 5.1 x 10(-4) +/- 2 x 10(-5) M). In addition, the laccase catalyzed the polymerization of 1, 8-dihydroxynaphthalene, a natural fungal melanin precursor, into a high-molecular-weight melanin and catalyzed the oxidation, or decolorization, of the dye poly B-411, a lignin-like polymer. These findings indicate that this laccase may be involved in melanin polymerization in this phytopathogen's hyphae and/or in lignin depolymerization in its infected plant host.
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Affiliation(s)
- W A Edens
- Departments of Microbiology, Montana State University, Bozeman, Montana 59717, USA
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Dooley D, Catalano R. Unemployment, disguised unemployment, and health: the US case. Int Arch Occup Environ Health 1999; 72 Suppl:S16-9. [PMID: 10197467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- D Dooley
- Dept. of Psychology and Social Behavior, University of California, Irvine 92697, USA.
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Abstract
OBJECTIVE This study measured the impact of unemployment and underemployment on alcohol misuse. METHOD A panel of respondents from the National Longitudinal Survey of Youth was studied in 1984-85 and 1988-89. In each pair of years, the effect of employment change (e.g., becoming underemployed) on alcohol misuse was assessed controlling for misuse in the first year. Alcohol misuse was operationalized in two ways: elevated symptoms and heavy drinking. Three samples were analyzed: a core sample of 2,441 who were available in both pairs of years (approximately 65% male) and two extended samples that included everyone available in one pair of years but not the other (n = 4,183 in 1984-85 and n = 3,926 in 1988-89). RESULTS The 1984-85 analyses revealed a significant association of adverse change in employment with both elevated alcohol symptoms and heavy drinking (the latter moderated by prior heavy drinking). The 1988-89 analyses found no relationship between adverse change in employment and heavy drinking in the core sample and no main effect of adverse change in employment on symptoms, but they did reveal interactions involving prior symptoms (core sample) and marital status (extended sample). CONCLUSIONS Several explanations for these decreasing effects over time were considered including changes in measurement reliability, statistical power, economic environment and respondents' maturity. These results confirm previous findings that job loss can increase the risk of alcohol misuse, provide new evidence that two types of underemployment (involuntary part-time and poverty-level wage) can also increase this risk and suggest that these effects vary over time.
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Affiliation(s)
- D Dooley
- Department of Psychology and Social Behavior, University of California, Irvine 92697, USA
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Dooley D, Prause J. Effect of favorable employment change on alcohol abuse: one- and five-year follow-ups in the National Longitudinal Survey of Youth. Am J Community Psychol 1997; 25:787-807. [PMID: 9534219 DOI: 10.1023/a:1022213229097] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Job loss has been linked to adverse outcomes such as alcohol abuse, but improved employment, usually assumed to be beneficial, has seldom been evaluated and may not help with addictive disorders. Using the National Longitudinal Survey of Youth, young adults who were unemployed or underemployed (low income or involuntary part-time) in 1984 were followed up in 1985 and 1989. Controlling for 1984 alcohol abuse, there were no effects of positive employment change on 1985 symptoms, but there were significant restorative effects on 1985 binge drinking among those who were heavy drinkers in 1984. There also appeared to be an indirect link of favorable 1984-1985 employment change to heavy drinking in 1989 via 1989 employment status. Because the effects of underemployment partially resembled those of unemployment, the discussion cautions against the conventional wisdom of promoting any work, including underemployment, as curative for the ills of unemployment.
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Affiliation(s)
- D Dooley
- Department of Psychology, University of California, Irvine 92697, USA
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Abstract
This study explores whether self-esteem is adversely affected by economic underemployment as defined by unemployment, involuntary part-time employment, intermittent unemployment, and poverty income in a group of recent school-leavers. Results indicate that self-esteem was significantly lower in each of the economically underemployed groups relative to the adequately employed after controlling for early self-esteem, socio-economic status, gender, ethnicity, aptitude, age, and education. There were no differences in self-esteem among the economically underemployed groups after adjusting for the control variables. Economic underemployment proved to be a distinct concept relative to self-reported job satisfaction. Underemployment was negatively related to self-esteem after controlling for perceived job satisfaction and the other control variables. Our findings suggest a need for societal attention to the levels of underemployment on par with the attention given to monitoring traditional unemployment levels.
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Affiliation(s)
- J A Prause
- School of Social Ecology, University of California, Irvine, USA
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Abstract
This paper reviews the relationship between health and inadequate employment, especially unemployment. Poor physical or mental health can lead, via poor work performance, to job loss; however, studies that control for such selection effects are still scarce except for a few health outcomes. For example, aggregate-level studies typically find a positive association between unemployment and suicide rates over time. At the individual level of analysis, panel surveys of laid-off workers tend to find increased psychiatric problems such as depression and substance abuse. Few studies have evaluated interventions to prevent or reduce the adverse health effects of job loss. There have been even fewer studies of the health effects of other types of inadequate employment such as the increasingly prevalent forms of underemployment.
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Affiliation(s)
- D Dooley
- School of Social Ecology, University of California, Irvine 92717, USA
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Dooley D, Catalano R, Wilson G. Depression and unemployment: panel findings from the Epidemiologic Catchment Area study. Am J Community Psychol 1994; 22:745-765. [PMID: 7639201 DOI: 10.1007/bf02521557] [Citation(s) in RCA: 127] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Studies that have found an association between unemployment and psychological depression often fail to establish the direction of causal influence. Analyses of Epidemiologic Catchment Area panel data revealed that of employed respondents not diagnosed with major depression at first interview, those who became unemployed had over twice the risk of increased depressive symptoms and of becoming clinically depressed as those who continued employed. Although the increase in symptoms was statistically significant, the effect on clinical depression was not, possibly because of the low power of the test. The reverse causal path from clinical depression at Time 1 to becoming unemployed by Time 2 was not supported. The unemployment rate in the respondent's community at time of interview was not related directly to psychological depression but appeared associated indirectly with depression via its impact on the risk of becoming unemployed. Implications for policy and further research were discussed.
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Affiliation(s)
- D Dooley
- School of Social Ecology, University of California, Irvine 29717, USA
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Catalano R, Dooley D, Novaco RW, Wilson G, Hough R. Using ECA survey data to examine the effect of job layoffs on violent behavior. Hosp Community Psychiatry 1993; 44:874-9. [PMID: 8225302 DOI: 10.1176/ps.44.9.874] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The study examined two hypotheses: that being laid off increases the likelihood of violence and that being employed in an industry in which employment is unexpectedly low decreases the likelihood of violence. METHODS Logistic regression analyses were used to examine data for more than 4,000 persons who participated in initial and follow-up interviews as part of the Epidemiologic Catchment Area survey. Data for persons who were working and not violent at the time of the initial interview but who were unemployed at reinterview were examined, as were data for persons who remained employed in industries with low employment levels. RESULTS The risk of violent behavior of those who were laid off was nearly six times higher than that of their employed counterparts. Controlling for concurrent psychiatric disorder did not reveal a lower risk. The risk of violent behavior was reduced among those who remained employed in industries where layoffs were occurring. CONCLUSIONS Economic contraction seems to affect violence in the community in two countervailing processes--one process increases violence and one reduces it. However, the net effect may well be that violence decreases in communities experiencing economic contraction.
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Affiliation(s)
- R Catalano
- School of Public Health, University of California, Berkeley 94720
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Catalano R, Dooley D, Wilson G, Hough R. Job loss and alcohol abuse: a test using data from the Epidemiologic Catchment Area project. J Health Soc Behav 1993; 34:215-225. [PMID: 7989666] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The hypothesis that job loss affects the incidence of clinically significant alcohol abuse is tested using panel data from the Epidemiologic Catchment Area project. Results suggest that the incidence of clinically significant alcohol abuse is greater among those who have been laid off than among those who have not. However, employed persons in communities in which total employment is unexpectedly low are at reduced risk of becoming alcohol abusers. The implications of the results for economic policy and for mental health services are discussed briefly.
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Affiliation(s)
- R Catalano
- School of Public Health, University of California at Berkeley 94720
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Abstract
OBJECTIVES Little is known about the effect of noncompletion on telephone surveys of health issues. This paper identifies a little-studied source of noncompletion, passive refusal, and evaluates its contribution to noncompletion bias along with two other sources: noncooperation and noncontact. Passive refusals include respondents who repeatedly request callbacks and households where interviewers repeatedly encounter an answering machine. METHODS Measures of noncompletion (noncooperation, passive refusal, and noncontact), demographic and socioeconomic characteristics, health risk factors, and indicators of health care access and health status were collected through the Orange County Health Surveys on 4893 respondents. The surveys sampled by random-digit dialing and interviewed by computer-assisted telephone. RESULTS Passive refusals have a substantial impact on completion rates and bias due to noncompletion. Commonly used definitions for completion rates may underestimate the bias due to noncompletion because they omit passive refusals. After we controlled for demographic and socioeconomic factors, few noncompletion biases appeared on selected health indicators. CONCLUSIONS These results suggest improved reporting of completion rates and support a multivariate framework for studying noncompletion in telephone health surveys.
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Affiliation(s)
- S I Mishra
- Department of Medicine, University of California-Irvine 92717
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Serxner S, Catalano R, Dooley D, Mishra S. Influences on cigarette smoking quantity. Selection, stress, or culture? J Occup Med 1992; 34:934-9. [PMID: 1447601] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The selection, job stress, and job culture models of the association between occupation and smoking quantity were empirically evaluated in a random sample of 556 employed smoking adults in Orange County, California. Almost three quarters of the sample were heavy smokers (20 or more cigarettes per day). The largest percent of heavy smokers were blue-collar workers (77%). Age, sex, ethnicity, and the industry in which one works were all associated with heavy smoking, implying that selection and culture models contribute to smoking behavior. For example, men had twice the odds of being heavy smokers than did women, and Anglos had almost two and a half times the odds of being a heavy smoker than did non-Anglos. Smokers employed in the service, financial, insurance, and retail industries were one fourth as likely to be heavy smokers as those employed in the public administration sector. Smokers employed in the public administration sector had the highest percent of heavy smokers (88.9%). Job stress was not associated with heavy smoking compared with light smoking. Smoking cessation and prevention programs should address the social and job cultures in which the behavior occurs. Job-culture models of intervention should include elements that focus on individual coping mechanisms involving susceptibility to social pressure; social environment models imply that change in organizational culture is necessary.
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Affiliation(s)
- S Serxner
- Cancer Research Center of Hawaii, University of Hawaii, Manoa 96813
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Serxner S, Catalano R, Dooley D, Mishra S. Tobacco use: selection, stress, or culture? J Occup Med 1991; 33:1035-9. [PMID: 1753299] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The effects of selection, job stress, and culture models on the association between occupation and smoking were empirically estimated on a random sample of 2,362 employed adults in Orange County, California using data collected through the Orange County Health Survey. The largest percent of smokers were blue-collar workers (32.4%). The logistic regression analysis results indicated that age, sex, education, ethnicity, job stress, and the industry in which employees work had significant impact on the risk of smoking. The findings imply that all three models contribute to smoking behavior. Smoking cessation and prevention programs may include elements that address both stress and environment in intervention design. Stress models imply that such program should focus on change in individual coping mechanisms; social environment models imply that change in group norms and attitudes is necessary.
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Affiliation(s)
- S Serxner
- Cancer Research Center of Hawaii, University of Hawaii, Manoa 96813
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Dooley D. Medical ethics in Ireland: a decade of change. Hastings Cent Rep 1991; 21:18-21. [PMID: 2004894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- D Dooley
- Department of Philosophy, University College, Cork, Ireland
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Dubur GJ, Veveris MM, Weinheimer G, Bisenieks EA, Makarova NR, Kimenis AA, Uldrikis JR, Lukevics EJ, Dooley D, Osswald H. Synthesis and selective vasodilating properties of esters of 2,6-dimethyl-4-(2-difluoromethoxyphenyl)-1,4-dihydro-pyridine-3,5-di- carboxylic acid. Arzneimittelforschung 1989; 39:1185-9. [PMID: 2532883] [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] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study presents the synthesis of new 1,4-dihydropyridine (DHP) derivatives which are phenoxy- and alkoxyalkyl esters of 2,6-dimethyl-4-(2-difluoromethoxyphenyl)-1,4-dihydropyridine-3,5-dica rbo xylic acid and reports on the biological activity of the compounds. It was found that the DHP derivatives showed high affinity to the DHP receptor of rat brain membranes and antagonize potently the potassium depolarization-induced vasospasm in a fashion compatible with the assumption of a calcium entry blockade. The higher vasodilating potency of especially compound III for the cerebral vasculature might represent an improved selectivity profile due to specific substitution patterns of the DHP molecule by increasing lipophilicity. Thus, the new DHP derivatives might be useful as therapeutic agents for hypertension and impaired cerebral microcirculation.
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Affiliation(s)
- G J Dubur
- Institute for Organic Synthesis, Riga (USSR), Fed. Rep. of Germany
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Dooley D, Catalano R, Rook K, Serxner S. Economic stress and suicide: multilevel analyses. Part 2: Cross-level analyses of economic stress and suicidal ideation. Suicide Life Threat Behav 1989; 19:337-51. [PMID: 2609363] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This paper reports the second of two studies of the hypothesis that the economy affects suicide; both studies were based in the same community during approximately the same time period. Although many aggregate-level tests have been conducted using archival measures of unemployment and suicide (the approach used in Part 1), the impact of economic climate on suicidal ideation has not been measured at the individual level. In the study reported here, aggregate economic indicators were combined with individual-level measures of stressful events, symptoms, and suicidal ideation obtained in a survey of Los Angeles from 1978 to 1982. Each of the two studies revealed small associations between economic stress and suicide or suicidal ideation, but they were inconsistent with respect to specific subgroups.
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Affiliation(s)
- D Dooley
- University of California, Irvine
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Dooley D, Catalano R, Rook K, Serxner S. Economic stress and suicide: multilevel analyses. Part 1: Aggregate time-series analyses of economic stress and suicide. Suicide Life Threat Behav 1989; 19:321-36. [PMID: 2609362] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Of the research on health and economic stress, the approach that has produced the strongest findings has been the aggregate time-series analysis of unemployment and suicide rates. A review of the literature indicates that this aggregate work has been disputed on both methodological and interpretive grounds. To address these issues, two studies of the relationship between economic stress and suicide were conducted on the same population. The first, reported in this paper (Part 1), replicated the aggregate time-series work with improvements in method, using monthly data for 1975-1982 for Los Angeles. A second study (reported in Part 2) combined aggregate economic indicators with individual-level measures of stressful events, symptoms, and suicidal ideation.
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Affiliation(s)
- D Dooley
- University of California, Irvine
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Dooley D, Catalano R. Barbara Snell Dohrenwend memorial lecture. The epidemiology of economic stress. Am J Community Psychol 1984; 12:387-409. [PMID: 6486106 DOI: 10.1007/bf00896502] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Dooley D, Catalano R. Why the economy predicts help-seeking: a test of competing explanations. J Health Soc Behav 1984; 25:160-176. [PMID: 6470457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Catalano RC, Dooley D. The economy and mental health: a reply to Liem and Rayman. Am Psychol 1984; 39:180-1. [PMID: 6703466 DOI: 10.1037/0003-066x.39.2.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Catalano R, Dooley D. Health effects of economic instability: a test of economic stress hypothesis. J Health Soc Behav 1983; 24:46-60. [PMID: 6853998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Catalano R, Dooley D, Jackson R. Economic predictors of admissions to mental health facilities in a nonmetropolitan community. J Health Soc Behav 1981; 22:284-297. [PMID: 7288134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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