Efficacy of electroacupuncture stimulating Zusanli (ST36) and Xuanzhong (GB39) on synovial angiogenesis in rats with adjuvant arthritis

OBJECTIVE

To investigate the efficacy of electroacupuncture (EA) stimulating Zusanli (ST36) and Xuanzhong (GB39) on synovial angiogenesis in rats with adjuvant arthritis (AA).

METHODS

AA models were established by bilateral injection of Freund's complete adjuvant (FCA) in male Sprague-Dawley rats. Three days after injection, rats were given EA at Zusanli (ST36) and Xuanzhong (GB39) acupoints, once every other day, for 16 d. The arthritis index score, paw volume, and hematoxylin-eosin (HE) staining was performed for each animal. Angiogenesis marker cluster of differentiation 34 (CD34) expression and synovial cell apoptosis in synovial tissue were observed. The levels of Notch1, hairy and enhancer of split homolog-1 (Hes1), transforming growth factor-beta (TGF-β) and basic fibroblast growth factor (bFGF) were subsequently detected.

RESULTS

We found that EA significantly decreased arthritis index scores, paw volume, and HE staining scores. EA could significantly inhibit the expression of CD34, promoting apoptosis of synovial cells in the joint synovial tissue of AA rats. The expression of Notch1 signaling pathway proteins and mRNAs (Notch1, Hes1, TGF-β, and bFGF) were markedly downregulated by EA treatment.

CONCLUSIONS

These results prove that EA attenuates synovial angiogenesis by inhibiting the Notch1 signaling pathway in AA rat models. Based on our findings, we propose that EA is a promising complementary and alternative therapy in rheumatoid arthritis.

Effect of Tuina along "bladder meridian" alleviating intervertebral disc degeneration by regulating the transforming growth factor-β1/Smad signaling pathway in a rabbit model

OBJECTIVE

The aim of this study was to investigate the protective effects of Tuina (a traditional Chinese massage therapy) on intervertebral disc (IVD) degeneration and the regulatory mechanisms of the transforming growth factor-β1 (TGF-β1)/small mothers against decapentaplegic (Smad) signaling pathway.

METHODS

Thirty New Zealand white rabbits were randomized into five groups: the control group, model group, model + Tuina group (Tuina group), model + TGF-β1 group (TGF-β1 group), and model + TGF-β1 inhibitor SB431542 group (SB431542 group). The model was established by posterolateral annulus fibrosus puncturing (AFP). Recombinant TGF-β1 and inhibitor SB431542 was injected into the TGF-β1 group and SB431542 group with a microsyringe, respectively. The rabbits in the Tuina group received Tuina treatment along the bladder meridian for 4 weeks. Magnetic resonance imaging (MRI) was performed on rabbits before AFP and after 4 weeks of intervention. Lumbar IVDs (L2-L3 to L4-L5) were harvested after intervention. Histopathological changes in the IVDs were measured by hematoxylin and eosin (HE) staining. Type I collagen was analyzed by immunohistochemistry detection. The expression level of matrix metalloproteinase-3 (MMP3) was determined by enzyme-linked immunosorbent assay. Cell apoptosis was evaluated by terminal deoxynucleotidyl transferase-mediated nick end labeling and Western blotting. Real-time polymerase chain reaction and Western blotting were used to analyze the expression of TGF-β1 and Smad2/3/4 and a disintegrin and metalloproteinase with thrombospondin motifs 5.

RESULTS

Posterolateral AFP induced IVD degeneration in rabbits with histopathological damage and noticeable changes in MRI images. Tuina alleviated histo-pathological changes and reversed the expression of extracellular matrix degeneration-related molecules and apoptosis-related proteins. Furthermore, AFP induced the activation of TGF-β1 and Smad2/3/4, whereas Tuina therapy markedly reduced the protein expression of Smad2/3 and the gene expression of TGF-β1 and Smad2/3/4. Additionally, the TGF-β1/Smad signaling pathway was activated in the TGF-β1 group, while the TGF-β1/Smad signaling pathway was inhibited in the SB431542 group.

CONCLUSION

Posterolateral AFP induced disc degeneration as determined by MRI assessment and histological analysis. Tuina alleviated disc degeneration, possibly by inhibiting the fibrotic response mediated by the TGF-β1/Smad pathway, thus alleviating extracellular matrix degeneration and reducing cell apoptosis.

Results of combined vitreoretinal surgery and phacoemulsification with intraocular lens implantation

PURPOSE

To assess the outcome and complications after combined pars plana vitrectomy and phacoemulsification with intraocular lens implantation in patients with concomitant cataract and vitreoretinal abnormalities.

METHODS

This retrospective study consisted of 113 eyes of 109 patients with various vitreoretinal abnormalities and visually significant cataract. Vitreoretinal surgery was combined with clear corneal phacoemulsification and intraocular mplantation.

RESULTS

The combined surgery resulted in minimal complications, and postoperative visual acuity was improved in 83 eyes (71.6%). Visual acuity was improved by two or more lines in 26 eyes (66.6%) with proliferative diabetic retinopathy, 22 eyes (73%) with proliferative vitreoretinopathy, eight eyes (30.7%) with macular abnormalities, four eyes (55.5%) with trauma and two eyes (40%) with retinal vein occlusion.

CONCLUSIONS

The combined vitreoretinal surgery and phacoemulsification with intraocular lens implantation was safe and effective in treating vitreoretinal abnormalities coexisting with cataract. Combined surgery is recommended for all patients having simultaneous vitreoretinal pathological changes and cataract. The addition of phacoemulsification does not prolong vitreoretinal operative time notably nor increase the risk of intraoperative and postoperative complications significantly

Influence of overlying tissue and probe geometry on the sensitivity of a near-infrared tissue oximeter

In this paper, the influences of overlying tissue and detecting distance between the source and the detector on the measurement of a tissue oximeter were discussed. The signal-noise-ratio of the detector was also examined. A semi-infinite multi-layer Monte Carlo model was induced to simulate the migration of the photons in the skin, adipose and muscle. The thickness of the adipose layer and the separation between the source and the detector in the muscle were changed to simulate the clinical application. Partial pathlength was introduced as a characteristic parameter to evaluate the sensitivity of the oximeter. A two-wavelength (700 and 830 nm) tissue oximeter was developed to verify the results of the simulation. The Monte Carlo simulation results showed that the sensitivity of the near infrared spectroscopy (NIRS) oximeter declined greatly with increasing overlying tissue thickness. Increasing the distance between the light source and the detector improved the sensitivity. However, in order to achieve a sufficiently high signal-to-noise ratio, it was necessary to limit this distance. The results of a bicycle ergometer exercise verified the above results and showed that, for a special adipose thickness (AT), there may be a reasonable range of the emitter-detector separation.

CD44-mediated neutrophil apoptosis in the rat

BACKGROUND

Apoptosis is an important mechanism by which neutrophils are removed from sites of inflammation, including the kidney. This study investigated whether ligation of the cell-surface adhesion molecule, CD44, can trigger neutrophil apoptosis.

METHODS

The anti-rat CD44 antibody OX-50 was used to induce apoptosis of cultured blood neutrophils, as determined by flow cytometry using annexin V staining and by transmission electron microscopy. The functional consequences of OX-50-mediated neutrophil depletion were examined in a rat model of accelerated antiglomerular basement membrane glomerulonephritis.

RESULTS

Flow cytometric analysis using the OX-50 antibody, which recognizes the common amino terminal domain of CD44, showed that rat blood neutrophils express very high levels of CD44. The addition of OX-50, but not control antibodies, rapidly induced neutrophil apoptosis in cultured rat blood leukocytes, as demonstrated by annexin V staining and by electron microscopy. Cross-linking of CD44 was essential since F(ab) fragments of the OX-50 antibody failed to induce neutrophil apoptosis. The CD44 ligand hyaluronan and an antibody to the CD44v6 isoform failed to induce neutrophil apoptosis, indicating that OX-50 antibody-mediated neutrophil apoptosis is epitope specific. This effect was specific to neutrophils since the OX-50 antibody did not induce apoptosis in other CD44-expressing cell types (lymphocytes, mesangial cells, or tubular epithelial cells). An injection of OX-50 antibody into normal rats caused a rapid and profound neutropenia, and apoptotic neutrophils could be seen in the blood by electron microscopy. Furthermore, the administration of OX-50 antibody abrogated neutrophil-dependent glomerular injury (proteinuria) on day 1 of rat antiglomerular basement membrane glomerulonephritis, whereas injury on day 10 of the disease (neutrophil independent) was largely unaffected.

CONCLUSIONS

The cross-linking of specific epitopes of the CD44 molecule can rapidly induce neutrophil apoptosis in vitro and inhibit neutrophil-dependent renal injury in vivo. This finding suggests that physiological ligands of the CD44 molecule may play an important role in eliminating neutrophils from sites of inflammation, including inflammatory kidney disease.

Sympathetic inhibition with clonidine improves autonomic balance in congestive heart failure

In this double-blind, placebo-controlled crossover study, we examined the effect of transdermal clonidine (given for 5 days) on autonomic control in 14 patients with mild to moderate congestive heart failure by heart rate variability analysis. Compared with placebo, clonidine increased the 24-h mean R-R interval from 718+/-110 to 811+/-117 ms (P<0.01), increased the S.D. of all normal RR intervals (SDNN) from 60.8+/-18.5 to 80.9+/-21.4 ms (P<0.01), the S.D. of the average RR intervals for all 5-min segments (SDANN) from 54.7+/-15.2 to 70.5+/-18.4 ms (P<0.01) and the mean of the S.D.s of all RR intervals for all 5-min segments (SDNN index) from 29.2+/-8.3 to 36.5+/-8.1 ms (P<0.01). The root mean square successive differences (r-MSSD) and the percent of differences between adjacent RR intervals >50 ms (pNN50) were also increased from 18.3+/-6.7 to 23.1+/-7.0 ms (P<0.01) and from 2.1+/-1.9 to 4.5+/-3.0% (P<0.01). In addition, total power, low frequency power and high frequency power were increased from 641+/-322 to 898+/-403 ms2/Hz (P<0.01), from 149+/-97 to 216+/-133 ms2/Hz (P<0.01) and from 52.8+/-27.1 to 93.2+/-41.3 ms2/Hz (P<0.01), respectively. The plasma norepinephrine level was decreased significantly from 0.52+/-0.18 to 0.24+/-0.09 ng/ml (P<0.01) after clonidine therapy. Changes in heart rate variability measures after clonidine administration were positively related to changes in plasma norepinephrine level. These results indicate that suppressing the sympathetic nervous system by clonidine improves autonomic balance in patients with congestive heart failure. But whether such restoration of the autonomic control has a beneficial effect on the long-term management of these patients still needs further investigation.

CD44 and hyaluronan expression in the development of experimental crescentic glomerulonephritis

CD44 is a widely expressed cell surface glycoprotein which is involved in both cell-matrix and cell-cell interactions which regulate a variety of processes, including leucocyte migration and activation. Therefore, we examined the expression of CD44, and its major ligand hyaluronan, during the induction and progression of experimental glomerulonephritis. Antibody staining of normal rat kidney showed constitutive CD44 expression by resident glomerular macrophages, parietal epithelial cells, medullary and occasional cortical tubules. There was a marked increase in CD44 expression over days 1, 7 and 21 of rat crescentic anti-glomerular basement membrane (GBM) glomerulonephritis. Infiltrating monocytes and lymphocytes were CD44+, with ultrastructural studies showing high levels of CD44 expressed on the surface of lymphocytes adherent to activated endothelium. Marked hyaluronan deposition was seen in areas of fibrosis on days 7 and 21, such as glomerular crescents and the periglomerular area. Hyaluronan deposition was accompanied by the presence of many CD44+ cells. Double immunohistochemistry showed that both CD44+ED1+ macrophages and CD44+ myofibroblasts (identified by expression of alpha-smooth muscle actin) were present in areas of fibrosis. There was also a dramatic increase in cortical tubular CD44 expression, which was most evident in areas of tubular damage. Although tubular epithelial cells expressed CD44 upon both the basolateral and luminal surface, CD44 expression was most prominent within tightjunctions, suggesting a role for CD44-CD44 interactions in cell-cell adhesion within the tubule. Analysis of CD44 isoforms by reverse transcriptase-polymerase chain reaction (RT-PCR) showed that the standard form of CD44 predominated in both normal and diseased kidney. However, a series of alternatively spliced CD44 isoforms was also detected, whose expression was markedly increased during disease. At least seven isoforms containing the v6 domain were identified, with the smallest form representing activated T cells. In conclusion, CD44 is constitutively expressed in normal kidney and is dramatically up-regulated in rat anti-GBM disease, suggesting possible roles for the CD44-hyaluronan interaction in leucocyte recruitment, renal fibrosis and tubular cell-matrix and cell-cell interactions during the induction and progression of crescentic glomerulonephritis.

De novo CD44 expression by proliferating mesangial cells in rat anti-Thy-1 nephritis

CD44 is the major cell-surface receptor for hyaluronan, and cell-matrix interactions mediated by the CD44/hyaluronan receptor-ligand pair are involved in a variety of cellular functions, including cell migration. The aim of the study presented here was to examine the expression of CD44 and hyaluronan in the mesangial proliferative response in rat anti-Thy-1 nephritis. In normal rat kidney, CD44 is expressed by medullary tubules, some distal tubules and thick ascending limbs of Henle, dendritic-like cells around Bowman's capsule, and some interstitial cells. However, only occasional CD44+ cells were found within the glomerular tuft. In experimental nephritis, there was an early glomerular influx of CD44+ macrophages, which peaked on Day 4 after anti-Thy-1 antibody injection. A striking finding was de novo CD44 expression by mesangial cells. This CD44 expression was restricted to the transient period of mesangial cell proliferation as shown by double-staining with an antibody against the proliferating cell nuclear antigen. Immunohistochemistry staining also demonstrated hyaluronan deposition within segmental areas of proliferating CD44+ cells, suggesting a functional interaction between the CD44/hyaluronan receptor-ligand pair during mesangial cell proliferation. In vitro, rat mesangial cells were shown to express mRNA and protein for the 90-kd isoform of CD44. In addition, hyaluronan-dependent aggregation of CD44+ mesangial cells was specifically inhibited by an anti-CD44 antibody, demonstrating a functional interaction between hyaluronan and the CD44 expressed on the surface of rat mesangial cells. In conclusion, these data suggest that cell-matrix interactions mediated by the CD44/hyaluronan receptor-ligand pair are involved in mesangial cell proliferation in rat anti-Thy-1 nephritis.

Two New Glycosides from the Roots of Cynanchum versicolor

Two new glycosides named cynanversicoside-A and -B, together with glaucogenin-C as the aglycone, were isolated from the Chinese crude drug "Pai-Wei", CYNANCHUM VERSICOLOR Bunge (Asclepiadaceae). Their structures were determined on the basis of spectral and chemical evidence as glaucogenin-C 3- O-beta- D-cymaropyranosyl-(1-->4)-alpha- L-diginopyranosyl-(1-->4)-beta- D-thevetopyranoside and glaucogenin-C 3- O-beta- D-glucopyranosyl-(1-->4)-beta- D-cymaropyranosyl-(1-->4)-alpha- L-diginopyranosyl-(1-->4)-beta- D-thevetopyranoside.

Two New Sesquiterpene Esters from Celastrus glaucophyllus

Two new sesquiterpene esters, celaglaupin and celaglausin, have been isolated from the root bark of CELASTRUS GLAUCOPHYLLUS. Their structures have been elucidated on the basis of two-dimensional NMR (1)H- (1)H COSY, (13)C- (1)H COSY, and NOESY) and other spectral (UV, IR, HR-mass, and DEPT) analysis as well as chemical methods, respectively.