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Cowman M, Godfrey E, Walsh T, Frawley E, Fowler D, Alvarez-Jimenez M, O’Connor K, Wykes T, Birchwood M, Donohoe G. Measures of Social and Occupational Function in Early Psychosis: A Systematic Review and Meta-analysis. Schizophr Bull 2024; 50:266-285. [PMID: 37173277 PMCID: PMC10919778 DOI: 10.1093/schbul/sbad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Deficits in social and occupational function are widely reported in psychosis, yet no one measure of function is currently agreed upon as a gold standard in psychosis research. The aim of this study was to carry out a systematic review and meta-analysis of functioning measures to determine what measures were associated with largest effect sizes when measuring between-group differences, changes over time, or response to treatment. Literature searches were conducted based on PsycINFO and PubMed to identify studies for inclusion. Cross-sectional and longitudinal observational and intervention studies of early psychosis (≤5 years since diagnosis) that included social and occupational functioning as an outcome measure were considered. A series of meta-analyses were conducted to determine effect size differences for between-group differences, changes over time, or response to treatment. Subgroup analyses and meta-regression were carried out to account for variability in study and participant characteristics. One hundred and sixteen studies were included, 46 studies provided data (N = 13 261) relevant to our meta-analysis. Smallest effect sizes for changes in function over time and in response to treatment were observed for global measures, while more specific measures of social and occupational function showed the largest effect sizes. Differences in effect sizes between functioning measures remained significant after variability in study and participant characteristics were accounted for. Findings suggest that more specific measures of social function are better able to detect changes in function over time and in response to treatment.
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Affiliation(s)
- Megan Cowman
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
| | - Emmet Godfrey
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
| | - Talissa Walsh
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
| | - Emma Frawley
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
| | - David Fowler
- School of Psychology, University of Sussex, Falmer, UK
| | - Mario Alvarez-Jimenez
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Karen O’Connor
- RISE Early Intervention in Psychosis Service, South Lee Mental Health Service, Cork, Ireland
- Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - Til Wykes
- School of Mental Health & Psychological Sciences, King’s College London, London, UK
| | - Max Birchwood
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Gary Donohoe
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
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Corley E, Gleeson C, Godfrey E, Cowman M, Patlola SR, Cannon DM, McKernan DP, Kelly JP, Hallahan B, McDonald C, Morris DW, Burke T, Donohoe G. Corpus callosum microstructural organization mediates the effects of physical neglect on social cognition in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110875. [PMID: 37844774 DOI: 10.1016/j.pnpbp.2023.110875] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/20/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023]
Abstract
Exposure to early life adversity is associated with both increased risk of developing schizophrenia and poorer performance on measures of social cognitive functioning. In this study, we examined whether interleukin-6 (IL-6) and Corpus Callosum (CC) microstructure mediated the association between childhood physical neglect and social cognition. Fifty-eight patients with a diagnosis of schizophrenia were included. The CANTAB emotion recognition task (unbiased hit rate) was used to assess social cognition. We found that the microstructural organization of the CC significantly mediated the association between physical neglect and emotion recognition. Furthermore, in a sequential mediation analysis that also considered the role of inflammatory response, the association between physical neglect, and lower emotion recognition performance was sequentially mediated by higher IL-6 and lower fractional anisotropy of the CC. This mediating effect of IL-6 was only present when simultaneously considering the effects of CC microstructural organization and remained significant while controlling for the effects of sex, BMI and medication dosage (but not age). Overall, the findings suggest that the association between physical neglect and poorer emotion recognition in schizophrenia occurs, at least in part, via its association with white matter microstructure.
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Affiliation(s)
- Emma Corley
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | - Christina Gleeson
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | - Emmet Godfrey
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | - Megan Cowman
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | | | - Dara M Cannon
- Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland; Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Ireland
| | - Declan P McKernan
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Ireland
| | - John P Kelly
- Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, University of Galway, Ireland
| | - Brian Hallahan
- Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland; Department of Psychiatry, Clinical Science Institute, University of Galway, Ireland
| | - Colm McDonald
- Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland; Department of Psychiatry, Clinical Science Institute, University of Galway, Ireland
| | - Derek W Morris
- Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland; School of Biological and Chemical Sciences, University of Galway, Ireland
| | - Tom Burke
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland
| | - Gary Donohoe
- School of Psychology, University of Galway, Ireland; Center for Neuroimaging Cognition and Genomics, University of Galway, Ireland.
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Frawley E, Cowman M, Lepage M, Donohoe G. Social and occupational recovery in early psychosis: a systematic review and meta-analysis of psychosocial interventions. Psychol Med 2023; 53:1787-1798. [PMID: 34474696 PMCID: PMC10106304 DOI: 10.1017/s003329172100341x] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/20/2021] [Accepted: 07/29/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Psychosis, even in its early stages, ranks highly among the causes of disability worldwide, resulting in an increased focus on improved recovery of social and occupational functioning. This study aimed to provide an estimate of the effectiveness of psychosocial interventions for improving functioning in early psychosis. We also sought evidence of superiority between intervention approaches. METHODS An electronic search was conducted using PubMed and PsycINFO to identify original articles reporting on trials of psychosocial interventions in early-stage psychosis, published up to December 2020 and is reported following PRISMA guidelines. Data were extracted on validated measures of functioning from included studies and pooled standardised mean difference (SMD) was estimated. RESULTS In total, 31 studies involving 2811 participants were included, focusing on: cognitive behavioural therapy for psychosis (CBTp), family-based therapy, supported employment, cognitive remediation training (CRT) and multi-component psychosocial interventions. Across interventions, improved function was observed (SMD = 0.239; 95% confidence interval 0.115-0.364, p < 0.001). Effect sizes varied by intervention type, stage of illness, length and duration of treatment and outcome measure used. In particular, interventions based on CRT significantly outperformed symptom-focused CBT interventions, while multi-component interventions were associated with largest gains. CONCLUSIONS Psychosocial interventions, particularly when provided as part of a multi-component intervention model and delivered in community-based settings are associated with significant improvements in social and occupational function. This review underscores the value of sensitively tracking and targeting psychosocial function as part of the standard provided by early intervention services.
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Affiliation(s)
- E. Frawley
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - M. Cowman
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - M. Lepage
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - G. Donohoe
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland Galway, Galway, Ireland
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Frawley E, Cowman M, Cella M, Cohen D, Ryan E, Hallahan B, Bowie C, McDonald C, Fowler D, Wykes T, Donohoe G. Cognitive Remediation and Social Recovery in Early Psychosis (CReSt-R): protocol for a pilot randomised controlled study. Pilot Feasibility Stud 2022; 8:109. [PMID: 35610711 PMCID: PMC9126749 DOI: 10.1186/s40814-022-01064-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/06/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Psychosis, even in its early stages, is associated with significant disability, causing it to be ranked ahead of paraplegia and blindness in those aged 18-35 in terms of years lived with disability. Current pharmacological and psychological interventions intervention have focused primarily on the reduction of positive symptoms (hallucinations and delusions), with little benefit to domains of psychosis such as cognitive difficulties and social and occupational functioning. METHODS/DESIGN The CReSt-R intervention trial is a single center, pilot randomised controlled study based at the National University of Ireland (NUI), Galway. The trial will recruit participants from four clinical sites with assessment and intervention completed by the primary NUI Galway team. The trial will explore the feasibility, acceptability, and effectiveness of a novel psychosocial intervention for early psychosis based on a combined cognitive remediation training and cognitive behavioural therapy approach focused on social recovery. Participants, aged 16-35 within the first 5 years of a diagnosed psychotic disorder, will be recruited from the Children and Adolescent Mental Health Service and the Adult Mental Health Services in the region. DISCUSSION Cognitive remediation training (for improving cognition) and social recovery focused cognitive behavioural therapy, have both separately demonstrated effectiveness. This trial will evaluate the feasibility, acceptability, and explore the efficacy of a treatment approach that combines both approaches as part of an integrated, multicomponent intervention. TRIAL REGISTRATION Cognitive Remediation & Social Recovery in Early Psychosis (CReSt-R): ClincialTrials.gov Identifier NCT04273685. Trial registered Feb 18th, 2020. Last updated April 14th, 2021.
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Affiliation(s)
- E Frawley
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - M Cowman
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - M Cella
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, England
| | - D Cohen
- South Galway Child & Adolescent Mental Health Service, Health Service Executive, Merlin Park Hospital, Galway, Ireland
- Department of Psychiatry, National University of Ireland, Galway, Ireland
| | - E Ryan
- Psychology Service, Adult Mental Health Service, University Hospital Galway, Galway, Ireland
| | - B Hallahan
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - C Bowie
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - C McDonald
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland
| | - D Fowler
- Department of Psychology, University of Sussex, Brighton, England
| | - T Wykes
- Institute of Psychiatry, Psychology & Neuroscience, King's College, London, England
| | - G Donohoe
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland, Galway, Ireland.
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Cowman M, Holleran L, Lonergan E, O’Connor K, Birchwood M, Donohoe G. Cognitive Predictors of Social and Occupational Functioning in Early Psychosis: A Systematic Review and Meta-analysis of Cross-Sectional and Longitudinal Data. Schizophr Bull 2021; 47:1243-1253. [PMID: 33761534 PMCID: PMC8379554 DOI: 10.1093/schbul/sbab033] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Many individuals with early psychosis experience impairments in social and occupational function. Identification of modifiable predictors of function such as cognitive performance has the potential to inform effective treatments. Our aim was to estimate the strength of the relationship between psychosocial function in early psychosis and different domains of cognitive and social cognitive performance. We conducted a systematic review and meta-analysis of peer-reviewed, cross-sectional, and longitudinal studies examining cognitive predictors of psychosocial function. Literature searches were conducted in PsycINFO, PubMed, and reference lists of relevant articles to identify studies for inclusion. Of the 2565 identified, 46 studies comprising 3767 participants met inclusion criteria. Separate meta-analyses were conducted for 9 cognitive domains. Pearson correlation values between cognitive variables and function were extracted. All cognitive domains were related to psychosocial function both cross-sectionally and longitudinally. Importantly, these associations remained significant even after the effects of symptom severity, duration of untreated psychosis, and length of illness were accounted for. Overall, general cognitive ability and social cognition were most strongly associated with both concurrent and long-term function. Associations demonstrated medium effect sizes. These findings suggest that treatments targeting cognitive deficits, in particular those focusing on social cognition, are likely to be important for improving functional outcomes in early psychosis.
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Affiliation(s)
- Megan Cowman
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Laurena Holleran
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Edgar Lonergan
- First Episode Psychosis Service, South Lee Mental Health Service, Cork, Ireland
| | - Karen O’Connor
- First Episode Psychosis Service, South Lee Mental Health Service, Cork, Ireland
| | - Max Birchwood
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Gary Donohoe
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland Galway, Galway, Ireland
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Matthews E, Cowman M, Denieffe S. Using experience-based co-design for the development of physical activity provision in rehabilitation and recovery mental health care. J Psychiatr Ment Health Nurs 2017; 24:545-552. [PMID: 28544037 DOI: 10.1111/jpm.12401] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2017] [Indexed: 01/01/2023]
Affiliation(s)
- E Matthews
- Department of Nursing and Health Care, Waterford Institute of Technology, Waterford, Ireland
| | - M Cowman
- Department of Sport and Exercise Sciences, Centre for Health Behaviour Research, Waterford Institute of Technology, Waterford, Ireland
| | - S Denieffe
- Department of Nursing and Health Care, Waterford Institute of Technology, Waterford, Ireland
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Stenger J, Cowman M, Eggers F, Eyring EM, Kaatze U, Petrucci S. Molecular Dynamics and Kinetics of Monosaccharides in Solution. A Broadband Ultrasonic Relaxation Study. J Phys Chem B 2000. [DOI: 10.1021/jp9940194] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J. Stenger
- Drittes Physikalisches Institut, Georg-August-Universität, Bürgerstrasse 42-44, D-37073 Göttingen, Germany, Department of Chemical Engineering, Chemistry, and Material Science, Polytechnic University, Brooklyn, New York 11201, Max-Planck-Institut für Biophysikalische Chemie, Am Fassberg, D-37077 Göttingen, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, and Chemistry Department, Polytechnic University, Route 110, Farmingdale, New York 11735
| | - M. Cowman
- Drittes Physikalisches Institut, Georg-August-Universität, Bürgerstrasse 42-44, D-37073 Göttingen, Germany, Department of Chemical Engineering, Chemistry, and Material Science, Polytechnic University, Brooklyn, New York 11201, Max-Planck-Institut für Biophysikalische Chemie, Am Fassberg, D-37077 Göttingen, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, and Chemistry Department, Polytechnic University, Route 110, Farmingdale, New York 11735
| | - F. Eggers
- Drittes Physikalisches Institut, Georg-August-Universität, Bürgerstrasse 42-44, D-37073 Göttingen, Germany, Department of Chemical Engineering, Chemistry, and Material Science, Polytechnic University, Brooklyn, New York 11201, Max-Planck-Institut für Biophysikalische Chemie, Am Fassberg, D-37077 Göttingen, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, and Chemistry Department, Polytechnic University, Route 110, Farmingdale, New York 11735
| | - E. M. Eyring
- Drittes Physikalisches Institut, Georg-August-Universität, Bürgerstrasse 42-44, D-37073 Göttingen, Germany, Department of Chemical Engineering, Chemistry, and Material Science, Polytechnic University, Brooklyn, New York 11201, Max-Planck-Institut für Biophysikalische Chemie, Am Fassberg, D-37077 Göttingen, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, and Chemistry Department, Polytechnic University, Route 110, Farmingdale, New York 11735
| | - U. Kaatze
- Drittes Physikalisches Institut, Georg-August-Universität, Bürgerstrasse 42-44, D-37073 Göttingen, Germany, Department of Chemical Engineering, Chemistry, and Material Science, Polytechnic University, Brooklyn, New York 11201, Max-Planck-Institut für Biophysikalische Chemie, Am Fassberg, D-37077 Göttingen, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, and Chemistry Department, Polytechnic University, Route 110, Farmingdale, New York 11735
| | - S. Petrucci
- Drittes Physikalisches Institut, Georg-August-Universität, Bürgerstrasse 42-44, D-37073 Göttingen, Germany, Department of Chemical Engineering, Chemistry, and Material Science, Polytechnic University, Brooklyn, New York 11201, Max-Planck-Institut für Biophysikalische Chemie, Am Fassberg, D-37077 Göttingen, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, and Chemistry Department, Polytechnic University, Route 110, Farmingdale, New York 11735
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Cowman M, Eggers F, Eyring EM, Horoszewski D, Kaatze U, Kreitner R, Petrucci S, Klöppel-Riech M, Stenger J. Microsecond to Subnanosecond Molecular Relaxation Dynamics of the Interaction of Ca2+ with Some Carbohydrates in Aqueous Solution. J Phys Chem B 1998. [DOI: 10.1021/jp983351x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. Cowman
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
| | - F. Eggers
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
| | - E. M. Eyring
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
| | - D. Horoszewski
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
| | - U. Kaatze
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
| | - R. Kreitner
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
| | - S. Petrucci
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
| | - M. Klöppel-Riech
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
| | - J. Stenger
- Department of Chemical Engineering, Chemistry, and Materials Science, Polytechnic University, Brooklyn, New York 11201, Max Planck-Institut für biophysikalische Chemie, D-37077 Göttingen-Nikolausberg, Germany, Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, Department of Chemistry and Weber Institute, Polytechnic University, Farmingdale, New York 11735, and Drittes Physikalisches Institut, Georg-August-Universität, D-37073 Göttingen, Germany
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McKee CM, Penno MB, Cowman M, Burdick MD, Strieter RM, Bao C, Noble PW. Hyaluronan (HA) fragments induce chemokine gene expression in alveolar macrophages. The role of HA size and CD44. J Clin Invest 1996; 98:2403-13. [PMID: 8941660 PMCID: PMC507693 DOI: 10.1172/jci119054] [Citation(s) in RCA: 597] [Impact Index Per Article: 21.3] [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] [Indexed: 02/03/2023] Open
Abstract
Hyaluronan (HA) is a glycosaminoglycan constituent of extracellular matrix. In its native form HA exists as a high molecular weight polymer, but during inflammation lower molecular weight fragments accumulate. We have identified a collection of inflammatory genes induced in macrophages by HA fragments but not by high molecular weight HA. These include several members of the chemokine gene family: macrophage inflammatory protein-1alpha, macrophage inflammatory protein-1beta, cytokine responsive gene-2, monocyte chemoattractant protein-1, and regulated on activation, normal T cell expressed and secreted. HA fragments as small as hexamers are capable of inducing expression of these genes in a mouse alveolar macrophage cell line, and monoclonal antibody to the HA receptor CD44 completely blocks binding of fluorescein-labeled HA to these cells and significantly inhibits HA-induced gene expression. We also investigated the ability of HA fragments to induce chemokine gene expression in human alveolar macrophages from patients with idiopathic pulmonary fibrosis and found that interleukin-8 mRNA is markedly induced. These data support the hypothesis that HA fragments generated during inflammation induce the expression of macrophage genes which are important in the development and maintenance of the inflammatory response.
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Affiliation(s)
- C M McKee
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
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Abstract
Macrophages play an important role in the acute tissue inflammatory response through the release of cytokines and growth factors in response to stimuli such as lipopolysaccharide (LPS). Macrophage inflammatory effector functions are also influenced by interactions with the extracellular matrix (ECM). Such macrophage-ECM interactions may be important in regulating chronic inflammatory responses. Recent evidence has suggested that hyaluronan (HA), a glycosaminoglycan (GAG) component of ECM can induce inflammatory gene expression in murine macrophages. HA exists in its native form as a large polymer, but is found as smaller fragments under inflammatory conditions. The NF-kappa B/I-kappa B transcriptional regulatory system has been shown to be a critical component of the host inflammatory response. We examined the effects of high molecular weight HA and lower molecular weight HA fragments on NF-kappa B activation in mouse macrophages. Only the smaller HA fragments were found to activate NF-kappa B DNA binding activity. After HA stimulation, I-kappa B alpha mRNA was induced and I-kappa B alpha protein levels, which initially decreased, were restored. The induction of I-kappa Balpha expression was not observed for other GAGs. The time course of I-kappa B alpha protein regeneration in response to HA fragments was consistent with an autoregulatory mechanism. In support of this mechanism, in vitro translated murine I-kappa B alpha inhibited HA fragment-induced NF-kappa B DNA binding activity. The NF-kappa B DNA binding complex in HA-stimulated extracts was found to contain p50 and p65 subunits. Activation of the NF-kappa B/I-kappa B system in macrophages by ECM fragments may be an important mechanism for propagating the tissue inflammatory response.
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Affiliation(s)
- P W Noble
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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