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Tan L, Cao Y, Yan J, Mao K, Liu L, Wang X, Ye W, Harris RA, Zhang H. TiO 2 nanorod arrays@PDA/Ag with biomimetic polydopamine as binary mediators for duplex SERS detection of illegal food dyes. Anal Chim Acta 2024; 1287:342047. [PMID: 38182363 DOI: 10.1016/j.aca.2023.342047] [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: 10/15/2023] [Revised: 11/11/2023] [Accepted: 11/18/2023] [Indexed: 01/07/2024]
Abstract
Based on TiO2 nanorod arrays@PDA/Ag (TNRs@PDA/Ag), a better surface-enhanced Raman scattering (SERS) sensor with effective enrichment and enhancement was investigated for duplex SERS detection of illicit food dyes. Biomimetic PDA functions as binary mediators by utilizing the structural characteristics of polydopamine (PDA), which include the conjugated structure and abundant hydrophilic groups. One PDA functioned as an electron transfer mediator to enhance the efficiency of electron transfer, and the other as an enrichment mediator to effectively enrich rhodamine B (RhB) and crystal violet (CV) through hydrogen bonding, π-π stacking, and electrostatic interactions. Individual and duplex detection of illicit food dyes (RhB and CV) was performed using TNRs@PDA/Ag to estimate SERS applications. Their linear equations and limits of detection of 1 nM for RhB and 5 nM for CV were derived. Individual and duplex food colour detection was successfully accomplished even in genuine chili meal with good results. The bifunctional TNRs@PDA/Ag-based highly sensitive and duplex SERS dye detection will have enormous potential for food safety monitoring.
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Affiliation(s)
- Lin Tan
- State Key Laboratory of Applied Organic Chemistry, Key Laboratory of Special Functional Materials and Structural Design (Ministry of Education), Lanzhou University, Lanzhou 730000, China
| | - Yanqiang Cao
- State Key Laboratory of Applied Organic Chemistry, Key Laboratory of Special Functional Materials and Structural Design (Ministry of Education), Lanzhou University, Lanzhou 730000, China
| | - Juanjuan Yan
- State Key Laboratory of Applied Organic Chemistry, Key Laboratory of Special Functional Materials and Structural Design (Ministry of Education), Lanzhou University, Lanzhou 730000, China
| | - Kang Mao
- State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, Guiyang, 550081, China
| | - Li Liu
- Center for Inspection of Gansu Drug Administration (Center for Vaccine Inspection of Gansu), Lanzhou 730030, China
| | - Xiaolong Wang
- State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, China.
| | - Weichun Ye
- State Key Laboratory of Applied Organic Chemistry, Key Laboratory of Special Functional Materials and Structural Design (Ministry of Education), Lanzhou University, Lanzhou 730000, China.
| | - R A Harris
- Department of Physics, University of the Free State, Bloemfontein 9301, South Africa.
| | - Hua Zhang
- State Key Laboratory of Environmental Geochemistry, Institute of Geochemistry, Chinese Academy of Sciences, Guiyang, 550081, China.
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Harris RA, Mandell DS. Years of life lost to drug overdose in the Latinx community during the most recent wave of overdose deaths. Am J Addict 2023; 32:610-614. [PMID: 37543854 PMCID: PMC10662957 DOI: 10.1111/ajad.13459] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/18/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This study estimated years of life lost (YLL) among US Latinx individuals during the most recent wave of drug overdose deaths. METHODS A serial cross-sectional study of YLL (life expectancy minus age at death) from death certificate records of Latinx individuals who died from drug overdoses from 2015 to mid-2022. RESULTS Over the study period, 58,209 Latinx individuals aged 15-64 years died from drug overdoses resulting in 2,266,784 YLL. Age-group YLL differences remained stable, but gender YLL trajectories diverged. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE This study extends our understanding of the immense loss to Latinx communities from preventable drug deaths.
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA USA
| | - David S. Mandell
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
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French R, Worley J, Lowenstein M, Bogner HR, Calderbank T, DePhilippis D, Forrest A, Gibbons MBC, Harris RA, Heywood S, Kampman K, Mandell DS, McKay JR, Newman ST, Oslin DW, Wadden S, Wolk CB. Adapting psychotherapy in collaborative care for treating opioid use disorder and co-occurring psychiatric conditions in primary care. Fam Syst Health 2023; 41:377-388. [PMID: 37227828 PMCID: PMC10517081 DOI: 10.1037/fsh0000791] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Opioid use disorder (OUD) and psychiatric conditions commonly co-occur yet are infrequently treated with evidence-based therapeutic approaches, resulting in poor outcomes. These conditions, separately, present challenges to treatment initiation, retention, and success. These challenges are compounded when individuals have OUD and psychiatric conditions. METHOD Recognizing the complex needs of these individuals, gaps in care, and the potential for primary care to bridge these gaps, we developed a psychotherapy program that integrates brief, evidence-based psychotherapies for substance use, depression, and anxiety, building on traditional elements of the Collaborative Care Model (CoCM). In this article, we describe this psychotherapy program in a primary care setting as part of a compendium of collaborative services. RESULTS Patients receive up to 12 sessions of evidence-based psychotherapy and case management based on a structured treatment manual that guides treatment via Motivational Enhancement; Cognitive Behavioral Therapies for depression, anxiety, and/or substance use disorder; and/or Behavioral Activation components. DISCUSSION Novel, integrated treatments are needed to advance service delivery for individuals with OUD and psychiatric conditions and these programs must be rigorously evaluated. We describe our team's efforts to test our psychotherapy program in a large primary care network as part of an ongoing three-arm randomized controlled trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Rachel French
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Julie Worley
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Margaret Lowenstein
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hillary R. Bogner
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tara Calderbank
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Dominick DePhilippis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- VA Office of Mental Health and Suicide Prevention, Veterans Health Administration, Washington DC, 20420, USA
| | - Andrew Forrest
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mary Beth Connolly Gibbons
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rebecca Arden Harris
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Saida Heywood
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kyle Kampman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David S. Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - James R. McKay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Schyler Tristen Newman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David W. Oslin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Steven Wadden
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Courtney Benjamin Wolk
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
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Harris RA, Mandell DS. Fatal drug overdose among middle-aged Black men: A life table analysis. Addict Behav 2023; 144:107743. [PMID: 37137170 PMCID: PMC10330327 DOI: 10.1016/j.addbeh.2023.107743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/13/2023] [Accepted: 04/22/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND For Black men of middle-age, the overdose mortality statistics are increasingly dire. To better understand the severity of the crisis, we estimated the cumulative risk of drug overdose deaths among non-Hispanic Black men in mid-life using a period life table approach. We report the chances of Black men aged 45 years dying of a drug overdose before age 60. METHODS A period life table reflects what would happen to a hypothetical cohort if it experienced the prevailing age-specific probabilities of death. In our hypothetical cohort, we followed 100,000 non-Hispanic Black men aged 45 years for 15 years. All-cause death probabilities were obtained from the National Center for Health Statistics (NCHS) 2021 life table series. Overdose mortality rates were obtained from the National Vital Statistics System through the Wide-Ranging Online Data for Epidemiologic Research of the Centers for Disease Control and Prevention (CDC WONDER) database. We also constructed a period life table for a comparison group of White men. RESULTS The life table shows that, for Black men who are 45 years of age in the United States, 1 in 52 (nearly 2%) is expected to die of drug overdose before reaching age 60, if current mortality rates persist. For White men, the estimate is 1 in 91 men (about 1%). The life table also shows that from age 45 to 59 years, the number of overdose deaths increased in the cohort of Black men but decreased in White men. CONCLUSIONS This study extends our understanding of the immense loss to Black communities from the preventable drug deaths of Black men in middle-age.
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
| | - David S Mandell
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Harris RA, Long JA, Bao Y, Mandell DS. Racial, Ethnic, and Sex Differences in Methadone-Involved Overdose Deaths Before and After the US Federal Policy Change Expanding Take-home Methadone Doses. JAMA Health Forum 2023; 4:e231235. [PMID: 37294585 PMCID: PMC10257097 DOI: 10.1001/jamahealthforum.2023.1235] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/04/2023] [Indexed: 06/10/2023] Open
Abstract
Importance In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) permitted states to relax restrictions on take-home methadone doses for treatment-adherent patients to minimize COVID-19 exposures. Objective To assess whether the methadone take-home policy change was associated with drug overdose deaths among different racial, ethnic, and sex groups. Design, Setting, and Participants Interrupted time series analysis from January 1, 2018, to June 30, 2022. Data analysis was conducted from February 18, 2023, to February 28, 2023. In this population-based cohort study of drug overdose mortality including 14 529 methadone-involved deaths, monthly counts of methadone-involved drug overdose deaths were obtained for 6 demographic groups: Hispanic men and women, non-Hispanic Black men and women, and non-Hispanic White men and women. Exposure On March 16, 2020, in response to the first wave of the COVID-19 pandemic, SAMHSA issued an exemption to the states that permitted up to 28 days of take-home methadone for stable patients and 14 days for less stable patients. Main Outcome Measures Monthly methadone-involved overdose deaths. Results From January 1, 2018, to June 30, 2022 (54 months), there were 14 529 methadone-involved deaths in the United States; 14 112 (97.1%) occurred in the study's 6 demographic groups (Black men, 1234; Black women, 754; Hispanic men, 1061; Hispanic women, 520; White men, 5991; and White women, 4552). Among Black men, there was a decrease in monthly methadone deaths associated with the March 2020 policy change (change of slope from the preintervention period, -0.55 [95% CI, -0.95 to -0.15]). Hispanic men also experienced a decrease in monthly methadone deaths associated with the policy change (-0.42 [95% CI, -0.68 to -0.17]). Among Black women, Hispanic women, White men, and White women, the policy change was not associated with a change in monthly methadone deaths (Black women, -0.27 [95% CI, -1.13 to 0.59]; Hispanic women, 0.29 [95% CI, -0.46 to 1.04]; White men, -0.08 [95% CI, -1.05 to 0.88]; and White women, -0.43 [95% CI, -1.26 to 0.40]). Conclusions and Relevance In this interrupted time series study of monthly methadone-involved overdose deaths, the take-home policy may have helped reduce deaths for Black and Hispanic men but had no association with deaths of Black or Hispanic women or White men or women.
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - Judith A. Long
- Corporal Michael J. Crescenz VA Medical Center, VA Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania
- Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Yuhua Bao
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - David S. Mandell
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Abstract
This cross-sectional study calculates years of life lost to drug overdose in non-Hispanic Black female individuals and describes the changes in years of life lost that have occurred during the current overdose crisis.
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - David S. Mandell
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Harris RA. Drug Overdose Deaths Among Non-Hispanic Black Men in the U.S.: Age-Specific Projections Through 2025. AJPM Focus 2023; 2:100063. [PMID: 37377540 PMCID: PMC10299749 DOI: 10.1016/j.focus.2022.100063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Introduction Fatal drug overdoses have risen sharply in the U.S. since 2015, reaching their highest levels during the pandemic. Non-Hispanic Black men have been disproportionately harmed by this latest surge; overdose mortality per 100,000 has increased fourfold since 2015. Whether the mortality rate will continue to climb is unknown. In this study, we addressed the narrower question of which age groups are likely to experience a significant increase or decrease in the burden of drug overdose deaths through 2025, based on foreseeable changes in the age structure of the Black male population. Methods We used the 2020 and provisional 2021 age-specific mortality rates from the Centers for Disease Control WONDER (Wide-Ranging Online Data for Epidemiologic Research) database and the standard population balancing equation to project overdose deaths in 2025. Overdose deaths were identified by ICD-10 codes. We bracketed the projections between 2 plausible alternatives: a pessimistic forecast based on time series extrapolations and an optimistic forecast that assumes success nationally in lowering overdose deaths through prevention, treatment, and harm reduction initiatives. Results Among Black men aged 31-47 years, overdose deaths in 2025 are expected to increase by 440 or 11% (95% CI=8%, 14%) relative to 2020. By contrast, overdose deaths among younger Black men aged 19-30 years are expected to decline by 160 or -9% (95% CI= -15%, -5%). Among older Black men aged 48-64 years, overdose deaths are also expected to decline by 330 or -7% (95% CI= -10%, -4%). Similar results were found using 2021 provisional mortality rates. Conclusions Overdose deaths are predicted to increase significantly over current levels among Black men in their 30s and 40s. Local policy makers should direct harm reduction resources, such as naloxone kits, syringes, and fentanyl test strips, to places frequented by Black men in this age group. Outreach messaging should be tailored to resonate with men of middle age. Equally urgent is the scaling up of nonstigmatizing, evidence-based drug treatment and recovery support services in Black neighborhoods.
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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Harris RA, Campbell K, Calderbank T, Dooley P, Aspero H, Maginnis J, O’Donnell N, Coviello D, French R, Bao Y, Mandell DS, Bogner HR, Lowenstein M. Integrating peer support services into primary care-based OUD treatment: Lessons from the Penn integrated model. Healthc (Amst) 2022; 10:100641. [PMID: 35785613 PMCID: PMC9933784 DOI: 10.1016/j.hjdsi.2022.100641] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/04/2022]
Abstract
Opioid use disorder (OUD) is a major public health emergency in the United States. In 2020, 2.7 million individuals had an OUD. Medication for opioid use disorder is the evidence-based, standard of care for treating OUD in outpatient settings, especially buprenorphine because it is effective and has low toxicity. Buprenorphine is increasingly prescribed in primary care, a setting that provides greater anonymity and convenience than substance use disorder treatment centers. Yet two-thirds of people who begin buprenorphine treatment discontinue within the first six months. Treatment dropout elevates the risks of return to use, infections, higher levels of medical care and related costs, justice system involvement, and death. One promising form of retention support is peer service programs. Peers combine their lived experience of substance use and recovery with formal training to help patients engage and persist in OUD treatment. They provide a range of services, including health education, encouragement and empathy, coping skills, recovery modeling, and concrete assistance in overcoming the situational barriers to retention. However, guidance is needed to define the peer role in primary care, the specific tasks peers should perform, the competencies those tasks require, training and professional development needs, and peer performance standards. Guidance also is needed to integrate peers into the care team, allocate and coordinate responsibilities among care team members, manage peer operations and workflow, and facilitate effective team communication. Here we describe a peer support program in the University of Pennsylvania Health System (UPHS or Penn Medicine) network of primary care practices. This paper details the program's core components, values, and activities. We also report the organizational challenges, unresolved questions, and lessons for the field in administering a peer support program to meet the needs of patients served by a large, urban medical system with an extensive suburban and rural catchment area. CLINICAL TRIALS REGISTRATION: www.clinicaltrials.gov registration: NCT04245423.
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Kristen Campbell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Tara Calderbank
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Patrick Dooley
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Heather Aspero
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jessica Maginnis
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Nicole O’Donnell
- Center for Addiction Medicine and Policy, University of Pennsylvania, Philadelphia, PA, USA
| | - Donna Coviello
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Rachel French
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, 19104, USA,School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA,National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Yuhua Bao
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - David S. Mandell
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, 19104, USA,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Hillary R. Bogner
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Margaret Lowenstein
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, 19104, USA,Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
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Harris RA. Sex and Drug Overdose Mortality Trends, 1999-2020. JAMA Psychiatry 2022; 79:833-834. [PMID: 35793079 DOI: 10.1001/jamapsychiatry.2022.1688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - David S. Mandell
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Robert Gross
- Departments of Medicine and Epidemiology, Biostatistics, Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- The Corporal Michael Crescenz VA Medical Center, Philadelphia, Pennsylvania
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Harris RA, Mandell DS, Kampman KM, Bao Y, Campbell K, Cidav Z, Coviello DM, French R, Livesey C, Lowenstein M, Lynch KG, McKay JR, Oslin DW, Wolk CB, Bogner HR. Collaborative care in the treatment of opioid use disorder and mental health conditions in primary care: A clinical study protocol. Contemp Clin Trials 2021; 103:106325. [PMID: 33631356 PMCID: PMC8117118 DOI: 10.1016/j.cct.2021.106325] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND People with opioid use disorder (OUD) often have a co-occurring psychiatric disorder, which elevates the risk of morbidity and mortality. Promising evidence supports the use of collaborative care for treating people with OUD in primary care. Whether collaborative care interventions that treat both OUD and psychiatric disorders will result in better outcomes is presently unknown. METHODS The Whole Health Study is a 3-arm randomized controlled trial designed to test collaborative care treatment for OUD and the psychiatric disorders that commonly accompany OUD. Approximately 1200 primary care patients aged ≥18 years with OUD and depression, anxiety, or PTSD will be randomized to one of three conditions: (1) Augmented Usual Care, which consists of a primary care physician (PCP) waivered to prescribe buprenorphine and an addiction psychiatrist to consult on medication-assisted treatment; (2) Collaborative Care, which consists of a waivered PCP, a mental health care manager trained in psychosocial treatments for OUD and psychiatric disorders, and an addiction psychiatrist who provides consultation for OUD and mental health; or (3) Collaborative Care Plus, which consists of all the elements of the Collaborative Care arm plus a Certified Recovery Specialist to help with treatment engagement and retention. Primary outcomes are six-month rates of opioid use and six-month rates of remission of co-occurring psychiatric disorders. DISCUSSION The Whole Health Study will investigate whether collaborative care models that address OUD and co-occurring depression, anxiety, or PTSD will result in better patient outcomes. The results will inform clinical care delivery during the current opioid crisis. CLINICAL TRIALS REGISTRATION www.clinicaltrials.gov registration: NCT04245423.
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - David S Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kyle M Kampman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yuhua Bao
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY 10065, USA
| | - Kristen Campbell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zuleyha Cidav
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Donna M Coviello
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rachel French
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cecilia Livesey
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Margaret Lowenstein
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kevin G Lynch
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - James R McKay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - David W Oslin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA 19104, USA
| | - Courtney Benjamin Wolk
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hillary R Bogner
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
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Grantham EK, Warden AS, McCarthy GS, DaCosta A, Mason S, Blednov Y, Mayfield RD, Harris RA. Role of toll-like receptor 7 (TLR7) in voluntary alcohol consumption. Brain Behav Immun 2020; 89:423-432. [PMID: 32726684 PMCID: PMC7572874 DOI: 10.1016/j.bbi.2020.07.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/09/2020] [Accepted: 07/22/2020] [Indexed: 12/16/2022] Open
Abstract
Overactivation of neuroimmune signaling has been linked to excessive ethanol consumption. Toll-like receptors (TLRs) are a major component of innate immune signaling and initiate anti- and pro-inflammatory responses via intracellular signal transduction cascades. TLR7 is upregulated in post-mortem brain tissue from humans with alcohol use disorder (AUD) and animals with prior exposure to ethanol. Despite this evidence, the role of TLR7 in the regulation of voluntary ethanol consumption has not been studied. We test the hypothesis that TLR7 activation regulates voluntary ethanol drinking behavior by administering a TLR7 agonist (R848) during an intermittent access drinking procedure in mice. Acute activation of TLR7 reduced ethanol intake, preference, and total fluid intake due, at least in part, to an acute sickness response. However, chronic pre-treatment with R848 resulted in tolerance to the adverse effects of the drug and a subsequent increase in ethanol consumption. To determine the molecular machinery that mediates these behavioral changes, we evaluated gene expression after acute and chronic TLR7 activation. We found that acute TLR7 activation produces brain region specific changes in expression of immune pathway genes, whereas chronic TLR7 activation causes downregulation of TLRs and blunted cytokine induction, suggesting molecular tolerance. Our results demonstrate a novel role for TLR7 signaling in regulating voluntary ethanol consumption. Taken together, our findings suggest TLR7 may be a viable target for development of therapies to treat AUD.
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Affiliation(s)
- E K Grantham
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, 2500 Speedway, Stop 14800, Austin, TX 78712, USA; Institute for Neuroscience, University of Texas at Austin, Austin, TX 78712, USA.
| | - A S Warden
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, 2500 Speedway, Stop 14800, Austin, TX 78712, USA; Institute for Neuroscience, University of Texas at Austin, Austin, TX 78712, USA; Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - G S McCarthy
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, 2500 Speedway, Stop 14800, Austin, TX 78712, USA; Institute for Cell and Molecular Biology, University of Texas at Austin, Austin, TX 78712, USA
| | - A DaCosta
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, 2500 Speedway, Stop 14800, Austin, TX 78712, USA
| | - S Mason
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, 2500 Speedway, Stop 14800, Austin, TX 78712, USA
| | - Y Blednov
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, 2500 Speedway, Stop 14800, Austin, TX 78712, USA
| | - R D Mayfield
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, 2500 Speedway, Stop 14800, Austin, TX 78712, USA; Institute for Neuroscience, University of Texas at Austin, Austin, TX 78712, USA
| | - R A Harris
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, 2500 Speedway, Stop 14800, Austin, TX 78712, USA; Institute for Neuroscience, University of Texas at Austin, Austin, TX 78712, USA
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Harris RA, Kranzler HR, Chang KM, Doubeni CA, Gross R. Long-term use of hydrocodone vs. oxycodone in primary care. Drug Alcohol Depend 2019; 205:107524. [PMID: 31707268 PMCID: PMC9338763 DOI: 10.1016/j.drugalcdep.2019.06.026] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/20/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Hydrocodone and oxycodone are the Schedule II opioids most often prescribed in primary care. Notwithstanding the dangers of prescription opioid use, the likelihood of long-term use with either drug is presently unknown. METHODS Using a retrospective cohort design and data from a commerical healthcare claims repository, we compared the likelihood of long-term use of hydrocodone and oxycodone in primary care patients presenting with acute back pain. Treatment was categorized as long-term if the prescription dates spanned ≥90 days from initial prescription to the run-out date of the last prescription, and included ≥120 days' supply or ≥10 fills. Instrumental variable methods and probit regression were used to model the effect of drug choice on long-term use, estimate the average treatment effect, and correct for confounding by indication. RESULTS A total of 3,983 patients who were prescribed only hydrocodone or only oxycodone were followed for 270 days in 2016. Long-term opioid use was observed in 320 patients (8%). Controlling for potential confounders including morphine milligram equivalents and dosage, an estimated 12% (95 CI, 10%-14%) treated with hydrocodone transitioned to long-term use vs. 2% (95 CI, 1%-3%) on oxycodone. Among patients who received more than one prescription (n = 1,866), an estimated 23% (95 CI, 19%-26%) treated with hydrocodone transitioned to long-term use vs. 5% (95 CI, 3%-7%) on oxycodone. The difference between drugs was supported in sensitivity and subgroup analyses. Sample selection bias was not detected. CONCLUSIONS Long-term use was substantially greater for patients treated with hydrocodone than oxycodone, despite equianalgesia.
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Henry R Kranzler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; VISN 4 Mental Illness Research, Education and Clinical Center, The Corporal Michael Crescenz VA Medical Center, United States
| | - Kyong-Mi Chang
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; The Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, United States
| | - Chyke A Doubeni
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Robert Gross
- Department of Medicine, Infectious Diseases, Department of Epidemiology, Biostatistics, Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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15
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Hao G, Pollock NK, Harris RA, Gutin B, Su S, Wang X. Associations between muscle mass, physical activity and dietary behaviour in adolescents. Pediatr Obes 2019; 14:e12471. [PMID: 30280506 DOI: 10.1111/ijpo.12471] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 01/26/2018] [Revised: 07/12/2018] [Accepted: 07/30/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Investigations in older individuals suggest that adequate nutrition and physical activity are particularly important to skeletal muscle health; however, data in adolescents are scant and equivocal. The objective was to determine the associations among diet, physical activity and skeletal muscle mass in adolescents. METHODS We assessed diet with four to seven 24-h recalls and physical activity by accelerometry in 640 adolescents. Using total body measures of fat-free soft tissue mass and fat mass assessed by dual-energy X-ray absorptiometry, the skeletal muscle mass index (SMMI) was derived by adjusting fat-free soft tissue mass for fat mass in addition to height. RESULTS Skeletal muscle mass index (SMMI) was negatively associated with consumption of sugar-sweetened beverages (standardized beta coefficient [β] = -0.10, P = 0.001) and saturated fats (β = -0.28, P < 0.001). SMMI was positively associated with physical activity (moderate + vigorous) (β = 0.20, P < 0.001). In further analysis, we observed a significant interaction between physical activity and sugar-sweetened beverage intake on SMMI (P = 0.002). CONCLUSION Our study in adolescence suggests that physical activity and consumption of both sugar-sweetened beverages and saturated fats are associated with skeletal muscle mass. More importantly, our findings suggest that sugar-sweetened beverage intake may attenuate the beneficial effects of physical activity on skeletal muscle mass.
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Affiliation(s)
- G Hao
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - N K Pollock
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - R A Harris
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - B Gutin
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - S Su
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - X Wang
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
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16
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Yang T, Xu G, Newton PT, Chagin AS, Mkrtchian S, Carlström M, Zhang XM, Harris RA, Cooter M, Berger M, Maddipati KR, Akassoglou K, Terrando N. Maresin 1 attenuates neuroinflammation in a mouse model of perioperative neurocognitive disorders. Br J Anaesth 2018; 122:350-360. [PMID: 30770053 PMCID: PMC6396737 DOI: 10.1016/j.bja.2018.10.062] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [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: 07/18/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 12/15/2022] Open
Abstract
Background Resolution of inflammation is an active and dynamic process after surgery. Maresin 1 (MaR1) is one of a growing number of specialised pro-resolving lipids biosynthesised by macrophages that regulates acute inflammation. We investigated the effects of MaR1 on postoperative neuroinflammation, macrophage activity, and cognitive function in mice. Methods Adult male C57BL/6 (n=111) and Ccr2RFP/+Cx3cr1GFP/+ (n=54) mice were treated with MaR1 before undergoing anaesthesia and orthopaedic surgery. Systemic inflammatory changes, bone healing, neuroinflammation, and cognition were assessed at different time points. MaR1 protective effects were also evaluated using bone marrow derived macrophage cultures. Results MaR1 exerted potent systemic anti-inflammatory effects without impairing fracture healing. Prophylaxis with MaR1 prevented surgery-induced glial activation and opening of the blood–brain barrier. In Ccr2RFP/+Cx3cr1GFP/+ mice, fewer infiltrating macrophages were detected in the hippocampus after surgery with MaR1 prophylaxis, which resulted in improved memory function. MaR1 treatment also reduced expression of pro-inflammatory cell surface markers and cytokines by in vitro cultured macrophages. MaR1 was detectable in the cerebrospinal fluid of older adults before and after surgery. Conclusions MaR1 exerts distinct anti-inflammatory and pro-resolving effects through regulation of macrophage infiltration, NF-κB signalling, and cytokine release after surgery. Future studies on the use of pro-resolving lipid mediators may inform novel approaches to treat neuroinflammation and postoperative neurocognitive disorders.
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Affiliation(s)
- T Yang
- Department of Physiology and Pharmacology, Stockholm, Sweden; Department of Medicine, Division of Nephrology, Durham, NC, USA
| | - G Xu
- Department of Physiology and Pharmacology, Stockholm, Sweden
| | - P T Newton
- Department of Physiology and Pharmacology, Stockholm, Sweden
| | - A S Chagin
- Department of Physiology and Pharmacology, Stockholm, Sweden; Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - S Mkrtchian
- Department of Physiology and Pharmacology, Stockholm, Sweden
| | - M Carlström
- Department of Physiology and Pharmacology, Stockholm, Sweden
| | - X-M Zhang
- Applied Immunology & Immunotherapy, Center for Molecular Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - R A Harris
- Applied Immunology & Immunotherapy, Center for Molecular Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M Cooter
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - M Berger
- Center for Cognitive Neuroscience, Center for the Study of Aging & Human Development, Durham, NC, USA; Center for the Study of Aging & Human Development, Durham, NC, USA; Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - K R Maddipati
- Department of Pathology-Bioactive Lipids Research Program, Wayne State University, Detroit, MI, USA
| | - K Akassoglou
- Gladstone Institutes, San Francisco, CA, USA; Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - N Terrando
- Department of Physiology and Pharmacology, Stockholm, Sweden; Center for Translational Pain Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA; Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
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17
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Erickson EK, Grantham EK, Warden AS, Harris RA. Neuroimmune signaling in alcohol use disorder. Pharmacol Biochem Behav 2018; 177:34-60. [PMID: 30590091 DOI: 10.1016/j.pbb.2018.12.007] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [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: 05/22/2018] [Revised: 10/25/2018] [Accepted: 12/20/2018] [Indexed: 02/07/2023]
Abstract
Alcohol use disorder (AUD) is a widespread disease with limited treatment options. Targeting the neuroimmune system is a new avenue for developing or repurposing effective pharmacotherapies. Alcohol modulates innate immune signaling in different cell types in the brain by altering gene expression and the molecular pathways that regulate neuroinflammation. Chronic alcohol abuse may cause an imbalance in neuroimmune function, resulting in prolonged perturbations in brain function. Likewise, manipulating the neuroimmune system may change alcohol-related behaviors. Psychiatric disorders that are comorbid with AUD, such as post-traumatic stress disorder, major depressive disorder, and other substance use disorders, may also have underlying neuroimmune mechanisms; current evidence suggests that convergent immune pathways may be involved in AUD and in these comorbid disorders. In this review, we provide an overview of major neuroimmune cell-types and pathways involved in mediating alcohol behaviors, discuss potential mechanisms of alcohol-induced neuroimmune activation, and present recent clinical evidence for candidate immune-related drugs to treat AUD.
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Affiliation(s)
- Emma K Erickson
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX 78712-01095, USA.
| | - Emily K Grantham
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX 78712-01095, USA
| | - Anna S Warden
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX 78712-01095, USA
| | - R A Harris
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX 78712-01095, USA
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18
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Harris RA, Haberer JE, Musinguzi N, Chang KM, Schechter CB, Doubeni CA, Gross R. Predicting short-term interruptions of antiretroviral therapy from summary adherence data: Development and test of a probability model. PLoS One 2018; 13:e0194713. [PMID: 29566096 PMCID: PMC5864044 DOI: 10.1371/journal.pone.0194713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/08/2018] [Indexed: 11/18/2022] Open
Abstract
Antiretroviral therapy (ART) for HIV is vulnerable to unplanned treatment interruptions-consecutively missed doses over a series of days-which can result in virologic rebound. Yet clinicians lack a simple, valid method for estimating the risk of interruptions. If the likelihood of ART interruption could be derived from a convenient-to-gather summary measure of medication adherence, it might be a valuable tool for both clinical decision-making and research. We constructed an a priori probability model of ART interruption based on average adherence and tested its predictions using data collected on 185 HIV-infected, treatment-naïve individuals over the first 90 days of ART in a prospective cohort study in Mbarara, Uganda. The outcome of interest was the presence or absence of a treatment gap, defined as >72 hours without a dose. Using the pre-determined value of 0.50 probability as the cut point for predicting an interruption, the classification accuracy of the model was 73% (95% CI = 66%- 79%), the specificity was 87% (95% CI = 79%- 93%), and the sensitivity was 59% (95% CI = 48%- 69%). Overall model performance was satisfactory, with an area under the receiver operator characteristic curve (AUROC) of 0.85 (95% CI = 0.80-0.91) and Brier score of 0.20. The study serves as proof-of-concept that the probability model can accurately differentiate patients on the continuum of risk for short-term ART interruptions using a summary measure of adherence. The model may also aid in the design of targeted interventions.
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Affiliation(s)
- Rebecca Arden Harris
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Jessica E. Haberer
- Harvard Medical School, Boston, Massachusetts, United States of America
- Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | | | - Kyong-Mi Chang
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
- Philadelphia VA Medical Center, Philadelphia, Pennsylvania, United States of America
| | - Clyde B. Schechter
- Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Chyke A. Doubeni
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Robert Gross
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
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19
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Harris RA, Grobman ME, Allen MJ, Schachtel J, Rawson NE, Bennett B, Ledyayev J, Hopewell B, Coates JR, Reinero CR, Lever TE. Standardization of a Videofluoroscopic Swallow Study Protocol to Investigate Dysphagia in Dogs. J Vet Intern Med 2017; 31:383-393. [PMID: 28240398 PMCID: PMC5354069 DOI: 10.1111/jvim.14676] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/13/2016] [Accepted: 01/17/2017] [Indexed: 12/30/2022] Open
Abstract
Background Videofluoroscopic swallow study (VFSS) is the gold standard for diagnosis of dysphagia in veterinary medicine but lacks standardized protocols that emulate physiologic feeding practices. Age impacts swallow function in humans but has not been evaluated by VFSS in dogs. Hypothesis/Objectives To develop a protocol with custom kennels designed to allow free‐feeding of 3 optimized formulations of contrast media and diets that address limitations of current VFSS protocols. We hypothesized that dogs evaluated by a free‐feeding VFSS protocol would show differences in objective swallow metrics based on age. Animals Healthy juvenile, adult, and geriatric dogs (n = 24). Methods Prospective, experimental study. Custom kennels were developed to maintain natural feeding behaviors during VFSS. Three food consistencies (thin liquid, pureed food, and dry kibble) were formulated with either iohexol or barium to maximize palatability and voluntary prehension. Dogs were evaluated by 16 swallow metrics and compared across age groups. Results Development of a standardized VFSS protocol resulted in successful collection of swallow data in healthy dogs. No significant differences in swallow metrics were observed among age groups. Substantial variability was observed in healthy dogs when evaluated under these physiologic conditions. Features typically attributed to pathologic states, such as gastric reflux, were seen in healthy dogs. Conclusions and Clinical Importance Development of a VFSS protocol that reflects natural feeding practices may allow emulation of physiology resulting in clinical signs of dysphagia. Age did not result in significant changes in swallow metrics, but additional studies are needed, particularly in light of substantial normal variation.
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Affiliation(s)
- R A Harris
- Department of Communication Science and Disorders, University of Missouri, Columbia, MO
| | - M E Grobman
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, Columbia, MO
| | - M J Allen
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO
| | - J Schachtel
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, Columbia, MO
| | | | | | | | - B Hopewell
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO
| | - J R Coates
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, Columbia, MO
| | - C R Reinero
- Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, Columbia, MO
| | - T E Lever
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO
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20
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Thom NJ, Early AR, Hunt BE, Harris RA, Herring MP. Eating and arterial endothelial function: a meta-analysis of the acute effects of meal consumption on flow-mediated dilation. Obes Rev 2016; 17:1080-1090. [PMID: 27469597 DOI: 10.1111/obr.12454] [Citation(s) in RCA: 24] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 05/24/2016] [Accepted: 06/05/2016] [Indexed: 01/15/2023]
Abstract
Given that endothelial dysfunction precedes atherosclerotic cardiovascular disease, exploring the parameters that modify postprandial flow-mediated dilation (FMD) is important for public health. The objectives of the study are to estimate the population effect of meal ingestion on FMD and to determine how the effect varied based on patient characteristics and modifiable methodological features. Articles published before June 2015 were located using MEDLINE, PubMed and Web of Science. One hundred fifty-four effects were derived from 78 articles involving 2,548 subjects were selected. Included articles required measurement of FMD in adults before and after meal ingestion. Effects were analysed using an unstandardized mean gain random effects model, and significant moderators were analysed using meta-regression. Meal consumption significantly reduced FMD by a heterogeneous mean effect size delta (Δ) of -2.03 (95% CI: [-2.28, -1.77]), an ~2% reduction in FMD. FMD reductions were larger among normal weight individuals, males, those with a cardio-metabolic disorder, those with elevated baseline FMD, and individuals with impaired glucose tolerance at baseline. Macronutrient meal ingestion significantly reduced FMD, an effect that was moderated by body mass index, sex and two-way interactions between disease status and both baseline FMD and baseline blood glucose levels.
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Affiliation(s)
- N J Thom
- Department of Biology, Wheaton College, Wheaton, IL, USA.
| | - A R Early
- Applied Health Science Department, Wheaton College, Wheaton, IL, USA
| | - B E Hunt
- Applied Health Science Department, Wheaton College, Wheaton, IL, USA
| | - R A Harris
- Georgia Prevention Institute, August University, Augusta, GA, USA
| | - M P Herring
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,Health Research Institute (HRI), University of Limerick, Limerick, Ireland
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21
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Prakash J, Kumar P, Harris RA, Swart C, Neethling JH, van Vuuren AJ, Swart HC. Synthesis, characterization and multifunctional properties of plasmonic Ag-TiO2 nanocomposites. Nanotechnology 2016; 27:355707. [PMID: 27456278 DOI: 10.1088/0957-4484/27/35/355707] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report on the synthesis of multifunctional Ag-TiO2 nanocomposites and their optical, physio-chemical, surface enhanced Raman scattering (SERS) and antibacterial properties. A series of Ag-TiO2 nanocomposites were synthesized by sol-gel technique and characterized by x-ray diffraction, scanning and transmission electron microscopy, energy-dispersed x-ray analysis, photoluminescence, UV-vis, x-ray photoelectron and Raman spectroscopy and Brunauer-Emmett-Teller method. The Ag nanoparticles (NPs) (7-20 nm) were found to be uniformly distributed around and strongly attached to TiO2 NPs. The novel optical responses of the nanocomposites are due to the strong electric field from the localized surface plasmon (LSP) excitation of the Ag NPs and decreased recombination of photo-induced electrons and holes at Ag-TiO2 interface providing potential materials for photocatalysis. The nanocomposites show enhancement in the SERS signals of methyl orange (MO) molecules with increasing Ag content attributed to the long-range electromagnetic enhancement from the excited LSP of the Ag NPs. To further understand the SERS activity, molecular mechanics and molecular dynamics simulations were used to study the geometries and SERS enhancement of MO adsorbed onto Ag-TiO2 respectively. Simulation results indicate that number of ligands (MO) that adsorb onto the Ag NPs as well as binding energy per ligand increases with increasing NP density and molecule-to-surface orientation is mainly flat resulting in strong bond strength between MO and Ag NP surface and enhanced SERS signals. The antimicrobial activity of the Ag-TiO2 nanocomposites was tested against the bacterium Staphylococcus aureus and enhanced antibacterial effect was observed with increasing Ag content explained by contact killing action mechanism. These results foresee promising applications of the plasmonic metal-semiconductor based nano-biocomposites for both chemical and biological samples.
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Affiliation(s)
- Jai Prakash
- Department of Physics, University of the Free State, Bloemfontein, ZA 9300, South Africa. Department of Chemical Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, India
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22
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Radenkovic M, Silver C, Arvastsson J, Lynch K, Lernmark Å, Harris RA, Agardh CD, Cilio CM. Altered regulatory T cell phenotype in latent autoimmune diabetes of the adults (LADA). Clin Exp Immunol 2016; 186:46-56. [PMID: 27357431 DOI: 10.1111/cei.12834] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 12/30/2022] Open
Abstract
Latent autoimmune diabetes of the adults (LADA) accounts for up to 12% of all patients with diabetes. Initially the disease resembles type 2 diabetes (T2D); however, the typical presence of β cell autoantibodies indicates an autoimmune basis of LADA. While dysfunctional regulatory T cells (Tregs ) have been implicated in autoimmune diabetes, these cells have been scarcely studied in LADA. The aim of this study was to investigate the frequency and phenotype of circulating Tregs in LADA patients early during disease progression. Flow cytometric analysis was performed on whole blood and peripheral mononuclear cells (PBMC) from patients diagnosed with LADA prior to insulin deficiency (n = 39) and from healthy volunteers (n = 20). Overall, we found the frequency and activation status of peripheral putative Tregs to be altered in LADA patients compared to healthy controls. While total T cells and CD4(+) T cells expressing high levels of CD25 (CD4(+) CD25(hi) ) were unchanged, the frequency and total numbers of CD4(+) T cells expressing an intermediate level of CD25 (CD4(+) CD25(int) ) were decreased in LADA patients. Interestingly, the expression of the Treg -specific marker forkhead box protein 3 (FoxP3), as well as the activation and memory makers CD69, cytotoxic T lymphocyte associated antigen 4 (CTLA-4), CCR4 and CD45RO were increased in CD4(+) CD25(+) T cells of the patients. Our data depict phenotypical changes in T cells of LADA patients that may reflect a derangement in peripheral immune regulation contributing to the slow process leading to insulin-dependent diabetes in these patients.
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Affiliation(s)
- M Radenkovic
- Lund University Diabetes Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - C Silver
- Lund University Diabetes Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - J Arvastsson
- Lund University Diabetes Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - K Lynch
- Pediatrics Epidemiology Center, Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - Å Lernmark
- Lund University Diabetes Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - R A Harris
- Applied Immunology & Immunotherapy, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - C-D Agardh
- Lund University Diabetes Center, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - C M Cilio
- Lund University Diabetes Center, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Pediatrics, Lund University, Lund, Sweden
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23
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Monaghan T, Harding MJ, Harris RA, Friel RJ, Christie SDR. Customisable 3D printed microfluidics for integrated analysis and optimisation. Lab Chip 2016; 16:3362-3373. [PMID: 27452498 DOI: 10.1039/c6lc00562d] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The formation of smart Lab-on-a-Chip (LOC) devices featuring integrated sensing optics is currently hindered by convoluted and expensive manufacturing procedures. In this work, a series of 3D-printed LOC devices were designed and manufactured via stereolithography (SL) in a matter of hours. The spectroscopic performance of a variety of optical fibre combinations were tested, and the optimum path length for performing Ultraviolet-visible (UV-vis) spectroscopy determined. The information gained in these trials was then used in a reaction optimisation for the formation of carvone semicarbazone. The production of high resolution surface channels (100-500 μm) means that these devices were capable of handling a wide range of concentrations (9 μM-38 mM), and are ideally suited to both analyte detection and process optimisation. This ability to tailor the chip design and its integrated features as a direct result of the reaction being assessed, at such a low time and cost penalty greatly increases the user's ability to optimise both their device and reaction. As a result of the information gained in this investigation, we are able to report the first instance of a 3D-printed LOC device with fully integrated, in-line monitoring capabilities via the use of embedded optical fibres capable of performing UV-vis spectroscopy directly inside micro channels.
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Affiliation(s)
- T Monaghan
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK.
| | - M J Harding
- Department of Chemistry, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK.
| | - R A Harris
- School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - R J Friel
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK.
| | - S D R Christie
- Department of Chemistry, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK.
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Abstract
In this chapter, we review the effects of global null mutant and overexpressing transgenic mouse lines on voluntary self-administration of alcohol. We examine approximately 200 publications pertaining to the effects of 155 mouse genes on alcohol consumption in different drinking models. The targeted genes vary in function and include neurotransmitter, ion channel, neuroimmune, and neuropeptide signaling systems. The alcohol self-administration models include operant conditioning, two- and four-bottle choice continuous and intermittent access, drinking in the dark limited access, chronic intermittent ethanol, and scheduled high alcohol consumption tests. Comparisons of different drinking models using the same mutant mice are potentially the most informative, and we will highlight those examples. More mutants have been tested for continuous two-bottle choice consumption than any other test; of the 137 mouse genes examined using this model, 97 (72%) altered drinking in at least one sex. Overall, the effects of genetic manipulations on alcohol drinking often depend on the sex of the mice, alcohol concentration and time of access, genetic background, as well as the drinking test.
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Affiliation(s)
- J Mayfield
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX, United States
| | - M A Arends
- Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA, United States
| | - R A Harris
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX, United States.
| | - Y A Blednov
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, Austin, TX, United States
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Marballi K, Genabai NK, Blednov YA, Harris RA, Ponomarev I. Alcohol consumption induces global gene expression changes in VTA dopaminergic neurons. Genes Brain Behav 2015; 15:318-26. [PMID: 26482798 DOI: 10.1111/gbb.12266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/28/2015] [Accepted: 10/16/2015] [Indexed: 12/22/2022]
Abstract
Alcoholism is associated with dysregulation in the neural circuitry that mediates motivated and goal-directed behaviors. The dopaminergic (DA) connection between the ventral tegmental area (VTA) and the nucleus accumbens is viewed as a critical component of the neurocircuitry mediating alcohol's rewarding and behavioral effects. We sought to determine the effects of binge alcohol drinking on global gene expression in VTA DA neurons. Alcohol-preferring C57BL/6J × FVB/NJ F1 hybrid female mice were exposed to a modified drinking in the dark (DID) procedure for 3 weeks, while control animals had access to water only. Global gene expression of laser-captured tyrosine hydroxylase (TH)-positive VTA DA neurons was measured using microarrays. A total of 644 transcripts were differentially expressed between the drinking and nondrinking mice, and 930 transcripts correlated with alcohol intake during the last 2 days of drinking in the alcohol group. Bioinformatics analysis of alcohol-responsive genes identified molecular pathways and networks perturbed in DA neurons by alcohol consumption, which included neuroimmune and epigenetic functions, alcohol metabolism and brain disorders. The majority of genes with high and specific expression in DA neurons were downregulated by or negatively correlated with alcohol consumption, suggesting a decreased activity of DA neurons in high drinking animals. These changes in the DA transcriptome provide a foundation for alcohol-induced neuroadaptations that may play a crucial role in the transition to addiction.
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Affiliation(s)
- K Marballi
- Waggoner Center for Alcohol and Addiction Research and The College of Pharmacy, The University of Texas at Austin, Austin
| | - N K Genabai
- Waggoner Center for Alcohol and Addiction Research and The College of Pharmacy, The University of Texas at Austin, Austin.,Center of Emphasis in Neurosciences, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Y A Blednov
- Waggoner Center for Alcohol and Addiction Research and The College of Pharmacy, The University of Texas at Austin, Austin
| | - R A Harris
- Waggoner Center for Alcohol and Addiction Research and The College of Pharmacy, The University of Texas at Austin, Austin
| | - I Ponomarev
- Waggoner Center for Alcohol and Addiction Research and The College of Pharmacy, The University of Texas at Austin, Austin
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Harris RA. Acute respiratory infections in young Ethiopian children. Pediatric Health Med Ther 2015; 6:121-122. [PMID: 29388583 PMCID: PMC5683276 DOI: 10.2147/phmt.s85573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Rebecca Arden Harris
- Department of Family and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
- Correspondence: Rebecca Arden Harris, Department of Family and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467, USA, Email
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Kim JH, Bae KH, Choi YK, Go Y, Choe M, Jeon YH, Lee HW, Koo SH, Perfield JW, Harris RA, Lee IK, Park KG. Fibroblast growth factor 21 analogue LY2405319 lowers blood glucose in streptozotocin-induced insulin-deficient diabetic mice by restoring brown adipose tissue function. Diabetes Obes Metab 2015; 17:161-9. [PMID: 25359298 DOI: 10.1111/dom.12408] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [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: 08/25/2014] [Revised: 10/20/2014] [Accepted: 10/24/2014] [Indexed: 01/01/2023]
Abstract
AIM To investigate the effects of LY2405319, an analogue of fibroblast growth factor 21 (FGF21), on glucose homeostasis in streptozotocin (STZ)-induced insulin-deficient mice (STZ mice). METHODS Nine-week-old male C57BL/6J mice were administered a single intraperitoneal injection of STZ (150 mg/kg). One week later, after confirmation of hyperglycaemia, saline or LY2405319 (5 mg/kg) was injected subcutaneously daily for 4 weeks. Changes in glucose homeostasis, energy metabolism and brown adipose tissue (BAT) function were assessed. RESULTS The STZ mice had elevated blood glucose and reduced plasma FGF21 levels, impaired glucose uptake in the BAT, and BAT mitochondria with absent or swollen cristae and fewer lipid vacuoles. LY2405319 significantly reduced blood glucose levels and this was associated with increased BAT glucose uptake and changes in gene expression and morphology, indicating improved mitochondrial lipid metabolism in the BAT. Importantly, the ability of LY2405319 to lower blood glucose in STZ mice was compromised after removing interscapular BAT. CONCLUSIONS Our results show that LY2405319 reduces blood glucose levels in insulin-deficient diabetes by improving BAT metabolism. Additional studies investigating the therapeutic potential of FGF21 for the treatment of type 1 diabetes are warranted.
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Affiliation(s)
- J-H Kim
- Department of Biomedical Science, Graduate school of Medicine, Kyungpook National University, Daegu, South Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Aging and Metabolism, Kyungpook National University School of Medicine, Daegu, South Korea
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Affiliation(s)
- Rebecca Arden Harris
- Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
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Mia S, Warnecke A, Zhang XM, Malmström V, Harris RA. An optimized protocol for human M2 macrophages using M-CSF and IL-4/IL-10/TGF-β yields a dominant immunosuppressive phenotype. Scand J Immunol 2014; 79:305-14. [PMID: 24521472 PMCID: PMC4282403 DOI: 10.1111/sji.12162] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 02/06/2014] [Indexed: 12/11/2022]
Abstract
Monocytes are highly abundant circulatory effector cells and play a vital role in driving or resolving inflammatory processes depending on their activation phenotype. We investigated and compared a panel of polarization protocols of blood-derived monocytes to achieve a stable, optimal and effective regimen for in vitro induction of immunosuppressive human macrophages, evaluating their surface receptor expression, cytokine profile, scavenging function and ability to suppress T-cell proliferation. Importantly, we assessed the effect of copolarization or secondary pro-inflammatory stimulation of a primary anti-inflammatory activation phenotype. A combination of IL-4/IL-10/TGF-β yielded a relatively stable and dominant immunosuppressive phenotype characterized by higher IL-10 production and down-regulated TNF-α, IL-6, CD86, CD274 and MHC II expression. Functionally, IL-4/IL-10/TGF-β-stimulated macrophages (M2) had a potent deactivating effect on a subsequent pro-inflammatory LPS/IFNγ-activated macrophage (M1) stimulation and significantly suppressed T-cell proliferation. Monocytes derived from patients with chronic inflammatory diseases could be induced to be anti-inflammatory using this protocol. Pre-differentiation with GM-CSF or M-CSF was further demonstrated to enhance final M1/M2 activation status. Our findings indicate a robust polarization protocol for generation of specific immunosuppressive human monocyte-derived macrophages.
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Affiliation(s)
- S Mia
- Applied Immunology & Immunotherapy, Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska University Hospital at Solna, Karolinska Institutet, Stockholm, Sweden
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Harris RA. We have strict statutes and most biting laws. JAMA Intern Med 2014; 174:1202. [PMID: 25003891 DOI: 10.1001/jamainternmed.2014.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rebecca Arden Harris
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
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31
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Croymans DM, Krell SL, Oh CS, Katiraie M, Lam CY, Harris RA, Roberts CK. Effects of resistance training on central blood pressure in obese young men. J Hum Hypertens 2013; 28:157-64. [PMID: 24005959 DOI: 10.1038/jhh.2013.81] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 04/25/2013] [Accepted: 05/07/2013] [Indexed: 11/09/2022]
Abstract
Central blood pressure is a predictor of the risk of cardiovascular disease (CVD), and the effects of resistance training (RT) on central blood pressure are largely unknown. This study explored the effects of high-intensity RT on central blood pressure, indices of arterial stiffness and wave reflection and inflammatory/atherogenic markers in overweight or obese, sedentary young men. Thirty-six participants were randomized to RT (12 weeks of training, 3/wk, n=28) or control groups (C, 12 weeks of no training, n=8) and assessed for changes in central and brachial blood pressures, augmentation index (AIx), carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT), body composition, lipids and inflammatory/atherogenic markers. High-intensity RT resulted in decreased central and brachial systolic/diastolic blood pressures (all P0.03), despite not altering AIx (P=0.34) or cfPWV (P=0.43). The vascular endothelial growth factor increased (P=0.03) after RT, without any change in cIMT, C-reactive protein, oxidized LDL (oxLDL) or other inflammatory markers (all P0.1). Changes in the central systolic blood pressure (cSBP) were positively correlated with changes in oxLDL (r=0.42, P=0.03) and soluble E-selectin (r=0.41, P=0.04). In overweight/obese young men, high-intensity RT decreases cSBP, independently of weight loss and changes in arterial stiffness. The cardioprotective effects of RT may be related to effects on central blood pressure.
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Affiliation(s)
- D M Croymans
- 1] David Geffen School of Medicine, University of California, Los Angeles, CA, USA [2] Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - S L Krell
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - C S Oh
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - M Katiraie
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - C Y Lam
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - R A Harris
- Georgia Prevention Institute, Georgia Health Sciences University, Augusta, GA, USA
| | - C K Roberts
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
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Qualter P, Brown SL, Rotenberg KJ, Vanhalst J, Harris RA, Goossens L, Bangee M, Munn P. Trajectories of loneliness during childhood and adolescence: predictors and health outcomes. J Adolesc 2013; 36:1283-93. [PMID: 23465384 DOI: 10.1016/j.adolescence.2013.01.005] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 12/27/2012] [Accepted: 01/17/2013] [Indexed: 10/27/2022]
Abstract
The present study employed latent growth mixture modeling to discern distinct trajectories of loneliness using data collected at 2-year intervals from age 7-17 years (N = 586) and examine whether measures taken at age 5 years were good predictors of group membership. Four loneliness trajectory classes were identified: (1) low stable (37% of the sample), (2) moderate decliners (23%), (3) moderate increasers (18%), and (4) relatively high stable (22%). Predictors at age 5 years for the high stable trajectory were low trust beliefs, low trusting, low peer acceptance, parent reported negative reactivity, an internalizing attribution style, low self-worth, and passivity during observed play. The model also included outcome variables. We found that both the high stable and moderate increasing trajectories were associated with depressive symptoms, a higher frequency of visits to the doctor, and lower perceived general health at age 17. We discuss implications of findings for future empirical work.
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Affiliation(s)
- P Qualter
- University of Central Lancashire, Lancashire, England, UK.
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Blednov YA, Benavidez JM, Black M, Chandra D, Homanics GE, Rudolph U, Harris RA. Linking GABA(A) receptor subunits to alcohol-induced conditioned taste aversion and recovery from acute alcohol intoxication. Neuropharmacology 2012; 67:46-56. [PMID: 23147414 DOI: 10.1016/j.neuropharm.2012.10.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Revised: 10/12/2012] [Accepted: 10/28/2012] [Indexed: 10/27/2022]
Abstract
GABA type A receptors (GABA(A)-R) are important for ethanol actions and it is of interest to link individual subunits with specific ethanol behaviors. We studied null mutant mice for six different GABA(A)-R subunits (α1, α2, α3, α4, α5 and δ). Only mice lacking the α2 subunit showed reduction of conditioned taste aversion (CTA) to ethanol. These results are in agreement with data from knock-in mice with mutation of the ethanol-sensitive site in the α2-subunit (Blednov et al., 2011). All together, they indicate that aversive property of ethanol is dependent on ethanol action on α2-containing GABA(A)-R. Deletion of the α2-subunit led to faster recovery whereas absence of the α3-subunit slowed recovery from ethanol-induced incoordination (rotarod). Deletion of the other four subunits did not affect this behavior. Similar changes in this behavior for the α2 and α3 null mutants were found for flurazepam motor incoordination. However, no differences in recovery were found in motor-incoordinating effects of an α1-selective modulator (zolpidem) or an α4-selective agonist (gaboxadol). Therefore, recovery of rotarod incoordination is under control of two GABA(A)-R subunits: α2 and α3. For motor activity, α3 null mice demonstrated higher activation by ethanol (1 g/kg) whereas both α2 (-/-) and α3 (-/Y) knockout mice were less sensitive to ethanol-induced reduction of motor activity (1.5 g/kg). These studies demonstrate that the effects of ethanol at GABAergic synapses containing α2 subunit are important for specific behavioral effects of ethanol which may be relevant to the genetic linkage of the α2 subunit with human alcoholism.
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Affiliation(s)
- Y A Blednov
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, 1 University Station, A4800, Austin, TX 78712, USA.
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Blednov YA, Mayfield RD, Belknap J, Harris RA. Behavioral actions of alcohol: phenotypic relations from multivariate analysis of mutant mouse data. Genes Brain Behav 2012; 11:424-35. [PMID: 22405477 DOI: 10.1111/j.1601-183x.2012.00780.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Behavioral studies on genetically diverse mice have proven powerful for determining relationships between phenotypes and have been widely used in alcohol research. Most of these studies rely on naturally occurring genetic polymorphisms among inbred strains and selected lines. Another approach is to introduce variation by engineering single-gene mutations in mice. We have tested 37 different mutant mice and their wild-type controls for a variety (31) of behaviors and have mined this data set by K-means clustering and analysis of correlations. We found a correlation between a stress-related response (activity in a novel environment) and alcohol consumption and preference for saccharin. We confirmed several relationships detected in earlier genetic studies, including positive correlation of alcohol consumption with saccharin consumption and negative correlations with conditioned taste aversion and alcohol withdrawal severity. Introduction of single-gene mutations either eliminated or greatly diminished these correlations. The three tests of alcohol consumption used (continuous two-bottle choice and two limited access tests: drinking in the dark and sustained high alcohol consumption) share a relationship with saccharin consumption, but differ from each other in their correlation networks. We suggest that alcohol consumption is controlled by multiple physiological systems where single-gene mutations can disrupt the networks of such systems.
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Affiliation(s)
- Y A Blednov
- Waggoner Center for Alcohol and Addiction Research, Section on Neurobiology, Institute for Neuroscience, Institute for Cell and Molecular Biology, University of Texas at Austin, TX 78712, USA
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Etheridge N, Mayfield RD, Harris RA, Dodd PR. Identifying changes in the synaptic proteome of cirrhotic alcoholic superior frontal gyrus. Curr Neuropharmacol 2011; 9:122-8. [PMID: 21886576 PMCID: PMC3137166 DOI: 10.2174/157015911795017164] [Citation(s) in RCA: 7] [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: 10/01/2009] [Revised: 04/17/2010] [Accepted: 05/26/2010] [Indexed: 01/25/2023] Open
Abstract
Hepatic complications are a common side-effect of alcoholism. Without the detoxification capabilities of the liver, alcohol misuse induces changes in gene and protein expression throughout the body. A global proteomics approach was used to identify these protein changes in the brain. We utilised human autopsy tissue from the superior frontal gyrus (SFG) of six cirrhotic alcoholics, six alcoholics without comorbid disease, and six non-alcoholic non-cirrhotic controls. Synaptic proteins were isolated and used in two-dimensional differential in-gel electrophoresis coupled with mass spectrometry. Many expression differences were confined to one or other alcoholic sub-group. Cirrhotic alcoholics showed 99 differences in protein expression levels from controls, of which half also differed from non-comorbid alcoholics. This may reflect differences in disease severity between the sub-groups of alcoholics, or differences in patterns of harmful drinking. Alternatively, the protein profiles may result from differences between cirrhotic and non-comorbid alcoholics in subjects’ responses to alcohol misuse. Ten proteins were identified in at least two spots on the 2D gel; they were involved in basal energy metabolism, synaptic vesicle recycling, and chaperoning. These post-translationally modified isoforms were differentially regulated in cirrhotic alcoholics, indicating a level of epigenetic control not previously observed in this disorder.
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Affiliation(s)
- N Etheridge
- School of Chemistry and Molecular Biosciences, University of Queensland, Australia
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Harris RA, Osterndorff-Kahanek E, Ponomarev I, Homanics GE, Blednov YA. Testing the silence of mutations: Transcriptomic and behavioral studies of GABA(A) receptor α1 and α2 subunit knock-in mice. Neurosci Lett 2010; 488:31-5. [PMID: 21056629 DOI: 10.1016/j.neulet.2010.10.075] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 10/28/2010] [Accepted: 10/29/2010] [Indexed: 12/13/2022]
Abstract
Knock-in mice were constructed with mutations in the α1 (H(270), A(277)) and α2 (H(270), A(277)) subunits of the GABAA receptor, which resulted in receptors that lacked modulation by ethanol but retained normal responses to GABA in vitro. A key question is whether these mutant receptors also function normally in vivo. Perturbation of brain function was evaluated by gene expression profiling in the cerebral cortex and by behavioral pharmacology experiments with GABAergic drugs. Analysis of individual transcripts found only six transcripts that were changed in α1 knock-in mice and three in the α2 mutants (p<0.05, corrected for multiple comparisons). Two transcripts that are sensitive to neuronal activity, Arc and Fos, increased about 250% in the α2 mutants, and about 50% in the α1 mutants. Behavioral effects (loss of righting reflex, rotarod) of flurazepam and pentobarbital were not different between α2 mutants and wild-type, but they were enhanced for α1 knock-in mice. These results indicate that introduction of these mutations in the α2 subunit of the GABAA receptor does not produce marked perturbation of brain function, as measured by gene expression and GABAergic behavioral responses, but the same mutations in the α1 subunit produce more pronounced changes, especially in GABAergic function.
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Affiliation(s)
- R A Harris
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, 1 University Station, A4800, Austin, TX 78712, United States
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Blednov YA, Borghese CM, McCracken ML, Benavidez JM, Geil CR, Osterndorff-Kahanek E, Werner DF, Iyer S, Swihart A, Harrison NL, Homanics GE, Harris RA. Loss of ethanol conditioned taste aversion and motor stimulation in knockin mice with ethanol-insensitive α2-containing GABA(A) receptors. J Pharmacol Exp Ther 2010; 336:145-54. [PMID: 20876231 DOI: 10.1124/jpet.110.171645] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
GABA type A receptors (GABA(A)-Rs) are potential targets of ethanol. However, there are multiple subtypes of this receptor, and, thus far, individual subunits have not been definitively linked with specific ethanol behavioral actions. Interestingly, though, a chromosomal cluster of four GABA(A)-R subunit genes, including α2 (Gabra2), was associated with human alcoholism (Am J Hum Genet 74:705-714, 2004; Pharmacol Biochem Behav 90:95-104, 2008; J Psychiatr Res 42:184-191, 2008). The goal of our study was to determine the role of receptors containing this subunit in alcohol action. We designed an α2 subunit with serine 270 to histidine and leucine 277 to alanine mutations that was insensitive to potentiation by ethanol yet retained normal GABA sensitivity in a recombinant expression system. Knockin mice containing this mutant subunit were tested in a range of ethanol behavioral tests. These mutant mice did not develop the typical conditioned taste aversion in response to ethanol and showed complete loss of the motor stimulant effects of ethanol. Conversely, they also demonstrated changes in ethanol intake and preference in multiple tests. The knockin mice showed increased ethanol-induced hypnosis but no difference in anxiolytic effects or recovery from acute ethanol-induced motor incoordination. Overall, these studies demonstrate that the effects of ethanol at GABAergic synapses containing the α2 subunit are important for specific behavioral effects of ethanol that may be relevant to the genetic linkage of this subunit with human alcoholism.
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Affiliation(s)
- Y A Blednov
- Waggoner Center for Alcohol and Addiction Research, University of Texas, 1 University Station, Austin, TX 78712, USA.
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Werner DF, Swihart A, Rau V, Jia F, Borghese CM, McCracken ML, Iyer S, Fanselow MS, Oh I, Sonner JM, Eger EI, Harrison NL, Harris RA, Homanics GE. Inhaled anesthetic responses of recombinant receptors and knockin mice harboring α2(S270H/L277A) GABA(A) receptor subunits that are resistant to isoflurane. J Pharmacol Exp Ther 2010; 336:134-44. [PMID: 20807777 DOI: 10.1124/jpet.110.170431] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The mechanism by which the inhaled anesthetic isoflurane produces amnesia and immobility is not understood. Isoflurane modulates GABA(A) receptors (GABA(A)-Rs) in a manner that makes them plausible targets. We asked whether GABA(A)-R α2 subunits contribute to a site of anesthetic action in vivo. Previous studies demonstrated that Ser270 in the second transmembrane domain is involved in the modulation of GABA(A)-Rs by volatile anesthetics and alcohol, either as a binding site or a critical allosteric residue. We engineered GABA(A)-Rs with two mutations in the α2 subunit, changing Ser270 to His and Leu277 to Ala. Recombinant receptors with these mutations demonstrated normal affinity for GABA, but substantially reduced responses to isoflurane. We then produced mutant (knockin) mice in which this mutated subunit replaced the wild-type α2 subunit. The adult mutant mice were overtly normal, although there was evidence of enhanced neonatal mortality and fear conditioning. Electrophysiological recordings from dentate granule neurons in brain slices confirmed the decreased actions of isoflurane on mutant receptors contributing to inhibitory synaptic currents. The loss of righting reflex EC(50) for isoflurane did not differ between genotypes, but time to regain the righting reflex was increased in N(2) generation knockins. This effect was not observed at the N(4) generation. Isoflurane produced immobility (as measured by tail clamp) and amnesia (as measured by fear conditioning) in both wild-type and mutant mice, and potencies (EC(50)) did not differ between the strains for these actions of isoflurane. Thus, immobility or amnesia does not require isoflurane potentiation of the α2 subunit.
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Affiliation(s)
- D F Werner
- Department of Anesthesiology, University of Pittsburgh, 3501 Fifth Avenue, Pittsburgh, PA 15261, USA
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Harris RA. Differential effects of membrane perturbants on voltage-activated sodium and calcium channels and calcium-dependent potassium channels. Biophys J 2010; 45:132-4. [PMID: 19431539 DOI: 10.1016/s0006-3495(84)84137-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Akesson C, Uvebrant K, Oderup C, Lynch K, Harris RA, Lernmark A, Agardh CD, Cilio CM. Altered natural killer (NK) cell frequency and phenotype in latent autoimmune diabetes in adults (LADA) prior to insulin deficiency. Clin Exp Immunol 2010; 161:48-56. [PMID: 20408863 DOI: 10.1111/j.1365-2249.2010.04114.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Approximately 10% of the patients diagnosed with type 2 diabetes (T2D) have detectable serum levels of glutamic acid decarboxylase 65 autoantibodies (GADA). These patients usually progress to insulin dependency within a few years, and are classified as being latent autoimmune diabetes in adults (LADA). A decrease in the frequency of peripheral blood natural killer (NK) cells has been reported recently in recent-onset T1D and in high-risk individuals prior to the clinical onset. As NK cells in LADA patients have been investigated scarcely, the aim of this study was to use multicolour flow cytometry to define possible deficiencies or abnormalities in the frequency or activation state of NK cells in LADA patients prior to insulin dependency. All patients were GADA-positive and metabolically compensated, but none were insulin-dependent at the time blood samples were taken. LADA patients exhibited a significant decrease in NK cell frequency in peripheral blood compared to healthy individuals (P=0.0018), as reported previously for recent-onset T1D patients. Interestingly, NKG2D expression was increased significantly (P<0.0001), whereas killer cell immunoglobulin-like receptor (KIR)3DL1 expression was decreased (P<0.0001) within the NK cell population. These observations highlight a defect in both frequency and activation status of NK cells in LADA patients and suggest that this immunological alteration may contribute to the development of autoimmune diabetes by affecting peripheral tolerance. Indeed, recent evidence has demonstrated a regulatory function for NK cells in autoimmunity. Moreover, the decrease in NK cell number concords with observations obtained in recent-onset T1D, implying that similar immunological dysfunctions may contribute to the progression of both LADA and T1D.
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Affiliation(s)
- C Akesson
- Cellular Autoimmunity Unit, Department of Clinical Sciences, Malmö University Hospital, Malmö, Sweden
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Ozburn AR, Harris RA, Blednov YA. Behavioral differences between C57BL/6J x FVB/NJ and C57BL/6J x NZB/B1NJ F1 hybrid mice: relation to control of ethanol intake. Behav Genet 2010; 40:551-63. [PMID: 20364436 DOI: 10.1007/s10519-010-9357-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 03/13/2010] [Indexed: 10/19/2022]
Abstract
C57BL/6J x FVB/NJ F1 (B6 x FVB) mice consume more alcohol than C57BL/6J x NZB/B1NJ F1 (B6 x NZB) mice and this high alcohol consumption is stable after abstinence whereas B6 x NZB show reduced consumption, thus providing models of Sustained Alcohol Preference (SAP) and Reduced Alcohol Preference (RAP). In female hybrids, we assessed several behavioral responses to define behaviors which might predict SAP and RAP. B6 x FVB exhibited less severe ethanol-induced conditioned taste aversion and were less sensitive to ethanol-induced loss of righting reflex than B6 x NZB. Both hybrids demonstrated ethanol-induced place preference and a low ethanol withdrawal severity. We found that these hybrids differ in their sensitivity to the aversive and sedative, but not rewarding, effects of ethanol. Results of elevated plus maze, mirror chamber, and locomotor tests reveal B6 x FVB mice are less anxious and more active than B6 x NZB mice. Results obtained offer insights about factors that determine SAP and RAP in these new genetic models of alcohol consumption.
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Affiliation(s)
- A R Ozburn
- Waggoner Center for Alcoholism and Addiction Research, Institute for Neuroscience, University of Texas at Austin, 1 University Station, Austin, TX 78712-0159, USA.
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Zhang Y, Hao L, Savalani MM, Harris RA, Di Silvio L, Tanner KE. In vitro biocompatibility of hydroxyapatite-reinforced polymeric composites manufactured by selective laser sintering. J Biomed Mater Res A 2010; 91:1018-27. [PMID: 19107791 DOI: 10.1002/jbm.a.32298] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The selective laser sintering (SLS) technique was used to manufacture hydroxyapatite-reinforced polyethylene and polyamide composites as potential customized maxillofacial implants. In vitro tests were carried out to assess cellular responses, in terms of cell attachment, morphology, proliferation, differentiation, and mineralized nodule formation, using primary human osteoblast cells. This study showed that the SLS composite processed was biocompatible, with no adverse effects observed on cell viability and metabolic activity, supporting a normal metabolism and growth pattern for osteoblasts. Positive von Kossa staining demonstrated the presence of bone-like mineral on the SLS materials. Higher hydroxyapatite content composites enhanced cell proliferation, increased alkaline phosphatase activity, and produced more osteocalcin. The present findings showed that SLS materials have good in vitro biocompatibility and hence demonstrated biologically the potential of SLS for medical applications.
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Affiliation(s)
- Y Zhang
- Department of Materials, Queen Mary University of London, Mile End Road, London E1 4NS, UK
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Zhang Y, Guzinski M, Eger EI, Laster MJ, Sharma M, Harris RA, Hemmings HC. Bidirectional modulation of isoflurane potency by intrathecal tetrodotoxin and veratridine in rats. Br J Pharmacol 2010; 159:872-8. [PMID: 20105175 DOI: 10.1111/j.1476-5381.2009.00583.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Results from several studies point to voltage-gated Na(+) channels as potential mediators of the immobility produced by inhaled anaesthetics. We hypothesized that the intrathecal administration of tetrodotoxin, a drug that blocks Na(+) channels, should enhance anaesthetic potency, and that concurrent administration of veratridine, a drug that augments Na(+) channel opening, should reverse the increase in potency. EXPERIMENTAL APPROACH We measured the change in isoflurane potency for reducing movement in response to a painful stimulus as defined by MAC (minimum alveolar concentration of anaesthetic required to abolish movement in 50% of subjects) caused by intrathecal infusion of various concentrations of tetrodotoxin into the lumbothoracic subarachnoid space of rats, and the change in MAC caused by the administration of a fixed dose of tetrodotoxin plus various doses of intrathecal veratridine. KEY RESULTS Intrathecal infusion of tetrodotoxin (0.078-0.63 microM) produced a reversible dose-related decrease in MAC, of more than 50% at the highest concentration. Intrathecal co-administration of veratridine (1.6-6.4 microM) reversed this decrease in a dose-related manner, with nearly complete reversal at the highest veratridine dose tested. CONCLUSIONS AND IMPLICATIONS Intrathecal administration of tetrodotoxin increases isoflurane potency (decreases isoflurane MAC), and intrathecal administration of veratridine counteracts this effect in vivo. These findings are consistent with a role for voltage-gated Na(+) channel blockade in the immobility produced by inhaled anaesthetics.
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Affiliation(s)
- Y Zhang
- Department of Anesthesiology, Fuwai Hospital and Cardiovascular Institute, Beijing, China
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Radley GJ, Sama A, Watson J, Harris RA. Characterization, quantification, and replication of human sinus bone for surgery simulation phantoms. Proc Inst Mech Eng H 2010; 223:875-87. [PMID: 19908426 DOI: 10.1243/09544119jeim577] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The requirement for artificial but realistic, tactile, anatomical models for surgical practice in medical simulation is increasingly evident and shows potential for greater efficiency and availability, and lower costs. Anatomically correct, detailed models with the physical surgical characteristics of real tissue, combined with the ability to reproduce one-off cases, would provide an invaluable tool in the development of surgery. This research work investigates the capture of geometrical and physical data from the human sinus to subsequently direct the production and optimization of such simulation phantoms. Micro-computed tomography analysis of the entire sinus was performed to characterize the sinus complex geometry. Following an extensive review, specialized mechanical testing apparatus and methods relevant to the surgical methods employed were designed and produced. This provided comparative analysis methods for both biological and artificial phantom materials and allowed the optimization of phantom materials with respect to the derived target values.
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Affiliation(s)
- G J Radley
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Loughborough, Leicestershire, UK
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Abstract
Objectives Obesity and venous disease are commonly encountered together. The aetio- logical relationship, however, has not been clear. Popliteal venous compression (PVC) has been encountered both on ultrasound and venographically. In this study, patients with symptoms and/or signs of chronic venous hypertension with PVC were investigated and the relationship to obesity was defined. Methods A total of 89 patients were included in the study, of which 49 limbs were classified as having PVC defined as a greater than 90% reduction in the maximum internal diameter (ID) of the popliteal vein (POPV) with knee locking. Forty consecutive limbs with venous disease with no evidence of PVC were used as controls. The body mass index (BMI) of each group was calculated and the clinical symptoms and signs were documented. After the failure of conservative treatment, 30 of the 49 underwent open popliteal decompression. Results Patients with PVC were found to have a BMI of 34.6 ± 6.2 compared with 25.3 ± 3.0 of the controls. The POPV ID in the PVC group before and after knee locking changed from 11.7 ± 5.0 to 1.0 ± 2.1 mm, respectively. Postoperatively, the POPV ID before and after knee locking changed from 10.2 ± 2.2 to 9.0 ± 1.5 mm, respectively. At 16.2 ± 12.1 months follow-up, all the major clinical parameters improved at a statistically significant level. Conclusions There appears to be a relationship between obesity, chronic venous disease and PVC. POPV compression syndrome may clarify the previously unexplained venous presentations. Surgical decompression provides good results in patients unresponsive to conservative treatment.
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Affiliation(s)
- R J Lane
- Dalcross Private Hospital,
Sydney, New South Wales
- North Shore Private Hospital,
Sydney, New South Wales
- Royal North Shore Hospital,
Sydney, New South Wales
- Vascular Specialists Investigations and Management, Sydney, New South Wales,
Australia
| | - M L Cuzzilla
- Dalcross Private Hospital,
Sydney, New South Wales
- Vascular Specialists Investigations and Management, Sydney, New South Wales,
Australia
| | - R A Harris
- Dalcross Private Hospital,
Sydney, New South Wales
- North Shore Private Hospital,
Sydney, New South Wales
| | - M N Phillips
- Royal North Shore Hospital,
Sydney, New South Wales
- Vascular Specialists Investigations and Management, Sydney, New South Wales,
Australia
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Abstract
The vanilloid receptor TRPV1 is activated by ethanol and this may be important for some of the central and peripheral actions of ethanol. To determine if this receptor has a role in ethanol-mediated behaviors, we studied null mutant mice in which the Trpv1 gene was deleted. Mice lacking this gene showed significantly higher preference for ethanol and consumed more ethanol in a two-bottle choice test as compared with wild type littermates. Null mutant mice showed shorter duration of loss of righting reflex induced by low doses of ethanol (3.2 and 3.4 g/kg) and faster recovery from motor incoordination induced by ethanol (2 g/kg). However, there were no differences between null mutant and wild type mice in severity of ethanol-induced acute withdrawal (4 g/kg) or conditioned taste aversion to ethanol (2.5 g/kg). Two behavioral phenotypes (decreased sensitivity to ethanol-induced sedation and faster recovery from ethanol-induced motor incoordination) seen in null mutant mice were reproduced in wild type mice by injection of a TRPV1 antagonist, capsazepine (10 mg/kg). These two ethanol behaviors were changed in the opposite direction after injection of capsaicin, a selective TRPV1 agonist, in wild type mice. The studies provide the first evidence that TRPV1 is important for specific behavioral actions of ethanol.
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Affiliation(s)
- Y A Blednov
- Waggoner Center for Alcohol and Addiction Research, University of Texas, 1 University Station A4800, Austin, TX 78712-0159, USA.
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Abstract
The design of scaffolds with an intricate and controlled internal structure represents a challenge for tissue engineering. Several scaffold-manufacturing techniques allow the creation of complex architectures but with little or no control over the main features of the channel network such as the size, shape, and interconnectivity of each individual channel, resulting in intricate but random structures. The combined use of computer-aided design (CAD) systems and layer-manufacturing techniques allows a high degree of control over these parameters with few limitations in terms of achievable complexity. However, the design of complex and intricate networks of channels required in CAD is extremely time-consuming since manually modelling hundreds of different geometrical elements, all with different parameters, may require several days to design individual scaffold structures. An automated design methodology is proposed by this research to overcome these limitations. This approach involves the investigation of novel software algorithms, which are able to interact with a conventional CAD program and permit the automated design of several geometrical elements, each with a different size and shape. In this work, the variability of the parameters required to define each geometry has been set as random, but any other distribution could have been adopted. This methodology has been used to design five cubic scaffolds with interconnected pore channels that range from 200 to 800 μm in diameter, each with an increased complexity of the internal geometrical arrangement. A clinical case study, consisting of an integration of one of these geometries with a craniofacial implant, is then presented.
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Affiliation(s)
- E Ramin
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Loughborough, UK
| | - R A Harris
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Loughborough, UK
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Raveendran M, Tardif S, Ross CN, Austad SN, Harris RA, Milosavljevic A, Rogers J. Polymorphic microsatellite loci for the common marmoset (Callithrix jacchus) designed using a cost- and time-efficient method. Am J Primatol 2008; 70:906-10. [PMID: 18561252 DOI: 10.1002/ajp.20581] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We describe a cost- and time-efficient method for designing new microsatellite markers in any species with substantial genomic DNA sequence data available. Using this technique, we report 14 new polymorphic dinucleotide microsatellite loci isolated from the common marmoset. The relative yield of new polymorphisms was higher with less labor than described in previous marmoset studies. Of 20 loci initially evaluated, 14 were polymorphic and amplified reliably (70% success rate). The number of alleles ranged from 3 to 9 with heterozygosity varying from 0.48 to 0.83.
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Affiliation(s)
- M Raveendran
- Department of Genetics, Southwest Foundation for Biomedical Research, San Antonio, Texas 78227, USA.
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Abstract
Plentiful data from both animal and human studies support the importance of genetic influences in substance abuse and dependence (Bierut et al., 1998; Tsuang et al., 1998; Kendler et al., 2003). This review summarizes the evidence supporting such genetic influences, places them into perspective regarding animal and human studies, discusses the importance of both genes and environment, and highlights some specific genes of interest regarding the vulnerabilities for problems associated with alcohol use disorders. A long history of repetitive heavy use of alcohol exists across generations as well as the high prevalence of alcohol-related problems in Western societies. Moreover, the information offered here addresses the importance of more general issues regarding genetics and gene expression related to alcohol abuse and dependence.
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Affiliation(s)
- R D Mayfield
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX 78712, USA
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Savalani MM, Hao L, Zhang Y, Tanner KE, Harris RA. Fabrication of porous bioactive structures using the selective laser sintering technique. Proc Inst Mech Eng H 2008; 221:873-86. [PMID: 18161247 DOI: 10.1243/09544119jeim232] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Hydroxyapatite, a ceramic with which natural bone inherently bonds, has been incorporated into a polymer matrix to enhance the bioactivity of implant materials. In order to manufacture custom-made bioactive implants rapidly, selective laser sintering has been investigated to fabricate hydroxyapatite and polyamide composites and their properties investigated. One objective of this research was to identify the maximum hydroxyapatite content that could be incorporated into the matrix, which was sintered at various parameters. The study focused on investigating the control of porosity and pore size of the matrix by manipulating the selective laser sintering parameters of the laser power and laser scan speed. The interception method was used to analyse the internal porous morphology of the matrices which were cross-sectioned through the vertical plane. Most notably, all structures built demonstrated interconnection and penetration throughout the matrix. Liquid displacement was also used to analyse the porosity of the matrices. The laser power showed a negative relationship between porosity and variation in parameter values until a critical power value was reached. However, the same relationship for laser scan speed matrices was inconsistent. The effects of the laser power and laser scanning speed on the features of porous structures that could influence cell spreading, proliferation, and bone regeneration are presented.
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Affiliation(s)
- M M Savalani
- Wolfson School of Mechanical & Manufacturing Engineering, Rapid Manufacturing Research Group, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
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