A 3D primary human cell-based in vitro model of non-alcoholic steatohepatitis for efficacy testing of clinical drug candidates

Non-alcoholic steatohepatitis (NASH) is a progressive and severe liver disease, characterized by lipid accumulation, inflammation, and downstream fibrosis. Despite its increasing prevalence, there is no approved treatment yet available for patients. This has been at least partially due to the lack of predictive preclinical models for studying this complex disease. Here, we present a 3D in vitro microtissue model that uses spheroidal, scaffold free co-culture of primary human hepatocytes, Kupffer cells, liver endothelial cells and hepatic stellate cells. Upon exposure to defined and clinically relevant lipotoxic and inflammatory stimuli, these microtissues develop key pathophysiological features of NASH within 10 days, including an increase of intracellular triglyceride content and lipids, and release of pro-inflammatory cytokines. Furthermore, fibrosis was evident through release of procollagen type I, and increased deposition of extracellular collagen fibers. Whole transcriptome analysis revealed changes in the regulation of pathways associated with NASH, such as lipid metabolism, inflammation and collagen processing. Importantly, treatment with anti-NASH drug candidates (Selonsertib and Firsocostat) decreased the measured specific disease parameter, in accordance with clinical observations. These drug treatments also significantly changed the gene expression patterns of the microtissues, thus providing mechanisms of action and revealing therapeutic potential. In summary, this human NASH model represents a promising drug discovery tool for understanding the underlying complex mechanisms in NASH, evaluating efficacy of anti-NASH drug candidates and identifying new approaches for therapeutic interventions.

Ventriculoperitoneal shunt dysfunction in a patient presenting with neurogenic pulmonary edema

✓ The authors report on a patient with dysfunction of a ventriculoperitoneal shunt who presented with two episodes of neurogenic pulmonary edema within the space of a few months. The edema resolved on correction of the shunt dysfunction. Because neurogenic pulmonary edema may be a rare consequence of shunt dysfunction, it is important to recognize this unusual association and provide appropriate diagnostic measures and treatment.

Passive electrical properties of ventral horn neurons in rat spinal cord slices

Recordings were made from large neurons located in the ventral horn of transverse spinal cord slices from young rats (7-15 days). Whole cell recordings were made simultaneously with two electrodes from the soma of these neurons, visualized using infra-red differential interference contrast optics. Positive identification of motoneurons could not always be achieved. The response of a neuron to a brief pulse of current delivered by one electrode, and recorded by the other electrode, were matched optimally to responses of a compartmental model of the same neuron with an identical current pulse as input. The compartmental model was based on a reconstruction of the neuron, using Biocytin staining. The compartmental model had three free parameters: specific membrane capacitance (Cm), membrane resistivity (Rm), and cytoplasmatic resistivity (Ri), all assumed to be uniform throughout the neuron. The experimental and model responses could be matched unequivocally for four neurons, giving Cm = 2.4 +/- 0.5 microF/cm2, Rm = 5.3 +/- 0. 9 kOmega/cm2, and Ri = 87 +/- 22 Omega/cm. No somatic shunt was required. For the remaining six neurons, a less perfect fit (but still within 95% confidence limits) was indicative of nonhomogeneous membrane properties. The electrotonic length of uncut dendrites was 0.85 +/- 0.14 lambda. The results resolve the issue of a somatic shunt conductance for motoneurons, relegating it to a microelectrode impalement artifact. They are consistent with previous reports on the electrical compactness of motoneurons to steady state currents and voltages. However, the much higher value of Cm (than the previously assumed 1 microF/cm2) implies much greater dendritic attenuation of fast synaptic potentials, and a much enhanced integrative response of motoneurons to synaptic potentials.