Low-level laser therapy for closed-head traumatic brain injury in mice: effect of different wavelengths

BACKGROUND AND OBJECTIVES

Traumatic brain injury (TBI) affects millions worldwide and is without effective treatment. One area that is attracting growing interest is the use of transcranial low-level laser therapy (LLLT) to treat TBI. The fact that near-infrared light can penetrate into the brain would allow non-invasive treatment to be carried out with a low likelihood of treatment-related adverse events. LLLT may treat TBI by increasing respiration in the mitochondria, causing activation of transcription factors, reducing inflammatory mediators and oxidative stress, and inhibiting apoptosis.

STUDY DESIGN/MATERIALS AND METHODS

We tested LLLT in a mouse model of closed-head TBI produced by a controlled weight drop onto the skull. Mice received a single treatment with continuous-wave 665, 730, 810, or 980 nm lasers (36 J/cm(2) delivered at 150 mW/cm(2)) 4-hour post-TBI and were followed up by neurological performance testing for 4 weeks.

RESULTS

Mice with moderate-to-severe TBI treated with 665 and 810 nm laser (but not with 730 or 980 nm) had a significant improvement in Neurological Severity Score that increased over the course of the follow-up compared to sham-treated controls. Morphometry of brain sections showed a reduction in small deficits in 665 and 810 nm laser treated mouse brains at 28 days.

CONCLUSIONS

The effectiveness of 810 nm agrees with previous publications, and together with the effectiveness of 660 nm and non-effectiveness of 730 and 980 nm can be explained by the absorption spectrum of cytochrome oxidase, the candidate mitochondrial chromophore in transcranial LLLT.

Reinnervation and neuropeptides in mouse skin flaps

Degeneration and regeneration of nerves in skin flaps has so far been studied mainly by classical staining methods and there is little information on neuropeptide involvement. Therefore, we have investigated immunocytochemically the temporal course of reinnervation of neuropeptide appearance in skin flaps of mice. Fibres immunoreactive for a general neural marker protein gene product 9.5 (PGP 9.5), and for the neuropeptides substance P, calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY) disappeared by 24 h in the flap and surrounding skin. By the 7th day, PGP 9.5-immunoreactive nerves were seen close to the pedicle. By 15 days, they were seen within the body of the flap, clustered focally without specific organisation in greater density than in control skin. Many were also immunoreactive for CGRP and substance P. Neural immunoreactivity for VIP and NPY appeared later (day 30). Thus, regrowing nerves appear initially to be denser than normal innervation. The early appearance of apparently hypertrophic sensory neuropeptide-containing (CGRP and substance P) fibres may have a role in trophic, regulatory and reparative processes.

CBD Suppression of EAE Is Correlated with Early Inhibition of Splenic IFN-γ + CD8+ T Cells and Modest Inhibition of Neuroinflammation

In this study cannabidiol (CBD) was administered orally to determine its effects and mechanisms in the experimental autoimmune encephalomyelitis (EAE) model of multiple sclerosis (MS). We hypothesized that 75 mg/kg of oral CBD given for 5 days after initiation of disease would reduce EAE severity through suppression of either the early peripheral immune or late neuroimmune response. EAE was induced in C57BL/6 mice at two different magnitudes, and peripheral inflammatory and neuroinflammatory responses were measured at days 3, 10, and 18. Th1, Th17, Tc1, Tc17, Tregs, and myeloid derived suppressor cells (MDSC) were identified from the lymph nodes and spleens of each mouse to determine if CBD altered the suppressor cell or inflammatory cell populations in secondary lymphoid tissues. Additionally, neuroinflammation was identified in brain and spinal cord tissues using various immunohistochemical techniques and flow cytometry. Early treatment of EAE with oral CBD reduced clinical disease at the day 18 timepoint which correlated with a significant decrease in the percentage of MOG_35-55 specific IFN-γ producing CD8⁺ T cells in the spleen at day 10. Analysis of both T cell infiltration and lesion size within the spinal cord also showed a moderate reduction in neuroinflammation within the central nervous system (CNS). These results provide evidence that oral CBD suppressed the peripheral immune response that precedes neuroinflammation; however, analysis of the neuroinflammatory endpoints also suggest that the modest reduction in neuroinflammation was only partially responsible for CBD's neuroprotective capability. Graphical Abstract CBD was administered orally for the first 5 days following initiation of EAE. CBD attenuated clinical disease, and we found that CBD suppressed IFN-γ producing CD8⁺ T cells in the spleen at day 10. There was also modest suppression of neuroinflammation. Together these data demonstrate that early, oral administration of CBD protected mice from disease, but the modest effects on neuroinflammation suggest other mechanisms participate in CBD's neuroprotective effect in EAE.

Nanoparticle-based targeted delivery of pentagalloyl glucose reverses elastase-induced abdominal aortic aneurysm and restores aorta to the healthy state in mice

AIM

Abdominal aortic aneurysms (AAA) is a life-threatening weakening and expansion of the abdominal aorta due to inflammatory cell infiltration and gradual degeneration of extracellular matrix (ECM). There are no pharmacological therapies to treat AAA. We tested the hypothesis that nanoparticle (NP) therapy that targets degraded elastin and delivers anti-inflammatory, anti-oxidative, and ECM stabilizing agent, pentagalloyl glucose (PGG) will reverse advance stage aneurysm in an elastase-induced mouse model of AAA.

METHOD AND RESULTS

Porcine pancreatic elastase (PPE) was applied periadventitially to the infrarenal aorta in mice and AAA was allowed to develop for 14 days. Nanoparticles loaded with PGG (EL-PGG-NPs) were then delivered via IV route at 14-day and 21-day (10 mg/kg of body weight). A control group of mice received no therapy. The targeting of NPs to the AAA site was confirmed with fluorescent dye marked NPs and gold NPs. Animals were sacrificed at 28-d. We found that targeted PGG therapy reversed the AAA by decreasing matrix metalloproteinases MMP-9 and MMP-2, and the infiltration of macrophages in the medial layer. The increase in diameter of the aorta was reversed to healthy controls. Moreover, PGG treatment restored degraded elastic lamina and increased the circumferential strain of aneurysmal aorta to the healthy levels.

CONCLUSION

Our results support that site-specific delivery of PGG with targeted nanoparticles can be used to treat already developed AAA. Such therapy can reverse inflammatory markers and restore arterial homeostasis.

Cannabidiol (CBD) induces functional Tregs in response to low-level T cell activation

Many effects of the non-psychoactive cannabinoid, cannabidiol (CBD), have been described in immune responses induced by strong immunological stimuli. It has also been shown that CBD enhances IL-2 production in response to low-level T cell stimulation. Since IL-2, in combination with TGF-β1, are critical for Treg induction, we hypothesized that CBD would induce CD4+CD25+FOXP3+ Tregs in response to low-level stimulation. Low-level T cell stimulation conditions were established based on minimal CD25 expression in CD4+ cells using suboptimal PMA/Io (4nM/0.05μM, S/o), ultrasuboptimal PMA/Io (1nM/0.0125μM, Us/o) or soluble anti-CD3/28 (400-800ng each, s3/28). CBD increased CD25+FOXP3+ cells from CD4+, CD4+CD25+, and CD4+CD25- T cells, as well as in CD4+ T cells derived from FOXP3-GFP mice. Most importantly, the Us/o+CBD-induced CD4+CD25+ Tregs robustly suppressed responder T cell proliferation, demonstrating that the mechanism by which CBD is immunosuppressive under low-level T cell stimulation involves induction of functional Tregs.

Purification of innate immunostimulant from green tea using a silkworm muscle contraction assay

A polysaccharide was purified from a hot water extract of green tea leaves by measuring the immunostimulatory activity in silkworm larvae. Nuclear magnetic resonance and chemical analysis of acid hydrolysates revealed that the purified substance possessed a backbone containing polygalacturonic acids with methyl ester residues. Treatment with β-glucanase attenuated the muscle contraction activity of the purified sample, suggesting that the β-glucan structure, probably as a branched form, was required for its activity. The purified fraction stimulated the production of interleukin-6 by mouse peritoneal macrophages. These results suggest that measuring immunostimulation in silkworm larvae is useful for evaluating innate immunostimulants from various sources.

Role of elastic fiber degradation in disease pathogenesis

Elastin is a crucial extracellular matrix protein that provides structural integrity to tissues. Crosslinked elastin and associated microfibrils, named elastic fiber, contribute to biomechanics by providing the elasticity required for proper function. During aging and disease, elastic fiber can be progressively degraded and since there is little elastin synthesis in adults, degraded elastic fiber is not regenerated. There is substantial evidence linking loss or damage of elastic fibers to the clinical manifestation and pathogenesis of a variety of diseases. Disruption of elastic fiber networks by hereditary mutations, aging, or pathogenic stimuli results in systemic ailments associated with the production of elastin degradation products, inflammatory responses, and abnormal physiology. Due to its longevity, unique mechanical properties, and widespread distribution in the body, elastic fiber plays a central role in homeostasis of various physiological systems. While pathogenesis related to elastic fiber degradation has been more thoroughly studied in elastic fiber rich tissues such as the vasculature and the lungs, even tissues containing relatively small quantities of elastic fibers such as the eyes or joints may be severely impacted by elastin degradation. Elastic fiber degradation is a common observation in certain hereditary, age, and specific risk factor exposure induced diseases representing a converging point of pathological clinical phenotypes which may also help explain the appearance of co-morbidities. In this review, we will first cover the role of elastic fiber degradation in the manifestation of hereditary diseases then individually explore the structural role and degradation effects of elastic fibers in various tissues and organ systems. Overall, stabilizing elastic fiber structures and repairing lost elastin may be effective strategies to reverse the effects of these diseases.

katG (SER 315 THR) gene mutation in isoniazid resistant Mycobacterium tuberculosis

BACKGROUND Isoniazid (INH) together with Rifampicin (RFP) forms the cornerstone of a short chemotherapy course for tuberculosis (TB) treatment. Mutation at codon 315 of katG gene is most prevalent in isoniazid resistant Mycobacterium tuberculosis (MTB) and is high in area with high TB incidence. Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) has been found to be a reliable and effective tool for the identification of the specific gene alteration.

OBJECTIVE

The objective of this study was to screen Ser315Thr mutation of KatG gene of INH resistant MTB strain by PCR-RFLP technique.

METHODS

Altogether 37 INHr MTB isolates obtained from German Nepal Tuberculosis Project (GENETUP) Kathmandu Nepal was included in the study. Deoxyribonucleic Acid (DNA) extraction was performed according to protocol of SORPOCLEAN from the culture isolates. Amplification of the fragment with katG codon 315 was performed in a Biometra Thermocycler using primers. The amplified fragment was cleaved with MspI. The restriction fragments obtained were electrophoresed in a 2% agarose gel and were visualized using transilluminator.

RESULTS

The katG Ser315Thr mutation was observed in 23 (62.2%) out of 37 INH resistant isolates. The drug susceptibility profile of INHr MTB isolates showed all isolates to be resistant to INH and RFP whereas 26 and 27 MTB isolates were resistant to Ethambutol (EMB) and Streptomycin (S) respectively. Seventeen (17) patients were harbouring katG gene mutated strain among Ethambutol and Streptomycin resistant cases.

CONCLUSION

The study identified high prevalence of Ser315Thr mutation in katG. The isolates harbouring this mutation were also simultaneously resistant to RFP. Ser315Th could be a potential genetic marker for predicting MDR-TB.

A review on characterization, applications and structure-activity relationships of Bacillus species-produced bacteriocins

Antimicrobial peptides (AMPs) are inherently occurring proteins that are produced by microorganisms as secondary metabolites. Members of genus Bacillus produce many types of AMPs by ribosomal (bacteriocins) and non-ribosomal (polymyxins and iturins) mechanisms. Bacteriocins are ribosomally synthesized peptides that inhibit the growth of closely related bacterial strains. Moreover, bacteriocins produced by Bacillus species have been widely used in pharmaceutical, food industry, fishery, livestock as well as in agriculture sector. The objective of this review is to assess the characterization of the Bacillus-derived bacteriocins, their potential use in different sectors and structure-activity relationships.

Systemic delivery of targeted nanotherapeutic reverses angiotensin II-induced abdominal aortic aneurysms in mice

Abdominal aortic aneurysm (AAA) disease causes dilation of the aorta, leading to aortic rupture and death if not treated early. It is the 14th leading cause of death in the U.S. and 10th leading cause of death in men over age 55, affecting thousands of patients. Despite the prevalence of AAA, no safe and efficient pharmacotherapies exist for patients. The deterioration of the elastic lamina in the aneurysmal wall is a consistent feature of AAAs, making it an ideal target for delivering drugs to the AAA site. In this research, we conjugated nanoparticles with an elastin antibody that only targets degraded elastin while sparing healthy elastin. After induction of aneurysm by 4-week infusion of angiotensin II (Ang II), two biweekly intravenous injections of pentagalloyl glucose (PGG)-loaded nanoparticles conjugated with elastin antibody delivered the drug to the aneurysm site. We show that targeted delivery of PGG could reverse the aortic dilation, ameliorate the inflammation, restore the elastic lamina, and improve the mechanical properties of the aorta at the AAA site. Therefore, simple iv therapy of PGG loaded nanoparticles can be an effective treatment option for early to middle stage aneurysms to reverse disease progression and return the aorta to normal homeostasis.

Post-operative drop in hemoglobin and need of blood transfusion in cesarean section at Dhulikhel Hospital, Kathmandu University Hospital

BACKGROUND

Cesarean section has been identified as one of the commonest indication for blood transfusion in obstetric practice because it involves risk of major intra-operative blood loss. Different figures varying from less than 500 ml to more than 1000 ml have been quoted as estimated blood loss associated with caesarean section. There is also a wide variation in blood ordering practices for this surgery.

OBJECTIVE

The objective of this study is to evaluate the blood ordering practice and transfusion for cesarean sections at our institute, to see post-operative drop in hemoglobin and hematocrit and to correlate those parameters with the duration between uterine incision and repair.

METHODS

In this prospective observational study, non-randomised purposive sample was taken from 121 ladies who underwent elective and emergency cesarean section at the department of obstetrics of Dhulikhel Hospital-Kathmandu University Hospital. Post-cesarean drop in hemoglobin and hematocrit and their relation with duration of uterine manipulation was calculated. Cross-match to transfusion (C/T ratio) ratio, transfusion probability (%T) and transfusion index (Ti) were also calculated.

RESULTS

Most frequent blood group was found to be O positive (38%) among those ladies. Average post-cesarean drop in hemoglobin was 1.52±1.27 gm/dl and drop in haematocrit was 5.49±4.1%. Post-operative drop in hemoglobin and haematocrit had weak and positive linear relation with duration between uterine incision and repair. Cross-match to transfusion ratio was 1, transfusion probability 100% and transfusion index was 2.

CONCLUSION

There is no need of routine cross-matching of blood for cesarean section. Only grouping with confirmation of availability should be done for emergency situation.

Low-level laser therapy for closed-head traumatic brain injury in mice: effect of different wavelengths

BACKGROUND AND OBJECTIVES

Traumatic brain injury (TBI) affects millions worldwide and is without effective treatment. One area that is attracting growing interest is the use of transcranial low-level laser therapy (LLLT) to treat TBI. The fact that near-infrared light can penetrate into the brain would allow non-invasive treatment to be carried out with a low likelihood of treatment-related adverse events. LLLT may treat TBI by increasing respiration in the mitochondria, causing activation of transcription factors, reducing inflammatory mediators and oxidative stress, and inhibiting apoptosis.

STUDY DESIGN/MATERIALS AND METHODS

We tested LLLT in a mouse model of closed-head TBI produced by a controlled weight drop onto the skull. Mice received a single treatment with continuous-wave 665, 730, 810, or 980 nm lasers (36 J/cm(2) delivered at 150 mW/cm(2)) 4-hour post-TBI and were followed up by neurological performance testing for 4 weeks.

RESULTS

Mice with moderate-to-severe TBI treated with 665 and 810 nm laser (but not with 730 or 980 nm) had a significant improvement in Neurological Severity Score that increased over the course of the follow-up compared to sham-treated controls. Morphometry of brain sections showed a reduction in small deficits in 665 and 810 nm laser treated mouse brains at 28 days.

CONCLUSIONS

The effectiveness of 810 nm agrees with previous publications, and together with the effectiveness of 660 nm and non-effectiveness of 730 and 980 nm can be explained by the absorption spectrum of cytochrome oxidase, the candidate mitochondrial chromophore in transcranial LLLT.

Kaplan B. Characterization of cannabidiol-induced increases in CD25 and FOXP3 expression on CD4+ T cells (IRC11P.421)

Cannabis sativa-derived cannabinoid compounds are being investigated as potential immunosuppressive agents and important drug candidates for immune related diseases. Our previous data demonstrated that under conditions of suboptimal T cell activation, cannabidiol (CBD) could increase interleukin-2 (IL-2) production. Initially this result was surprising given that cannabinoids are immunosuppressive, but IL-2 can also contribute to regulatory T cell (Treg) induction. We tested the hypothesis that part of the mechanism for immunosuppression by CBD is induction of a Treg population in response to suboptimal activation. Splenocytes were treated with CBD or vehicle (VH; 0.1% ethanol) for 30 minutes, then stimulated with low concentrations of PMA and ionomycin (Io). CBD induced IL-2, TGF-β, CD25 and FOXP3 on CD4+ T cells in response to 4 nM PMA/0.05 µM Io after an overnight stimulation. Further characterization of this effect demonstrated that CBD also induced CD25 and FOXP3 on CD4+ T cells after a 5-day incubation with 1 nM PMA/0.01 µM Io. Interestingly, while CBD robustly induced IL-2 after an overnight incubation with 4 nM PMA/0.05 µM Io, the IL-2 in the culture supernatant dropped by day 5. Overall, these data suggest that the mechanism by which CBD is immunosuppressive might involve induction of Tregs in response to suboptimal activation of T cells.

Effect of cannabidiol (CBD) on CD4+ cells under differential immunological activation state

We previously reported that cannabidiol (CBD), one of the Cannabis sativa-derived cannabinoids, induced functional CD4+CD25+FOXP3+ Tregs in response to low level stimulation of PMA/Io. CBD increased CD25+FOXP3+ cells in CD4+, CD4+CD25+, and CD4+CD25− T cells, as well as in CD4+ T cells derived from FOXP3-GFP mice. T cell stimulation conditions were suboptimal PMA/Io (4 nM/0.05 μM, S/o) and ultrasuboptimal PMA/Io (1 nM/0.0125 μM, Us/o). We also observed that CBD + Us/o increased IL-2, IL-10 and TGF-β1 immunomodulatory cytokines. Here, we measured the effect of CBD + Us/o or S/o on CD4+ cells. Splenocytes were treated with CBD (1–10 μM) for 30 min plus S/o or Us/o activation and cultured for 1 day or 5 days. Immunofluorescence staining showed that CBD + Us/o treatment increased the percentage of CD4+ cells while CBD + S/o treatment decreased the percentage of CD4+cells. CD4+CD25+ expression by Us/o or S/o activation alone was also measured. CD25 expression in response to Us/o activation was lower than that by S/o activation in CD4+ cells. This study will provide important information on the effect of CBD on CD4 cells under differential immunological activation state by PMA/Io.

Cannabidiol (CBD) induces functional CD4+ CD25+ FOXP3+ Tregs

We previously reported that cannabidiol (CBD), one of the Cannabis sativa-derived cannabinoid compounds and a potent immunosuppressive agent, increased CD25 and FOXP3 expression on CD4+ cells under “ultrasuboptimal” T cell stimulation (1 nM PMA/0.0125 μM Ionomycin, designated “Us/o”). We also observed that CBD increased IL-10 and il10 mRNA expression under Us/o stimulation. Thus, we tested the hypothesis that CBD-induced CD4+ CD25+ FOXP3+ cells are functional Tregs. First, we determined that the expression of CD25 and FOXP3 was induced on CD4-enriched cells in response to CBD (10 μM) plus Us/o activation as compared to CBD plus low level anti-CD3/28 stimulation (soluble anti-CD3 and anti-CD28 antibodies at 400 or 800 ng each) for 5 days. Second, we determined the functionality of the CBD-induced Tregs using a mixed lymphocyte response assay. For this study, splenocytes were treated with CBD (10 μM) plus Us/o activation for 5 days. CBD-induced CD4+ CD25+ and CD4+ CD25− cells were then purified and treated with mitomycin C (MMC). Fresh, naïve responder splenocytes were activated with anti-CD3/28-coated beads to induce proliferation of the responder cells, then mixed with the MMC-treated CD4+ CD25+ or CD4+ CD25− cells. CBD-induced CD4+ CD25+ cells, but not CBD-induced CD4+ CD25− cells, suppressed responder cell proliferation. Thus, CBD induced functional Tregs under conditions of low level activation, which is consistent with other studies demonstrating that CBD can induce Tregs under optimal stimulation conditions.

Elastin stabilization prevents impaired biomechanics in human pulmonary arteries and pulmonary hypertension in rats with left heart disease

Pulmonary hypertension worsens outcome in left heart disease. Stiffening of the pulmonary artery may drive this pathology by increasing right ventricular dysfunction and lung vascular remodeling. Here we show increased stiffness of pulmonary arteries from patients with left heart disease that correlates with impaired pulmonary hemodynamics. Extracellular matrix remodeling in the pulmonary arterial wall, manifested by dysregulated genes implicated in elastin degradation, precedes the onset of pulmonary hypertension. The resulting degradation of elastic fibers is paralleled by an accumulation of fibrillar collagens. Pentagalloyl glucose preserves arterial elastic fibers from elastolysis, reduces inflammation and collagen accumulation, improves pulmonary artery biomechanics, and normalizes right ventricular and pulmonary hemodynamics in a rat model of pulmonary hypertension due to left heart disease. Thus, targeting extracellular matrix remodeling may present a therapeutic approach for pulmonary hypertension due to left heart disease.