1
|
Sun B, Fang D, Li W, Li M, Zhu S. NIR-II nanoprobes for investigating the glymphatic system function under anesthesia and stroke injury. J Nanobiotechnology 2024; 22:200. [PMID: 38654299 DOI: 10.1186/s12951-024-02481-w] [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: 01/14/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
The glymphatic system plays an important role in the transportation of cerebrospinal fluid (CSF) and the clearance of metabolite waste in brain. However, current imaging modalities for studying the glymphatic system are limited. Herein, we apply NIR-II nanoprobes with non-invasive and high-contrast advantages to comprehensively explore the function of glymphatic system in mice under anesthesia and cerebral ischemia-reperfusion injury conditions. Our results show that the supplement drug dexmedetomidine (Dex) enhances CSF influx in the brain, decreases its outflow to mandibular lymph nodes, and leads to significant differences in CSF accumulation pattern in the spine compared to isoflurane (ISO) alone, while both ISO and Dex do not affect the clearance of tracer-filled CSF into blood circulation. Notably, we confirm the compromised glymphatic function after cerebral ischemia-reperfusion injury, leading to impaired glymphatic influx and reduced glymphatic efflux. This technique has great potential to elucidate the underlying mechanisms between the glymphatic system and central nervous system diseases.
Collapse
Affiliation(s)
- Bin Sun
- Joint Laboratory of Opto-Functional Theranostics in Medicine and Chemistry, First Hospital of Jilin University, Changchun, 130021, China
- State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry, Jilin University, Changchun, 130012, China
| | - Danlan Fang
- Joint Laboratory of Opto-Functional Theranostics in Medicine and Chemistry, First Hospital of Jilin University, Changchun, 130021, China
- State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry, Jilin University, Changchun, 130012, China
| | - Wenzhong Li
- Joint Laboratory of Opto-Functional Theranostics in Medicine and Chemistry, First Hospital of Jilin University, Changchun, 130021, China
| | - Mengfei Li
- Joint Laboratory of Opto-Functional Theranostics in Medicine and Chemistry, First Hospital of Jilin University, Changchun, 130021, China
| | - Shoujun Zhu
- Joint Laboratory of Opto-Functional Theranostics in Medicine and Chemistry, First Hospital of Jilin University, Changchun, 130021, China.
- State Key Laboratory of Supramolecular Structure and Materials, Center for Supramolecular Chemical Biology, College of Chemistry, Jilin University, Changchun, 130012, China.
| |
Collapse
|
2
|
Mortberg MA, Gentile JE, Nadaf N, Vanderburg C, Simmons S, Dubinsky D, Slamin A, Maldonado S, Petersen C, Jones N, Kordasiewicz H, Zhao H, Vallabh S, Minikel E. A single-cell map of antisense oligonucleotide activity in the brain. Nucleic Acids Res 2023; 51:7109-7124. [PMID: 37188501 PMCID: PMC10415122 DOI: 10.1093/nar/gkad371] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 02/23/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/17/2023] Open
Abstract
Antisense oligonucleotides (ASOs) dosed into cerebrospinal fluid (CSF) distribute broadly throughout the central nervous system (CNS). By modulating RNA, they hold the promise of targeting root molecular causes of disease and hold potential to treat myriad CNS disorders. Realization of this potential requires that ASOs must be active in the disease-relevant cells, and ideally, that monitorable biomarkers also reflect ASO activity in these cells. The biodistribution and activity of such centrally delivered ASOs have been deeply characterized in rodent and non-human primate (NHP) models, but usually only in bulk tissue, limiting our understanding of the distribution of ASO activity across individual cells and across diverse CNS cell types. Moreover, in human clinical trials, target engagement is usually monitorable only in a single compartment, CSF. We sought a deeper understanding of how individual cells and cell types contribute to bulk tissue signal in the CNS, and how these are linked to CSF biomarker outcomes. We employed single nucleus transcriptomics on tissue from mice treated with RNase H1 ASOs against Prnp and Malat1 and NHPs treated with an ASO against PRNP. Pharmacologic activity was observed in every cell type, though sometimes with substantial differences in magnitude. Single cell RNA count distributions implied target RNA suppression in every single sequenced cell, rather than intense knockdown in only some cells. Duration of action up to 12 weeks post-dose differed across cell types, being shorter in microglia than in neurons. Suppression in neurons was generally similar to, or more robust than, the bulk tissue. In macaques, PrP in CSF was lowered 40% in conjunction with PRNP knockdown across all cell types including neurons, arguing that a CSF biomarker readout is likely to reflect ASO pharmacodynamic effect in disease-relevant cells in a neuronal disorder. Our results provide a reference dataset for ASO activity distribution in the CNS and establish single nucleus sequencing as a method for evaluating cell type specificity of oligonucleotide therapeutics and other modalities.
Collapse
Affiliation(s)
- Meredith A Mortberg
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Juliana E Gentile
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Naeem M Nadaf
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Charles Vanderburg
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Sean Simmons
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Dan Dubinsky
- Genomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA
| | - Adam Slamin
- Genomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA
| | - Salome Maldonado
- Genomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA
| | - Caroline L Petersen
- Genomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA
| | - Nichole Jones
- Genomics Platform, Broad Institute of MIT and Harvard, Cambridge, MA 02141, USA
| | | | - Hien T Zhao
- Ionis Pharmaceuticals, Carlsbad, CA 92010, USA
| | - Sonia M Vallabh
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA02115, USA
- Prion Alliance, Cambridge, MA 02139, USA
| | - Eric Vallabh Minikel
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- McCance Center for Brain Health and Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Neurology, Harvard Medical School, Boston, MA02115, USA
- Prion Alliance, Cambridge, MA 02139, USA
| |
Collapse
|
3
|
Chang HS. Hypothesis on the pathophysiology of syringomyelia based on analysis of phase-contrast magnetic resonance imaging of Chiari-I malformation patients. F1000Res 2023; 10:996. [PMID: 37637502 PMCID: PMC10450261 DOI: 10.12688/f1000research.72823.2] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2023] [Indexed: 08/29/2023] Open
Abstract
Background: Despite several hypotheses, our understanding of syringomyelia's pathophysiology remains limited. The hypothesis proposed by Oldfield et al. suggests that piston-like movement of the cerebellar tonsils propels the cerebrospinal fluid (CSF) into the syrinx via the spinal perivascular space. However, a significant question remains unanswered: how does the CSF enter and stay in the syrinx, which has a higher pressure than the subarachnoid space. In the current study, we attempted to verify Oldfield's hypothesis using phase-contrast magnetic resonance imaging (MRI) data from patients with syringomyelia. Methods: We analyzed phase-contrast MRI scans of 18 patients with Chiari-I malformation associated with syringomyelia, all of whom underwent foramen magnum decompression, and 21 healthy volunteers. We obtained velocity waveforms for CSF and brain tissue from regions of interest (ROI) set at the various locations. These waveforms were synchronized at the peak timing of downward CSF flow. We compared the preoperative patient data with the control data and also compared the preoperative patient data with the postoperative patient data. Results: The syrinx shrank in 17 (94%) of the patients, and they experienced significant clinical improvement. When comparing pre- and postoperative MRI results, the only significant difference noted was the preoperative elevated velocity of the cerebellar tonsil, which disappeared post-surgery. The CSF velocities in the subarachnoid space were higher in the preoperative patients than in the controls, but they did not significantly differ in the postoperative MRI. The tonsillar velocity in the preoperative MRI was significantly lower than that of the CSF, suggesting that the elevated tonsillar velocity was more of an effect, rather than the cause, of the elevated CSF velocity. Conclusions: Given these findings, a completely new paradigm seems necessary. We, therefore, propose a novel hypothesis: the generative force of syringomyelia may be the direction-selective resistance to CSF flow in the subarachnoid space.
Collapse
Affiliation(s)
- Han Soo Chang
- Department of Neurosurgery, Tokai University, 143 Shimokasuya, Isehara, Kanagawa, 259-1143, Japan
| |
Collapse
|
4
|
Modeste ES, Ping L, Watson CM, Duong DM, Dammer EB, Johnson ECB, Roberts BR, Lah JJ, Levey AI, Seyfried NT. Quantitative proteomics of cerebrospinal fluid from African Americans and Caucasians reveals shared and divergent changes in Alzheimer's disease. Mol Neurodegener 2023; 18:48. [PMID: 37468915 PMCID: PMC10355042 DOI: 10.1186/s13024-023-00638-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/14/2022] [Accepted: 06/21/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Despite being twice as likely to get Alzheimer's disease (AD), African Americans have been grossly underrepresented in AD research. While emerging evidence indicates that African Americans with AD have lower cerebrospinal fluid (CSF) levels of Tau compared to Caucasians, other differences in AD CSF biomarkers have not been fully elucidated. Here, we performed unbiased proteomic profiling of CSF from African Americans and Caucasians with and without AD to identify both common and divergent AD CSF biomarkers. METHODS Multiplex tandem mass tag-based mass spectrometry (TMT-MS) quantified 1,840 proteins from 105 control and 98 AD patients of which 100 identified as Caucasian while 103 identified as African American. We used differential protein expression and co-expression approaches to assess how changes in the CSF proteome are related to race and AD. Co-expression network analysis organized the CSF proteome into 14 modules associated with brain cell-types and biological pathways. A targeted mass spectrometry method, selected reaction monitoring (SRM), with heavy labeled internal standards was used to measure a panel of CSF module proteins across a subset of African Americans and Caucasians with or without AD. A receiver operating characteristic (ROC) curve analysis assessed the performance of each protein biomarker in differentiating controls and AD by race. RESULTS Consistent with previous findings, the increase of Tau levels in AD was greater in Caucasians than in African Americans by both immunoassay and TMT-MS measurements. CSF modules which included 14-3-3 proteins (YWHAZ and YWHAG) demonstrated equivalent disease-related elevations in both African Americans and Caucasians with AD, whereas other modules demonstrated more profound disease changes within race. Modules enriched with proteins involved with glycolysis and neuronal/cytoskeletal proteins, including Tau, were more increased in Caucasians than in African Americans with AD. In contrast, a module enriched with synaptic proteins including VGF, SCG2, and NPTX2 was significantly lower in African Americans than Caucasians with AD. Following SRM and ROC analysis, VGF, SCG2, and NPTX2 were significantly better at classifying African Americans than Caucasians with AD. CONCLUSIONS Our findings provide insight into additional protein biomarkers and pathways reflecting underlying brain pathology that are shared or differ by race.
Collapse
Affiliation(s)
- Erica S. Modeste
- School of Medicine, Department of Biochemistry, Emory University, Atlanta, GA USA
| | - Lingyan Ping
- School of Medicine, Department of Biochemistry, Emory University, Atlanta, GA USA
| | - Caroline M. Watson
- School of Medicine, Department of Neurology, Emory University, Atlanta, GA USA
| | - Duc M. Duong
- School of Medicine, Department of Biochemistry, Emory University, Atlanta, GA USA
| | - Eric B. Dammer
- School of Medicine, Department of Biochemistry, Emory University, Atlanta, GA USA
| | - Erik C. B. Johnson
- School of Medicine, Department of Neurology, Emory University, Atlanta, GA USA
| | - Blaine R. Roberts
- School of Medicine, Department of Biochemistry, Emory University, Atlanta, GA USA
| | - James J. Lah
- School of Medicine, Department of Neurology, Emory University, Atlanta, GA USA
| | - Allan I. Levey
- School of Medicine, Department of Neurology, Emory University, Atlanta, GA USA
| | - Nicholas T. Seyfried
- School of Medicine, Department of Biochemistry, Emory University, Atlanta, GA USA
- School of Medicine, Department of Neurology, Emory University, Atlanta, GA USA
| |
Collapse
|
5
|
Jara C, Veas C, Delgado C, Cabezas C, Chandía M. [Flow cytometry increases the proportion of valuable samples in cerebrospinal fluid with normal cell count in malignant blood diseases]. Rev Med Chil 2023; 151:560-564. [PMID: 38687537 DOI: 10.4067/s0034-98872023000500560] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/13/2023] [Indexed: 05/02/2024]
Abstract
BACKGROUND The alteration of cerebrospinal fluid (CSF) in hematologic neoplasms is a poor prognostic marker. The characteristics of CSF are usually analyzed by flow cytometry or cytology. However, paucicellular CSF samples (≤5 cells/dL) can sometimes be considered unsuitable for analysis due to the low number of events. OBJECTIVE To evaluate the proportion of samples reported as suitable for analysis obtained by cytometry (FCM) and cytology in paucicellular CSF samples. MATERIAL AND METHODS 169 samples ofpaucicellular CSF corresponding to 115 patients with hematologic neoplasms were selected. The samples were obtained by lumbar puncture in tubes conditioned with EDTA and Transfix®. We characterized the immunophenotype ofCSF samples with an 8-color panel, and 55 samples (32%) were in a small sample tube (SST). In all cases, monocytes were identified by CD14 labeling and T lymphocytes by CD3 labeling. The acquisition was carried out in a FACSCantoII® cytometer, and the analysis was performed using Infinicyt® software. RESULTS The proportion of samples suitable for analysis was higher in FCM compared to cytology (98% vs 61%, p < 0.000). We identified the presence of T lymphocytes and/or monocytes in most samples (98% and 90%, respectively). In the SST samples, the number of events recorded in low-volume samples (< 1 mL) was lower than in samples with higher volume (140 vs 556, p < 0.001), with a median of identification of 3 cell populations. CONCLUSION FCM allows the analysis of a higher proportion ofpaucicellular CSF samples than cytology in hematologic neoplasms study.
Collapse
Affiliation(s)
- Casandra Jara
- Unidad de Anatomía Patológica, Hospital Guillermo Grant Benavente, Concepción, Chile
| | - Carlos Veas
- Unidad de Anatomía Patológica, Hospital Guillermo Grant Benavente, Concepción, Chile
| | - Carolina Delgado
- Departamento de Especialidades, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Claudia Cabezas
- Departamento de Especialidades, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Mauricio Chandía
- Unidad de Anatomía Patológica, Hospital Guillermo Grant Benavente, Concepción, Chile
| |
Collapse
|
6
|
Mazanhanga MT, Joubert A, Castel SA, van der Merwe M, Maartens G, Dooley KE, Upton CM, Wiesner L. Liquid chromatography-tandem mass spectrometry analysis of delamanid and its metabolite in human cerebrospinal fluid using protein precipitation and on-line solid-phase extraction. J Pharm Biomed Anal 2023; 227:115281. [PMID: 36739721 PMCID: PMC10023415 DOI: 10.1016/j.jpba.2023.115281] [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: 12/19/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
The penetration of the antituberculosis drug delamanid into the central nervous system is not established. The distribution of delamanid and its major metabolite, DM-6705, into the cerebrospinal fluid requires investigation. A liquid chromatography-tandem mass spectrometry method for the quantification of delamanid and DM-6705 in human cerebrospinal fluid was developed and validated. The calibration range for both analytes was 0.300 - 30.0 ng/mL. The deuterium-labelled analogue of delamanid (delamanid-d4) and OPC-14714 were used as internal standards for delamanid and DM-6705, respectively. Samples were processed by protein precipitation followed by on-line solid-phase extraction and high-performance liquid chromatography on an Agilent 1260 HPLC system. A Phenomenex Gemini-NX C18 (5.0 µm, 50 mm × 2.0 mm) analytical column was used for on-line solid-phase extraction, and a Waters Xterra MS C18 (5.0 µm, 100 mm × 2.1 mm) analytical column for chromatographic separation using gradient elution, at a flow rate of 300 µL/min. The total run time was 7.5 min. Analytes were detected by multiple reaction monitoring on an AB Sciex 5500 triple quadrupole mass spectrometer at unit mass resolution, with electrospray ionization in the positive mode. Accuracy and precision were assessed over three independent validation batches. Extraction recoveries were more than 98% and were consistent across the analytical range. Both analytes in CSF exhibited non-specific adsorption to polypropylene tubes. The method was used to analyse cerebrospinal fluid samples from patients with pulmonary tuberculosis in an exploratory pharmacokinetic study.
Collapse
Affiliation(s)
- Marian T Mazanhanga
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Anton Joubert
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Sandra A Castel
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Marthinus van der Merwe
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Gary Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Kelly E Dooley
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Lubbe Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| |
Collapse
|
7
|
Runge K, Balla A, Fiebich BL, Maier SJ, von Zedtwitz K, Nickel K, Dersch R, Domschke K, Tebartz van Elst L, Endres D. Neurodegeneration Markers in the Cerebrospinal Fluid of 100 Patients with Schizophrenia Spectrum Disorder. Schizophr Bull 2023; 49:464-473. [PMID: 36200879 PMCID: PMC10016411 DOI: 10.1093/schbul/sbac135] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Schizophrenia spectrum disorders (SSD) can be associated with neurodegenerative processes causing disruption of neuronal, synaptic, or axonal integrity. Some previous studies have reported alterations of neurodegenerative markers (such as amyloid beta [Aβ], tau, or neurofilaments) in patients with SSD. However, the current state of research remains inconclusive. Therefore, the rationale of this study was to investigate established neurodegenerative markers in the cerebrospinal fluid (CSF) of a large group of patients with SSD. STUDY DESIGN Measurements of Aβ1-40, Aß1-42, phospho- and total-tau in addition to neurofilament light (NFL), medium (NFM), and heavy (NFH) chains were performed in the CSF of 100 patients with SSD (60 F, 40 M; age 33.7 ± 12.0) and 39 controls with idiopathic intracranial hypertension (33 F, 6 M; age 34.6 ± 12.0) using enzyme-linked immunoassays. STUDY RESULTS The NFM levels were significantly increased in SSD patients (P = .009), whereas phospho-tau levels were lower in comparison to the control group (P = .018). No other significant differences in total-tau, beta-amyloid-quotient (Aβ1-42/Aβ1-40), NFL, and NFH were identified. CONCLUSIONS The findings argue against a general tauopathy or amyloid pathology in patients with SSD. However, high levels of NFM, which has been linked to regulatory functions in dopaminergic neurotransmission, were associated with SSD. Therefore, NFM could be a promising candidate for further research on SSD.
Collapse
Affiliation(s)
- Kimon Runge
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Agnes Balla
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd L Fiebich
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon J Maier
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina von Zedtwitz
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Rick Dersch
- Clinic of Neurology and Neurophysiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
8
|
Jeppesen R, Orlovska-Waast S, Sørensen NV, Christensen RHB, Benros ME. Cerebrospinal Fluid and Blood Biomarkers of Neuroinflammation and Blood-Brain Barrier in Psychotic Disorders and Individually Matched Healthy Controls. Schizophr Bull 2022; 48:1206-1216. [PMID: 35939296 PMCID: PMC9673272 DOI: 10.1093/schbul/sbac098] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Neuroinflammation and blood-brain barrier (BBB) dysfunction have been observed in patients with psychotic disorders. However, previous studies have mainly focused on selected patients and broad screenings of cerebrospinal fluid (CSF) of patients with recent onset psychosis compared to healthy controls are lacking. STUDY DESIGN We included 104 patients with recent onset psychotic disorder and 104 individually matched healthy controls. CSF and blood were analyzed for readily available markers assessing neuroinflammation and BBB dysfunction. Primary outcomes were CSF white blood cell count (WBC), total protein, IgG Index, and CSF/serum albumin ratio. Secondary outcomes included additional markers of inflammation and BBB, and analyses of association with clinical variables. STUDY RESULTS CSF/serum albumin ratio (Relative Mean Difference (MD): 1.11; 95%CI: 1.00-1.23; P = .044) and CSF/serum IgG ratio (MD: 1.17; 95%CI: 1.01-1.36; P = .036) was increased in patients compared to controls. A higher number of patients than controls had CSF WBC >3 cells/µl (seven vs. one, OR: 7.73, 95%CI: 1.33-146.49, P = .020), while WBC>5 cells/µl was found in two patients (1.9%) and no controls. Inpatients had higher serum WBC and neutrophil/lymphocyte ratio (all p-values for effect heterogeneity < .011). Mean CSF WBC (MD: 1.10; 95%CI: 0.97-1.26), protein (MD: 1.06; 95%CI: 0.98-1.15) and IgG index (MD: 1.05; 95%CI: 0.96-1.15) were not significantly elevated. CONCLUSIONS When comparing a broad group of patients with psychotic disorders with healthy controls, patients had increased BBB permeability, more patients had high CSF WBC levels, and inpatients had increased peripheral inflammation, consistent with the hypothesis of a subgroup of patients with increased activation of the immune system.
Collapse
Affiliation(s)
- Rose Jeppesen
- Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sonja Orlovska-Waast
- Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nina Vindegaard Sørensen
- Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rune Haubo Bojesen Christensen
- Biological and Precision Psychiatry, Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Eriksen Benros
- To whom correspondence should be addressed; Michael Eriksen Benros; Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospital, Gentofte Hospitalsvej 15, 4th floor, 2900 Hellerup, Denmark; tel: 45 26255239, fax: 45 38647504, e-mail:
| |
Collapse
|
9
|
Zafar S, Noor A, Younas N, Shafiq M, Schmitz M, Wurster I, Brockmann K, Gasser T, Zerr I. SWATH Mass Spectrometry-Based CSF Proteome Profile of GBA-Linked Parkinson's Disease Patients. Int J Mol Sci 2022; 23:ijms232214166. [PMID: 36430645 PMCID: PMC9699576 DOI: 10.3390/ijms232214166] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
β-glucocerebrosidase (GBA)-associated mutations are a significant risk factor for Parkinson's disease (PD) that aggravate the disease pathology by upregulating the deposition of α-Synuclein (α-Syn). The resultant clinical profile varies for PD patients without GBA mutations. The current study aimed to identify the proteomic targets involved in the pathogenic pathways leading to the differential clinical presentation of GBA-associated PD. CSF samples (n = 32) were obtained from PD patients with GBA mutations (n = 22), PD patients without GBA mutations (n = 7), and healthy controls that were carriers of GBA mutations (n = 3). All samples were subjected to in-gel tryptic digestion followed by the construction of the spectral library and quantitative SWATH-based analysis. CSF α-Syn levels were reduced in both PDIdiopathic and PDGBA cases. Our SWATH-based mass spectrometric analysis detected 363 proteins involved in immune response, stress response, and cell signaling in various groups. Intergroup analysis showed that 52 proteins were significantly up- or downregulated in various groups. Of these 52 targets, 20 proteins were significantly altered in PDGBA cases only while 2 showed different levels in PDIdiopathic patients. Our results show that the levels of several pathologically relevant proteins, including Contactin-1, Selenium-binding protein 1, Adhesion G Protein-Coupled Receptor, and Apolipoprotein E are significantly different among the sporadic and genetic variants of PD and hint at aggravated synaptic damage, oxidative stress, neuronal loss, and aggregation of α-Syn in PDGBA cases.
Collapse
Affiliation(s)
- Saima Zafar
- Clinical Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Robert-Koch-Straße 40, 37075 Göttingen, Germany
- Biomedical Engineering and Sciences Department, School of Mechanical and Manufacturing Engineering (SMME), National University of Sciences and Technology (NUST), Bolan Road, H-12, Islamabad 44000, Pakistan
- Correspondence: ; Tel.: +49-551-39-65398
| | - Aneeqa Noor
- Clinical Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Robert-Koch-Straße 40, 37075 Göttingen, Germany
- Biomedical Engineering and Sciences Department, School of Mechanical and Manufacturing Engineering (SMME), National University of Sciences and Technology (NUST), Bolan Road, H-12, Islamabad 44000, Pakistan
| | - Neelam Younas
- Clinical Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Mohsin Shafiq
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Matthias Schmitz
- Clinical Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Isabel Wurster
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- German Center for Neurodegenerative Disease (DZNE), 72076 Tübingen, Germany
| | - Kathrin Brockmann
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- German Center for Neurodegenerative Disease (DZNE), 72076 Tübingen, Germany
| | - Thomas Gasser
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- German Center for Neurodegenerative Disease (DZNE), 72076 Tübingen, Germany
| | - Inga Zerr
- Clinical Department of Neurology, University Medical Center Göttingen and the German Center for Neurodegenerative Diseases (DZNE), Robert-Koch-Straße 40, 37075 Göttingen, Germany
| |
Collapse
|
10
|
Tan Y, Liu H, OuYang L, Xu W, Liang X, Zhou H, Shen C, Hu Z, Zhu Y. Impact of Cerebrospinal Fluid Sample Handling on Cytokine Detection Results. Ann Clin Lab Sci 2022; 52:470-474. [PMID: 35777804] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the impact of different treatment methods on cerebrospinal fluid (CSF) cytokine detection. METHODS CSF samples were collected from 25 patients. The levels of IL-6, IL-10, IFN-γ, and IL-2 were measured after CSF was stored at room temperature (25°C) or 4°C for 6, 12, and 24 hrs. The CSF was frozen at -80°C, thawed at room temperature for 1 hr every 8 hrs and then frozen. This process was repeated three times in a row, and then cytokine levels in CSF were detected again. RESULTS The four cytokines were stable when the CSF was kept at room temperature for 6 hrs. After 12 hrs of storage, the levels of the four cytokines decreased, and the changes in IL-6 and IL-10 levels were statistically significant. After 24 hrs of storage, the levels of the four cytokines were further reduced, and the changes were statistically significant. Cytokines were stable when CSF was stored at 4°C, and only IL-10 exhibited statistically significant changes when stored for 24 hrs. IL-6, IL-10 IFN-γ, and IL-2 were stable in CSF samples after three freeze-thaw cycles. CONCLUSION The stability of CSF cytokines is poor after storage at room temperature and good after storage at 4°C. Therefore, cytokine detection should be carried out after CSF collection as often as possible. If the detection cannot be done quickly enough, the specimens should be stored in cold storage for no more than 24 hrs.
Collapse
Affiliation(s)
- YunChang Tan
- Department of General Surgery and Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| | - Huai Liu
- Department of Laboratory, Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| | - LiangLiang OuYang
- Department of Laboratory, Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| | - Wei Xu
- Department of Laboratory, Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| | - XiaoJun Liang
- Department of Laboratory, Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| | - HuiXiang Zhou
- Department of Laboratory, Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| | - Chao Shen
- Department of Laboratory, Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| | - ZhiJian Hu
- Department of Laboratory, Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| | - YuLi Zhu
- Department of Laboratory, Jiujiang University Clinical Medical College, Jiujiang University Hospital, Jiujiang City, Jiangxi Province, China
| |
Collapse
|
11
|
Martens A, de Buhr N, Ishikawa H, Schroten H, von Köckritz-Blickwede M. Characterization of Oxygen Levels in an Uninfected and Infected Human Blood-Cerebrospinal-Fluid-Barrier Model. Cells 2022; 11:cells11010151. [PMID: 35011713 PMCID: PMC8750020 DOI: 10.3390/cells11010151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/23/2021] [Accepted: 12/30/2021] [Indexed: 02/07/2023] Open
Abstract
The host–pathogen interaction during meningitis can be investigated with blood-cerebrospinal-fluid-barrier (BCSFB) cell culture models. They are commonly handled under atmospheric oxygen conditions (19–21% O2), although the physiological oxygen conditions are significantly lower in cerebrospinal fluid (CSF) (7–8% O2). We aimed to characterize oxygen levels in a Streptococcus (S.) suis-infected BCSFB model with transmigrating neutrophils. A BCSFB model with human choroid plexus epithelial cells growing on transwell-filters was used. The upper “blood”-compartment was infected and blood-derived neutrophils were added. S. suis and neutrophils transmigrated through the BCSFB into the “CSF”-compartment. Here, oxygen and pH values were determined with the non-invasive SensorDish® reader. Slight orbital shaking improved the luminescence-based measurement technique for detecting free oxygen. In the non-infected BCSFB model, an oxygen value of 7% O2 was determined. However, with S. suis and transmigrating neutrophils, the oxygen value significantly decreased to 2% O2. The pH level decreased slightly in all groups. In conclusion, we characterized oxygen levels in the BCSFB model and demonstrated the oxygen consumption by cells and bacteria. Oxygen values in the non-infected BCSFB model are comparable to in vivo values determined in pigs in the CSF. Infection and transmigrating neutrophils decrease the oxygen value to lower values.
Collapse
Affiliation(s)
- Alexander Martens
- Department of Biochemistry, University of Veterinary Medicine Hannover, 30559 Hannover, Germany;
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, 30559 Hannover, Germany
| | - Nicole de Buhr
- Department of Biochemistry, University of Veterinary Medicine Hannover, 30559 Hannover, Germany;
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, 30559 Hannover, Germany
- Correspondence: (N.d.B.); (M.v.K.-B.); Tel.: +49-511-953-6119 (N.d.B.)
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, University of Tsukuba, Tsukuba-City, Inaraki 305-8575, Japan;
| | - Horst Schroten
- Department of Pediatrics, Pediatric Infectious Diseases, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany;
| | - Maren von Köckritz-Blickwede
- Department of Biochemistry, University of Veterinary Medicine Hannover, 30559 Hannover, Germany;
- Research Center for Emerging Infections and Zoonoses (RIZ), University of Veterinary Medicine Hannover, 30559 Hannover, Germany
- Correspondence: (N.d.B.); (M.v.K.-B.); Tel.: +49-511-953-6119 (N.d.B.)
| |
Collapse
|
12
|
Hu C, Chen C, Chen J, Xiao K, Zhou W, Xia Y, Yang W, Wang L, Shi Q, Dong XP. Cerebrospinal Fluids from Patients with Five Common Genetic Prion Diseases in China Display Distinct Reactivities in the RT-QuIC Assays. Biomed Environ Sci 2021; 34:830-833. [PMID: 34782050 DOI: 10.3967/bes2021.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/12/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Chao Hu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Cao Chen
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 420115, Hubei, China
| | - Jia Chen
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Kang Xiao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Wei Zhou
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Ying Xia
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;College of Life Science and Technology, Heilongjiang Bayi Agricultural University, Daqing 163711, Heilongjiang, China
| | - Wei Yang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;College of Life Science and Technology, Heilongjiang Bayi Agricultural University, Daqing 163711, Heilongjiang, China
| | - Lin Wang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;College of Life Science and Technology, Heilongjiang Bayi Agricultural University, Daqing 163711, Heilongjiang, China
| | - Qi Shi
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Xiao Ping Dong
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (Zhejiang University), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China;Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 420115, Hubei, China;China Academy of Chinese Medical Sciences, Beijing 100700, China;Center for Global Public Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| |
Collapse
|
13
|
Castellazzi M, Pizzicotti S, Lombardo I, Alfiero S, Morotti A, Pellegatti P, Negri G, Natali L, Ferri C, Fainardi E, Bellini T, Pugliatti M. Sexual dimorphism in the cerebrospinal fluid total protein content. Clin Chem Lab Med 2021; 58:1885-1890. [PMID: 32598300 DOI: 10.1515/cclm-2020-0419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/01/2020] [Accepted: 05/18/2020] [Indexed: 11/15/2022]
Abstract
Objectives Cerebrospinal fluid (CSF) is a clear, colorless body fluid filling the central nervous system. The determination of the CSF total protein (TP) content represents an important screening test of various pathologies. We aimed to address the effect of sex and age on CSF-TP content and the use of the current upper reference limits (URLs). Methods CSF-TP content was analysed in a selected population of 1,252 patients (648 women and 604 men; age 18-89 years) who underwent lumbar puncture as a part of the diagnostic work-up. Samples presenting (i) more than 5 white blood cells (WBC)/µL, (ii) discolorations and (iii) reduced glucose were not included. Results The CSF-TP content median values were significantly higher in men than in women (46 vs. 37 mg/dL) even after adjusting for age and different hospital inpatients. CSF-TP content positively correlated with age both in men and in women with a constant difference between sexes of 8.5 mg/dL. Applying the most used URLs (mainly 45 and 50 mg/dL, but also 60 mg/dL), men received a laboratory report suggestive of altered CSF-TP content more frequently than women. The use of age- and sex-calibrated CSF-TP URLs reduced, but not eliminated, this sex-gap. Conclusions Using the current URLs, a condition of "elevated CSF-TP content" may be overestimated in men or, conversely, underestimated in women, regardless of the age and of the diagnosis. These results highlighted the need to apply CSF-TP URLs values normalized for both sex and age.
Collapse
Affiliation(s)
- Massimiliano Castellazzi
- Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
- Interdepartmental Research Center for the Study of Multiple Sclerosis and Inflammatory and Degenerative Diseases of the Nervous System, University of Ferrara, Ferrara, Italy
| | - Stefano Pizzicotti
- Chemical-Clinical Analysis Laboratory, "S. Anna" University Hospital, Ferrara, Italy
| | - Ilenia Lombardo
- Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Sarah Alfiero
- Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Patrizia Pellegatti
- Chemical-Clinical Analysis Laboratory, "S. Anna" University Hospital, Ferrara, Italy
| | - Giovanna Negri
- Chemical-Clinical Analysis Laboratory, "S. Anna" University Hospital, Ferrara, Italy
| | - Lara Natali
- Chemical-Clinical Analysis Laboratory, "S. Anna" University Hospital, Ferrara, Italy
| | - Caterina Ferri
- Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Enrico Fainardi
- Interdepartmental Research Center for the Study of Multiple Sclerosis and Inflammatory and Degenerative Diseases of the Nervous System, University of Ferrara, Ferrara, Italy
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Tiziana Bellini
- Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Maura Pugliatti
- Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy
- Interdepartmental Research Center for the Study of Multiple Sclerosis and Inflammatory and Degenerative Diseases of the Nervous System, University of Ferrara, Ferrara, Italy
| |
Collapse
|
14
|
Pautova A, Burnakova N, Revelsky A. Metabolic Profiling and Quantitative Analysis of Cerebrospinal Fluid Using Gas Chromatography-Mass Spectrometry: Current Methods and Future Perspectives. Molecules 2021; 26:3597. [PMID: 34208377 PMCID: PMC8231178 DOI: 10.3390/molecules26123597] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022] Open
Abstract
Cerebrospinal fluid is a key biological fluid for the investigation of new potential biomarkers of central nervous system diseases. Gas chromatography coupled to mass-selective detectors can be used for this investigation at the stages of metabolic profiling and method development. Different sample preparation conditions, including extraction and derivatization, can be applied for the analysis of the most of low-molecular-weight compounds of the cerebrospinal fluid, including metabolites of tryptophan, arachidonic acid, glucose; amino, polyunsaturated fatty and other organic acids; neuroactive steroids; drugs; and toxic metabolites. The literature data analysis revealed the absence of fully validated methods for cerebrospinal fluid analysis, and it presents opportunities for scientists to develop and validate analytical protocols using modern sample preparation techniques, such as microextraction by packed sorbent, dispersive liquid-liquid microextraction, and other potentially applicable techniques.
Collapse
Affiliation(s)
- Alisa Pautova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Laboratory of Human Metabolism in Critical States, Negovsky Research Institute of General Reanimatology, Petrovka str. 25-2, 107031 Moscow, Russia
| | - Natalia Burnakova
- Laboratory of Mass Spectrometry, Chemistry Department, Lomonosov Moscow State University, GSP-1, Leninskie Gory, 1-3, 119991 Moscow, Russia; (N.B.); (A.R.)
| | - Alexander Revelsky
- Laboratory of Mass Spectrometry, Chemistry Department, Lomonosov Moscow State University, GSP-1, Leninskie Gory, 1-3, 119991 Moscow, Russia; (N.B.); (A.R.)
| |
Collapse
|
15
|
Gaunitz S, Tjernberg LO, Schedin-Weiss S. What Can N-glycomics and N-glycoproteomics of Cerebrospinal Fluid Tell Us about Alzheimer Disease? Biomolecules 2021; 11:858. [PMID: 34207636 PMCID: PMC8226827 DOI: 10.3390/biom11060858] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 12/18/2022] Open
Abstract
Proteomics-large-scale studies of proteins-has over the last decade gained an enormous interest for studies aimed at revealing proteins and pathways involved in disease. To fully understand biological and pathological processes it is crucial to also include post-translational modifications in the "omics". To this end, glycomics (identification and quantification of glycans enzymatically or chemically released from proteins) and glycoproteomics (identification and quantification of peptides/proteins with the glycans still attached) is gaining interest. The study of protein glycosylation requires a workflow that involves an array of sample preparation and analysis steps that needs to be carefully considered. Herein, we briefly touch upon important steps such as sample preparation and preconcentration, glycan release, glycan derivatization and quantification and advances in mass spectrometry that today are the work-horse for glycomics and glycoproteomics studies. Several proteins related to Alzheimer disease pathogenesis have altered protein glycosylation, and recent glycomics studies have shown differences in cerebrospinal fluid as well as in brain tissue in Alzheimer disease as compared to controls. In this review, we discuss these techniques and how they have been used to shed light on Alzheimer disease and to find glycan biomarkers in cerebrospinal fluid.
Collapse
Affiliation(s)
- Stefan Gaunitz
- Department of Clinical Chemistry, Karolinska University Hospital, 14186 Stockholm, Sweden;
| | - Lars O. Tjernberg
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17164 Solna, Sweden;
| | - Sophia Schedin-Weiss
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 17164 Solna, Sweden;
| |
Collapse
|
16
|
Höpfinger A, Berghoff M, Karrasch T, Schmid A, Schäffler A. Systematic Quantification of Neurotrophic Adipokines RBP4, PEDF, and Clusterin in Human Cerebrospinal Fluid and Serum. J Clin Endocrinol Metab 2021; 106:e2239-e2250. [PMID: 33484131 DOI: 10.1210/clinem/dgaa983] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT Data on the presence/quantification of the neurotrophic adipokines retinol-binding protein-4 (RBP4), clusterin, and pigment epithelium-derived factor (PEDF) in human cerebrospinal fluid (CSF) are scarce and migration of these adipokines across of the blood-brain barrier (BBB) is uncertain. OBJECTIVE This work aimed to quantify RBP4, PEDF, and clusterin in paired serum and CSF samples of patients undergoing neurological evaluation. METHODS A total of 268 patients (109 male, 159 female) were included. Adipokine serum and CSF concentrations were measured by enzyme-linked immunosorbent assay in duplicate. RESULTS RBP4 was abundant in serum (mean, 31.9 ± 24.2 μg/mL). The serum concentrations were approximately 145 times higher than in CSF (CSF to serum RBP4 ratio, 8.2 ± 4.3 × 10-3). PEDF was detectable in serum (mean, 30.2 ± 11.7 μg/mL) and concentrations were approximately 25 times higher than in CSF (CSF to serum PEDF ratio, 42.3 ± 15.6 × 10-3). Clusterin serum concentrations were abundant with mean levels of 346.0 ± 114.6 μg/mL, which were approximately 40 times higher than CSF levels (CSF to serum clusterin ratio, 29.6 ± 23.4 × 10-3). RBP4 and PEDF serum levels correlated positively with CSF levels, which were increased in overweight/obese patients and in type 2 diabetic patients. The CSF concentrations of all 3 adipokines increased with BBB dysfunction. RBP4 in CSF correlated positively with inflammatory parameters. In detail, only RBP4 showed the kinetics and associations that are mandatory for a putative mediator of the fat-brain axis. CONCLUSION RBP4, PEDF, and clusterin are permeable to the BBB and increase with the measure of BBB dysfunction. RBP4 represents an inflammatory neurotrophic adipokine and is a promising mediator of the fat-brain axis.
Collapse
Affiliation(s)
- Alexandra Höpfinger
- Department of Internal Medicine III, Giessen University Hospital, Gießen, Germany
| | - Martin Berghoff
- Department of Neurology, Giessen University Hospital, Gießen, Germany
| | - Thomas Karrasch
- Department of Internal Medicine III, Giessen University Hospital, Gießen, Germany
| | - Andreas Schmid
- Department of Internal Medicine III, Giessen University Hospital, Gießen, Germany
| | - Andreas Schäffler
- Department of Internal Medicine III, Giessen University Hospital, Gießen, Germany
| |
Collapse
|
17
|
Shahan B, Choi EY, Nieves G. Cerebrospinal Fluid Analysis. Am Fam Physician 2021; 103:422-428. [PMID: 33788511] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cerebrospinal fluid (CSF) analysis is a diagnostic tool for many conditions affecting the central nervous system. Urgent indications for lumbar puncture include suspected central nervous system infection or subarachnoid hemorrhage. CSF analysis is not necessarily diagnostic but can be useful in the evaluation of other neurologic conditions, such as spontaneous intracranial hypotension, idiopathic intracranial hypertension, multiple sclerosis, Guillain-Barré syndrome, and malignancy. Bacterial meningitis has a high mortality rate and characteristic effects on CSF white blood cell counts, CSF protein levels, and the CSF:serum glucose ratio. CSF culture can identify causative organisms and antibiotic sensitivities. Viral meningitis can present similarly to bacterial meningitis but usually has a low mortality rate. Adjunctive tests such as CSF lactate measurement, latex agglutination, and polymerase chain reaction testing can help differentiate between bacterial and viral causes of meningitis. Immunocompromised patients may have meningitis caused by tuberculosis, neurosyphilis, or fungal or parasitic infections. Subarachnoid hemorrhage has a high mortality rate, and rapid diagnosis is key to improve outcomes. Computed tomography of the head is nearly 100% sensitive for subarachnoid hemorrhage in the first six hours after symptom onset, but CSF analysis may be required if there is a delay in presentation or if imaging findings are equivocal. Xanthochromia and an elevated red blood cell count are characteristic CSF findings in patients with subarachnoid hemorrhage. Leptomeningeal carcinomatosis can mimic central nervous system infection. It has a poor prognosis, and large-volume CSF cytology is diagnostic.
Collapse
|
18
|
Lee J, Cho Y, Kim HS, Kang HJ, Kim M, Lee YK. A comparison of the analysis of 3 types of body fluids using the XN-350 hematology analyzer versus light microscopy assessment. Medicine (Baltimore) 2021; 100:e24852. [PMID: 33725957 PMCID: PMC7982217 DOI: 10.1097/md.0000000000024852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/26/2021] [Indexed: 01/05/2023] Open
Abstract
We evaluated the capacity of the XN-350 instrument to analyze 3 different types of body fluid samples under "body fluid mode."The performance of XN-350 was evaluated in terms of precision, carryover, limit of blank, limit of detection, limit of quantification, and linearity. Cell enumeration and differential data produced by the XN-350 were compared to manual chamber counting results in 63 cerebrospinal fluid (CSF), 51 ascitic fluid, and 51 pleural fluid (PF) samples. Comparisons between XN-350 versus Cytospin data were also performed in PF samples.The precision, carry-over, limit of blank, and linearity of the XN-350 were acceptable. The limits of detection for white blood cells (WBCs) and red blood cells were 1.0/μL, and 1,000.0/μL, respectively; the corresponding limits of quantitation (LOQs) were 5.0/μL and 2,000.0/μL, respectively. The XN-350's cell enumeration and differential counting correlated well with those of manual chamber counting for all 3 sample types (except for differential counting in CSF samples), particularly parameters involving monocytes (r = 0.33) and mononuclear cells (MO- body fluid [BF]; r = 0.26), as well as total cell (TC-BF) enumeration (r = 0.50) and WBC-BF (r = 0.50) in PF samples. The MO-BF in CSF samples differed significantly from manual chamber counting results, but neither TC-BF nor WBC-BF in PF samples did. The XN-350 also showed good correlations with Cytospin analyses for differential counting of neutrophils, lymphocytes, and monocytes in PF samples. The differential counting of eosinophils via the XN-350 and Cytospin were not significantly correlated, but the difference between them was not significant.The XN-350 is an acceptable alternative to manual fluid analysis. Samples with low cellularity around the LOQ should be checked manually. Moreover, manual differential counting should be performed on CSF samples, particularity those with low cell numbers.
Collapse
|
19
|
Kim S, Song J, Yoon J, Kim K, Chung J, Noh Y. Voxel-wise partial volume correction method for accurate estimation of tissue sodium concentration in 23 Na-MRI at 7 T. NMR Biomed 2021; 34:e4448. [PMID: 33270326 PMCID: PMC7816248 DOI: 10.1002/nbm.4448] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 10/22/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
Sodium is crucial for the maintenance of cell physiology, and its regulation of the sodium-potassium pump has implications for various neurological conditions. The distribution of sodium concentrations in tissue can be quantitatively evaluated by means of sodium MRI (23 Na-MRI). Despite its usefulness in diagnosing particular disease conditions, tissue sodium concentration (TSC) estimated from 23 Na-MRI can be strongly biased by partial volume effects (PVEs) that are induced by broad point spread functions (PSFs) as well as tissue fraction effects. In this work, we aimed to propose a robust voxel-wise partial volume correction (PVC) method for 23 Na-MRI. The method is based on a linear regression (LR) approach to correct for tissue fraction effects, but it utilizes a 3D kernel combined with a modified least trimmed square (3D-mLTS) method in order to minimize regression-induced inherent smoothing effects. We acquired 23 Na-MRI data with conventional Cartesian sampling at 7 T, and spill-over effects due to the PSF were considered prior to correcting for tissue fraction effects using 3D-mLTS. In the simulation, we found that the TSCs of gray matter (GM) and white matter (WM) were underestimated by 20% and 11% respectively without correcting tissue fraction effects, but the differences between ground truth and PVE-corrected data after the PVC using the 3D-mLTS method were only approximately 0.6% and 0.4% for GM and WM, respectively. The capability of the 3D-mLTS method was further demonstrated with in vivo 23 Na-MRI data, showing significantly lower regression errors (ie root mean squared error) as compared with conventional LR methods (p < 0.001). The results of simulation and in vivo experiments revealed that 3D-mLTS is superior for determining under- or overestimated TSCs while preserving anatomical details. This suggests that the 3D-mLTS method is well suited for the accurate determination of TSC, especially in small focal lesions associated with pathological conditions.
Collapse
Affiliation(s)
- Sang‐Young Kim
- Neuroscience Research InstituteGachon UniversityIncheonRepublic of Korea
| | - Junghyun Song
- Neuroscience Research InstituteGachon UniversityIncheonRepublic of Korea
| | - Jong‐Hyun Yoon
- Neuroscience Research InstituteGachon UniversityIncheonRepublic of Korea
| | - Kyoung‐Nam Kim
- Department of Biomedical EngineeringGachon UniversityIncheonRepublic of Korea
| | - Jun‐Young Chung
- Neuroscience Research InstituteGachon UniversityIncheonRepublic of Korea
- Department of NeuroscienceGachon University College of MedicineIncheonRepublic of Korea
| | - Young Noh
- Neuroscience Research InstituteGachon UniversityIncheonRepublic of Korea
- Department of Neurology, Gil Medical CenterGachon University College of Medicin eIncheonRepublic of Korea
| |
Collapse
|
20
|
Jönsson M, Gerdle B, Ghafouri B, Bäckryd E. The inflammatory profile of cerebrospinal fluid, plasma, and saliva from patients with severe neuropathic pain and healthy controls-a pilot study. BMC Neurosci 2021; 22:6. [PMID: 33522900 PMCID: PMC7852144 DOI: 10.1186/s12868-021-00608-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/06/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Neuropathic pain (NeuP) is a complex, debilitating condition of the somatosensory system, where dysregulation between pro- and anti-inflammatory cytokines and chemokines are believed to play a pivotal role. As of date, there is no ubiquitously accepted diagnostic test for NeuP and current therapeutic interventions are lacking in efficacy. The aim of this study was to investigate the ability of three biofluids - saliva, plasma, and cerebrospinal fluid (CSF), to discriminate an inflammatory profile at a central, systemic, and peripheral level in NeuP patients compared to healthy controls. METHODS The concentrations of 71 cytokines, chemokines and growth factors in saliva, plasma, and CSF samples from 13 patients with peripheral NeuP and 13 healthy controls were analyzed using a multiplex-immunoassay based on an electrochemiluminescent detection method. The NeuP patients were recruited from a clinical trial of intrathecal bolus injection of ziconotide (ClinicalTrials.gov identifier NCT01373983). Multivariate data analysis (principal component analysis and orthogonal partial least square regression) was used to identify proteins significant for group discrimination and protein correlation to pain intensity. Proteins with variable influence of projection (VIP) value higher than 1 (combined with the jack-knifed confidence intervals in the coefficients plot not including zero) were considered significant. RESULTS We found 17 cytokines/chemokines that were significantly up- or down-regulated in NeuP patients compared to healthy controls. Of these 17 proteins, 8 were from saliva, 7 from plasma, and 2 from CSF samples. The correlation analysis showed that the most important proteins that correlated to pain intensity were found in plasma (VIP > 1). CONCLUSIONS Investigation of the inflammatory profile of NeuP showed that most of the significant proteins for group separation were found in the less invasive biofluids of saliva and plasma. Within the NeuP patient group it was also seen that proteins in plasma had the highest correlation to pain intensity. These preliminary results indicate a potential for further biomarker research in the more easily accessible biofluids of saliva and plasma for chronic peripheral neuropathic pain where a combination of YKL-40 and MIP-1α in saliva might be of special interest for future studies that also include other non-neuropathic pain states.
Collapse
Affiliation(s)
- Mika Jönsson
- Pain and Rehabilitation Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Björn Gerdle
- Pain and Rehabilitation Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Emmanuel Bäckryd
- Pain and Rehabilitation Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
21
|
Reavis ZW, Mirjankar N, Sarangi S, Boyle SH, Kuhn CM, Matson WR, Babyak MA, Matson SA, Siegler IC, Kaddurah-Daouk R, Suarez EC, Williams RB, Grichnik K, Stafford-Smith M, Georgiades A. Sex and race differences of cerebrospinal fluid metabolites in healthy individuals. Metabolomics 2021; 17:13. [PMID: 33462762 PMCID: PMC8041469 DOI: 10.1007/s11306-020-01757-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 12/09/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Analyses of cerebrospinal fluid (CSF) metabolites in large, healthy samples have been limited and potential demographic moderators of brain metabolism are largely unknown. OBJECTIVE Our objective in this study was to examine sex and race differences in 33 CSF metabolites within a sample of 129 healthy individuals (37 African American women, 29 white women, 38 African American men, and 25 white men). METHODS CSF metabolites were measured with a targeted electrochemistry-based metabolomics platform. Sex and race differences were quantified with both univariate and multivariate analyses. Type I error was controlled for by using a Bonferroni adjustment (0.05/33 = .0015). RESULTS Multivariate Canonical Variate Analysis (CVA) of the 33 metabolites showed correct classification of sex at an average rate of 80.6% and correct classification of race at an average rate of 88.4%. Univariate analyses revealed that men had significantly higher concentrations of cysteine (p < 0.0001), uric acid (p < 0.0001), and N-acetylserotonin (p = 0.049), while women had significantly higher concentrations of 5-hydroxyindoleacetic acid (5-HIAA) (p = 0.001). African American participants had significantly higher concentrations of 3-hydroxykynurenine (p = 0.018), while white participants had significantly higher concentrations of kynurenine (p < 0.0001), indoleacetic acid (p < 0.0001), xanthine (p = 0.001), alpha-tocopherol (p = 0.007), cysteine (p = 0.029), melatonin (p = 0.036), and 7-methylxanthine (p = 0.037). After the Bonferroni adjustment, the effects for cysteine, uric acid, and 5-HIAA were still significant from the analysis of sex differences and kynurenine and indoleacetic acid were still significant from the analysis of race differences. CONCLUSION Several of the metabolites assayed in this study have been associated with mental health disorders and neurological diseases. Our data provide some novel information regarding normal variations by sex and race in CSF metabolite levels within the tryptophan, tyrosine and purine pathways, which may help to enhance our understanding of mechanisms underlying sex and race differences and potentially prove useful in the future treatment of disease.
Collapse
Affiliation(s)
- Zackery W Reavis
- Department of Pharmacology & Cancer Biology, School of Medicine, Duke University, Durham, NC, USA
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | | | | | - Stephen H Boyle
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Cynthia M Kuhn
- Department of Pharmacology & Cancer Biology, School of Medicine, Duke University, Durham, NC, USA
| | | | - Michael A Babyak
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
| | | | - Ilene C Siegler
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Rima Kaddurah-Daouk
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Edward C Suarez
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Redford B Williams
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
| | | | - Mark Stafford-Smith
- Department of Anesthesiology, School of Medicine, Duke University, Durham, NC, USA
| | - Anastasia Georgiades
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Box 3454 DUMC, Durham, NC, 27710, USA.
| |
Collapse
|
22
|
Bodilsen J, Mariager T, Vestergaard HH, Christiansen MH, Kunwald M, Lüttichau HR, Kristensen BT, Bjarkam CR, Nielsen H. Association of Lumbar Puncture With Spinal Hematoma in Patients With and Without Coagulopathy. JAMA 2020; 324:1419-1428. [PMID: 33048155 PMCID: PMC8094417 DOI: 10.1001/jama.2020.14895] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Coagulopathy may deter physicians from performing a lumbar puncture. OBJECTIVE To determine the risk of spinal hematoma after lumbar puncture in patients with and without coagulopathy. DESIGN, SETTING, AND PARTICIPANTS Danish nationwide, population-based cohort study using medical registries to identify persons who underwent lumbar puncture and had cerebrospinal fluid analysis (January 1, 2008-December 31, 2018; followed up through October 30, 2019). Coagulopathy was defined as platelets lower than 150 × 109/L, international normalized ratio (INR) greater than 1.4, or activated partial thromboplastin time (APTT) longer than 39 seconds. EXPOSURES Coagulopathy at the time of lumbar puncture. MAIN OUTCOMES AND MEASURES Thirty-day risk of spinal hematoma. Risks were provided as numbers and percentages with 95% CIs. Secondary analyses included risks of traumatic lumbar puncture (>300 × 106 erythrocytes/L after excluding patients diagnosed with subarachnoid hemorrhage). Adjusted hazard rate ratios (HRs) were computed using Cox regression models. RESULTS A total of 83 711 individual lumbar punctures were identified among 64 730 persons (51% female; median age, 43 years [interquartile range, 22-62 years]) at the time of the procedure. Thrombocytopenia was present in 7875 patients (9%), high INR levels in 1393 (2%), and prolonged APTT in 2604 (3%). Follow-up was complete for more than 99% of the study participants. Overall, spinal hematoma occurred within 30 days for 99 of 49 526 patients (0.20%; 95% CI, 0.16%-0.24%) without coagulopathy vs 24 of 10 371 patients (0.23%; 95% CI, 0.15%-0.34%) with coagulopathy. Independent risk factors for spinal hematoma were male sex (adjusted hazard ratio [HR], 1.72; 95% CI, 1.15-2.56), those aged 41 through 60 years (adjusted HR, 1.96; 95% CI, 1.01-3.81) and those aged 61 through 80 years (adjusted HR, 2.20; 95% CI, 1.12-4.33). Risks did not increase significantly according to overall severity of coagulopathy, in subgroup analyses of severity of coagulopathy by pediatric specialty or medical indication (infection, neurological condition, and hematological malignancy), nor by cumulative number of procedures. Traumatic lumbar punctures occurred more frequently among patients with INR levels of 1.5 to 2.0 (36.8%; 95% CI, 33.3%-40.4%), 2.1 to 2.5 (43.7%; 95% CI, 35.8%-51.8%), and 2.6 to 3.0 (41.9% 95% CI 30.5-53.9) vs those with normal INR (28.2%; 95% CI, 27.7%-28.75%). Traumatic spinal tap occurred more often in patients with an APTT of 40 to 60 seconds (26.3%; 95% CI, 24.2%-28.5%) vs those with normal APTT (21.3%; 95% CI, 20.6%-21.9%) yielding a risk difference of 5.1% (95% CI, 2.9%-7.2%). CONCLUSIONS AND RELEVANCE In this Danish cohort study, risk of spinal hematoma following lumbar puncture was 0.20% among patients without coagulopathy and 0.23% among those with coagulopathy. Although these findings may inform decision-making about lumbar puncture by describing rates in this sample, the observed rates may reflect bias due to physicians selecting relatively low-risk patients for lumbar puncture.
Collapse
Affiliation(s)
- Jacob Bodilsen
- Departments of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | - Theis Mariager
- Departments of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Mikkel Kunwald
- Department of Neurosurgery, Aalborg University Hospital, Aalborg, Denmark
| | - Hans Rudolf Lüttichau
- Department of Pulmonary and Infectious Diseases, Herlev Gentofte Hospital, Copenhagen, Denmark
| | | | - Carsten Reidies Bjarkam
- Department of Neurosurgery, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Nielsen
- Departments of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| |
Collapse
|
23
|
Liu Y, Li H, Wang J, Xue Q, Yang X, Kang Y, Li M, Xu J, Li G, Li C, Chang HC, Su KP, Wang F. Association of Cigarette Smoking With Cerebrospinal Fluid Biomarkers of Neurodegeneration, Neuroinflammation, and Oxidation. JAMA Netw Open 2020; 3:e2018777. [PMID: 33006621 PMCID: PMC7532384 DOI: 10.1001/jamanetworkopen.2020.18777] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Cigarette smoking has been associated with risk of neurodegenerative disorders, such as Alzheimer disease. The association between smoking and biomarkers of changes in human cerebrospinal fluid (CSF) is not fully understood. OBJECTIVE To investigate the association of cigarette smoking with CSF biomarkers of neurodegeneration, neuroinflammation, oxidation, and neuroprotection. DESIGN, SETTING, AND PARTICIPANTS In this case-control study of 191 adult men in China, biomarkers in the CSF of participants with and without significant cigarette exposure were examined. Participants who did not smoke and had no history of substance use disorder or dependence were assigned to the nonsmoking group. The active smoking group included participants who consumed at least 10 cigarettes per day for 1 year. Five-milliliter samples of CSF were obtained from routine lumbar puncture conducted before anterior cruciate ligament reconstruction surgery. Data collection took place from September 2014 to January 2016, and analysis took place from January to February 2016. EXPOSURES Cigarette smoking. MAIN OUTCOMES AND MEASURES CSF levels of β-amyloid 42 (Aβ42), which has diagnostic specificity for Alzheimer disease, tumor necrosis factor alpha (TNFα), brain-derived neurotrophic factor (BDNF), total superoxide dismutase (SOD), and nitric oxide synthase (NOS) were measured. Sociodemographic data and history of smoking were obtained. RESULTS Of 191 participants, 87 (45.5%) were included in the active smoking group and 104 (54.4%) in the nonsmoking group. Compared with the active smoking group, the nonsmoking group was younger (mean [SD] age, 34.4 [10.5] years vs 29.6 [9.5] years; P = .01), had more education (mean [SD] duration of education, 11.9 [3.1] years vs 13.2 [2.6] years; P = .001), and had lower body mass index (mean [SD], 25.9 [3.6] vs 24.9 [4.0]; P = .005). Comparing the nonsmoking group with the smoking group, mean (SD) CSF levels of Aβ42 (38.0 [25.9] pg/mL vs 52.8 [16.5] pg/mL; P < .001) and TNFα (23.0 [2.5] pg/mL vs 28.0 [2.0] pg/mL; P < .001) were significantly lower, while BDNF (23.1 [3.9] pg/mL vs 13.8 [2.7] pg/mL; P < .001), total SOD (15.7 [2.6] U/L vs 13.9 [2.4] U/L; P < .001), total NOS (28.3 [7.2] U/L vs 14.7 [5.6] U/L; P < .001), inducible NOS (16.0 [5.4] U/L vs 10.3 [2.7] U/L; P < .001), and constitutive NOS (12.4 [6.9] U/mL vs 4.4 [3.9] U/mL) were higher. In addition, in participants in the smoking group who were aged 40 years or older, total SOD levels were negatively correlated with Aβ42 levels (r = -0.57; P = .02). In those who smoked at least 20 cigarettes per day, TNFα levels were positively correlated with Aβ42 levels (r = 0.51; P = .006). The association of TNFα with Aβ42 production was stronger than that of total SOD with Aβ42 production (z = -4.38; P < .001). CONCLUSIONS AND RELEVANCE This case-control study found that cigarette smoking was associated with at-risk biomarkers for Alzheimer disease, as indicated by higher Aβ42 levels, excessive oxidative stress, neuroinflammation, and impaired neuroprotection found in the CSF of participants in the active smoking group.
Collapse
Affiliation(s)
- Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
- College of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Hui Li
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, China
- Xinjiang Key Laboratory of Neurological Disorder Research, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Huhhot, China
| | - Jian Wang
- Department of Psychology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qing Xue
- Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | | | - Yimin Kang
- Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Huhhot, China
| | - Mengjie Li
- Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Huhhot, China
- Sleep Medicine Center, Peking University International Hospital, Beijing, China
| | - Jinzhong Xu
- Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, China
| | - Guohua Li
- Xinjiang Key Laboratory of Neurological Disorder Research, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Cunbao Li
- Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Huhhot, China
| | - Hui-Chih Chang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
- Department of Psychiatry and Mind-Body Interface Laboratory, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Kuan-Pin Su
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Department of Psychiatry and Mind-Body Interface Laboratory, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Fan Wang
- Xinjiang Key Laboratory of Neurological Disorder Research, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Huhhot, China
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| |
Collapse
|
24
|
|
25
|
Li L, Li R, Zacharek A, Wang F, Landschoot-Ward J, Chopp M, Chen J, Cui X. ABCA1/ApoE/HDL Signaling Pathway Facilitates Myelination and Oligodendrogenesis after Stroke. Int J Mol Sci 2020; 21:ijms21124369. [PMID: 32575457 PMCID: PMC7352241 DOI: 10.3390/ijms21124369] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023] Open
Abstract
ATP-binding cassette transporter A1 (ABCA1) plays an important role in the regulation of apolipoprotein E (ApoE) and the biogenesis of high-density lipoprotein (HDL) cholesterol in the mammalian brain. Cholesterol is a major source for myelination. Here, we investigate whether ABCA1/ApoE/HDL contribute to myelin repair and oligodendrogenesis in the ischemic brain after stroke. Specific brain ABCA1-deficient (ABCA1-B/-B) and ABCA1-floxed (ABCA1fl/fl) control mice were subjected to permanent distal middle-cerebral-artery occlusion (dMCAo) and were intracerebrally administered (1) artificial mouse cerebrospinal fluid (CSF) as vehicle control, (2) human plasma HDL3, and (3) recombined human ApoE2 starting 24 h after dMCAo for 14 days. All stroke mice were sacrificed 21 days after dMCAo. The ABCA1-B/-B–dMCAo mice exhibit significantly reduced myelination and oligodendrogenesis in the ischemic brain as well as decreased functional outcome 21 days after stroke compared with ABCA1fl/fl mice; administration of human ApoE2 or HDL3 in the ischemic brain significantly attenuates the deficits in myelination and oligodendrogenesis in ABCA1-B/-B–dMCAo mice ( p < 0.05, n = 9/group). In vitro, ABCA1-B/-B reduces ApoE expression and decreases primary oligodendrocyte progenitor cell (OPC) migration and oligodendrocyte maturation; HDL3 and ApoE2 treatment significantly reverses ABCA1-B/-B-induced reduction in OPC migration and oligodendrocyte maturation. Our data indicate that the ABCA1/ApoE/HDL signaling pathway contributes to myelination and oligodendrogenesis in the ischemic brain after stroke.
Collapse
Affiliation(s)
- Li Li
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA; (L.L.); (R.L.); (A.Z.); (F.W.); (J.L.-W.); (M.C.); (J.C.)
| | - Rongwen Li
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA; (L.L.); (R.L.); (A.Z.); (F.W.); (J.L.-W.); (M.C.); (J.C.)
| | - Alex Zacharek
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA; (L.L.); (R.L.); (A.Z.); (F.W.); (J.L.-W.); (M.C.); (J.C.)
| | - Fengjie Wang
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA; (L.L.); (R.L.); (A.Z.); (F.W.); (J.L.-W.); (M.C.); (J.C.)
| | - Julie Landschoot-Ward
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA; (L.L.); (R.L.); (A.Z.); (F.W.); (J.L.-W.); (M.C.); (J.C.)
| | - Michael Chopp
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA; (L.L.); (R.L.); (A.Z.); (F.W.); (J.L.-W.); (M.C.); (J.C.)
- Department of Physics, Oakland University, Rochester, MI 48309, USA
| | - Jieli Chen
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA; (L.L.); (R.L.); (A.Z.); (F.W.); (J.L.-W.); (M.C.); (J.C.)
| | - Xu Cui
- Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA; (L.L.); (R.L.); (A.Z.); (F.W.); (J.L.-W.); (M.C.); (J.C.)
- Correspondence: ; Tel.: 01-313-916-2864
| |
Collapse
|
26
|
Manoufali M, Mobashsher AT, Mohammed B, Bialkowski K, Mills PC, Abbosh A. Implantable Sensor for Detecting Changes in the Loss Tangent of Cerebrospinal Fluid. IEEE Trans Biomed Circuits Syst 2020; 14:452-462. [PMID: 32070996 DOI: 10.1109/tbcas.2020.2973387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The increasing utilization of cerebrospinal fluid (CSF) in early detection of Alzheimer's disease (AD) is attributed to the change of Amyloid- β proteins. Since, the brain is suspended in CSF, changes of Amyloid- β proteins in CSF reflect a pathophysiological variation of the brain due to AD. However, the correlation between Amyloid- β proteins and the dielectric properties (DPs) of CSF is still an open question. This paper reports the characterized DPs of CSF collected from canines using lumbar punctures. The CSF samples from canines show a strong correlation with respect to human in terms of the loss tangent, which indicates suitability of using canines as translational primates. Amyloid- β [ Aβ(1-40) and Aβ(1-42)] proteins associated with AD were added to CSF samples in order to emulate AD condition. The results of emulated AD condition suggest a decrease in the relative permittivity and increase in the loss tangent. To detect changes in the loss tangent of CSF, which combines both relative permittivity and conductivity, a developed sensor is proposed. The designed sensor consists of a voltage controlled oscillator (VCO) and implantable antenna, which exhibits a wideband and low quality factor to be stable with respect to changes in the loss tangent of CSF. The measurements of the received power levels from the sensor in different liquid-based phantoms having different loss tangent values were used to correlate changes in the loss tangent. The developed correlation model is able to predict the loss tangent based on the received power level, which can be used to detect changes in the loss tangent of CSF due to AD. Consequently, this approach could be used as an early diagnosis of AD.
Collapse
|
27
|
Johnson ECB, Dammer EB, Duong DM, Ping L, Zhou M, Yin L, Higginbotham LA, Guajardo A, White B, Troncoso JC, Thambisetty M, Montine TJ, Lee EB, Trojanowski JQ, Beach TG, Reiman EM, Haroutunian V, Wang M, Schadt E, Zhang B, Dickson DW, Ertekin-Taner N, Golde TE, Petyuk VA, De Jager PL, Bennett DA, Wingo TS, Rangaraju S, Hajjar I, Shulman JM, Lah JJ, Levey AI, Seyfried NT. Large-scale proteomic analysis of Alzheimer's disease brain and cerebrospinal fluid reveals early changes in energy metabolism associated with microglia and astrocyte activation. Nat Med 2020; 26:769-780. [PMID: 32284590 PMCID: PMC7405761 DOI: 10.1038/s41591-020-0815-6] [Citation(s) in RCA: 464] [Impact Index Per Article: 116.0] [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: 10/11/2019] [Accepted: 02/27/2020] [Indexed: 12/12/2022]
Abstract
Our understanding of Alzheimer's disease (AD) pathophysiology remains incomplete. Here we used quantitative mass spectrometry and coexpression network analysis to conduct the largest proteomic study thus far on AD. A protein network module linked to sugar metabolism emerged as one of the modules most significantly associated with AD pathology and cognitive impairment. This module was enriched in AD genetic risk factors and in microglia and astrocyte protein markers associated with an anti-inflammatory state, suggesting that the biological functions it represents serve a protective role in AD. Proteins from this module were elevated in cerebrospinal fluid in early stages of the disease. In this study of >2,000 brains and nearly 400 cerebrospinal fluid samples by quantitative proteomics, we identify proteins and biological processes in AD brains that may serve as therapeutic targets and fluid biomarkers for the disease.
Collapse
Affiliation(s)
- Erik C B Johnson
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Eric B Dammer
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Duc M Duong
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Lingyan Ping
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Maotian Zhou
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Luming Yin
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | | | | | - Madhav Thambisetty
- Clinical and Translational Neuroscience Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Thomas J Montine
- Department of Pathology, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Edward B Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas G Beach
- Department of Pathology, Banner Sun Health Research Institute, Sun City, AZ, USA
| | - Eric M Reiman
- Banner Alzheimer's Institute, Arizona State University and University of Arizona, Phoenix, AZ, USA
| | - Vahram Haroutunian
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- JJ Peters VA Medical Center MIRECC, Bronx, NY, USA
| | - Minghui Wang
- Department of Genetics and Genomic Sciences, Mount Sinai Center for Transformative Disease Modeling, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eric Schadt
- Department of Genetics and Genomic Sciences, Mount Sinai Center for Transformative Disease Modeling, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bin Zhang
- Department of Genetics and Genomic Sciences, Mount Sinai Center for Transformative Disease Modeling, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Nilüfer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Todd E Golde
- Department of Neuroscience, Center for Translational Research in Neurodegenerative Disease, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Vladislav A Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Philip L De Jager
- Center for Translational & Computational Neuroimmunology, Department of Neurology, Taub Institute, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Thomas S Wingo
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Srikant Rangaraju
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Ihab Hajjar
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Joshua M Shulman
- Departments of Neurology, Neuroscience and Molecular & Human Genetics, Baylor College of Medicine, Houston, TX, USA
- Jan and Dan Duncan Neurologic Research Institute, Texas Children's Hospital, Houston, TX, USA
| | - James J Lah
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Allan I Levey
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Nicholas T Seyfried
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA.
| |
Collapse
|
28
|
Affiliation(s)
- Geren S Stone
- From the Departments of Medicine (G.S.S., N.J.), Radiology (M.G.), and Pathology (M.M.S.), Massachusetts General Hospital, and the Departments of Medicine (G.S.S., N.J.), Radiology (M.G.), and Pathology (M.M.S.), Harvard Medical School - both in Boston
| | - McKinley Glover
- From the Departments of Medicine (G.S.S., N.J.), Radiology (M.G.), and Pathology (M.M.S.), Massachusetts General Hospital, and the Departments of Medicine (G.S.S., N.J.), Radiology (M.G.), and Pathology (M.M.S.), Harvard Medical School - both in Boston
| | - Nikolaus Jilg
- From the Departments of Medicine (G.S.S., N.J.), Radiology (M.G.), and Pathology (M.M.S.), Massachusetts General Hospital, and the Departments of Medicine (G.S.S., N.J.), Radiology (M.G.), and Pathology (M.M.S.), Harvard Medical School - both in Boston
| | - Maroun M Sfeir
- From the Departments of Medicine (G.S.S., N.J.), Radiology (M.G.), and Pathology (M.M.S.), Massachusetts General Hospital, and the Departments of Medicine (G.S.S., N.J.), Radiology (M.G.), and Pathology (M.M.S.), Harvard Medical School - both in Boston
| |
Collapse
|
29
|
Bharucha T, Gangadharan B, Kumar A, de Lamballerie X, Newton PN, Winterberg M, Dubot-Pérès A, Zitzmann N. Mass spectrometry-based proteomic techniques to identify cerebrospinal fluid biomarkers for diagnosing suspected central nervous system infections. A systematic review. J Infect 2019; 79:407-418. [PMID: 31404562 PMCID: PMC6838782 DOI: 10.1016/j.jinf.2019.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/04/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Central nervous system (CNS) infections account for considerable death and disability every year. An urgent research priority is scaling up diagnostic capacity, and introduction of point-of-care tests. We set out to assess current evidence for the application of mass spectrometry (MS) peptide sequencing in identification of diagnostic biomarkers for CNS infections. METHODS We performed a systematic review (PROSPEROCRD42018104257) using PRISMA guidelines on use of MS to identify cerebrospinal fluid (CSF) biomarkers for diagnosing CNS infections. We searched PubMed, Embase, Web of Science, and Cochrane for articles published from 1 January 2000 to 1 February 2019, and contacted experts. Inclusion criteria involved primary research except case reports, on the diagnosis of infectious diseases except HIV, applying MS to human CSF samples, and English language. RESULTS 4,620 papers were identified, of which 11 were included, largely confined to pre-clinical biomarker discovery, and eight (73%) published in the last five years. 6 studies performed further work termed verification or validation. In 2 of these studies, it was possible to extract data on sensitivity and specificity of the biomarkers detected by ELISA, ranging from 89-94% and 58-92% respectively. CONCLUSIONS The findings demonstrate feasibility and potential of the methods in a variety of infectious diseases, but emphasise the need for strong interdisciplinary collaborations to ensure appropriate study design and biomarker validation.
Collapse
Affiliation(s)
- Tehmina Bharucha
- Institute of Glycobiology, Department of Biochemistry, South Parks Road, Oxford OX1 3RQ, United Kingdom; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic.
| | - Bevin Gangadharan
- Institute of Glycobiology, Department of Biochemistry, South Parks Road, Oxford OX1 3RQ, United Kingdom
| | - Abhinav Kumar
- Institute of Glycobiology, Department of Biochemistry, South Parks Road, Oxford OX1 3RQ, United Kingdom
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
| | - Markus Winterberg
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok 10400, Thailand
| | - Audrey Dubot-Pérès
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao Democratic People's Republic; Unité des Virus Émergents (UVE: Aix-Marseille Univ - IRD 190 - Inserm 1207 - IHU Méditerranée Infection), Marseille, France; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom
| | - Nicole Zitzmann
- Institute of Glycobiology, Department of Biochemistry, South Parks Road, Oxford OX1 3RQ, United Kingdom
| |
Collapse
|
30
|
Chu C, Murdock MH, Jing D, Won TH, Chung H, Kressel AM, Tsaava T, Addorisio ME, Putzel GG, Zhou L, Bessman NJ, Yang R, Moriyama S, Parkhurst CN, Li A, Meyer HC, Teng F, Chavan SS, Tracey KJ, Regev A, Schroeder FC, Lee FS, Liston C, Artis D. The microbiota regulate neuronal function and fear extinction learning. Nature 2019; 574:543-548. [PMID: 31645720 PMCID: PMC6818753 DOI: 10.1038/s41586-019-1644-y] [Citation(s) in RCA: 248] [Impact Index Per Article: 49.6] [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: 08/23/2018] [Accepted: 09/05/2019] [Indexed: 12/13/2022]
Abstract
Multicellular organisms have co-evolved with complex consortia of viruses, bacteria, fungi and parasites, collectively referred to as the microbiota1. In mammals, changes in the composition of the microbiota can influence many physiologic processes (including development, metabolism and immune cell function) and are associated with susceptibility to multiple diseases2. Alterations in the microbiota can also modulate host behaviours-such as social activity, stress, and anxiety-related responses-that are linked to diverse neuropsychiatric disorders3. However, the mechanisms by which the microbiota influence neuronal activity and host behaviour remain poorly defined. Here we show that manipulation of the microbiota in antibiotic-treated or germ-free adult mice results in significant deficits in fear extinction learning. Single-nucleus RNA sequencing of the medial prefrontal cortex of the brain revealed significant alterations in gene expression in excitatory neurons, glia and other cell types. Transcranial two-photon imaging showed that deficits in extinction learning after manipulation of the microbiota in adult mice were associated with defective learning-related remodelling of postsynaptic dendritic spines and reduced activity in cue-encoding neurons in the medial prefrontal cortex. In addition, selective re-establishment of the microbiota revealed a limited neonatal developmental window in which microbiota-derived signals can restore normal extinction learning in adulthood. Finally, unbiased metabolomic analysis identified four metabolites that were significantly downregulated in germ-free mice and have been reported to be related to neuropsychiatric disorders in humans and mouse models, suggesting that microbiota-derived compounds may directly affect brain function and behaviour. Together, these data indicate that fear extinction learning requires microbiota-derived signals both during early postnatal neurodevelopment and in adult mice, with implications for our understanding of how diet, infection, and lifestyle influence brain health and subsequent susceptibility to neuropsychiatric disorders.
Collapse
Affiliation(s)
- Coco Chu
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Mitchell H Murdock
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Deqiang Jing
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Tae Hyung Won
- Boyce Thompson Institute and Department of Chemistry and Chemical Biology, Cornell University, Ithaca, NY, USA
| | - Hattie Chung
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Adam M Kressel
- Center for Biomedical Science and Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Elmezzi Graduate School, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Department of Surgery, Northshore University Hospital, Northwell Health, Manhasset, NY, USA
| | - Tea Tsaava
- Center for Biomedical Science and Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Meghan E Addorisio
- Center for Biomedical Science and Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Gregory G Putzel
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Lei Zhou
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Nicholas J Bessman
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Ruirong Yang
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Saya Moriyama
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Christopher N Parkhurst
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Anfei Li
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Heidi C Meyer
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Fei Teng
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Sangeeta S Chavan
- Center for Biomedical Science and Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Elmezzi Graduate School, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Kevin J Tracey
- Center for Biomedical Science and Bioelectronic Medicine, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Elmezzi Graduate School, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Aviv Regev
- Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Howard Hughes Medical Institute, Koch Institute of Integrative Cancer Research, Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Frank C Schroeder
- Boyce Thompson Institute and Department of Chemistry and Chemical Biology, Cornell University, Ithaca, NY, USA
| | - Francis S Lee
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medicine, Cornell University, New York, NY, USA
- Department of Pharmacology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Conor Liston
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, Cornell University, New York, NY, USA.
- Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, NY, USA.
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medicine, Cornell University, New York, NY, USA.
| | - David Artis
- Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, Cornell University, New York, NY, USA.
- Friedman Center for Nutrition and Inflammation, Joan and Sanford I. Weill Department of Medicine, Department of Microbiology and Immunology, Weill Cornell Medicine, Cornell University, New York, NY, USA.
| |
Collapse
|
31
|
Bustamante MC, Cronin DS. Cavitation threshold evaluation of porcine cerebrospinal fluid using a Polymeric Split Hopkinson Pressure Bar-Confinement chamber apparatus. J Mech Behav Biomed Mater 2019; 100:103400. [PMID: 31476553 DOI: 10.1016/j.jmbbm.2019.103400] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 06/26/2019] [Revised: 08/14/2019] [Accepted: 08/17/2019] [Indexed: 01/16/2023]
Abstract
Studies investigating mild Traumatic Brain Injury (mTBI) in the military population using experimental head surrogates and Finite Element (FE) head models have demonstrated the existence of transient negative pressures occurring within the head at the contrecoup location to the blast wave impingement. It has been hypothesized that this negative pressure may cause cavitation of cerebrospinal fluid (CSF) and possibly lead to brain tissue damage from cavitation bubble collapse. The cavitation pressure threshold of human CSF is presently unknown, although existing FE studies in the literature have assumed a value of -100 kPa. In the present study, the cavitation threshold of degassed porcine CSF at body temperature (37 °C) was measured using a unique modified Polymeric Split Hopkinson Pressure Bar apparatus, and compared to thresholds of distilled water at various conditions. The loading pulse generated in the apparatus was comparable to experimentally measured pressures resulting from blast exposure, and those predicted by an FE model. The occurrence of cavitation was identified using high-speed imaging and the corresponding pressures were determined using a computational model of the apparatus that was previously developed and validated. The probability of cavitation was calculated (ISO/TS, 18506) from forty-one experimental tests on porcine CSF, representing an upper bound for in vivo CSF. The 50% probability of cavitation for CSF (-0.467 MPa ± 7%) was lower than that of distilled water (-1.37 MPa ± 16%) under the same conditions. The lesser threshold of CSF could be related to the constituents such as blood cells and proteins. The results of this study can be used to inform FE head models subjected to blast exposure and improve prediction of the potential for CSF cavitation and response of brain tissue.
Collapse
Affiliation(s)
- M C Bustamante
- Department of Mechanical Engineering, University of Waterloo, 200 University Ave. W., Waterloo, ON, N2L3G1, Canada.
| | - D S Cronin
- Department of Mechanical Engineering, University of Waterloo, 200 University Ave. W., Waterloo, ON, N2L3G1, Canada.
| |
Collapse
|
32
|
Abstract
IMPORTANCE Nonculture infection tests of cerebrospinal fluid (CSF) samples using polymerase chain reaction and antigen or antibody assays are frequently ordered on lumbar puncture specimens concurrently with routine CSF cell counts, but the value of CSF infection testing in otherwise healthy children is unknown. OBJECTIVE To determine the value of nonculture CSF infection testing in immune-competent children with normal CSF cell counts. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study reviewed screening and diagnostic tests in the electronic medical record system of a large academic tertiary care children's hospital. Records of children aged 0.5 to 18.9 years (n = 4083) who underwent lumbar puncture (n = 4811 procedures) in an inpatient or outpatient facility of Children's Hospital of Philadelphia between July 1, 2007, and December 31, 2016, were reviewed. Those with indwelling CSF shunts or catheters; those with active or past oncologic, immunologic, or rheumatologic conditions; or those taking immune-suppressing medications were excluded from analysis. This study was conducted from July 20, 2017, to March 13, 2019. MAIN OUTCOMES AND MEASURES Outcome variables included frequency of nonculture CSF infection testing and frequency of positive results in the entire cohort, and among those with normal cell counts. Normal cell counts were defined as CSF white blood cell counts lower than 5 cells/μL and CSF red blood cell counts lower than 500 cells/μL. RESULTS In total, 4811 lumbar puncture procedures were performed on 4083 unique children, with a median (range) age of 7.4 (0.5-18.9) years, 2537 boys (52.7%), and 3331 (69.2%) with normal CSF cell counts. At least 1 nonculture CSF infection test was performed on 1270 lumbar puncture specimens with normal cell counts (38.1%; 95% CI, 36%-40%), and more tests were performed in the summer months. Only 18 (1.4%; 95% CI, 0.9%-2.2%) of 1270 lumbar puncture specimens with normal cell counts had at least 1 nonculture infection test with a positive result; 2 of these 18 children required clinical intervention for their positive results, but each also had other clear clinical signs of infection. CONCLUSIONS AND RELEVANCE Nonculture CSF infection testing appeared to be common in immune-competent children with normal CSF cell counts, but positive results were uncommon and were not independently associated with clinical care; delaying the decision to send nonculture infection tests until CSF cell counts are available could reduce unnecessary diagnostic testing and medical costs, which may improve value-based care.
Collapse
Affiliation(s)
- Jennifer L. McGuire
- Division of Neurology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Department of Neurology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Nichole V. Tuite
- Division of Neurology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sanjeev K. Swami
- Department of Pediatrics, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Division of Infectious Disease, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Robert A. Avery
- Department of Neurology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Division of Ophthalmology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Ophthalmology, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| |
Collapse
|
33
|
Chmielewski A, Hubert T, Descamps A, Mazur D, Daoudi M, Ciofi P, Fontaine C, Caiazzo R, Pattou F, Prevot V, Pigeyre M. Preclinical Assessment of Leptin Transport into the Cerebrospinal Fluid in Diet-Induced Obese Minipigs. Obesity (Silver Spring) 2019; 27:950-956. [PMID: 31006983 PMCID: PMC6593767 DOI: 10.1002/oby.22465] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 02/13/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE A minipig model was employed to explore the changes in endogenous leptin transport into the central nervous system and in hypothalamic sensitivity to exogenous leptin when individuals are placed on high-fat diet (HFD) compared with standard diet. METHODS Serum and cerebrospinal fluid (CSF) leptin concentrations during 10 weeks of HFD versus standard diet and exogenous leptin-induced STAT3 phosphorylation in the hypothalamus of minipigs were assessed, and the hypothalamic leptin-sensitive cells were characterized by immunofluorescence. RESULTS The efficiency of the passage of endogenous blood-borne leptin into the CSF (measured as the log [CSF:serum leptin ratio]) decreased over time in minipigs fed a HFD (β = -0.04 ± 0.005 per kilogram of weight gain in HFD; P < 0.0001), while it remained stable in minipigs fed a standard diet. However, the ability of peripherally administered leptin to activate its receptor in hypothalamic neurons was preserved in obese minipigs at 10 weeks of HFD. CONCLUSIONS Together, these data are consistent with the existence of an early-onset tranport deficiency for endogenous circulating leptin into the brain in individuals developing obesity, preceding the acquisition of hypothalamic leptin resistance. Although additional studies are required to identify the underlying mechanisms, our study paves the way for the development of new preclinical pharmacological models targeting the restoration of the shuttling of peripheral leptin into the central nervous system to manage obesity.
Collapse
Affiliation(s)
- Alexandra Chmielewski
- Translational Research Laboratory for DiabetesInserm U1190LilleFrance
- European Genomic Institute for Diabetes (EGID)LilleFrance
- Development and Plasticity of the Neuroendocrine BrainJean‐Pierre Aubert Research Center, Inserm U1172LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| | - Thomas Hubert
- Translational Research Laboratory for DiabetesInserm U1190LilleFrance
- European Genomic Institute for Diabetes (EGID)LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| | - Amandine Descamps
- Translational Research Laboratory for DiabetesInserm U1190LilleFrance
- European Genomic Institute for Diabetes (EGID)LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| | - Daniele Mazur
- Development and Plasticity of the Neuroendocrine BrainJean‐Pierre Aubert Research Center, Inserm U1172LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| | - Mehdi Daoudi
- Translational Research Laboratory for DiabetesInserm U1190LilleFrance
- European Genomic Institute for Diabetes (EGID)LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| | - Philippe Ciofi
- Inserm U862, Neurocentre Magendie, Bordeaux UniversityBordeauxFrance
| | - Christian Fontaine
- School of MedicineUniversity of LilleLilleFrance
- Anatomy DepartmentUniversity of LilleLilleFrance
| | - Robert Caiazzo
- Translational Research Laboratory for DiabetesInserm U1190LilleFrance
- European Genomic Institute for Diabetes (EGID)LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| | - François Pattou
- Translational Research Laboratory for DiabetesInserm U1190LilleFrance
- European Genomic Institute for Diabetes (EGID)LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| | - Vincent Prevot
- European Genomic Institute for Diabetes (EGID)LilleFrance
- Development and Plasticity of the Neuroendocrine BrainJean‐Pierre Aubert Research Center, Inserm U1172LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| | - Marie Pigeyre
- Translational Research Laboratory for DiabetesInserm U1190LilleFrance
- European Genomic Institute for Diabetes (EGID)LilleFrance
- School of MedicineUniversity of LilleLilleFrance
| |
Collapse
|
34
|
Decramer T, Wouters A, Kiekens C, Theys T. Froin Syndrome After Spinal Cord Injury. World Neurosurg 2019; 127:490-491. [PMID: 31048043 DOI: 10.1016/j.wneu.2019.04.198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/09/2019] [Revised: 04/20/2019] [Accepted: 04/22/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Froin syndrome is characterized by xanthochromia and hypercoagulability of the cerebrospinal fluid (CSF) due to elevated protein levels. This entity results from blockage of the spinal canal by a mass lesion leading to an isolated caudal CSF space. CASE DESCRIPTION A 48-year-old male, who developed spasticity after a C6 spinal cord injury (SCI) 20 years earlier, presented with subobstruction of his intrathecal baclofen pump. A catheter access port aspiration revealed an extremely high protein concentration (38 g/L) with no signs of infection. Froin syndrome was confirmed when magnetic resonance imaging showed a complete obstruction of the spinal canal at the SCI level. CONCLUSIONS We report the first case of Froin syndrome after SCI. Froin syndrome can impact intrathecal drug delivery and CSF diagnostics.
Collapse
Affiliation(s)
- Thomas Decramer
- Department of Neurosurgery, University Hospitals, Leuven, Belgium.
| | - Anke Wouters
- Department of Neurology, University Hospitals, Leuven, Belgium
| | - Carlotte Kiekens
- Department of Physical and Rehabilitation Medicine, University Hospitals, Leuven, Belgium
| | - Tom Theys
- Department of Neurosurgery, University Hospitals, Leuven, Belgium
| |
Collapse
|
35
|
Abstract
A rare case of Mollaret meningitis characterized by four recurrent episodes of aseptic meningitis during a three-year period is reported. The patient showed a high fever and severe headache accompanied by a high level of cerebrospinal fluid (CSF) cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). The symptoms and high CSF cytokines were resolved immediately after introducing indomethacin treatment. Reactivation of the latent virus is considered to be the cause of this rare disease, and indomethacin is believed to inhibit the periodic abnormal generation of eicosanoid in the brain, resulting in a reduction in the fever and subsequent inflammation.
Collapse
Affiliation(s)
- Masahito Kawabori
- Department of Neurosurgery, Otaru General Hospital, Japan
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
| | - Kota Kurisu
- Department of Neurosurgery, Otaru General Hospital, Japan
| | | | - Yuzuru Ohta
- Department of Neurosurgery, Otaru General Hospital, Japan
| | - Shoji Mabuchi
- Department of Neurosurgery, Otaru General Hospital, Japan
| | - Kiyohiro Houkin
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Japan
| |
Collapse
|
36
|
Valitsky M, Benhamron S, Nitzan K, Karussis D, Ella E, Abramsky O, Kassis I, Rosenmann H. Cerebrospinal Fluid (CSF) Exchange with Artificial CSF Enriched with Mesenchymal Stem Cell Secretions Ameliorates Experimental Autoimmune Encephalomyelitis. Int J Mol Sci 2019; 20:ijms20071793. [PMID: 30978957 PMCID: PMC6480705 DOI: 10.3390/ijms20071793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 03/28/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022] Open
Abstract
The complexity of central nervous system (CNS) degenerative/inflammatory diseases and the lack of substantially effective treatments point to the need for a broader therapeutic approach to target multiple components involved in the disease pathogenesis. We suggest a novel approach directed for the elimination of pathogenic agents from the CNS and, in parallel, its enrichment with an array of neuroprotective substances, using a "cerebrospinal fluid (CSF) exchange" procedure, in which endogenous (pathogenic) CSF is removed and replaced by artificial CSF (aCSF) enriched with secretions of human mesenchymal stem cells (MSCs). MSCs produce a variety of neuroprotective agents and have shown beneficial effects when cells are transplanted in animals and patients with CNS diseases. Our data show that MSCs grown in aCSF secrete neurotrophic factors, anti-inflammatory cytokines, and anti-oxidant agents; moreover, MSC-secretions-enriched-aCSF exerts neuroprotective and immunomodulatory effects in neuronal cell lines and spleen lymphocytes. Treatment of experimental-autoimmune-encephalomyelitis (EAE) mice with this enriched-aCSF using an intracerebroventricular (ICV) CSF exchange procedure ("CSF exchange therapy") caused a significant delay in the onset of EAE and amelioration of the clinical symptoms, paralleled by a reduction in axonal damage and demyelination. These findings point to the therapeutic potential of the CSF exchange therapy using MSC-secretions-enriched-aCSF in inflammatory/degenerative diseases of the CNS.
Collapse
Affiliation(s)
- Michael Valitsky
- The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel.
| | - Sandrine Benhamron
- The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel.
| | - Keren Nitzan
- The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel.
| | - Dimitrios Karussis
- The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel.
| | - Ezra Ella
- The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel.
| | - Oded Abramsky
- The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel.
| | - Ibrahim Kassis
- The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel.
| | - Hanna Rosenmann
- The Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah Hebrew University Medical Center, Jerusalem 91120, Israel.
| |
Collapse
|
37
|
Magdoom KN, Zeinomar A, Lonser RR, Sarntinoranont M, Mareci TH. Phase contrast MRI of creeping flows using stimulated echo. J Magn Reson 2019; 299:49-58. [PMID: 30579226 PMCID: PMC6402592 DOI: 10.1016/j.jmr.2018.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Received: 11/10/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 05/30/2023]
Abstract
Creeping flows govern many important physiological phenomena such as elevated interstitial fluid flows in tumors, glymphatic flows in the brain, among other applications. However, few methods exist to measure such slow flows non-invasively in optically opaque biological tissues in vivo. Phase-contrast MRI is a velocimetry technique routinely used in the clinic to measure fast flows in biological tissues, such as blood and cerebrospinal fluid (CSF), in the order of cm/s. Use of this technique to encode slower flows is hampered by diffusion weighting and phase error introduced by gradient hardware imperfections. In this study, a new PC-MRI technique is developed using stimulated echo preparation to overcome these challenges. Flows as slow as 1 μm/s are measured and validated using controlled water flow through a pipe at 4.7 T. The error in measured flow rate obtained by integrating the measured velocity over the cross-sectional area of the pipe is less than 10%. The developed method was also able to capture slow natural convection flows appearing in liquids placed inside a horizontal bore magnet. Monitoring the 4D velocity vector field revealed that the natural convection flows decay exponentially with time. This method could be applied in future to study creeping flows, e.g. in tissue.
Collapse
Affiliation(s)
- Kulam Najmudeen Magdoom
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL, USA.
| | - Ahmad Zeinomar
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, USA
| | - Russell R Lonser
- Department of Neurological Surgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Malisa Sarntinoranont
- Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, FL, USA; J. Crayton Pruitt Family Department of Biomedical Engineering, 1275 Center Drive, Biomedical Sciences Building, Gainesville, FL, USA
| | - Thomas H Mareci
- Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, FL, USA; J. Crayton Pruitt Family Department of Biomedical Engineering, 1275 Center Drive, Biomedical Sciences Building, Gainesville, FL, USA
| |
Collapse
|
38
|
Abstract
Cerebrospinal fluid (CSF) is a physiologically essential fluid produced by the brain that is involved in protecting the brain and in the exchange of nutrients and waste products. CSF has long been utilized to confirm clinical suspicion of various infectious and inflammatory disorders, such as meningitis and multiple sclerosis. However, there has been increasing interest in collecting CSF in order to study the clinical significance of additional biomarkers. This chapter outlines the procedures necessary to collect, process, store, and utilize CSF obtained for the purposes of biobanking from both living and deceased patients.
Collapse
Affiliation(s)
- Randy S Tashjian
- Division of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Harry V Vinters
- Division of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - William H Yong
- Division of Neuropathology, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- Brain Tumor Translational Resource, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| |
Collapse
|
39
|
Garazdiuk M, Vanchuliak O, Garazdiuk O, Rak M, Grynchuk V. THE COMPARATIVE ANALYSIS OF DIFFERENT TECHNIQUES OF LASER POLARIMETRY FOR DETERMINATION OF TIME OF DEATH IN THE STUDY OF POLYCRYSTALLINE FILMS OF CEREBROSPINAL FLUID. Georgian Med News 2019:126-132. [PMID: 30829604] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The estimation of death coming prescription (DCP) is one of the most important issues that confronts a medical examiner during the corpse examination right at the scene of death. The most promising biological object for the DCP estimation is cerebrospinal fluid. Aim - to compare the effectiveness of methods being used: stokes-polarimetry, stokes-colorimetry, autofluorescence polarimetry in order to improve the accuracy of DCP for the long - and short-term time intervals. The object of the study - cerebrospinal fluid from 75 cadavers (study group) and 20 live individuals (control group). Methods used: stokes polarimetry, stokes-colorimetry, autofluorescence polarimetry. When analyzing the image of the biological sample within the statistical analysis using the stokes polarimetry it is possible to obtain some quantitative characteristics about the amount of the statistical moments of the 1st - 4th orders, which can be used to find the relationship between them and the DCP. However, the coordinate and morphological structure of biological samples are ignored when using this approach. A correlation method in this context is more functional and sensitive. Due to this a higher accuracy of DCP is achieved in a short period. The analysis revealed that the spatial-frequency filtration of polarization-inhomogeneous images of polycrystal films of cerebrospinal fluid improves the time monitoring sensitivity of biochemical changes in optically active molecular compounds. Speaking about fluorescence microscopy - it carries the information about the concentration of molecular complexes of proteins, NADH, flavins, porphyrins, etc. As in the postmortem period the changes in the cerebrospinal fluid begin with the changes in the concentration of biochemical compounds, and crystalline changes are secondary, this method is the most effective for diagnosing the death coming prescription in the first 8 hours. The fluorescent methods of laser polarimetric are precise at a short interval of DCP estimation, and the polarization ones allow us to estimate this parameter at the long-term time intervals, though with less accuracy.
Collapse
Affiliation(s)
- M Garazdiuk
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - O Vanchuliak
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - O Garazdiuk
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - M Rak
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - V Grynchuk
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| |
Collapse
|
40
|
Wolf MS, Chen Y, Simon DW, Alexander H, Ross M, Gibson GA, Manole MD, Bayır H, Kochanek PM, Clark RSB. Quantitative and qualitative assessment of glymphatic flux using Evans blue albumin. J Neurosci Methods 2019; 311:436-441. [PMID: 30292824 PMCID: PMC6258322 DOI: 10.1016/j.jneumeth.2018.09.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 07/11/2018] [Revised: 09/13/2018] [Accepted: 09/28/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND The glymphatic system is a proposed pathway for clearance of proteins and macromolecules from brain, and disrupted glymphatic flux is implicated in neurological disease. We capitalized on colorimetric, fluorescent, and protein-binding properties of Evans blue to evaluate glymphatic flux. NEW METHOD Twenty-five μL of 1% Evans blue-labeled albumin (EBA) in artificial cerebrospinal fluid (aCSF) was injected into the intracisternal space of anesthetized postnatal day 17 rats. Serum was collected at various time points after injection (n = 37) and EBA was measured spectrophotometrically. In separate rats (n = 3), a cranial window was placed over the parietal cortex and EBA transit was evaluated using in vivo multiphoton microscopy. Separate rats (n = 6) were processed for immunohistochemistry to examine localization of EBA. In some rats, intracranial pressure (ICP) was increased via intracisternal injection of aCSF. RESULTS EBA was detected in serum as early as 30 min, was maximal at 4 h, and was undetectable at 72 h after intracisternal injection. Using intra-vital microscopy and immunohistochemistry EBA could be tracked from CSF to perivascular locations. Consistent with removal via glymphatic flux, increasing ICP to 40 mmHg accelerated transit of EBA from CSF to blood. COMPARISON WITH EXISTING METHODS Transit of EBA from CSF to serum could be quantified spectrophotometrically without radioactive labeling. Glymphatic flux could also be qualitatively evaluated using EBA fluorescence. CONCLUSION We present a novel technique for simultaneous quantitative and qualitative evaluation of glymphatic flux in rats.
Collapse
Affiliation(s)
- Michael S Wolf
- Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, John G. Rangos Research Center - 6th Floor, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA
| | - Yaming Chen
- Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, John G. Rangos Research Center - 6th Floor, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA
| | - Dennis W Simon
- Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, John G. Rangos Research Center - 6th Floor, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA; Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA
| | - Henry Alexander
- Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, John G. Rangos Research Center - 6th Floor, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA
| | - Mark Ross
- Department of Cell Biology, Center for Biologic Imaging, University of Pittsburgh, BST S224, 3500 Terrace Street, Pittsburgh, Pennsylvania, 15261, USA
| | - Gregory A Gibson
- Department of Cell Biology, Center for Biologic Imaging, University of Pittsburgh, BST S224, 3500 Terrace Street, Pittsburgh, Pennsylvania, 15261, USA
| | - Miora D Manole
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA
| | - Hülya Bayır
- Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, John G. Rangos Research Center - 6th Floor, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA; Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA; Department of Environmental and Occupational Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, Pennsylvania, 15261, USA; Children's Neuroscience Institute, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA
| | - Patrick M Kochanek
- Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, John G. Rangos Research Center - 6th Floor, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA; Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA; Children's Neuroscience Institute, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA
| | - Robert S B Clark
- Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, John G. Rangos Research Center - 6th Floor, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA; Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA; Children's Neuroscience Institute, UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, Pennsylvania, 15224, USA.
| |
Collapse
|
41
|
French CD, Willoughby RE, Pan A, Wong SJ, Foley JF, Wheat LJ, Fernandez J, Encarnacion R, Ondrush JM, Fatteh N, Paez A, David D, Javaid W, Amzuta IG, Neilan AM, Robbins GK, Brunner AM, Hu WT, Mishchuk DO, Slupsky CM. NMR metabolomics of cerebrospinal fluid differentiates inflammatory diseases of the central nervous system. PLoS Negl Trop Dis 2018; 12:e0007045. [PMID: 30557317 PMCID: PMC6312347 DOI: 10.1371/journal.pntd.0007045] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 07/30/2018] [Revised: 12/31/2018] [Accepted: 12/02/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Myriad infectious and noninfectious causes of encephalomyelitis (EM) have similar clinical manifestations, presenting serious challenges to diagnosis and treatment. Metabolomics of cerebrospinal fluid (CSF) was explored as a method of differentiating among neurological diseases causing EM using a single CSF sample. METHODOLOGY/PRINCIPAL FINDINGS 1H NMR metabolomics was applied to CSF samples from 27 patients with a laboratory-confirmed disease, including Lyme disease or West Nile Virus meningoencephalitis, multiple sclerosis, rabies, or Histoplasma meningitis, and 25 controls. Cluster analyses distinguished samples by infection status and moderately by pathogen, with shared and differentiating metabolite patterns observed among diseases. CART analysis predicted infection status with 100% sensitivity and 93% specificity. CONCLUSIONS/SIGNIFICANCE These preliminary results suggest the potential utility of CSF metabolomics as a rapid screening test to enhance diagnostic accuracies and improve patient outcomes.
Collapse
Affiliation(s)
- Caitlin D. French
- Department of Nutrition, University of California, Davis, California, United States of America
| | - Rodney E. Willoughby
- Department of Pediatrics, Division of Infectious Disease, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- * E-mail: (REW); (CMS)
| | - Amy Pan
- Department of Pediatrics, Division of Infectious Disease, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Susan J. Wong
- Wadsworth Center Diagnostic Immunology Laboratory, New York State Department of Health, Albany, New York, United States of America
| | - John F. Foley
- Intermountain Healthcare, Salt Lake City, Utah, United States of America
| | - L. Joseph Wheat
- Department of Medicine, Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Josefina Fernandez
- Hospital Infantil Robert Reid Cabral, Santo Domingo, Distrito Nacional, República Dominicana
| | - Rafael Encarnacion
- Hospital Infantil Robert Reid Cabral, Santo Domingo, Distrito Nacional, República Dominicana
| | | | - Naaz Fatteh
- Inova Fairfax Hospital, Fairfax, Virginia, United States of America
| | - Andres Paez
- Departamento de Ciencias Basicas, Universidad de la Salle, Bogotá, Colombia
| | - Dan David
- Rabies Lab, Kimron Veterinary Institute, Beit Dagan, Israel
| | - Waleed Javaid
- Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, United States of America
| | - Ioana G. Amzuta
- Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, United States of America
| | - Anne M. Neilan
- Department of Medicine, Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Gregory K. Robbins
- Department of Medicine, Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Andrew M. Brunner
- Department of Medicine, Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - William T. Hu
- Mayo Clinic, Rochester, Minnesota, United States of America
| | - Darya O. Mishchuk
- Department of Food Science and Technology, University of California, Davis, California, United States of America
| | - Carolyn M. Slupsky
- Department of Nutrition, University of California, Davis, California, United States of America
- Department of Food Science and Technology, University of California, Davis, California, United States of America
- * E-mail: (REW); (CMS)
| |
Collapse
|
42
|
Mouliere F, Mair R, Chandrananda D, Marass F, Smith CG, Su J, Morris J, Watts C, Brindle KM, Rosenfeld N. Detection of cell-free DNA fragmentation and copy number alterations in cerebrospinal fluid from glioma patients. EMBO Mol Med 2018; 10:e9323. [PMID: 30401727 PMCID: PMC6284385 DOI: 10.15252/emmm.201809323] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 10/11/2018] [Accepted: 10/15/2018] [Indexed: 01/03/2023] Open
Abstract
Glioma is difficult to detect or characterize using current liquid biopsy approaches. Detection of cell-free tumor DNA (cftDNA) in cerebrospinal fluid (CSF) has been proposed as an alternative to detection in plasma. We used shallow whole-genome sequencing (sWGS, at a coverage of < 0.4×) of cell-free DNA from the CSF of 13 patients with primary glioma to determine somatic copy number alterations and DNA fragmentation patterns. This allowed us to determine the presence of cftDNA in CSF without any prior knowledge of point mutations present in the tumor. We also showed that the fragmentation pattern of cell-free DNA in CSF is different from that in plasma. This low-cost screening method provides information on the tumor genome and can be used to target those patients with high levels of cftDNA for further larger-scale sequencing, such as by whole-exome and whole-genome sequencing.
Collapse
Affiliation(s)
- Florent Mouliere
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Richard Mair
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Dineika Chandrananda
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
| | - Francesco Marass
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
- SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Christopher G Smith
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
| | - Jing Su
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
| | - James Morris
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
| | - Colin Watts
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - Nitzan Rosenfeld
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
- Cancer Research UK Major Centre - Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
| |
Collapse
|
43
|
Garazdiuk M, Bachinskyi V, Vanchuliak O, Garazdiuk O, Nechytailo O. [TIME SINCE DEATH ESTIMATION BY USING THE METHOD OF POLYCRYSTALLINE CEREBROSPINAL FLUID FILMS IMAGES MUTUAL POLARIZATION DEGREE LEVELS DISTRIBUTIONS TWO-DIMENSIONAL MAPPING WITH FINE-SCALE SPATIAL FREQUENCY FILTRATION]. Georgian Med News 2018:166-170. [PMID: 30516516] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective - to develop a method of two-dimensional Stokes-polarimetric spatial-frequency mapping of small-scale components of cerebrospinal fluid to improve the accuracy of post-mortem interval estimation. The object of the study was polycrystalline cerebrospinal fluid films taken from 69 corpses (the main study group) and 20 healthy volunteers (comparison group). For each sample, the coordinate distribution of the values of the complex degree of mutual polarization was determined in the optical arrangement of the Stokes polarimeter. The value of the statistical moments of 1 - 4 orders with further statistical processing was calculated. Time dependences of the variation of the value of the most sensitive statistical moments were built to achiev of values stabilization. The interval and the accuracy of the post-mortem interval were estimated by generalizing of the time dependences of the third and fourth order statistical moments of the polarization maps obtained by the two-dimensional mapping of the values distributions of the complex degree of mutual polarization of the small-scale component of polycrystalline networks of cerebrospinal fluid films. An interval of 10 h and the accuracy of post-mortem interval estimation ΔT = ± 12.5 min was established.
Collapse
Affiliation(s)
- M Garazdiuk
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - V Bachinskyi
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - O Vanchuliak
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - O Garazdiuk
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - O Nechytailo
- Higher State Educational Establishment of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| |
Collapse
|
44
|
Herman S, Khoonsari PE, Tolf A, Steinmetz J, Zetterberg H, Åkerfeldt T, Jakobsson PJ, Larsson A, Spjuth O, Burman J, Kultima K. Integration of magnetic resonance imaging and protein and metabolite CSF measurements to enable early diagnosis of secondary progressive multiple sclerosis. Theranostics 2018; 8:4477-4490. [PMID: 30214633 PMCID: PMC6134925 DOI: 10.7150/thno.26249] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/25/2018] [Indexed: 01/01/2023] Open
Abstract
Molecular networks in neurological diseases are complex. Despite this fact, contemporary biomarkers are in most cases interpreted in isolation, leading to a significant loss of information and power. We present an analytical approach to scrutinize and combine information from biomarkers originating from multiple sources with the aim of discovering a condensed set of biomarkers that in combination could distinguish the progressive degenerative phenotype of multiple sclerosis (SPMS) from the relapsing-remitting phenotype (RRMS). Methods: Clinical and magnetic resonance imaging (MRI) data were integrated with data from protein and metabolite measurements of cerebrospinal fluid, and a method was developed to sift through all the variables to establish a small set of highly informative measurements. This prospective study included 16 SPMS patients, 30 RRMS patients and 10 controls. Protein concentrations were quantitated with multiplexed fluorescent bead-based immunoassays and ELISA. The metabolome was recorded using liquid chromatography-mass spectrometry. Clinical follow-up data of the SPMS patients were used to assess disease progression and development of disability. Results: Eleven variables were in combination able to distinguish SPMS from RRMS patients with high confidence superior to any single measurement. The identified variables consisted of three MRI variables: the size of the spinal cord and the third ventricle and the total number of T1 hypointense lesions; six proteins: galectin-9, monocyte chemoattractant protein-1 (MCP-1), transforming growth factor alpha (TGF-α), tumor necrosis factor alpha (TNF-α), soluble CD40L (sCD40L) and platelet-derived growth factor AA (PDGF-AA); and two metabolites: 20β-dihydrocortisol (20β-DHF) and indolepyruvate. The proteins myelin basic protein (MBP) and macrophage-derived chemokine (MDC), as well as the metabolites 20β-DHF and 5,6-dihydroxyprostaglandin F1a (5,6-DH-PGF1), were identified as potential biomarkers of disability progression. Conclusion: Our study demonstrates, in a limited but well-defined and data-rich cohort, the importance and value of combining multiple biomarkers to aid diagnostics and track disease progression.
Collapse
Affiliation(s)
- Stephanie Herman
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Sweden
- Department of Pharmaceutical Biosciences, Uppsala University, Sweden
| | | | - Andreas Tolf
- Department of Neuroscience, Uppsala University, Sweden
| | - Julia Steinmetz
- Unit of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UCL Institute of Neurology, Queen Square, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
| | - Torbjörn Åkerfeldt
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Sweden
| | - Per-Johan Jakobsson
- Unit of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Sweden
| | - Ola Spjuth
- Department of Pharmaceutical Biosciences, Uppsala University, Sweden
| | | | - Kim Kultima
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Sweden
| |
Collapse
|
45
|
Maillet M, De Broucker T, Mailles A, Bouzat P, Stahl JP. Cerebrospinal fluid lactate concentration and bacterial encephalitis diagnosis. Med Mal Infect 2018; 48:396-402. [PMID: 29914776 DOI: 10.1016/j.medmal.2018.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/31/2017] [Revised: 04/22/2018] [Accepted: 05/23/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A French national study on infectious encephalitis enrolled 253 patients in 2007. Fifty-two per cent of patients had a proven etiological diagnosis; 16% had bacterial encephalitis. We aimed to assess the predictive value of CSF lactate concentration to diagnose bacterial encephalitis. PATIENTS AND METHODS Patients from the 2007 cohort whose CSF lactate concentration was available were included. Clinical and biological features associated with a bacterial etiology were assessed using univariate analysis and multivariate logistic regression. The ROC curve of CSF lactate concentration was used to define the most appropriate cut-off associated with bacterial etiology. RESULTS Fifty-seven patients (37 men, 20 women) were included. Ten patients had bacterial encephalitis, 20 patients had viral encephalitis. The mean CSF white blood cells (WBC), protein, glucose, and lactate levels were respectively 92 cells/mm3 (range: 0-450), 1.2g/L (range: 0.2-8.2), 3.9mmol/L (range: 0.8-8.8), and 2.8mmol/L (range: 0-9.4). In univariate analysis, CSF protein level (P<0.01), WBC count (P=0.02), and lactate concentration (P<0.01) were significantly associated with bacterial etiology. The only factor independently associated with bacterial etiology in the multivariate analysis was CSF lactate concentration. The area under the ROC curve of CSF lactate for the diagnosis of bacterial encephalitis was 0.86. The cut-off value of 3.4 mmol/L correctly classified 87.8% of patients with 70% sensitivity, 91.5% specificity, 64% positive predictive value, and 93% negative predictive value. CONCLUSION A high CSF lactate level seems to be a better predictor than WBC or proteins to differentiate bacterial encephalitis from other etiologies.
Collapse
Affiliation(s)
- M Maillet
- Service de maladies infectieuses, centre hospitalier universitaire de Grenoble, BP 218, 38043 Grenoble cedex 9, France.
| | - T De Broucker
- Service de neurologie, centre hospitalier de Saint-Denis, 2, rue du Dr-Delafontaine, 93200 Saint-Denis, France.
| | - A Mailles
- Santé publique France, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France; ESGIB, ESCMID Study Group for Infectious Diseases of the Brain.
| | - P Bouzat
- Pôle anesthésie et réanimation, centre hospitalier universitaire de Grenoble, Grenoble, France.
| | - J P Stahl
- Service de maladies infectieuses, centre hospitalier universitaire de Grenoble, BP 218, 38043 Grenoble cedex 9, France; ESGIB, ESCMID Study Group for Infectious Diseases of the Brain.
| |
Collapse
|
46
|
Cao W, Jian C, Zhang H, Xu S. Comparison of Clinical Features and Prognostic Factors of Cryptococcal Meningitis Caused by Cryptococcus neoformans in Patients With and Without Pulmonary Nodules. Mycopathologia 2018; 184:73-80. [PMID: 29737452 DOI: 10.1007/s11046-018-0263-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 11/22/2017] [Accepted: 04/18/2018] [Indexed: 12/22/2022]
Abstract
Whether the clinical features of cryptococcal meningitis (CM) patients vary with the coexistence of pulmonary nodules is not clear. This study aimed to compare the clinical features of CM in patients with and without pulmonary nodules detected by chest computed tomography (CT). The medical records of CM patients hospitalized in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 1, 2010, to December 31, 2016, were retrospectively reviewed. Baseline demographics, laboratory and radiographic findings, clinical managements, and outcomes were analyzed. A total of 90 CM patients were enrolled. Forty (44.4%) patients had pulmonary nodules (PN-positive), and 50 (55.6%) patients had no pulmonary nodules (PN-negative). Compared with PN-negative patients, PN-positive patients had higher cerebrospinal fluid (CSF)/serum albumin ratios, higher rates of CSF protein > 1000 mg/L, CSF glucose < 2.5 mmol/L, worse overall treatment response, higher rates of abnormal head CT and magnetic resonance imaging manifestations, and more unfavorable clinical outcomes. Multivariate analysis showed that immunocompromise (p = 0.037) and CSF glucose < 2.5 mmol/L (p = 0.044) indicated poor outcome in PN-positive patients, while CSF glucose < 2.5 mmol/L (p = 0.025) also indicated poor outcome in PN-negative patients. Amphotericin B in the initial therapy was a protective factor for PN-negative patients (p = 0.008). Certain clinical features showed significant differences between CM patients with and without pulmonary nodules, and several independent contributing factors impacted the clinical outcomes for CM patients. Future studies should be performed to further examine these factors.
Collapse
Affiliation(s)
- Wenhao Cao
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, People's Republic of China
| | - Cui Jian
- Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Huojun Zhang
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, People's Republic of China
| | - Shuyun Xu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, 430030, People's Republic of China.
| |
Collapse
|
47
|
Abe M, Kawaguchi H, Miura N, Akioka K, Ushikai M, Oi S, Yukawa A, Yoshikawa T, Izumi H, Horiuchi M. Diurnal Variation of Melatonin Concentration in the Cerebrospinal Fluid of Unanesthetized Microminipig. In Vivo 2018; 32:583-590. [PMID: 29695564 PMCID: PMC6000775 DOI: 10.21873/invivo.11279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/17/2018] [Revised: 03/10/2018] [Accepted: 03/12/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND/AIM The aim of this study was to develop a method for sequentially collecting cerebrospinal fluid (CSF) from an unanesthetized microminipig, which shares many physiological and anatomical similarities with humans, such as diurnality, and investigate the diurnal variation of melatonin concentration in the CSF. MATERIALS AND METHODS A catheter was placed percutaneously into the subarachnoid space of an anesthetized animal, and the tip of the catheter was placed into the cisterna magna under X-ray. We then sequentially collected CSF at light-on and -off times from the unanesthetized animal for several weeks. After catheter placement, a period of one week or more was necessary to relieve the contamination of RBCs in the CSF. RESULTS A higher melatonin level in the CSF was noted during lights-off time, and the level was higher than that in the serum. CONCLUSION This model of sequential collection of CSF will contribute to research in brain functions.
Collapse
Affiliation(s)
- Masaharu Abe
- Department of Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroaki Kawaguchi
- Department of Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoki Miura
- Veterinary Teaching Hospital, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | - Kohei Akioka
- Laboratory of Veterinary Histopathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | - Miharu Ushikai
- Department of Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Sayumi Oi
- Shin Nippon Biomedical Laboratories, Ltd., Kagoshima, Japan
| | - Airo Yukawa
- Shin Nippon Biomedical Laboratories, Ltd., Kagoshima, Japan
| | | | - Hiroyuki Izumi
- Shin Nippon Biomedical Laboratories, Ltd., Kagoshima, Japan
| | - Masahisa Horiuchi
- Department of Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| |
Collapse
|
48
|
Kipiani E. CHARACTERISTICS OF GAMMA OSCILLATIONS INDUCED BY KAINATE PRESSURE EJECTION ON CA1 HIPPOCAMPUS OF MICE BRAIN SLICES IN SUBMERGED CHAMBERS. Georgian Med News 2018:158-162. [PMID: 29905563] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Aim - mostly, gamma oscillations are studied in interface-type chambers. The purpose of the presented investigation is to describe the characteristics of gamma oscillations induced in submerged chambers by kainite pressure ejection. Horizontal combined entorhynal-hippocampal slices 300-350 µm were prepared from young mice (P18-28). Gamma oscillations were induced by 1 mM kainite pressure ejection at the boundary of stratum radiatum and lacunosum-moleculare of area CA1. Field potential recordings were registered from the vicinity of kainite application. Induced CA1 local field potential (LFP) oscillations were brief (7.55±3.77 sec.) and had heterogeneous nature; they could be divided into three epochs: well developed initial part of oscillation, middle part with reduced gamma power and last part of the rhythm with sporadic immergence of sparse (3 to 5) gamma cycles. Generally, initial parts of oscillations had higher amplitude and frequency than the middle part of it. Induction of consecutive gamma oscillations did not depend on the duration of the time intervals between oscillations. Their amplitude was affected by the order of induction but not by time intervals between oscillations. Neither the frequency was affected by the order of induced activities in the same slice. However, comparatively lower frequency oscillations were recorded after long time intervals between gamma activities. Induction of CA1 gamma oscillations in submerged conditions will offer significant experimental advantage, like using patch-clamp techniques to study the mechanism of this activity.
Collapse
Affiliation(s)
- E Kipiani
- Institute for Neurophysiology, Charite, Berlin, Germany; Department of Informatics, Mathematics and Natural Sciences, St. Andrew the First, Tbilisi, Georgia
| |
Collapse
|
49
|
Zapukhliak OS, Kachanovska VO, Isaeva EV, Netsyk OV, Isaev DS. Surface charge impact in nonsynaptic model of epilepsy in rat hippocampus. Fiziol Zh (1994) 2018. [PMID: 29537223 DOI: 10.15407/fz62.02.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Decreasing of surface charge screening near voltage-gated ion channels via reduction of extracellular cation divalent ions provide potent mechanism of altering cellular excitability and seizure threshold. Spontaneous field potentials were recorded from horizontal brain slices of young Wistar rats (postnatal day 10-12). Extracellular registrations wereobtained from CA1 and CA3 area of hippocampus. For induction of nonsynaptic epileptiform activity slices were perfused with artificial cerebrospinal fluid with omitted Ca2+and Mg2+ ions. Effect of different Mg2+ concentration (1, 2, and 3mmol/l) on initial stage of nonsynaptic epileptiform discharges was studied. Our results suggest that the change in Mg2+ concentration dramatically affects the probability of induction of low-Ca2+seizure-like activity (SLA), providing evidence that Mg2+ can alter cerebral excitability by affecting the surface charge and supporting the idea that surface charge could be a pharmacological target for anti-epileptic treatment.
Collapse
MESH Headings
- Animals
- Animals, Newborn
- Biomimetic Materials/chemistry
- Biomimetic Materials/pharmacology
- CA1 Region, Hippocampal/drug effects
- CA1 Region, Hippocampal/metabolism
- CA1 Region, Hippocampal/physiopathology
- CA3 Region, Hippocampal/drug effects
- CA3 Region, Hippocampal/metabolism
- CA3 Region, Hippocampal/physiopathology
- Calcium/metabolism
- Calcium/pharmacology
- Cations, Divalent
- Cerebrospinal Fluid/chemistry
- Culture Media/chemistry
- Culture Media/pharmacology
- Epilepsy/metabolism
- Epilepsy/physiopathology
- Evoked Potentials/drug effects
- Magnesium/pharmacology
- Microtomy
- Models, Biological
- Patch-Clamp Techniques
- Rats
- Rats, Wistar
- Static Electricity
- Tissue Culture Techniques
Collapse
|
50
|
Yahav G, Gershanov S, Salmon-Divon M, Ben-Zvi H, Mircus G, Goldenberg-Cohen N, Fixler D. Pathogen Detection Using Frequency Domain Fluorescent Lifetime Measurements. IEEE Trans Biomed Eng 2018; 65:2731-2741. [PMID: 29993446 DOI: 10.1109/tbme.2018.2814597] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Inflammation of the meninges is a source of severe morbidity and therefore is an important health concerns worldwide. The conventional clinical microbiology approaches used today to identify pathogens suffer from several drawbacks and frequently provide false results. This research describes a fast method to detect the presence of pathogens using the frequency domain (FD) fluorescence lifetime (FLT) imaging microscopy (FLIM) system. METHODS The study included 43 individuals divided into 4 groups: 9 diagnosed with different types of bacteria; 16 diagnosed with different types of viruses; 5 healthy samples served as a control; and 12 samples were negative to any pathogen, although presenting related symptoms. All samples contained leukocytes that were extracted from the cerebrospinal fluid (CSF) and were subjected to nuclear staining by 4', 6-diamidino-2-phenylindole (DAPI) and FLT analyses based on phase and amplitude crossing point (CRPO). RESULTS Using notched boxplots, we found differences in 95% probability between the first three groups through different notch ranges (NR). Pathogen samples presented a longer median FLT (3.28 ns with NR of 3.24-3.32 ns in bacteria and 3.18 ns with NR of 3.16-3.21 ns in viruses) compared to the control median FLT (2.65 ns with NR of 2.63-2.67 ns). Furthermore, we found that the undetected forth group was divided into two types: a relatively normal median FLT (2.72 ns with NR of 2.68-2.76 ns) and a prolonged FLT (3.22 ns with NR of 3.17-3.27 ns). CONCLUSION FLT measurements can differentiate between control and pathogen by the CRPO method. SIGNIFICANCE The FD-FLIM system can provide a high throughput diagnostic technique that does not require a physician.
Collapse
|