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1.
Shock ; 61(4): 557-563, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38604133

ABSTRACT

ABSTRACT: Escherichia coli and Staphylococcus aureus are two of the most common bacterial species responsible for sepsis. While it is observed that they have disparate clinical phenotypes, the signaling differences elicited by each bacteria that drive this variance remain unclear. Therefore, we used human whole blood exposed to heat-killed E. coli or S. aureus and measured the transcriptomic signatures. Relative to unstimulated control blood, heat-killed bacteria exposure led to significant dysregulation (upregulated and downregulated) of >5,000 genes for each experimental condition, with a slight increase in gene alterations by S. aureus. While there was significant overlap regarding proinflammatory pathways, Gene Ontology overrepresentation analysis of the most altered genes suggested biological processes like macrophage differentiation and ubiquinone biosynthesis were more unique to heat-killed S. aureus, compared with heat-killed E. coli exposure. Using Ingenuity Pathway Analysis, it was demonstrated that nuclear factor erythroid 2-related factor 2 signaling, a main transcription factor in antioxidant responses, was predominately upregulated in S. aureus exposed blood relative to E. coli. Furthermore, the use of pharmacologics that preferentially targeted the nuclear factor erythroid 2-related factor 2 pathway led to differential cytokine profiles depending on the type of bacterial exposure. These findings reveal significant inflammatory dysregulation between E. coli and S. aureus and provide insight into the targeting of unique pathways to curb bacteria-specific responses.


Subject(s)
Escherichia coli Infections , Staphylococcal Infections , Humans , Escherichia coli , Staphylococcus aureus , NF-E2-Related Factor 2/genetics , Gene Expression Regulation
2.
Free Radic Biol Med ; 209(Pt 1): 152-164, 2023 11 20.
Article in English | MEDLINE | ID: mdl-37852546

ABSTRACT

TNFα activates NADPH oxidase 1 (Nox1) in vascular smooth muscle cells (VSMCs). The extracellular superoxide anion (O2•-) produced is essential for the pro-inflammatory effects of the cytokine but the specific contributions of O2•- to signal transduction remain obscure. Extracellular superoxide dismutase (ecSOD, SOD3 gene) is a secreted protein that binds to cell surface heparin sulfate proteoglycans or to Fibulin-5 (Fib-5, FBLN5 gene), an extracellular matrix protein that also associates with elastin and integrins. ecSOD converts O2•- to hydrogen peroxide (H2O2) which prevents NO• inactivation, limits generation of hydroxyl radical (OH•), and creates high local concentrations of H2O2. We hypothesized that ecSOD modifies TNFα signaling in VSMCs. Knockdown of ecSOD (siSOD3) suppressed downstream TNFα signals including MAPK (JNK and ERK phosphorylation) and NF-κB activation (luciferase reporter and IκB phosphorylation), interleukin-6 (IL-6) secretion, iNOS and VCAM expression, and proliferation (Sulforhodamine B assay, PCNA western blot). These effects were associated with significant reductions in the expression of both Type1 and 2 TNFα receptors. Reduced Fib-5 expression (siFBLN5) similarly impaired NF-κB activation by TNFα, but potentiated FAK phosphorylation at Y925. siSOD3 also increased both resting and TNFα-induced phosphorylation of FAK and of glycogen synthase kinase-3ß (GSK3ß), a downstream target of integrin linked kinase (ILK). These effects were dependent upon α5ß1 integrins and siSOD3 increased resting sulfenylation (oxidation) of both integrin subunits, while preventing TNFα-induced increases in sulfenylation. To determine how ecSOD modified TNFα-induced inflammation in intact blood vessels, mesenteric arteries from VSMC-specific ecSOD knockout (KO) mice were exposed to TNFα (10 ng/ml) in culture for 48 h. Relaxation to acetylcholine and sodium nitroprusside was impaired in WT but not ecSOD KO vessels. Thus, ecSOD association with Fib-5 supports pro-inflammatory TNFα signaling while tonically inhibiting α5ß1 integrin activation.


Subject(s)
Muscle, Smooth, Vascular , Tumor Necrosis Factor-alpha , Mice , Animals , Muscle, Smooth, Vascular/metabolism , Tumor Necrosis Factor-alpha/genetics , Superoxide Dismutase/metabolism , NF-kappa B/genetics , NF-kappa B/metabolism , Hydrogen Peroxide/metabolism , Transcriptional Activation , Signal Transduction , Integrins/genetics , Integrins/metabolism
3.
FASEB J ; 37(7): e23028, 2023 07.
Article in English | MEDLINE | ID: mdl-37310356

ABSTRACT

Leucine-rich repeat containing 8A (LRRC8A) volume regulated anion channels (VRACs) are activated by inflammatory and pro-contractile stimuli including tumor necrosis factor alpha (TNFα), angiotensin II and stretch. LRRC8A associates with NADPH oxidase 1 (Nox1) and supports extracellular superoxide production. We tested the hypothesis that VRACs modulate TNFα signaling and vasomotor function in mice lacking LRRC8A exclusively in vascular smooth muscle cells (VSMCs, Sm22α-Cre, Knockout). Knockout (KO) mesenteric vessels contracted normally but relaxation to acetylcholine (ACh) and sodium nitroprusside (SNP) was enhanced compared to wild type (WT). Forty-eight hours of ex vivo exposure to TNFα (10 ng/mL) enhanced contraction to norepinephrine (NE) and markedly impaired dilation to ACh and SNP in WT but not KO vessels. VRAC blockade (carbenoxolone, CBX, 100 µM, 20 min) enhanced dilation of control rings and restored impaired dilation following TNFα exposure. Myogenic tone was absent in KO rings. LRRC8A immunoprecipitation followed by mass spectroscopy identified 33 proteins that interacted with LRRC8A. Among them, the myosin phosphatase rho-interacting protein (MPRIP) links RhoA, MYPT1 and actin. LRRC8A-MPRIP co-localization was confirmed by confocal imaging of tagged proteins, Proximity Ligation Assays, and IP/western blots. siLRRC8A or CBX treatment decreased RhoA activity in VSMCs, and MYPT1 phosphorylation was reduced in KO mesenteries suggesting that reduced ROCK activity contributes to enhanced relaxation. MPRIP was a target of redox modification, becoming oxidized (sulfenylated) after TNFα exposure. Interaction of LRRC8A with MPRIP may allow redox regulation of the cytoskeleton by linking Nox1 activation to impaired vasodilation. This identifies VRACs as potential targets for treatment or prevention of vascular disease.


Subject(s)
Muscle, Smooth, Vascular , Animals , Mice , Acetylcholine/pharmacology , Anions , Membrane Proteins/genetics , Mice, Knockout , Myosin-Light-Chain Phosphatase , Signal Transduction , Tumor Necrosis Factor-alpha/pharmacology , Muscle, Smooth, Vascular/cytology , Muscle, Smooth, Vascular/metabolism , Muscle, Smooth, Vascular/physiology
4.
bioRxiv ; 2023 Mar 10.
Article in English | MEDLINE | ID: mdl-36945623

ABSTRACT

Background: In vascular smooth muscle cells (VSMCs), LRRC8A volume regulated anion channels (VRACs) are activated by inflammatory and pro-contractile stimuli including tumor necrosis factor alpha (TNFα), angiotensin II and stretch. LRRC8A physically associates with NADPH oxidase 1 (Nox1) and supports its production of extracellular superoxide (O 2 -• ). Methods and Results: Mice lacking LRRC8A exclusively in VSMCs (Sm22α-Cre, KO) were used to assess the role of VRACs in TNFα signaling and vasomotor function. KO mesenteric vessels contracted normally to KCl and phenylephrine, but relaxation to acetylcholine (ACh) and sodium nitroprusside (SNP) was enhanced compared to wild type (WT). 48 hours of ex vivo exposure to TNFα (10ng/ml) markedly impaired dilation to ACh and SNP in WT but not KO vessels. VRAC blockade (carbenoxolone, CBX, 100 µM, 20 min) enhanced dilation of control rings and restored impaired dilation following TNFα exposure. Myogenic tone was absent in KO rings. LRRC8A immunoprecipitation followed by mass spectroscopy identified 35 proteins that interacted with LRRC8A. Pathway analysis revealed actin cytoskeletal regulation as the most closely associated function of these proteins. Among these proteins, the Myosin Phosphatase Rho-Interacting protein (MPRIP) links RhoA, MYPT1 and actin. LRRC8A-MPRIP co-localization was confirmed by confocal imaging of tagged proteins, Proximity Ligation Assays, and IP/western blots which revealed LRRC8A binding at the second Pleckstrin Homology domain of MPRIP. siLRRC8A or CBX treatment decreased RhoA activity in cultured VSMCs, and MYPT1 phosphorylation at T853 was reduced in KO mesenteries suggesting that reduced ROCK activity contributes to enhanced relaxation. MPRIP was a target of redox modification, becoming oxidized (sulfenylated) after TNFα exposure. Conclusions: Interaction of Nox1/LRRC8A with MPRIP/RhoA/MYPT1/actin may allow redox regulation of the cytoskeleton and link Nox1 activation to both inflammation and vascular contractility.

6.
Tissue Barriers ; 10(4): 2017226, 2022 10 02.
Article in English | MEDLINE | ID: mdl-34923902

ABSTRACT

Delivery of cargo to cells through the use of cell-penetrating peptide (CPP) sequences is an area of rich investigation for targeted therapeutics. Specific to the endothelium, the layer of cells that cover every blood vessel in the body, the loss or alteration of a key enzyme, endothelial nitric oxide synthase (eNOS), is known to contribute to endothelial health during severe, infectious challenge. While the beneficial effects of eNOS are often thought to be mediated through the generation of nitric oxide, some protection is theorized to be through eNOS binding to regulatory pathways via a pentabasic RRKRK motif. We hypothesized that delivery of the eNOS-RRKRK peptide sequence using common CPPs would allow protection against gram-negative lipopolysaccharide (LPS). Combination of the eNOS-RRKRK sequence to the CPP antennapedia (AP) reduced the impact of LPS-induced permeability in cultured human microvascular endothelial cells (HMVECs) as measured by transendothelial electrical resistance (TEER). There was also a modest reduction in cytokine production, however it was observed that AP alone significantly impaired LPS-induced endothelial permeability and cytokine production. In comparison, the CPP trans-activator of transcription (TAT) did not significantly alter endothelial inflammation by itself. When TAT was coupled to the eNOS-RRKRK sequence, protection against LPS-induced permeability was still demonstrated, however cytokine production was not reduced. These data demonstrate that the RRKRK sequence of eNOS can offer some NO-independent protection against LPS-mediated endothelial inflammation, however the degree of protection is highly dependent on the type of CPP utilized for cargo delivery.


Subject(s)
Cell-Penetrating Peptides , Nitric Oxide Synthase Type III , Humans , Nitric Oxide Synthase Type III/metabolism , Nitric Oxide Synthase Type III/pharmacology , Lipopolysaccharides/pharmacology , Lipopolysaccharides/metabolism , Cell-Penetrating Peptides/pharmacology , Nitric Oxide/metabolism , Nitric Oxide/pharmacology , Endothelial Cells/metabolism , Endothelium, Vascular/metabolism , Permeability , Inflammation/metabolism , Cytokines/metabolism , Trans-Activators/metabolism , Trans-Activators/pharmacology
7.
Transl Res ; 235: 115-128, 2021 09.
Article in English | MEDLINE | ID: mdl-33857660

ABSTRACT

Sepsis represents a life-threatening event often mediated by the host's response to pathogens such as gram-negative organisms, which release the proinflammatory lipopolysaccharide (LPS). Within the endothelium, the mitogen-activated protein kinase (MAPK) pathway is an important driver of endothelial injury during sepsis, of which oxidant-sensitive apoptosis signal-regulating kinase 1 (ASK1) is postulated to be a critical upstream regulator. We hypothesized that ASK1 would play a key role in endothelial inflammation during bacterial challenge. Utilizing RNA sequencing data from patients and cultured human microvascular endothelial cells (HMVECs), ASK1 expression was increased in sepsis and after LPS challenge. Two ASK1 inhibitors, GS444217 and MSC2023964A, reduced cytokine production in HMVECs following LPS stimulation, but had no effect on permeability as measured by transendothelial electrical resistance and intercellular space. MAPKs are known to interact with endothelial nitric oxide synthase (eNOS) and ASK1 expression levels correlated with eNOS expression in patients with septic shock. In addition, eNOS physically interacted with ASK1, though this interaction was not altered by ASK1 inhibition, nor did inhibition alter MAPK p38 activity. Instead, among MAPKs, ASK1 inhibition only impaired LPS-induced JNK phosphorylation. The reduction in JNK activation caused by ASK1 inhibition impaired JNK-mediated cytokine production without affecting permeability. Thus, LPS triggers JNK-dependent cytokine production that requires ASK1 activation, but both its effects on permeability and activation of p38 are ASK1-independent. These data demonstrate how distinct MAPK signaling pathways regulate endothelial inflammatory outputs during acute infectious challenge.


Subject(s)
Cytokines/biosynthesis , Endothelial Cells/metabolism , MAP Kinase Kinase Kinase 5/physiology , Toll-Like Receptor 4/physiology , Cells, Cultured , Humans , JNK Mitogen-Activated Protein Kinases/physiology , MAP Kinase Kinase Kinase 5/antagonists & inhibitors , MAP Kinase Signaling System/physiology , Nitric Oxide Synthase Type III/physiology , Permeability , p38 Mitogen-Activated Protein Kinases/physiology
8.
Injury ; 50(8): 1418-1422, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31307764

ABSTRACT

Jockey injuries in North American racing are not well understood. The types and severity of injuries as well as exposure need to be better characterized in order to reduce risk. We consider existing data sources and the opportunity to combine this data with a new data collection effort to better understand and potentially reduce risk to riders. Using a two-phase approach, data appears to be available which would allow useful information on jockey injuries that could inform efforts for risk reduction quickly and with modest resources. Initial successes can help to develop support for a more comprehensive data collection and risk reduction program.


Subject(s)
Accidental Falls/statistics & numerical data , Accidents, Occupational/statistics & numerical data , Athletic Injuries/epidemiology , Horses/injuries , Running/injuries , Animals , Data Management , Humans , North America/epidemiology
9.
Bol. latinoam. Caribe plantas med. aromát ; 18(3): 239-264, mayo 2019. tab, ilus
Article in English | LILACS | ID: biblio-1007935

ABSTRACT

Tillandsia L. genus comprises 649 species, with different uses at different times. T. usneoides L. uses are reported since the late- archaic and pre-Columbian cultures. In XIX-XX centuries, T. usneoides was used in some manufactured products, as polish and packing fruit. Tillandsia has a favorable reputation as medicine: for leucorrhea, rheumatism, ulcers, hemorrhoid treatment, as an anti-diabetic remedy, emetic, analgesic, purgative, contraceptive, antispasmodic and diuretic. Tillandsia chemical composition includes cycloartane triterpenes and hydroxy-flavonoids, which are present in at least 24 species. Several extracts and compounds from Tillandsia spp. have been reported with pharmacological actions, as anti-neoplasia, hypolipidemic, antifungal, anti-HSV-1, hypoglycemic and microbicide. This review communicates the economic importance, ethnobotany, chemistry composition and biological activities of the Tillandsia genus, and analyze its biological and economic perspective. Tillandsia genus has cultural, economic and pharmacological relevance, with a high potential in many essential aspects of the modern society.


El género Tillandsia L. comprende 649 especies, con diferentes usos en diferentes épocas. T. usneoides L. se han reportado desde el arcáico tardío hasta las culturas precolombinas. En los siglos XIX-XX, T. usneoides se usó en productos manufacturados: como abrasivo y embalaje de fruta. Como medicina tradicional, el género Tillandsia se reporta para leucorrea, reumatismo, úlceras, hemorroides, remedio antidiabético, emético, analgésico, purgante, anticonceptivo, antiespasmódico y diurético. Su composición química incluye triterpenos de tipo ciclo-artano e hidroxi-flavonoides, presentes en al menos 24 especies. Los extractos y compuestos del género Tillandsia se han reportado con propiedades antineoplásicas, hipolipidémicas, antifúngicas, anti-HSV-1, hipoglucemiantes y microbicidas. Esta revisión comunica la importancia económica, etnobotánica, composición química y las actividades biológicas del género Tillandsia, y analiza su perspectiva biológica y potencial económica. Tillandsia tiene importancia cultural, económica y farmacológica, con gran potencial en muchos aspectos esenciales de la sociedad moderna.


Subject(s)
Plants, Medicinal/chemistry , Plant Extracts/chemistry , Ethnobotany , Tillandsia/chemistry , Triterpenes/analysis , Plant Extracts/pharmacology , Bromeliaceae/chemistry
10.
Cell Commun Signal ; 17(1): 33, 2019 04 15.
Article in English | MEDLINE | ID: mdl-30987646

ABSTRACT

BACKGROUND: Vascular dysfunction is commonly seen during severe viral infections. Endothelial nitric oxide synthase (eNOS), has been postulated to play an important role in regulating vascular homeostasis as well as propagation of the inflammatory reaction. We hypothesized that the loss of eNOS would negatively impact toll-like receptor 3 (TLR3) signaling and worsen vascular function to viral challenge. METHODS: Human microvascular endothelial cells (HMVECs) were exposed to either control or eNOS siRNA and then treated with Poly I:C, a TLR3 agonist and mimicker of dsRNA viruses. Cells were assessed for protein-protein associations, cytokine and chemokine analysis as well as transendothelial electrical resistance (TEER) as a surrogate of permeability. RESULTS: HMVECs that had reduced eNOS expression had a significantly elevated increase in IL-6, IL-8 and IP-10 production after Poly I:C. In addition, the knockdown of eNOS enhanced the change in TEER after Poly I:C stimulation. Western blot analysis showed enhanced phosphorylation of p38 in sieNOS treated cells with Poly I:C compared to siControl cells. Proximity ligation assays further demonstrated direct eNOS-p38 protein-protein interactions. The addition of the p38 inhibitor, SB203580, in eNOS knockdown cells reduced both cytokine production after Poly I:C, and as well as mitigated the reduction in TEER, suggesting a direct link between eNOS and p38 in TLR3 signaling. CONCLUSIONS: These results suggest that reduction of eNOS increases TLR3-mediated inflammation in human endothelial cells in a p38-dependent manner. This finding has important implications for understanding the pathogenesis of severe viral infections and the associated vascular dysfunction.


Subject(s)
Endothelium, Vascular/metabolism , Inflammation/metabolism , Nitric Oxide Synthase Type III/physiology , Poly I-C/pharmacology , Toll-Like Receptor 3/agonists , p38 Mitogen-Activated Protein Kinases/metabolism , Capillary Permeability , Cells, Cultured , Chemokine CXCL10/metabolism , Gene Knockdown Techniques , Humans , Interleukin-6/metabolism , Interleukin-8/metabolism , Nitric Oxide Synthase Type III/genetics , RNA, Small Interfering/genetics
11.
FASEB J ; 32(2): 945-956, 2018 02.
Article in English | MEDLINE | ID: mdl-29061842

ABSTRACT

Endothelial dysfunction, characterized by changes in eNOS, is a common finding in chronic inflammatory vascular diseases. These states are associated with increased infectious complications. We hypothesized that alterations in eNOS would enhance the response to LPS-mediated TLR4 inflammation. Human microvascular endothelial cells were treated with sepiapterin or N-nitro-L-arginine methylester (L-NAME) to alter endogenous NO production, and small interfering RNA to knockdown eNOS. Alterations of endogenous NO by sepiapterin, and L-NAME provided no significant changes to LPS inflammation. In contrast, eNOS knockdown greatly enhanced endothelial IL-6 production and permeability in response to LPS. Knockdown of eNOS enhanced LPS-induced p38. Inhibition of p38 with SB203580 prevented IL-6 production, without altering permeability. Knockdown of p38 impaired NF-κB activation. Physical interaction between p38 and eNOS was demonstrated by immunoprecipitation, suggesting a novel, NO-independent mechanism for eNOS regulation of TLR4. In correlation, biopsy samples in patients with systemic lupus erythematous showed reduced eNOS expression with associated elevations in TLR4 and p38, suggesting an in vivo link. Thus, reduced expression of eNOS, as seen in chronic inflammatory disease, was associated with enhanced TLR4 signaling through p38. This may enhance the response to infection in patients with chronic inflammatory conditions.-Stark, R. J., Koch, S. R., Choi, H., Mace, E. H., Dikalov, S. I., Sherwood, E. R., Lamb, F. S. Endothelial nitric oxide synthase modulates Toll-like receptor 4-mediated IL-6 production and permeability via nitric oxide-independent signaling.


Subject(s)
Capillary Permeability , Endothelial Cells/metabolism , Interleukin-6/biosynthesis , MAP Kinase Signaling System , Nitric Oxide Synthase Type III/biosynthesis , Nitric Oxide/metabolism , Toll-Like Receptor 4/metabolism , Cells, Cultured , Chronic Disease , Endothelial Cells/pathology , Gene Expression Regulation, Enzymologic/drug effects , Humans , Imidazoles/pharmacology , Lipopolysaccharides/toxicity , Pyridines/pharmacology , Vasculitis/chemically induced , Vasculitis/metabolism , Vasculitis/pathology , p38 Mitogen-Activated Protein Kinases/antagonists & inhibitors , p38 Mitogen-Activated Protein Kinases/metabolism
12.
Transl Res ; 180: 53-67.e4, 2017 02.
Article in English | MEDLINE | ID: mdl-27567430

ABSTRACT

Repeated challenge of lipopolysaccharide (LPS) alters the response to subsequent LPS exposures via modulation of toll-like receptor 4 (TLR4). Whether activation of other TLRs can modulate TLR4 responses, and vice versa, remains unclear. Specifically with regards to endothelial cells, a key component of innate immunity, the impact of TLR cross-modulation is unknown. We postulated that TLR2 priming (via Pam3Csk4) would inhibit TLR4-mediated responses while TLR3 priming (via Poly I:C) would enhance subsequent TLR4-inflammatory signaling. We studied human umbilical vein endothelial cells (HUVECs) and neonatal human dermal microvascular endothelial cells (HMVECs). Cells were primed with a combination of Poly I:C (10 µg/ml), Pam3Csk4 (10 µg/ml), or LPS (100 ng/ml), then washed and allowed to rest. They were then rechallenged with either Poly I:C, Pam3Csk4 or LPS. Endothelial cells showed significant tolerance to repeated LPS challenge. Priming with Pam3Csk4 also reduced the response to secondary LPS challenge in both cell types, despite a reduced proinflammatory response to Pam3Csk4 in HMVECs compared to HUVECs. Poly I:C priming enhanced inflammatory and interferon producing signals upon Poly I:C or LPS rechallenge, respectively. Poly I:C priming induced interferon regulatory factor 7, leading to enhancement of interferon production. Finally, both Poly I:C and LPS priming induced significant changes in receptor-interacting serine/threonine-protein kinase 1 activity. Pharmacological inhibition of receptor-interacting serine/threonine-protein kinase 1 or interferon regulatory factor 7 reduced the potentiated phenotype of TLR3 priming on TLR4 rechallenge. These results demonstrate that in human endothelial cells, prior activation of TLRs can have a significant impact on subsequent exposures and may contribute to the severity of the host response.


Subject(s)
Endothelial Cells/metabolism , Immune Tolerance , Toll-Like Receptors/metabolism , Endothelial Cells/drug effects , Extracellular Signal-Regulated MAP Kinases/metabolism , Human Umbilical Vein Endothelial Cells/drug effects , Human Umbilical Vein Endothelial Cells/metabolism , Humans , Immune Tolerance/drug effects , Interferon Regulatory Factor-7/metabolism , Interferons/metabolism , Interleukin-6/biosynthesis , Lipopeptides/pharmacology , Lipopolysaccharides/pharmacology , Nuclear Pore Complex Proteins/metabolism , Phosphorylation/drug effects , Poly I-C/pharmacology , RNA-Binding Proteins/metabolism , Up-Regulation/drug effects
13.
Anesth Analg ; 122(5): 1423-33, 2016 May.
Article in English | MEDLINE | ID: mdl-26720618

ABSTRACT

BACKGROUND: Peripheral nerve injury is a significant perioperative problem. Intraoperative position-related neurapraxia may indicate impending peripheral nerve injury and can be detected by changes in somatosensory evoked potentials (SSEP). The purpose of this retrospective analysis of spine surgeries performed under general anesthesia with SSEP monitoring was to determine the relationship between intraoperative mean arterial blood pressure (MAP) and intraoperative upper extremity position-related neurapraxia in the prone surrender (superman) position. METHODS: We reviewed a computerized database of spine surgeries performed on adult patients in the prone surrender position. The authors reviewed intraoperative SSEP monitoring reports to identify the patients who developed intraoperative upper extremity position-related neurapraxia (case group) and patients who did not (control group). Propensity matching was performed to derive 2 demographically matched groups. Preoperative and intraoperative variables were included in the univariate Cox regression analysis of risk factors associated with neurapraxia. Multivariate Cox regression models were used to identify the independent risk factors. RESULTS: One hundred fifty-two patients were included in the analysis. The case group included 32 patients, whereas the control group included 120 matched patients. Intraoperative MAP <55 mm Hg for a total duration of ≥5 minutes was an independent risk factor associated with a greater incidence of upper extremity position-related neurapraxia compared with a duration of <5 minutes with MAP <55 mm Hg (hazard ratio, 3.43; confidence interval, 1.445-8.148; P = 0.0052). Intraoperative MAP >80 mm Hg for a total duration of >55 minutes was an independent predictor associated with a lower incidence of neurapraxia compared with a total duration ≤55 minutes (hazard ratio, 0.341; confidence interval, 0.163-0.717; P = 0.0045). CONCLUSIONS: In this study, we identified the changes in intraoperative MAP as independent predictors associated with upper extremity position-related neurapraxia in the prone surrender position under general anesthesia.


Subject(s)
Arterial Pressure , Evoked Potentials, Somatosensory , Intraoperative Neurophysiological Monitoring/methods , Orthopedic Procedures/adverse effects , Patient Positioning/adverse effects , Peripheral Nerve Injuries/etiology , Prone Position , Spine/surgery , Upper Extremity/innervation , Adult , Aged , Anesthesia, General , Chi-Square Distribution , Databases, Factual , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Multivariate Analysis , Peripheral Nerve Injuries/diagnosis , Peripheral Nerve Injuries/physiopathology , Peripheral Nerve Injuries/prevention & control , Predictive Value of Tests , Propensity Score , Proportional Hazards Models , Retrospective Studies , Risk Assessment , Risk Factors , Time Factors
14.
Clin Sci (Lond) ; 130(6): 451-61, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26669797

ABSTRACT

Prior exposure to lipopolysaccharide (LPS) produces a reduced or "tolerant" inflammatory response to subsequent challenges with LPS, however the potent pro-inflammatory effects of LPS limit its clinical benefit. The adjuvant monophosphoryl lipid A (MPLA) is a weak toll-like receptor 4 (TLR4) agonist that induces negligible inflammation but retains potent immunomodulatory properties. We postulated that pre-treatment with MPLA would inhibit the inflammatory response of endothelial cells to secondary LPS challenge. Human umbilical vein endothelial cells (HUVECs), were exposed to MPLA (10 µg/ml), LPS (100 ng/ml) or vehicle control. HUVECs were then washed and maintained in culture for 24 h before being challenged with LPS (100 ng/ml). Supernatants were collected and examined for cytokine production in the presence or absence of siRNA inhibitors of critical TLR4 signalling proteins. Pre-treatment with MPLA attenuated interleukin (IL)-6 production to secondary LPS challenge to a similar degree as LPS. The application of myeloid differentiation primary response gene 88 (MyD88) siRNA dramatically reduced MPLA-induced tolerance while TIR-domain-containing adapter-inducing interferon-ß (TRIF) siRNA had no effect. The tolerant phenotype in endothelial cells was associated with reduced IκB kinase (IKK), p38 and c-Jun N-terminal kinase (JNK) phosphorylation and enhanced IL-1 receptor associated kinase-M (IRAK-M) expression for LPS-primed HUVECs, but less so in MPLA primed cells. Instead, MPLA-primed HUVECs demonstrated enhanced p-extracellular-signal-regulated kinase (ERK) phosphorylation. In contrast with leucocytes in which tolerance is largely TRIF-dependent, MyD88 signalling mediated endotoxin tolerance in endothelial cells. Most importantly, MPLA, a vaccine adjuvant with a wide therapeutic window, induced tolerance to LPS in endothelial cells.


Subject(s)
Adjuvants, Immunologic/pharmacology , Human Umbilical Vein Endothelial Cells/drug effects , Lipid A/analogs & derivatives , Myeloid Differentiation Factor 88/metabolism , Adaptor Proteins, Vesicular Transport/metabolism , Extracellular Signal-Regulated MAP Kinases/metabolism , Human Umbilical Vein Endothelial Cells/metabolism , Humans , Immune Tolerance/drug effects , Interleukin-1 Receptor-Associated Kinases/metabolism , Lipid A/pharmacology , Lipopolysaccharides , Phosphorylation/drug effects
15.
Innate Immun ; 21(6): 565-74, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25540284

ABSTRACT

Monophosphoryl lipid A (MPLA) is a TLR4 agonist that is used as an immunomodulator in human vaccines; additionally, it has been shown to be protective in models of sepsis. As endothelial cells regulate inflammation, we hypothesized that MPLA would decrease activation of human umbilical vein endothelial cells (HUVECs) to LPS. We studied HUVECs challenged with LPS (100 ng/ml), MPLA (0.001-100 µg/ml) or a combination. Secretion of IL-6, RANTES (CCL5) and IP-10 (CXCL10) were assessed by ELISA. Activation of MAPK phosphorylation and cytokine transcription were assessed by Western blot analysis and PCR, respectively. MPLA alone was a weak stimulator of myeloid differentiation primary response protein 88-dependent IL-6 and did not induce TIR-domain-containing adapter-inducing IFN-ß (TRIF)-dependent chemokine responses. MPLA significantly reduced LPS-mediated IL-6 production. This inhibitory effect was also conferred for the TRIF-dependent chemokines RANTES and IP-10. Inhibition of LPS-mediated activation by MPLA was associated with reduced p38 phosphorylation and mRNAs encoding inflammatory cytokines. MPLA inhibition of LPS signaling appeared to be at the level of the TLR4 receptor, acting as a receptor antagonist with weak agonistic properties. This study provides evidence of a novel mechanism for the inhibitory effect of MPLA on LPS-induced endothelial activation.


Subject(s)
Chemokine CCL5/metabolism , Chemokine CXCL10/metabolism , Endothelial Cells/immunology , Interleukin-6/metabolism , Lipid A/analogs & derivatives , Cells, Cultured , Down-Regulation , Drug Combinations , Endothelial Cells/drug effects , Humans , Immunity, Innate/drug effects , Immunomodulation , Lipid A/pharmacology , Lipopolysaccharides/pharmacology , Signal Transduction/drug effects , Toll-Like Receptor 4/metabolism , Umbilical Veins/cytology
16.
Biochem Biophys Res Commun ; 425(4): 830-5, 2012 Sep 07.
Article in English | MEDLINE | ID: mdl-22892129

ABSTRACT

Ankyrin repeat domain 1 protein (Ankrd1), also known as cardiac ankyrin repeat protein (CARP), increases dramatically after tissue injury, and its overexpression improves aspects of wound healing. Reports that Ankrd1/CARP protein stability may affect cardiovascular organization, together with our findings that the protein is crucial to stability of the cardiomyocyte sarcomere and increased in wound healing, led us to compare the contribution of Ankrd1/CARP stability to its abundance. We found that the 26S proteasome is the dominant regulator of Ankrd1/CARP degradation, and that Ankrd1/CARP half-life is significantly longer in cardiomyocytes (h) than endothelial cells (min). In addition, higher endothelial cell density decreased the abundance of the protein without affecting steady state mRNA levels. Taken together, our data and that of others indicate that Ankrd1/CARP is highly regulated at multiple levels of its expression. The striking difference in protein half-life between a muscle and a non-muscle cell type suggests that post-translational proteolysis is correlated with the predominantly structural versus regulatory role of the protein in the two cell types.


Subject(s)
Endothelium, Vascular/metabolism , Heart Ventricles/metabolism , Muscle Proteins/metabolism , Myocytes, Cardiac/metabolism , Nuclear Proteins/metabolism , Proteasome Endopeptidase Complex/metabolism , Repressor Proteins/metabolism , Animals , Cell Count , Cells, Cultured , Half-Life , Heart Ventricles/cytology , Humans , Microvessels/metabolism , Proteolysis , Rats
17.
Eur Spine J ; 20(6): 869-74, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21170665

ABSTRACT

Reliable electromyography (EMG) thresholds for detecting medial breaches in the thoracic spine are lacking, and there is a paucity of reports evaluating this modality in patients with adolescent idiopathic scoliosis (AIS). This retrospective analysis evaluates the ability of triggered EMG to detect medial breaches with thoracic pedicle screws in patients with AIS. We reviewed 50 patients (937 pedicle screws) undergoing posterior spinal fusion (PSF) with intraoperative EMG testing. Postoperative CT scans were used for breach identification, and EMG values were analyzed. There were 47 medial breaches noted with a mean threshold stimulus of 10.2 mA (milliamperes). Only 8/47 breaches stimulated at 2-6 mA. Thirteen of the forty-seven screws tested at an EMG value ≤6 mA and/or a decrease of ≥65% compared with intraosseously placed screws. The sensitivity and positive predictive value for EMG was 0.28 and 0.21. A subanalysis of T10-T12 screws identified six of seven medial breaches. Using guidelines from the current literature, EMG does not appear to be reliable in detecting medial breaches from T2 to T9 but may have some utility from T10 to T12.


Subject(s)
Electromyography/adverse effects , Scoliosis/surgery , Spinal Fusion/adverse effects , Thoracic Vertebrae/surgery , Adolescent , Bone Screws , Electric Stimulation , Electromyography/methods , Female , Humans , Male , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Radiography , Retrospective Studies , Scoliosis/diagnostic imaging , Sensory Thresholds , Spinal Fusion/instrumentation , Spinal Fusion/methods , Thoracic Vertebrae/diagnostic imaging , Treatment Outcome
18.
Inorg Chem ; 48(14): 6359-61, 2009 Jul 20.
Article in English | MEDLINE | ID: mdl-20507106

ABSTRACT

Dithiolate bridging Ni-Fe complexes [(dppe)Ni(II)(mu-SEt)(2)Fe(II)(CN)(2)(CO)(2)](6) and [(dppe)Ni(II)(mu-pdt)Fe(II)(CN)(2)(CO)(2)] [dppe = 1,2-bis(diphenylphosphino)ethane and pdt = 1,3-propanedithiolate] have been synthesized and structurally characterized as structural analogues of the active site of Ni-Fe hydrogenase enzymes. The synthesis starts from key intermediate fac-[Fe(CN)(2)(CO)(3)I](-). [(dppe)Ni(II)(mu-SEt)(2)Fe(II)(CN)(2)(CO)(2)](6), which features a near-planar diethanethiolate-bridged Ni-Fe rhomb, and the arrangement of 2CN(-) ligands is cis to each other. In contrast, [(dppe)Ni(II)(mu-pdt)Fe(II)(CN)(2)(CO)(2)] shows a much more folded NiS(2)Fe rhomb, a short Ni-Fe distance, trans 2CN(-) ligands, and a semibridging CN(-) between Ni and Fe.


Subject(s)
Hydrogenase/chemical synthesis , Catalytic Domain , Hydrogenase/chemistry , Models, Molecular
19.
J Am Chem Soc ; 129(34): 10446-56, 2007 Aug 29.
Article in English | MEDLINE | ID: mdl-17685516

ABSTRACT

Reactions of NO and CO with Fe(II) complexes of the tripodal trithiolate ligands NS3 and PS3* yield trigonal-bipyramidal (TBP) complexes with varying redox states and reactivity patterns with respect to dissociation of the diatomic ligand. The previously reported four-coordinate [Fe(II)(NS3)](-) complex reacts irreversibly with NO gas to yield the S = 3/2 {FeNO}(7) [Fe(NS3)(NO)](-) anion, isolated as the Me(4)N(+) salt. In contrast, the reaction of NO with the species generated by the reaction of FeCl(2) with Li(3)PS3* gives a high yield of the neutral, TBP, S = 1 complex, [Fe(PS3*)(NO)], the first example of a paramagnetic {FeNO}(6) complex. X-ray crystallographic analyses show that both [Fe(NS3)(NO)](-) and [Fe(PS3*)(NO)] feature short Fe-N(NO) distances, 1.756(6) and 1.676(3) A, respectively. However, whereas [Fe(NS3)(NO)]- exhibits a distinctly bent FeNO angle and a chiral pinwheel conformation of the NS3 ligand, [Fe(PS3*)(NO)] has nearly C(3v) local symmetry and a linear FeNO unit. The S = 1 [Fe(II)(PS3)L] complexes, where L = 1-MeIm, CN(-), CO, and NO(+), exhibit a pronounced lengthening of the Fe-P distances along the series, the values being 2.101(2), 2.142(1), 2.165(7), and 2.240(1) A, respectively. This order correlates with the pi-backbonding ability of the fifth ligand L. The cyclic voltammogram of the [Fe(NS3)(NO)](-) anion shows an irreversible oxidation at +0.394 V (vs SCE), apparently with loss of NO, when scanned anodically in DMF. In contrast, [Fe(PS3*)(NO)] exhibits a reversible {FeNO}(6)/{FeNO}(7) couple at a low potential of -0.127 V. Qualitatively consistent with these electrochemical findings, DFT (PW91/STO-TZP) calculations predict a substantially lower gas-phase adiabatic ionization potential for the [Fe(PS3)(NO)](-) anion (2.06 eV) than for [Fe(NS3)(NO)](-) (2.55 eV). The greater instability of the {FeNO}(7) state with the PS3* ligand results from a stronger antibonding interaction involving the metal d(z(2)) orbital and the phosphine lone pair than the analogous orbital interaction in the NS3 case. The antibonding interaction involving the NS3 amine lone pair affords a relatively "stereochemically active" dz2 electron, the z direction being roughly along the Fe-N(NO) vector. As a result, the {FeNO}(7) unit is substantially bent. By contrast, the lack of a trans ligand in [Fe(S(t)Bu)3(NO)](-), a rare example of a tetrahedral {FeNO}(7) complex, results in a "stereochemically inactive" d(z(2)) orbital and an essentially linear FeNO unit.


Subject(s)
Electrons , Heme/chemistry , Iron/chemistry , Nitric Oxide/chemistry , Sulfhydryl Compounds/chemistry , Crystallography, X-Ray , Electrochemistry , Models, Molecular , Molecular Structure , Spectrum Analysis, Raman , Vibration
20.
J Inorg Biochem ; 101(11-12): 1758-9, 2007 Nov.
Article in English | MEDLINE | ID: mdl-17723243

ABSTRACT

It is shown that the previously characterized [Fe(III)(SR)(4)](1-) (R=Et, i-Pr, Ph) complexes can be synthesized by the direct reaction of 4equiv. of LiSR with FeCl(3) in DMF solution. [Fe(III)(SR)(4)](1-) complexes are synthetic analogs for the [Fe(III)(S-Cys)(4)] center in rubredoxin proteins.


Subject(s)
Ferric Compounds/chemistry , Iron/chemistry , Rubredoxins/chemistry , Sulfhydryl Compounds/chemistry , Chlorides , Models, Chemical , Rubredoxins/chemical synthesis , Sulfhydryl Compounds/chemical synthesis
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