The whole lupus: Articulating biosocial interplay in systemic lupus erythematosus epidemiology and population disparities.

Systemic lupus erythematosus (SLE), commonly known simply as lupus, is an autoimmune disease in which the body's immune system attacks healthy tissue and organs. Characteristic of the disease is a disproportionate effect on women and communities of color, both in terms of prevalence and severity of symptoms. Lupus is also both genetically driven and subject to external environmental conditions, many with place based corollaries. Thus, lupus presents a series of complex and intersecting biosocial questions regarding its origin and treatment, questions which transdisciplinary approaches are uniquely suited to address. In this paper, we propose a framework, incorporating critical approaches to the production of embodied formations of race and gender as well as new understandings of the impact of environmental conditions and lived experience at the genetic level, that can direct future research into lupus that is both more inclusive of a range of influences and more precise in its ability to treat and diagnose the disease.

Glucocorticoids alter adrenomedullin receptor expression and secretion in endothelial-like cells and astrocytes.

Adrenomedullin (AM) is a novel vasodilatory peptide, which acts primarily through the calcitonin receptor-like receptor (CLR) in combination with either receptor-activity-modifying-protein (RAMP) 2 or 3 (forming receptors, AM1 and AM2 respectively). AM is also highly expressed in the brain and it has shown neuropeptide characteristics. Furthermore, AM plays an important role during inflammation. Interestingly, AM secretion and AM receptor expression had also proven to be glucocorticoid (GC)-dependent in a variety of cell types, suggesting an intriguing relationship between the two compounds that needed to be further characterized. Protein studies have never been carried out in endothelial cells and neither have astrocytes been thoroughly investigated. Hence we studied the effect of GC treatments on AM secretion and AM-sensitivity in ECV304 an endothelial-like cell line and C6 rat astrocytes, focusing on receptor protein expression. We demonstrated that GCs could directly up-regulate RAMP2 expression intracellularly in endothelial cells. On the contrary, GCs were essential to maintain RAMP basal levels in astrocytes, where they could alter AM secretion within 24h. Although RAMP2 has shown to be similarly up-regulated also by AM exposure, no change in AM receptor expression was noted in C6 cells. In conclusion, our study indicates that GCs are able to regulate AM-sensitivity and AM secretion differently in endothelial-like cells and astrocytes. In particular, GCs altered RAMP2 in ECV304 cells, while affecting AM secretion in astrocytes, an interaction which could have interesting therapeutic implications for the blood-brain barrier regulation during both physiological and inflammatory conditions.

Adrenomedullin receptors on human T cells are glucocorticoid-sensitive.

Adrenomedullin (AM) is a novel vasodilatatory peptide which acts primarily through the calcitonin receptor-like receptor (CLR) in combination with either receptor-activity-modifying-protein (RAMP) 2 or 3 (forming receptors, AM(1) and AM(2) respectively). AM plays an important role during inflammation, with its expression increasing following cytokine treatment, promoting macrophage action in situ and high expression by T cells during hypoxic conditions. Examination of T cell AM receptor expression has previously been incomplete, hence we here consider the presentation of AM receptors and their responsiveness to AM and glucocorticoids (GC). AM receptor expression was examined by PCR and flow cytometry in primary human T cells, revealing that RAMP2, 3 and CLR are physiologically expressed in unstimulated T cells, both intracellularly and on the cell surface. PHA stimulation decreased receptor proteins, significantly so for CLR and RAMP3. Incubation with AM elicited limited receptor alterations however, GC treatment (10(-6) M; 24 h) markedly affected cell surface expression, significantly increasing receptor components in unstimulated cells and significantly decreasing the same in stimulated T cells. Our findings indicate that human T cells utilize both AM(1) and AM(2) receptors, which are GC-sensitive in an activation-state dependent manner.

Glutamate receptors in neuroinflammatory demyelinating disease.

Multiple sclerosis (MS) is a chronic demyelinating disease of the human central nervous system (CNS). The condition predominantly affects young adults and is characterised by immunological and inflammatory changes in the periphery and CNS that contribute to neurovascular disruption, haemopoietic cell invasion of target tissues, and demyelination of nerve fibres which culminate in neurological deficits that relapse and remit or are progressive. The main features of MS can be reproduced in the inducible animal counterpart, experimental autoimmune encephalomyelitis (EAE). The search for new MS treatments invariably employs EAE to determine drug activity and provide a rationale for exploring clinical efficacy. The preclinical development of compounds for MS has generally followed a conventional, immunotherapeutic route. However, over the past decade, a group of compounds that suppress EAE but have no apparent immunomodulatory activity have emerged. These drugs interact with the N-methyl-D-aspartate (NMDA) and alpha-amino-3-hydroxy-5-isoxazolepropionic acid (AMPA)/kainate family of glutamate receptors reported to control neurovascular permeability, inflammatory mediator synthesis, and resident glial cell functions including CNS myelination. The review considers the importance of the glutamate receptors in EAE and MS pathogenesis. The use of receptor antagonists to control EAE is also discussed together with the possibility of therapeutic application in demyelinating disease.

Modulation of blood-brain barrier dysfunction and neurological deficits during acute experimental allergic encephalomyelitis by the N-methyl-D-aspartate receptor antagonist memantine.

Previous studies by us have strongly indicated a role for the N-methyl-D-aspartate (NMDA) receptor in the pathogenesis of experimental allergic encephalomyelitis (EAE) and, moreover, the loss of blood-brain barrier (BBB) integrity implicit in the disease. The current investigation has used the NMDA receptor antagonist memantine to modify the neurological course of EAE and, in particular, prevent BBB breakdown. Memantine was administered orally either semiprophylactically, from day 7 postinoculation (PI), or therapeutically, 10 to 11 days PI. Semiprophylactic administration of drug at 60 mg/kg b.wt. significantly restored BBB integrity, reduced symptoms, and limited inflammatory lesions (p < 0.05), when assessed 12 days PI. Higher concentrations of memantine did not notably advance disease improvements observed at 60 mg/kg b.wt., and 40-mg/kg b.wt. doses only reduced histological scores (p < 0.05). Therapeutic application of memantine was found to be as effective as semiprophylactic dosing. Administration of drug at 60 mg/kg b.wt. was demonstrated as the optimum dose, significantly reducing disease, BBB permeability, and lesions (p < 0.01). Extended studies revealed that, after cessation of memantine treatment using either dosing regime, any subsequent appearance of disease was suppressed in severity and duration. We have provided further strong evidence in support of a role for the NMDA receptor in the development of EAE and, in particular, the loss of BBB function and recruitment of inflammatory cells. Moreover, memantine is therapeutically efficacious, suggesting the NMDA receptor as a viable pharmacological target for future treatment of human neurological conditions such as multiple sclerosis.