The International Spinal Cord Injury Pain Extended Data Set (Version 1.0).

OBJECTIVES: The objective of this study was to develop the International Spinal Cord Injury Pain Extended Data Set (ISCIPEDS) with the purpose of guiding the assessment and treatment of pain after spinal cord injury (SCI). SETTING: International. METHODS: The ISCIPEDS was reviewed by members of the International SCI Data Sets Committee, the International Spinal Cord Society Executive and Scientific Committees, American Spinal Injury Association and American Pain Society Boards, and the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain, individual reviewers and societies. RESULTS: The working group recommended four assessment domains for the ISCIPEDS: (i) Pain symptoms including variables related to pain type, temporal course, severity, unpleasantness, tolerability of pain and questionnaires assessing pain type and symptom severity; (ii) Sensory signs to detect and quantify sensory abnormalities commonly associated with neuropathic pain, including dynamic mechanical and thermal allodynia, and hyperalgesia; (iii) Treatments (ongoing and past 12 months); and (iv) Psychosocial factors and comorbid conditions. CONCLUSION: The ISCIPEDS was designed to be used together with the International SCI Pain Basic Data Set and provide a brief yet thorough assessment of domains related to chronic pain in individuals with SCI. The data set includes pain-relevant self-reported assessments, questionnaires and sensory examinations. The recommendations were based on (i) their relevance to individuals with SCI and chronic pain, (ii) the existence of published findings supporting the utility of the selected measures for use in individuals with SCI, and to the greatest extent possible (iii) their availability in the public domain free of charge.

Reproduction and embryonic diapause in a marsupial: insights from captive female Honey possums, Tarsipes rostratus (Tarsipedidae).

The reproductive physiology of the polyoestrous Honey possum (Tarsipes rostratus) is virtually unknown except that it shares with the kangaroos and wallabies the phenomenon of embryonic diapause. Its tiny size necessitates an alternate approach to study their reproductive cycle. We have accordingly utilised faecal steroid analysis. Baseline faecal cortisol levels in the Honey possum, at 4.1+/-0.3 mug g-1, are approximately 100-fold those of other mammals and are associated with adrenal glands that, on a mass-specific basis, are almost 10 times larger than the adrenals of other mammalian, including marsupial, species. Histological examination of the adrenal glands revealed no abnormalities, however, but their hypertrophy and the peaks recorded in faecal levels following disturbance suggest that the Honey possum is vulnerable to chronic stressors in the captive situation. Mean faecal progestagens (124.4+/-107.3 ng g-1) and oestradiol-17beta (4.1+/-1.1 ng g-1) in 4 non-pregnant females maintained long term were not different from those of 5 pregnant females (101.4+/-61.0 ng g-1 and 4.3+/-1.5 ng g-1, respectively) and, on analysis, revealed a cyclicity of 24+/-1.2 days. We would predict from this evidence that the gestation period, in the absence of lactation, is approximately 23 days. Four of the pregnant females, monitored from July to November under conditions of 10:14 L:D photoperiod, showed a fall in levels of progestagens from 175.9+/-10.8 ng g-1 in July and August to 30.9+/-9.4 ng g-1 in October, while mean faecal levels of oestradiol-17beta increased from 3.8+/-0.4 ng g-1 in July to 5.7+/-0.3 ng g-1 in October. September and October are months of peak reproductive activity in the wild and we suggest that these hormonal modulations may represent an entrained reproductive rhythm. Blastocysts appear to develop at varying rates, both within the one uterus, and between the two uteri of a single female. In addition, the time taken to reach the blastocyst stage may be longer than in any other marsupial studied to date. An association of the age of the pouch young with the stage reached by the developing blastocyst does not support the conclusion that blastocysts, once formed, grow slowly during lactation or diapause. Contrary to previous reports, we have documented what appears to be a lactational inhibition on blastocysts in diapause and have estimated the length of the 'delayed' reproductive cycle in two females as less than 2 weeks. Reactivation of blastocysts in Tarsipes has been shown to be stimulated by shortening day lengths after the summer solstice, a response similar to the annual breeding period of macropodid marsupials. Results from studying Honey possums in captive conditions suggest that the control of diapause in Tarsipes appears to be three-fold; lactational, photoperiodic and an entrained rhythm.

Reproductive activity in captive female Honey possums, Tarsipes rostratus, assessed by faecal steroid analysis.

Hormonal changes associated with reproductive activity in the unique pollen and nectar-feeding marsupial Honey possum, Tarsipes rostratus, have been monitored by the measurement of sex steroids excreted via the faeces. From a radio-metabolism study, 63% of administered [(14)C]oestradiol was excreted in the faeces and 37% via the urine. Peak levels in the faeces were reached 6h after injection and by a mean 12h, 95% of steroid was eliminated. The principal metabolic products of progesterone that were identified by chromatographic analysis were the isomers 5alpha- and 5beta-pregnan-3beta-ol-20-one with only trace amounts of progesterone and the isomers 5beta-pregnan-3beta,20beta- and 20alpha-diols. Extended excretory profiles for faecal progestagens (PM) and oestradiol-17beta (E(2)) are reported for the first time in a marsupial. The profiles from 4 females held in indoor cages with an artificial photoperiod suggest that long days inhibit reproductive activity in this species, as is the case in a number of other marsupials. One female appeared to resume cycling after a 5-month period and the time between peak levels of both E(2) and PM suggest that the length of the oestrous cycle in the Honey possum is approximately 25 days. The PM profile suggests that the corpora lutea secrete low levels of progesterone for approximately the first 19 days after ovulation, followed by increased rates of excretion during the final 6 days.

Expression of interleukin-9 leads to Th2 cytokine-dominated responses and fatal enteropathy in mice with chronic Schistosoma mansoni infections.

Mice infected with Schistosoma mansoni develop Th2 cytokine-mediated granulomatous pathology that is focused on the liver and intestines. In this study, transgenic mice constitutively expressing IL-9 were infected with S. mansoni and the outcome of infection was determined. Eight weeks after infection, transgenic mice with acute infections had a moderate increase in Th2 cytokine production but were overtly normal with respect to parasite infection and pathological responses. Transgenic mice with chronic infections died 10 weeks after infection, with 86% of transgenic mice dead by week 12 of infection, compared to 7% mortality in infected wild-type mice. Stimulation of mesenteric lymph node cells from infected transgenic mice with parasite antigen elicited elevated interleukin-4 (IL-4) and IL-5 production and reduced gamma interferon and tumor necrosis factor alpha production compared to the responses in wild-type mice. Morbid transgenic mice had substantial enlargement of the ileum, which was associated with muscular hypertrophy, mastocytosis, eosinophilia, goblet cell hyperplasia, and increased mucin expression. We also observed that uninfected transgenic mice exhibited alterations in their intestines. Although there was hepatic mastocytosis and eosinophilia in infected transgenic mice, there was no hepatocyte damage. Death of transgenic mice expressing IL-9 during schistosome infection was primarily associated with enteropathy. This study highlights the pleiotropic in vivo activity of IL-9 and demonstrates that an elevated Th2 cytokine phenotype leads to death during murine schistosome infection.

Elevated type 1, diminished type 2 cytokines and impaired antibody response are associated with hepatotoxicity and mortalities during Schistosoma mansoni infection of CD4-depleted mice.

During murine Schistosoma mansoni infections parasite eggs evoke a type 2 cytokine-dependent and CD4(+) T cell-mediated granulomatous response in the liver. In this study CD4(+) T cell-depleted CBA / Ca mice developed hepatic steatosis and had high mortalities during early acute schistosome infection. CD4-depleted mice had smaller liver granulomas and reduced hepatic fibrosis. The hepatocytotoxicity was characterized by microvesicular steatosis and neutrophil infiltration. The livers of depleted mice had similar levels of apoptosis as control infected mice but had a marked increase in lipid peroxidation indicative of their livers being under oxidative stress. CD4-depleted mice had impaired egg excretion and exacerbated intestinal pathology. A type 1 cytokine-dominated response was present in infected CD4-depleted mice and relatively reduced production of type 2 cytokines. Antibody responses to parasite antigens were also substantially reduced. Transfer of immune serum or IgG significantly delayed mortalities in depleted mice and prevented hepatocyte damage. Although biasing the cytokine dichotomy to a type 1-dominated response during murine schistosome infection is desirable with respect to certain pathological processes, i. e. it will reduce the granulomatous inflammation and hepatic fibrosis, these effects contribute to fatal pathology if there is reduced protective type 2 cytokines and a defect in antibody responses.

Schistosome infection of transgenic mice defines distinct and contrasting pathogenic roles for IL-4 and IL-13: IL-13 is a profibrotic agent.

Experimental Schistosoma mansoni infections of mice lead to a dynamic type 2 cytokine-mediated pathological process. We have used IL-4-deficient, IL-13-deficient, and IL-4/13-deficient mice to dissect the role of these cytokines in the development of immune response and pathology following S. mansoni infection. We demonstrate that while both of these cytokines are necessary to develop a robust Th2 cell-driven, eosinophil-rich granuloma response, they also perform disparate functions that identify novel sites for therapeutic intervention. IL-13-deficient mice demonstrated significantly enhanced survival following infection, which correlated with reduced hepatic fibrosis. In contrast, increased mortality was manifest in IL-4-deficient and IL-4/13-deficient mice, and this correlated with hepatocyte damage and intestinal pathology. Therefore, we demonstrate that during a dynamic type 2 cytokine disease process IL-13 is detrimental to survival following infection, whereas IL-4 is beneficial.

Dehydroepiandrosterone sulfate treatment of mice modulates infection with Schistosoma mansoni.

Female mice treated with dehydroepiandrosterone sulfate early during infection were partially protected (P < 0.05-0.005) from Schistosoma mansoni infection. Hormone treatment did not modify parasite-specific cellular or humoral responses. Serum dehydroepiandrosterone sulfate levels and testosterone infection were negatively correlated, r = -0.621 and r = -0.653, respectively, with schistosome worm burden. The partial resistance to schistosome infection in dehydroepiandrosterone sulfate-treated female mice may be due to the known antischistosomular activity of testosterone.