Paliperidone Prevents Brain Toll-Like Receptor 4 Pathway Activation and Neuroinflammation in Rat Models of Acute and Chronic Restraint Stress

Background:

Alterations in the innate immune/inflammatory system have been proposed to underlie the pathophysiology of psychotic disease, but the mechanisms implicated remain elusive. The main agents of the innate immunity are the family of toll-like receptors (TLRs), which detect circulating pathogen-associated molecular patterns and endogenous damage-associated molecular patterns (DAMPS). Current antipsychotics are able to modulate pro- and anti-inflammatory pathways, but their actions on TLRs remain unexplored.

Methods:

This study was conducted to elucidate the effects of paliperidone (1mg/Kg i.p.) on acute (6 hours) and chronic (6 hours/day during 21 consecutive days) restraint stress–induced TLR-4 pathway activation and neuroinflammation, and the possible mechanism(s) related (bacterial translocation and/or DAMPs activation). The expression of the elements of a TLR-4-dependent proinflammatory pathway was analyzed at the mRNA and protein levels in prefrontal cortex samples.

Results:

Paliperidone pre-treatment prevented TLR-4 activation and neuroinflammation in the prefrontal cortices of stressed rats. Regarding the possible mechanisms implicated, paliperidone regulated stress-induced increased intestinal inflammation and plasma lipopolysaccharide levels. In addition, paliperidone also prevented the activation of the endogenous activators of TLR-4 HSP70 and HGMB-1.

Conclusions:

Our results showed a regulatory role of paliperidone on brain TLR-4, which could explain the therapeutic benefits of its use for the treatment of psychotic diseases beyond its effects on dopamine and serotonin neurotransmission. The study of the mechanisms implicated suggests that gut-increased permeability, inflammation, and bacterial translocation of Gram-negative microflora and HSP70 and HGMB1 expression could be potential adjuvant therapeutic targets for the treatment of psychotic and other stress-related psychiatric pathologies.     

Platelet-activating factor primes neutrophil responses to agonists: role in promoting neutrophil-mediated endothelial damage

During inflammation polymorphonuclear cells (PMNs) are exposed to agonistic stimuli including activated complement, kallikrein, arachidonic acid metabolites, monokines, and platelet-activating factor (PAF). We report that PAF not only directly activates PMNs but in miniscule quantities (10(-12) mol/L) "primes" them as well, that is, permits PMNs to respond to subsequent stimuli that would be otherwise ineffectual. PAF priming of responses including superoxide generation, elastase release, and aggregation is time dependent and is maximal within five minutes. PAF need not be present during the subsequent exhibition of PMN agonists, but priming is inhibited by cold and is also inhibited by the PAF receptor antagonists BN 52021, L-652, and kadsurenone. An intact PAF molecule is required because lyso-PAF and methoxy-PAF do not prime PMN responses. PAF priming is associated with both enhanced expression of the adhesive glycoprotein identified by OKM- 1 antibody and an enhanced rise in intracellular calcium levels in response to the subsequent addition of agonists such as FMLP. PMNs primed with PAF and stimulated with either F-Met-Leu-Phe or phorbol esters are more effective in lysing and detaching cultured human endothelial cells--damage that can also be inhibited by the PAF antagonists. Because PAF is synthesized and exhibited on surfaces of endothelial cells perturbed by coagulation, we suggest that this lipid may potentiate otherwise trivial activators of marginated PMNs so that they become damaging to the PAF-synthesizing endothelium itself. If so, our studies suggest a possible therapeutic role for PAF inhibitors in excessive inflammatory states.     

Potential capsule switching from serogroup Y to B: The characterization of three such Neisseria meningitidis isolates causing invasive meningococcal disease in Canada

Three group B Neisseria meningitidis isolates, recovered from meningococcal disease cases in Canada and typed as B:2c:P1.5, were characterized. Multilocus sequence typing showed that all three isolates were related because of an identical sequence type (ST) 573. Isolates typed as 2c:P1.5 are common in serogroup Y meningococci but rare in isolates from serogroups B or C. Although no serogroup Y isolates have been typed as ST-573, eight isolates showed five to six housekeeping gene alleles that were identical to that of ST-573. This suggested that the B:2c:P1.5 isolates may have originated from serogroup Y organisms, possibly by capsule switching.Key Words: Capsule switching, Neisseria meningitidis, Serogroup YNeisseria meningitidis is a significant pathogen that causes invasive meningococcal disease (IMD). The average case fatality rate of 9% to 12% remains high despite the availability of effective antibiotics and vaccines (1). Laboratory study and surveillance of N meningitidis involves the characterization of a number of surface markers of the bacterium, including its capsule and outer membrane proteins (OMPs). Most epidemiological studies of meningococcal disease rely on differentiating meningococcal isolates based on their serogroup, serotype and serosubtype. Serogrouping is determined by the demonstration of serologically distinct epitopes present on chemically and structurally different capsules. Serotyping and serosubtyping rely on the detection of distinct epitopes present on three of five different classes of OMPs of N meningitidis. Serotyping epitopes are found on the class 2 or class 3 OMP (also called PorB) of N meningitidis; these OMPs are expressed in a mutually exclusively manner (ie, a strain will only express either a class 2 or class 3 OMP but not both). Serosubtyping epitopes are present on the class 1 OMP (also called PorA). Based on this nomenclature scheme, a strain can therefore be characterized by its antigenic formula; for example, B:15:P1.7,16 refers to serogroup B, serotype 15 and serosubtype P1.7,16.One of the most important virulence factors of meningococci is the capsular polysaccharide antigen, which is also the basis for serogrouping and is the target antigen for the currently licensed vaccines against A, C, Y and W135 organisms. Of the 13 known serogroups, five (serogroups A, B, C, Y and W135) are responsible for most of the meningococcal disease worldwide (2). In North America, most endemic and epidemic strains belong to serogroups B, C, Y and W135 (3,4). Capsules of serogroups B, C, Y and W135 meningococci contain sialic acid, either as a homopolymer of sialic acids assembled by alpha-2,8 linkages (serogroup B) or alpha-2,9 linkages (serogroup C), or as a heteropolymer of sialic acids with glucose (serogroup Y) or galactose (serogroup W135). Besides demonstrating structural similarities, these four serogroups of meningococci also have very similar capsule polysaccharide synthesis (cps) gene loci (5). Because of this similarity, capsule switching has been demonstrated in vivo and in vitro by specific gene replacement within the cps loci between different serogroups. To date, a number of IMD cases have been described in the literature to be caused by organisms in which capsule switching between serogroup B and C meningococci occurred (6-8).In the present paper, the authors describe three unusual serogroup B meningococci isolated from separate IMD cases in Nanaimo, British Columbia, that presented with the OMP antigens 2c:P1.5, characteristic of serogroup Y strains found in Canada (4). This antigenic profile prompted the authors to examine the relationship of these three serogroup B strains with antigenically similar serogroup Y organisms isolated in Canada. The authors describe the characterization of these antigenically similar isolates and postulate that the B:2c:P1.5 isolates arose by capsule switching from serogroup Y organisms.     

Comparison of three PCR methods for detection of Helicobacter pylori DNA and detection of cagA gene in gastric biopsy specimens

AIM:To comparatively evaluate PCR and other diagnosticmethods (the rapid urease test and/or culture) in order todetermine which of the three PCR methods (ureA,glmMand 26-kDa,SSA gene) was most appropriate in the diagnosisof Helicobacterpylori(Hpylori) infection and also to evaluatethe detection of a putative virulence marker of H pylori,thecage,gene,by PCR in biopsy specimens.METHODS:One hundred and eighty-nine biopsy specimenswere collected from 63 patients (three biopsies each)undergoing upper gastroduodenal endoscopy for variousdyspeptic symptoms.The PCR methods used to detectH pylori DNA directly from biopsies were the glmM,26-kDa,ureA and then cagA was used to compare the culturetechnique and CLO for urease with the culture techniquebeing used as the gold standard.RESULTS:Thirty-five percent of the biopsies were positivefor H pylori DNA using the 3 PCR methods,while 68% ofthese were positive for the cagA gene.Twenty-four percentof the biopsies were negative for H pylori DNA in all PCRmethods screened.The remaining 41% were either positivefor ureA gene only,glmM only,26-kDa only,or ureA glmM,ureA 26-kDa,glmM 26-kDa.Out of the 35% positivebiopsies,41% and 82% were positive by culture and CLOrespectively,while all negative biopsies were also negativeby culture and cagA.Cag A infection was also predominantlyfound in H pylori DNA of the biopsies irrespective of theclinical diagnosis.CONCLUSION:This method is useful for correctly identifyinginfections caused by H pylori and can be easily applied inour laboratory for diagnostic purposes.     

Willingness to accept H1N1 pandemic influenza vaccine: A cross-sectional study of Hong Kong community nurses

Background  

The 2009 pandemic of influenza A (H1N1) infection has alerted many governments to make preparedness plan to control the spread of influenza A (H1N1) infection. Vaccination for influenza is one of the most important primary preventative measures to reduce the disease burden. Our study aims to assess the willingness of nurses who work for the community nursing service (CNS) in Hong Kong on their acceptance of influenza A (H1N1) influenza vaccination.     

Anti‐inflammatory effects of exendin‐4, a glucagon‐like peptide‐1 analog,on human peripheral lymphocytes in patients with type 2 diabetes

Aims/Introduction

Type 2 diabetes is characterized by dysregulation of immunity, oxidative stress and reduced incretin effects. Experimental studies suggest that glucagon‐like peptide (GLP‐1) might have immunomodulating effects. We hypothesize that GLP‐1 receptor agonist, exendin‐4, might reduce inflammatory response in type 2 diabetes.

Materials and Methods

Using peripheral blood mononuclear cells (PBMC) sampled from 10 type 2 diabetes and 10 sex‐ and age‐matched control subjects and supernatants from PBMC culture, the expression of phospho‐mitogen activated protein kinase (MAPK) signaling pathways in CD4+ T helper lymphocytes and monocytes was analyzed using flow cytometry. Cytokines/chemokines and superoxide anion before and after treatment with exendin‐4 were measured by cytometric bead array and chemiluminesence assay, respectively.

Results

Compared with control subjects, PBMC from type 2 diabetes patients showed activated MAPK (P38, c‐Jun NH2‐terminal protein kinase and extracellular signal‐regulated kinase) signaling pathway, elevated superoxide anion, increased pro‐inflammatory cytokines (tumor necrosis factor‐α, interleukin‐1β, interleukin‐6) and chemokines (CCL5/regulated on activation normal T‐cell expressed and secreted and CXCL10/interferon‐γ‐induced protein 10). These changes were attenuated by exendin‐4, possibly through the suppression of p38 MAPK.

Conclusions

These results suggest that exendin‐4 might downregulate pro‐inflammatory responses and reduce oxidative stress by suppressing MAPK signaling pathways in type 2 diabetes.