This thesis explores physiological changes occurring after acute brain injury. The first two chapters focus on traumatic brain injury (TBI), a significant cause of disability and death worldwide. I discuss the evidence behind current management of secondary brain injury with emphasis on partial brain oxygen tension (PbtO2) and intracranial pressure (ICP). The second chapter describes a subgroup analysis of the effect of hypothermia on ICP and PbtO2 in 17 patients enrolled to the Eurotherm3235 trial. There was a mean decrease in ICP of 4.1 mmHg (n=9, p < 0.02) and a mean decrease in PbtO2 (7.8 ± 3.1 mmHg (p < 0.05)) in the hypothermia group that was not present in controls. The findings support previous studies in demonstrating a decrease in ICP with hypothermia. Decreased PbtO2 could partially explain worse outcomes seen in the hypothermia group in the Eurotherm3235 trial. Further analysis of PbtO2 and ICP guided treatment is needed. The third chapter focuses on delayed cerebral ischaemia (DCI) after aneurysmal subarachnoid haemorrhage (aSAH), another form of acute brain injury that causes significant morbidity and mortality. I include a background of alpha-calcitonin gene-related peptide (αCGRP), a potential treatment of DCI, along with results from a systematic review and meta-analysis of nine experimental models investigating αCGRP. The meta-analysis demonstrates a 40.8 ± 8.2% increase in cerebral vessel diameter in those animals treated with αCGRP compared with controls (p < 0.0005, 95% CI 23.7 to 57.9). Neurobehavioural scores were reported in four publications and showed a Physiological responses to brain tissue hypoxia and blood flow after acute brain injury standardised mean difference of 1.31 in favour of αCGRP (CI -0.49 to 3.12). I conclude that αCGRP reduces cerebral vessel narrowing seen after SAH in animal studies but note that there is insufficient evidence to determine its effect on functional outcomes. A review of previous trials of αCGRP administration in humans is included, in addition to an original retrospective analysis of CSF concentrations of αCGRP in humans. Enzyme-linked immunosorbent assay of CSF (n = 22) was unable to detect αCGRP in any sample, which contrasts with previous studies and was likely secondary to study methodology. Finally, I summarise by discussing a protocol I designed for a dose-toxicity study involving the intraventricular administration of αCGRP to patients with aSAH and provide some recommendations for future research. This protocol was based upon the systematic review and was submitted to the Medical Research Council's DPFS funding stream during the PhD.

Peptide hormones are responsible for cellular functions critical to the survival of an organism. Approximately 50% of all known peptide hormones are post-translationally modified at the C-terminus. Enzymatic oxidative conversion of C-terminal glycine extended peptide precursors results in an a-amidated peptide and glyoxylate. Peptidylglycine a-amidating monooxygenase (PAM) is the single known enzyme responsible for catalyzing this reaction. PAM is an O2, Cu(II), and Zn(II) dependent bifunctional enzyme. Initially, PAM hydroxylates the glycyl a-carbon followed by dealkylation of the hydroxylated intermediate to an a-amidated product and glyoxylate. PAM is also responsible for the conversion of glycine extended fatty acids to fatty acid amides and glyoxylate. PAM catalyzes the activation of all glycine-extended prohormones including biomolecules ranging from neuro to physio-homeostatic hormones. Identification of a-amidated hormones from a biological source has been severely hindered by the lack of a specific assay for this distinctive class of biological hormones, indicating that numerous a-amidated hormones remain undiscovered. Based on the selective in situ chemistry of PAM, a novel and specific assay was developed for the discovery of a-amidated hormones. The identification of novel a-amidated hormones will lead to an increased understanding of post-translational modifications and will pioneer a new understanding of a-amidated hormone biosynthesis, regulation, and bioactivity. Discovery of novel a-amidated biomolecules could also lead to their use as pharmaceuticals as there are several currently marketed a-amidated peptide based pharmaceuticals.Inhibition of PAM in cell culture leads to the accumulation of glycine-extended hormones in the conditioned medium. The medium was fractionated by chromatographic techniques and each specific fraction was then assayed by the newly developed platform technology for the presence of a-amidated hormones. For every a-amidated hormone synthesized by PAM, glyoxylate is also formed. Based on this 1:1 molar ratio, several novel spectrophotometric, fluorescent, and chemi-luminescent enzyme linked assays for glyoxylate were developed, which when utilized on cell culture fractions proved positive for the identification of a-amidated hormones. Each novel spectroscopic assay was independently verified by a variety of known methodologies. Moreover the assay was utilized to identify two known a-amidated hormones accumulated from cell culture, which were further verified by Mass Spectral analysis.

Neuropeptides are present in nerve fibers of the upper and lower airways. Local release of these substances may be of importance for the pathophysiology of airway disorders and may play a role in responses to different stimuli. However, little is known about the distribution of neuropeptides in the larynx. The superior laryngeal nerve is one of the vagal branches supplying the larynx. The aim of the present study was to investigate the fiber composition of this nerve and to analyse the distribution of different neuropeptides and mast cells in the larynx. The internal and the external branches of the superior laryngeal nerve had a similar number and size of the nerve fibers. Numerous unmyelinated fibers were evenly distributed in the branches. A large majority of the fibers were sensory myelinated and unmyelinated fibers; only a few of the myelinated fibers of the external branch ( 2-10 %) were motor. About a quarter of the unmyelinated fibers of the internal and the external branches had their cell bodies in the brainstem, and single myelinated and unmyelinated fibers emanated from the superior cervical ganglion. In every superior laryngeal nerve examined one to three spherical paraganglia were observed. These paraganglia contained cells which were similar to the type I and type II cells found in the carotid body and the paraganglia of the recurrent laryngeal nerve. Thin-walled sinusoidal blood vessels which were sometimes fenestrated were also present The laryngeal mucosa was supplied with nerve fibers exhibiting substance P- and calcitonin gene-related peptide-like immunoreactivity with regional differences in the distribution. The laryngeal side of the epiglottis and the ventral recess were richly supplied, and the vocal cords showed no evidence of immunoreactive nerve fibers. The distribution of connective tissue mast cells and mucosal mast cells/globular leucocytes was similar to that of nerve fibers displaying substance P- and calcitonin gene-related peptide-like immunoreactivity. These cells were found in close approximation to nerve fibers. Acetylcholinesterase-positive ganglionic cells in the larynx showed vasoactive intestinal polypeptide-, neuropeptide Y-and enkephalin-like immunoreactivity. Neuropeptide Y-like immunoreactivity was co-localized with tyrosine-hydroxylase/dopamine beta-hydroxylase-like immunoreactivity in nerve fibers in some blood vessel walls. Enkephalin-like immunoreactivity was rarely found in this location and co-localization with tyrosine- hydroxylase-like immunoreactivity was not detected. In glands and some blood vessel walls neuropeptide Y- and enkephalin-like immunoreactivity were localized in nerve fibers showing a positive acetylcholinesterase reaction and vasoactive intestinal polypeptide-like immunoreactivity. Thus, this indicates that neuropeptide Y is present in both the sympathetic and parasympathetic nervous systems, while enkephalin and vasoactive intestinal polypeptide are confined to the parasympathetic nervous system in the rat larynx. The present study shows that the superior laryngeal nerve is mainly sensory, and the study also provides a morphological basis for neuropeptide effects in laryngeal physiology/pathophysiology. / <p>S. 1-27: sammanfattning, s. 29-97: 6 uppsatser</p> / digitalisering@umu

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 4 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 4 uppsatser.

Submitted by Maria Anália Conceição (marianaliaconceicao@gmail.com) on 2016-06-23T13:14:13Z No. of bitstreams: 1 Publico-NOVO-05.pdf: 1218530 bytes, checksum: 4ed86e26ba531f290cfc9a29f57fba4d (MD5) / Approved for entry into archive by Maria Anália Conceição (marianaliaconceicao@gmail.com) on 2016-06-23T13:15:03Z (GMT) No. of bitstreams: 1 Publico-NOVO-05.pdf: 1218530 bytes, checksum: 4ed86e26ba531f290cfc9a29f57fba4d (MD5) / Made available in DSpace on 2016-06-23T13:15:03Z (GMT). No. of bitstreams: 1 Publico-NOVO-05.pdf: 1218530 bytes, checksum: 4ed86e26ba531f290cfc9a29f57fba4d (MD5) Previous issue date: 2014 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introdução: A disfunção na liberação de neuropeptídeos acarreta alterações na pele, podendo gerar distúrbios no processo cicatricial e/ou afecções cutâneas. Sendo assim, a liberação de neuropeptídeos é estudada na literatura, relacionando a utilização de agentes eletrofísicos. Objetivo: Investigar o efeito da estimulação elétrica na liberação de neuropeptídeos SP e CGRP em pele de ratos. Métodos: Foram utilizados 28 animais distribuídos em 4 grupos, Grupo Controle (GC): as amostras foram coletadas após 60 minutos da tricotomia sem estímulo elétrico; Grupo Sham (GS): após 60min da tricotomia foram colocadas as placas de eletrodos com esponja umedecida com cloreto de sódio 0,9% e sobreposto na linha mediana dorsal e dispersivo na região ventral, com o aparelho desligado por 30minutos; Grupo Estimulação Elétrica com Polo Positivo (GPP): após 60 minutos da tricotomia, foi realizada a estimulação elétrica sobre a linha mediana dorsal com polaridade Positiva e o no Grupo Estimulação Elétrica com polaridade Negativa (GPN): os mesmos parâmetros utilizados acima, com a mudança, onde o polo negativo passou para linha mediana dorsal. Ao término da estimulação elétrica, foram coletadas amostras de pele, submetidas ao Western blotting para análise dos neuropeptídeos CGRP e SP. Para a análise estatística foi utilizado o teste de Análise Variância (ANOVA) para identificar a diferença entre os grupos. Resultado: Não causou diferença significante na liberação de CGRP e SP na pele de rato. Conclusão: A estimulação elétrica ultraexcitante não influenciou na liberação de neuropeptídeos, CGRP e SP, em pele de ratos. / Introduction: A dysfunction in the release of neuropeptides cause changes in the skin, and may cause disturbances in the healing process and/or skin disorders. Therefore the release of neuropeptides has been studied in the literature, connecting the use of electrophysical agents. Objective: To investigate the effect of electrical stimulation on the release of neuropeptides SP and CGRP in rat skin. Methods: 28 animals were randomly divided into 4 groups, Control Group (CG): the samples were collected 60 minutes after shaving without electrical stimulation; Sham Group (SG): after 60 minutes of trichotomy were placed electrodes plates with damp sponge with sodium chloride 0.9% and superimposed on the dorsal midline and dispersive on the ventral region, with the equipment off for 30 minutes; Electrical Stimulation Positive Pole Group (GPP): later 60 minutes of trichotomy, electrical stimulation was performed on the dorsal midline with positive polarity and the Electrical Stimulation Group with negative polarity (NPG): the same parameters used above, with the change where the negative pole was passed into the dorsal midline. At the end of electrical stimulation, skin samples, tested by Western Blotting for analysis of neuropeptides CGRP and SP, were collected. For statistical analysis, analysis of variance (ANOVA) was used to identify differences between the groups. Result: There was a minor release of neuropeptides from the negative and positive polarity, however, not significant. Conclusion: The ultra-exciting electrical stimulation did not influence the release of neuropeptides, SP and CGRP, in rat skin.

Doctor of Philosophy / Department of Chemistry / Duy H. Hua / Three research projects are described in this dissertation, and they are: (i) discovery of piperidine derivatives as T-type calcium channel inhibitors for the treatment of epilepsy and neuropathic pain and as protein disulfide isomerase inhibitors for the treatment of influenza viral infection; (ii) discovery of peptide-based calcitonin gene-related peptide receptor antagonists for the treatment of inflammatory pain; and (iii) synthesis of substituted 6-(dimethylamino)-2-phenylisoindolin-1-ones for the inhibition of luciferase. T-type calcium channels are important regulators of nervous system, and upregulated T-type calcium channel activities have been found to link to various types of neurological disorders, such as epilepsy and neuropathic pain. To discover novel T-type calcium channel blockers, a series of 1,4-disubstituted piperidine derivatives were designed and synthesized. Among them, compound 1-4 was found to be a good T-type calcium channel inhibitor with an IC₅₀ of 1 nM for Ca[subscript v]3.2 inhibition. It also showed 86% suppression of seizure induced death in mice and good in vivo analgesic effects on both thermal and mechanical pain thresholds in Spared Nerve Injury rat models. Therefore 1-4 can potentially be used as a T-type calcium channel blocker in the treatment of epilepsy and neuropathic pain. Influenza is a respiratory viral infection. Since viruses rely on host cell proteins for their entry, survival and replication, development of drugs targeting host cell proteins has identified as an effective strategy in controlling viral infections. We synthesized a series of 1,4-disubstituted piperidine derivatives for the inhibition of protein disulfide isomerase enzyme and influenza. Among them, 1-29 was found to possess strong anti-influenza activity (EC₅₀ = 2.5 µM). This suggests the potential use of piperidine scaffold in designing anti-influenza drugs in future. Calcitonin gene-related peptide (CGRP) receptor antagonism has been identified as a successful approach for the treatment of inflammatory pain. Therefore, a novel class of peptide antagonists of CGRP receptor was synthesized and screened for their binding affinities to the CGRP receptor and their analgesic effects on inflammatory-induced pain in rats. Among them, peptide 2-3 showed a higher binding affinity towards the CGRP receptor than previously reported peptide antagonists and exhibited analgesic effects up to 2 h in both Aδ and c-fiber pain tests. Therefore 2-3 indicates its potential use as a CGRP receptor antagonist in the treatment of inflammatory pain. Firefly luciferase is commonly used as a reporter in cells expressing a luciferase gene or its enzymatic activity under the control of a promoter of interest to assess its transcriptional activity. It has been found that some molecules such as molecules with carboxylic acid moiety can directly inhibit luciferase activity in cells. However, it is suggested that carboxylic acid moiety of the compounds may also be associated with side reactions in cells. Therefore, to study whether carboxylic acid moiety causes side effects, we designed two probe molecules, 3-1 and 3-2. Synthesis of probe molecule 3-2 is discussed. Synthesis of probe molecule 3-1 and further investigation of its luciferase inhibition will therefore be useful to understand the toxicity of carboxylic acid containing drugs in future.

L’existence de douleurs neuropathiques et/ou de perte de la sensibilité douloureuse sont souvent le reflet d’une neuropathie sensitive affectant plus particulièrement les fibres nerveuses sensitives amyélinique Aδ et C, dites neuropathie des petites fibres (NPF). Ces fibres innervent, notamment, le derme et l’épiderme de la peau. Elles communiquent la sensibilité thermique et algique au système nerveux central et contribuent à l’homéostasie cutanée, entre autres, par la libération de neuropeptides en périphérie. De nombreuses pathologies sont associées à une altération de ces petites fibres dans la peau. Deux pathologies impliquant une NPF ont été étudiées au cours de ce travail : les escarres et la maladie de Charcot-Marie-Tooth type 1A. Un travail expérimental a été réalisé chez la souris pour répondre à la question suivante ; est-ce qu’une seule atteinte des fibres nociceptives, responsables de la perte de sensibilité peut entraîner un déséquilibre de l’homéostasie cutanée, responsable de l’apparition des escarres ? La mise en place d’un modèle de neuropathie sensitive fonctionnelle réversible a permis de mettre en en évidence l’implication des neuropeptides, substance P (SP) et « calcitonin gene-related peptide » (CGRP), libérés par les fibres nerveuses cutanées, dans la formation d’ulcères de pression. Un traitement préventif à la rhEPO (Recombinant Human Erythropoietin) dans ce modèle associant une neuropathie et des plaies de pression, protège la peau contre une pression ischémiante induisant une escarre par son effet neuroprotecteur sur les petites fibres cutanées. L’association CMT1A et NPF a été étudiée à partir de biopsies cutanées humaines. La quantification des fibres intraépidermiques révèle que 48% des patients CMT1A sont atteints d’une NPF. L’analyse des biopsies cutanées révèle également une altération du nombre et de la morphologie de cellules de Langerhans dans la maladie de CMT1A. L'ensemble de ces résultats confirme l'intérêt de l'étude des petites fibres dans des pathologies variées et confirme le potentiel thérapeutique neuroprotecteur de l'EPO / The neuropathic pain and/or hypoalgesia often reflect a sensory neuropathy that affects particularly sensory, Aδ (thinly myelinated) and C (unmyelinated) nerve fibers. This kind of neuropathy is named "small fiber neuropathy" (SFN). These small fibers innervate the dermis and epidermis. C and Aδ free nerve endings respond to a variable range of stimuli including mechanical, thermal and pain stimuli. They conduct nociceptive signals to central nervous system and contribute to skin homeostasis, among others, by the release of neuropeptides in the periphery. Many diseases are associated with an alteration of these cutaneous small fibers. Two pathologies involving SFN were studied in this work: pressure ulcers and Charcot-Marie-Tooth disease Type 1A (CMT1A). Experimental studies on mice were performed to determine if impairment of nociceptive fibers could lead to an imbalance of skin homeostasis and could be involved in development of pressure ulcers, apart from its role in pain signal transduction. A functional reversible sensory neuropathy mouse model was set up and helped to demonstrate the involvement of the neuropeptides, substance P (SP) and "calcitonin gene-related peptide" (CGRP), released by cutaneous nerve fibers in the formation of pressure ulcers. By its neuroprotective effect on small nerve fibers, a preventive rhEPO (Recombinant Human Erythropoietin) treatment in this model protects the skin against an ischemic pressure-induced Stage 2 ulcer. The CMT1A and SFN association has been studied from human skin biopsies. Quantification of intraepidermal nerve fibers reveals that 48% of CMT1A patients have a SFN. The analysis of skin biopsies also revealed an alteration in the number and morphology of Langerhans cells in CMT1A disease. All these results confirm the interest of the study of small fibers in various pathologies and confirm the neuroprotective therapeutic potential of EPO.

Die bakterielle Meningitis (BM) ist trotz antibiotischer Therapie eine Erkrankung mit einer hohen Mortalität und Morbidität. Kopfschmerzen und Meningismus sind Hauptsymtome und ein klinischer Hinweis für die Aktivierung trigeminaler Fasern. Ziel dieser Arbeit war es zu prüfen ob die freigesetzten Neuropeptide einen proinflammatorischen Effekt auf zerebrale Endothelzellen, einen wesentlichem Bestandteil der Blut-Hirn-Schranke haben. Wir verwendeten primär kultivierte zerebrale Kapillarendothelzellen (BMEC) der Ratte und als Stimulus Neuropeptide und/oder Pneumokokkenzellwände (PCW). Beide Neuropeptide, CGRP mehr als SP, verstärken den Effekt von PCW auf die mRNA Expression und Freisetzung von TNF-alpha, IL-1beta, IL-6, IL-10 und MIP-2 aus den BMEC. CGRP und SP haben nur eine geringe Wirkung. PCW regulieren die Dichte der CRLR (CGRP1-R) bzw. NK-1 Rezeptoren und erklären damit die kostimulatorische Wirkung. Zudem untersuchten wir den Effekt von PCW und/oder CGRP auf die Adrenomedullin (AM)- Synthese. AM ist ein vasodilatorisch wirkendes Peptid, dass vorwiegend in Endothelzellen konstitutiv gebildet wird und am CRLR Rezeptor wirkt. PCW und CGRP verstärken die Synthese von AM. Mit dieser Arbeit konnte gezeigt werden, dass PCW zur Hochregulation von Neuropeptidrezeptoren führt und CGRP und SP über diese Rezeptoren einen modulatorischen Effekt auf die Zytokinproduktion in BMEC haben. Ein genaues Verständnis dieser Interaktionen könnte die Entwicklung immunmodulatorischer Interventionen und damit eine Verbesserung der Prognose der bakteriellen Meningitis bewirken. / Despite antibiotic treatment bacterial meningitis is still associated with a high mortality and morbidity. Headache and meningismus as key symptoms, provide clear evidence for the activation of trigeminal nerve fibers. Aim of the study was to test whether the released neuropeptides have a proinflammatory effect in cerebral endothelial cells the major compartment of the blood brain barrier. We used primary brain microvascular endothelial cells of the rat (BMEC) which were stimulated with CGRP, SP and/or pneumococcal cell walls (PCW). Both neuropeptides CGRP more than SP enhanced PCW-induced mRNA expression and the release of TNF-alpha, IL-1-beta, IL-6, IL-10 and MIP-2. Neuropeptides alone were not able to induce these cytokines. PCW upregulate the density of CRLR receptor and regulate the NK-1 receptor and therefore may explain the costimulatory effect. Furthermore the effect of PCW and/or CGRP on adrenomedullin synthesis in BMEC was investigated. Adrenomedullin is a vasodilatatory peptide, which is constitutivly produced by endothelial cells and act on the CRLR receptor. PCW as well as CGRP enhance the synthesis of AM. Our data suggest that PCW upregulate neuropeptide receptors and modulate via these specific receptors the cytokine production. A detailed understanding of these interactions may open new immunmodulatory interventions and therefore may contribute to a better prognosis of bacterial meningitis.

Wong Cheuk Ying. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 101-124). / Abstracts in English and Chinese. / Abstract --- p.i / 摘要 --- p.iv / Acknowledgement --- p.vi / List of Abbreviations --- p.vii / Chapter Chapter 1. --- General Introduction --- p.1 / Chapter Chapter 2. --- Methods --- p.4 / Chapter 2.1 --- Measurement of cAMP and cGMP in VSMCs --- p.4 / Chapter 2.1.1 --- Cell culture --- p.4 / Chapter 2.1.2 --- Enzyme-immunoassay colorimetric measurement for cAMP and cGMP --- p.5 / Chapter 2.1.3 --- Statistical analysis --- p.6 / Chapter 2.2 --- Measurement of apoptosis in VSMCs and bone marrow-derived stem cells --- p.6 / Chapter 2.2.1 --- Cell culture --- p.6 / Chapter 2.2.2 --- Hoechst33258 --- p.7 / Chapter 2.2.3 --- Cell Death ELISA plus --- p.7 / Chapter 2.2.4 --- Protein extraction and Western blot analysis of PKG expression --- p.8 / Chapter 2.2.5 --- Statistical analysis --- p.9 / Chapter 2.3 --- Measurement of cell proliferation in VSMCs and bone marrow-derived stem cells --- p.9 / Chapter 2.3.1 --- Cell culture --- p.9 / Chapter 2.3.2 --- Cell count --- p.10 / Chapter 2.3.3 --- MTT assay --- p.11 / Chapter 2.3.4 --- BrdU-(5`Bromo-2-deoxyuridine) ELISA colorimetric assay --- p.11 / Chapter 2.3.5 --- Statistical analysis --- p.12 / Chapter Chapter 3. --- Effects of hyperglycemia on CGRP-induced cAMP response in VSMCs / Chapter 3.1 --- Introduction --- p.13 / Chapter 3.2 --- Results --- p.18 / Chapter 3.3 --- Discussion --- p.22 / Chapter Chapter 4. --- Role of cGMP and protein kinase G in regulation of apoptosis in VSMCs / Chapter 4.1 --- Introduction --- p.26 / Chapter 4.2 --- Results --- p.30 / Chapter 4.3 --- Discussion --- p.44 / Chapter Chapter 5. --- Role of protein kinase G in regulation of proliferation in VSMCs / Chapter 5.1 --- Introduction --- p.55 / Chapter 5.2 --- Results --- p.58 / Chapter 5.3 --- Discussion --- p.67 / Chapter Chapter 6. --- Effects of aging and eNOS- and iNOS-gene deletion (using eNOS- and iNOS-knockout mice) on apoptosis of VSMCs / Chapter 6.1 --- Introduction --- p.73 / Chapter 6.2 --- Results --- p.76 / Chapter 6.3 --- Discussion --- p.79 / Chapter Chapter 7. --- Role of protein kinase G in regulation of apoptosis and proliferation of bone marrow stromal stem cells / Chapter 7.1 --- Introduction --- p.81 / Chapter 7.2 --- Results --- p.84 / Chapter 7.3 --- Discussion --- p.92 / Chapter Chapter 8. --- Overall discussion --- p.95 / Chapter Chapter 9. --- References --- p.101