Abstract Multiple sclerosis (MS) is the most frequent chronic inflammatory demyelinating disease of the central nervous system leading to neurological disability in young adults. Finland belongs to the high-risk areas of MS with continuously increasing of prevalence rates. In comparison to the general population, patients with MS have an increased risk of premature mortality. The extent of comorbidity rates and their role in the outcomes of MS have not been fully investigated. The aim of this thesis was to evaluate the epidemiology and survival of MS in Northern Ostrobothnia. The neurological comorbidity and frequency of fractures in patients with MS were also investigated. All MS patients diagnosed in Oulu University Hospital during 1990–2010 were included in this study. The prevalence of MS was 103/105; the mean overall incidence was 6.3/105. Women had a 2.3-fold higher MS incidence than men. The overall incidence figures were clearly affected by a pronounced increase among females. Neurological comorbidities were common in MS patients with 17.1 % of patients suffering from some other neurological diseases in addition with MS. The most common diseases were migraine (10.4 %) and epilepsy (4.7 %).The prevalence of stroke was similar in MS patients compared to the general population, but the 21-year survival rate was significantly lower in MS patients who had suffered a stroke compared with those MS patients without stroke. MS patients experienced a high risk for fragility fractures especially vertebral fractures. The possibility of osteoporosis had been examined only 26 % patients with fragility fractures and osteoporosis was detected in the majority. The prevalence of MS in our cohort was similar to the Finnish average, but in the Seinäjoki area, the prevalence was double the national average. Although the increasing incidence of female MS has been confirmed also in other studies, the reasons for this phenomenon are unknown. The increased risk for fragility fractures may be associated with low D vitamin levels or pathogenesis of MS. These findings emphasize the role of comorbid diseases in disability and survival of MS patients and attention should be paid to these conditions also in clinical practice. / Tiivistelmä MS-tauti on nuorten aikuisten yleisin etenevä ja usein työkyvyttömyyteen johtava neuroimmunologinen sairaus. Suomi kuuluu korkean riskin alueeseen ja maassamme on havaittu alueellisia eroja MS-taudin esiintyvyydessä. MS-taudin ennusteeseen vaikuttavia tekijöitä ei täysin tunneta, mutta luonnollisen kulun tutkimuksissa on havaittu, että MS-tauti lyhentää eliniän ennustetta useita vuosia muuhun väestöön verrattuna. MS-tautia sairastavien potilaiden toimintakyvyn ja eliniän ennusteeseen vaikuttavista liitännäissairauksista on hyvin vähän tietoa. Tutkimuksen tarkoituksena oli selvittää MS-taudin epidemiologiaa sekä eliniän ennustetta Pohjois-Pohjanmaalla. Lisäksi tutkittiin MS-tautia sairastavien muuta neurologista sairastavuutta sekä luun murtumien esiintyvyyttä. Aineistona oli Oulun yliopistollisessa sairaalassa MS-taudin diagnoosin saaneet potilaat vuosilta 1990–2010. MS-taudin esiintyvyys oli 103/105 ja ilmaantuvuus keskimäärin 6.3/105. Naisilla MS-taudin ilmaantuvuus oli 2,3-kertainen miehiin verrattuna. MS-taudin ilmaantuvuus lisääntyi 15 vuoden seurannassa, mikä selittyi MS-taudin ilmaantuvuuden kasvulla naisten keskuudessa. MS-taudin lisäksi 17,1 %:lla potilaista oli jokin muu neurologinen sairaus. Yleisimmät sairaudet olivat migreeni (10,4 %) ja epilepsia (4,7 %). Neurologisista liitännäissairauksista aivoverenkiertohäiriöiden esiintyvyys oli yhtä suuri kuin väestössä yleensä, mutta sairastettu aivoverenkiertohäiriö lisäsi merkittävästi MS-potilaiden kuolleisuutta. MS-tautia sairastavilla havaittiin kohonnut riski etenkin matalaenergisiin murtumiin, joista merkittävä osuus oli selkärangan nikamamurtumia. Matalaenergisen murtuman saaneista potilaista luuntiheyden mittaus oli tehty vain 26 %:lle, joista suurimalla osalla todettiin osteoporoosi. Tutkimuksen perusteella MS-taudin esiintyvyys vastaa Suomen keskimääräistä esiintyvyyttä ja on noin puolet pienempi kuin Seinäjoen alueella, missä MS-taudin esiintyvyys on Suomen korkein. MS-taudin ilmaantuvuuden lisääntyminen naisten keskuudessa on havaittu myös muissa tutkimuksissa, mutta syy tähän ilmiöön on epäselvä. MS-tautia sairastavilla kohonnut murtumariski saattaa liittyä mataliin D-vitamiinipitoisuuksiin tai MS-taudin patogeneesiin. Koska liitännäissairastavuus sekä luunmurtumat heikentävät MS-tautia sairastavan toimintakykyä ja lisäävät kuolleisuutta, tulisi näihin kiinnittää enemmän huomiota myös kliinisessä työssä.

(EN) Research in interactions between the nervous and immune systems is focused mainly on mammals, while in other vertebrates, including birds, it remains neglected. Two types of cannabinoid receptors interconnect the nervous and immune systems: CB1, which is in mammals involved in regulation of neural processes, and CB2, which is in mammals involved in regulation of immune processes. However, little is presently known about the roles of these receptors in nervous and especially immune processes in birds. Therefore, in this work I focus on the expression of cannabinoid receptors in cognitively advanced bird species (parrots, passerines) during induced sterile peritoneal inflammation. Unlike passerines, parrots appear to lack the gene for CB2, which may affect the inflammation regulation. I have revealed no changes in the expression of these receptors during peritoneal inflammation neither in parrots, nor in songbirds. Nevertheless, the increase in expression of the proinflammatory cytokine IL- 1β in the brain in parrots confirms the importance of neuroimmune interaction and mutual influences along the gut-brain axis. This work suggests that even in birds, the central nervous system is affected by inflammation through the gut-brain axis. The expression of cannabinoid receptors does not change much...

Although the central nervous system was long perceived as the ivory tower without immune entities, there is growing evidence that the immune and nervous systems are intimated connected. These two systems have been shown to communicate both cellularly and molecularly under physiological and pathological conditions. Despite our increasing understanding of the interplay between these two systems, there are still numerous open questions. In this thesis, I address such unanswered questions related to: the role of microglia and their mechanism in contributing to pathologies in Rett syndrome; the beneficial effects of T-cell secreted cytokines in supporting social brain function; the evolutionary link of the interactions between the nervous and immune systems; the transcription regulation of a subset of microglia population in common neurodegenerative diseases. Collectively, the current thesis is focused on the joint frontier of bioinformatics and experimental work in neuroimmunology. A multifaceted approach, that includes transcriptomics, genomics and other biomolecular modules, was implemented to unearth signaling pathways and mechanisms underlying the presenting biological phenomena. The findings of this thesis can be summarized as follows: 1) MeCP2 acts as a master regulator in the transcriptional repression of inflammatory stimuli in macrophages; 2) T-cell secreted IFN-γ supports social brain function through an evolutionally conserved interaction between the immune and nervous systems; 3) The APOE-TREM2 pathway regulates the microglia phenotype switch in neurodegenerative diseases. Provided that recent technologies allow for readily manipulating the immune system, the findings presented herein may create new vistas for therapeutic interventions in various neurological disorders.

No description available.

<p>Immune-brain communication has important influences on stress circuitry and stress-related behaviours. Adaptive immune deficiency through loss of lymphocytes or an absence of gut bacteria has been linked to anxiety behaviours and stress responsiveness. In these models, there is a common deficit of T lymphocytes leading to the central hypothesis that T lymphocytes influence stress responsiveness and stress-related behaviours. This project considers the effects of T lymphocyte deficiency on anxiety and fear related behaviours as well as stress responsiveness in the hypothalamic pituitary adrenal (HPA) axis. Mice lacking T lymphocytes through knockout of the T cell receptor (TCR) β and δ chains, and B lymphocytes through knockout of the immunoglobulin M μ chain, were obtained and compared to C57BL/6 control mice. Activity, exploration, anxiety, fear and spatial learning tests were employed. Separately, gene expression was assessed for genes related to stress circuitry following chronic restraint stress. Additionally, lipopolysaccharide was used to determine the stress response to an innate immune challenge that was previously shown to elicit an exaggerated stress response in mice lacking Class I Major Histocompatibility Complex (MHC) and CD8+ T lymphocytes. It was found that mice lacking T lymphocytes, but not B lymphocytes, have reduced anxiety-like behaviour but an increased fear response. TCRβ-/-δ-/- mice also had altered expression of components of the HPA axis, serotonergic receptors and NMDA receptor subunits indicating an altered response to chronic stress. Finally, TCRβ-/-δ-/- mice do not display an exaggerated stress response to an innate immune challenge suggesting a central role for Class I MHC in the stress response that is not due to the CD8+ T lymphocyte deficiency that accompanies the functional loss of Class I MHC. These studies reflect an important role for T lymphocytes specifically in the development of the stress system and stress-related behaviours and enables a deeper understanding of neuroimmune influences on stress.</p> / Doctor of Philosophy (PhD)

A Doença de Alzheimer é a causa mais freqüente de demência senil e os gastos com pacientes com demência já supera os de pacientes com câncer ou com doenças cardiovasculares. As lesões características dessa doença são as placas amilóides e os emaranhados neurofibrilares. A neuroinflamação também está presente na maioria dos pacientes com Alzheimer, e parece contribuir para o dano no tecido neuronal. Adicionalmente, estudos vêm demonstrando que pacientes com Alzheimer também apresentam alterações sistêmicas, e, dessas, a mais relatada é o estado pró-inflamatório em tecidos periféricos, permitindo que a Doença de Alzheimer seja estudada em um contexto neuroimunológico. Utilizando um modelo murino para a Doença de Alzheimer, o camundongo 3xTg-AD (que desenvolve ambas as patologias &beta;-amilóide e tau), investigamos se aumento de mediadores inflamatórios também pode ser detectado nesse modelo, tanto no hipocampo (estrutura relevante para os sintomas da doença) como no sangue. Alterações cognitivas e comportamentais e a presença do precursor da proteína amilóide (APP) e/ ou peptídeo &beta;-amilóide em estruturas cerebrais relevantes para a doença (córtex, hipocampo, subículo e amígdala) permitiram validar o camundongo 3xTg-AD como um modelo murino da Doença de Alzheimer. Análises da expressão de mediadores inflamatórios no hipocampo demonstraram que a presença de APP e/ ou peptídeo &beta;-amilóide no cérebro não induz um estado pró-inflamatório no hipocampo ou no sangue, até os 12 meses de idade. Porém, a expressão de APP e/ ou peptídeo &beta;-amilóide no cérebro parece induzir distúrbios sistêmicos, já que algumas alterações periféricas foram encontradas. Como a resposta ao LPS envolve tanto tecidos periféricos, como o Sistema Nervoso Central, avaliou-se os efeitos da administração periférica de LPS nesse camundongo, aos 12 meses de idade. A resposta inflamatória ao LPS diferiu entre camundongos Wild Type (grupo controle) e 3xTg-AD. No sangue, menor aumento de IL-6 e MCP-1 e maior aumento de IFN-&gamma; foram encontrados nos camundongos 3xTg-AD. As conseqüências deste perfil de citocinas séricas no Sistema Nervoso Central foram distintas, dependendo da resposta avaliada: enquanto que a ativação do eixo HPA foi semelhante, a produção de citocinas inflamatórias no hipocampo foi atenuada. Portanto, no camundongo 3xTg-AD, a diferente resposta inflamatória ao LPS no sangue promoveu menor produção de mediadores inflamatórios no hipocampo. / Alzheimer\'s Disease is the most frequent cause of senil dementia and the costs with demented patients already exceeds that of patients with cancer or cardiovascular diseases. The characteristic lesions of this disease are amyloid plaques and neurofibrillary tangles. Neuroinflammation is also present in most of Alzheimer\'s patients, and seems to contribute to neuronal tissue damage. In addition, studies have demonstrated that patients with Alzheimer also display systemic alterations, and of those, the most reported is the pro-inflammatory state in peripheral tissues, allowing Alzheimer\'s Disease to be studied in a neuroimmunology context. Using a murine model of Alzheimer\'s Disease, the 3xTg-AD mice (which develops both amyloid-&beta;and tau pathologies), we investigated whether enhancement of inflammatory mediators can also be detected in this model, in both hippocampus (a relevant structure for the symptoms of the disease) and in blood. Cognitive and behavioral alterations and the presence of amyloid precursor protein (APP) and/ or amyloid-&beta; peptide in relevant brain structures for the disease (cortex, hippocampus, subiculum and amigdala) allowed the validation of 3xTg-AD mice as a murine model of Alzheimer\'s Disease. Analysis of inflammatory mediators expression in hippocampus demonstrated that the presence of APP and/ or amyloid-&beta; peptide in the brain does not induce a pro-inflammatory state in hippocampus or in the blood, until 12 months of age. Nevertheless, APP and/or amyloid-&beta; peptide expression in the brain seems to induce systemic disturbances, once peripheral alterations were detected. As LPS response includes both peripheral tissues and the Central Nervous System, we evaluated peripheral administration effects of LPS in these mice, at 12 months of age. The inflammatory response to LPS differed between Wild Type (control group) and 3xTg-AD. In the blood, smaller enhancement of IL-6 and MCP-1 and higher enhancement of IFN-&gamma; were found in 3xTg-AD mice. The consequences of this serum cytokine profile on the Central Nervous System were distinct, depending on the response evaluated: while HPA axis activation was similar, production of inflammatory cytokines in hippocampus was attenuated. Therefore, in the 3xTg-AD mice, a different inflammatory response to LPS in blood promoted lesser inflammatory mediators production in hippocampus.

A Doença de Alzheimer é a causa mais freqüente de demência senil e os gastos com pacientes com demência já supera os de pacientes com câncer ou com doenças cardiovasculares. As lesões características dessa doença são as placas amilóides e os emaranhados neurofibrilares. A neuroinflamação também está presente na maioria dos pacientes com Alzheimer, e parece contribuir para o dano no tecido neuronal. Adicionalmente, estudos vêm demonstrando que pacientes com Alzheimer também apresentam alterações sistêmicas, e, dessas, a mais relatada é o estado pró-inflamatório em tecidos periféricos, permitindo que a Doença de Alzheimer seja estudada em um contexto neuroimunológico. Utilizando um modelo murino para a Doença de Alzheimer, o camundongo 3xTg-AD (que desenvolve ambas as patologias &beta;-amilóide e tau), investigamos se aumento de mediadores inflamatórios também pode ser detectado nesse modelo, tanto no hipocampo (estrutura relevante para os sintomas da doença) como no sangue. Alterações cognitivas e comportamentais e a presença do precursor da proteína amilóide (APP) e/ ou peptídeo &beta;-amilóide em estruturas cerebrais relevantes para a doença (córtex, hipocampo, subículo e amígdala) permitiram validar o camundongo 3xTg-AD como um modelo murino da Doença de Alzheimer. Análises da expressão de mediadores inflamatórios no hipocampo demonstraram que a presença de APP e/ ou peptídeo &beta;-amilóide no cérebro não induz um estado pró-inflamatório no hipocampo ou no sangue, até os 12 meses de idade. Porém, a expressão de APP e/ ou peptídeo &beta;-amilóide no cérebro parece induzir distúrbios sistêmicos, já que algumas alterações periféricas foram encontradas. Como a resposta ao LPS envolve tanto tecidos periféricos, como o Sistema Nervoso Central, avaliou-se os efeitos da administração periférica de LPS nesse camundongo, aos 12 meses de idade. A resposta inflamatória ao LPS diferiu entre camundongos Wild Type (grupo controle) e 3xTg-AD. No sangue, menor aumento de IL-6 e MCP-1 e maior aumento de IFN-&gamma; foram encontrados nos camundongos 3xTg-AD. As conseqüências deste perfil de citocinas séricas no Sistema Nervoso Central foram distintas, dependendo da resposta avaliada: enquanto que a ativação do eixo HPA foi semelhante, a produção de citocinas inflamatórias no hipocampo foi atenuada. Portanto, no camundongo 3xTg-AD, a diferente resposta inflamatória ao LPS no sangue promoveu menor produção de mediadores inflamatórios no hipocampo. / Alzheimer\'s Disease is the most frequent cause of senil dementia and the costs with demented patients already exceeds that of patients with cancer or cardiovascular diseases. The characteristic lesions of this disease are amyloid plaques and neurofibrillary tangles. Neuroinflammation is also present in most of Alzheimer\'s patients, and seems to contribute to neuronal tissue damage. In addition, studies have demonstrated that patients with Alzheimer also display systemic alterations, and of those, the most reported is the pro-inflammatory state in peripheral tissues, allowing Alzheimer\'s Disease to be studied in a neuroimmunology context. Using a murine model of Alzheimer\'s Disease, the 3xTg-AD mice (which develops both amyloid-&beta;and tau pathologies), we investigated whether enhancement of inflammatory mediators can also be detected in this model, in both hippocampus (a relevant structure for the symptoms of the disease) and in blood. Cognitive and behavioral alterations and the presence of amyloid precursor protein (APP) and/ or amyloid-&beta; peptide in relevant brain structures for the disease (cortex, hippocampus, subiculum and amigdala) allowed the validation of 3xTg-AD mice as a murine model of Alzheimer\'s Disease. Analysis of inflammatory mediators expression in hippocampus demonstrated that the presence of APP and/ or amyloid-&beta; peptide in the brain does not induce a pro-inflammatory state in hippocampus or in the blood, until 12 months of age. Nevertheless, APP and/or amyloid-&beta; peptide expression in the brain seems to induce systemic disturbances, once peripheral alterations were detected. As LPS response includes both peripheral tissues and the Central Nervous System, we evaluated peripheral administration effects of LPS in these mice, at 12 months of age. The inflammatory response to LPS differed between Wild Type (control group) and 3xTg-AD. In the blood, smaller enhancement of IL-6 and MCP-1 and higher enhancement of IFN-&gamma; were found in 3xTg-AD mice. The consequences of this serum cytokine profile on the Central Nervous System were distinct, depending on the response evaluated: while HPA axis activation was similar, production of inflammatory cytokines in hippocampus was attenuated. Therefore, in the 3xTg-AD mice, a different inflammatory response to LPS in blood promoted lesser inflammatory mediators production in hippocampus.

Thesis (Ph. D.)--Ohio State University, 2007. / Full text release at OhioLINK's ETD Center delayed at author's request

Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2017-05-12T15:55:02Z No. of bitstreams: 1 liviabeatrizalmeidafontes.pdf: 3540783 bytes, checksum: 4cd586d1e69d6c2f9cd80253b1f7a163 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-12T16:31:34Z (GMT) No. of bitstreams: 1 liviabeatrizalmeidafontes.pdf: 3540783 bytes, checksum: 4cd586d1e69d6c2f9cd80253b1f7a163 (MD5) / Made available in DSpace on 2017-05-12T16:31:34Z (GMT). No. of bitstreams: 1 liviabeatrizalmeidafontes.pdf: 3540783 bytes, checksum: 4cd586d1e69d6c2f9cd80253b1f7a163 (MD5) Previous issue date: 2013-07-05 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / A esclerose múltipla (EM) é uma doença autoimune, crônica, progressiva, inflamatória e desmielinizante do sistema nervoso central (SNC). Devido à similaridade clínica e histopatológica com esta doença, a encefalomielite autoimune experimental (EAE) apresenta um modelo clínico experimental amplamente aceito da EM, devido ao fato de ambos terem processos fisiopatológicos mediados por células Th1 e citocinas pró-inflamatórias, como Interferon-gama (INF-γ), Fator de Necrose Tumoral alfa (TNF-α) e, mais recentemente, células Th17, produtores principalmente de IL-17, e radicais oxigenados, como NO e H2O2 produzidos principalmente por células fagocitárias. Os medicamentos hoje utilizados para a EM atuam sobre esses mediadores inflamatórios, porém, apresentam inconvenientes como, custo elevado e/ou efeitos adversos pronunciados. Devido a isso, a pesquisa por novas drogas para o tratamento da EM, concentra-se em substâncias que sejam capazes de modular a produção desses mediadores inflamatórios com maiores vantagens para o paciente. No presente estudo a EAE foi induzida em camundongos fêmeas da linhagem C57BL/6 com a MOG35-55 e os animais foram tratados com a Licochalcona A (isolado e purificado a partir da Glycyrhizza inflata) em doses de 15 e 30 mg/kg/dia e com o trans-cariofileno (obtido comercialmente em doses de 25 e 50 mg/kg/dia por gavagem (via oral) a partir do 10° dia até o pico dos sintomas clínicos da doença. Para verificar o efeito deste tratamento os seguintes parâmetros foram utilizados: avaliação clínica dos animais, realizada diariamente através da pesagem e pontuação dos escores neurológicos; análise histopatológica por hematoxilina e eosina do tecido cerebral e medula espinhal; produção de NO, avaliada pelo método de Griess; produção de H2O2, pelo método de Pick & Mizel, ambos em cultura de células peritoneais;níveis de IFN-γ, IL-17, TNF-α, quantificados por ELISA no sobrenadante de cultura de esplenócitos. O resultados mostraram que tanto a Licochalcona A, como principalmente o trans-cariofileno nas maiores doses administradas causaram redução significativa na neuroinflamação e desmielinização no SNC. Os níveis de NO, H2O2, IFN-γ, IL-17, TNF-α também apresentaram acentuada redução estando correlacionados com a melhoria dos sintomas clínicos. Os resultados sugerem que a Licochalcona A e o trans-cariofileno podem modular a produção de mediadores inflamatórios, interferindo sobre a patogênese da EAE. Tais substâncias podem ser instrumentos importantes para o tratamento de doenças desmielinizantes inflamatórias do SNC, tais como a EAE, o modelo clínico experimental mais utilizado para a esclerose múltipla. / The multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) with features to be chronic, progressive, inflammatory and demyelinating. Due to the clinical and histopathological similarity with experimental autoimmune encephalomyelitis disease (EAE) this became a widely accepted study animal model of MS because both have pathophysiological processes involving Th1 cells and soluble pro-inflammatory cytokines such as Interferon-gamma (INF-γ), tumor necrosis factor alpha (TNF-α) and more recently Th17 cells, primarily producers of IL-17, oxygen free radicals as NO and H2O2 by phagocytic cells. Drugs currently used in fact act on these inflammatory markers but have many disadvantages such as high cost and/or pronounced adverse effects. Due to that, the search for new drugs to treat MS focuses on substances that are able to modulate the production of these inflammatory mediators with greater advantages to the pacient. In the present study EAE was induced in female mice C57BL6 lineage with the MOG35-55 and the animals were treated with Licochalcone A (isolated and purified from Glycyrhizza Inflata) in doses 15 and 30 mg/Kg/dia and with trans-caryophyllene (obtained commercially in doses of 25 and 50 mg/Kg/dia by gavage (oral administration) from day 10° until the peak of the clinical symptoms of the disease. To verify the effect of this treatment the following parameters were used: clinical evaluation, was made by a neurological score of symptoms and weighing; histopathological analysis, for hematoxylin and eosin staining of the brain and spinal cord tissue at the end of the experiment; production of NO, evaluated by Griess method; production of H2O2; by Pick Mizel, both in culture of peritoneal cells; quantification of IFN-γ, IL-17, TNF-α was made by ELISA on the surface of spleen cells culture. Both Licochalcone A, as mainly the trans-caryophyllene in higher doses caused significant reduction in neuroinflamação and demyelination in the CNS. The levels of NO, H2O2, IFN-γ, IL-17, TNF-α also showed sharp reduction being correlated with the improvement of clinical symptoms. The results suggest that the Licochalcone A and trans-caryophyllene can modulate the production of inflammatory mediators, interfering on the pathogenesis of EAE. Such substances may be important instruments for treatment of CNS demyelinating inflammatory diseases such as EAE, animal model more used for multiple sclerosis.

No description available.