Introdução: A inflamação constitui um dos fatores mais importantes da fisiopatologia da asma brônquica, caracterizada por uma resposta eosinofílica com produção de citocinas de perfil Th2. A persistência desta inflamação induz no pulmão um processo de reparo associado à redução progressiva da função pulmonar, que nem sempre é revertida pelos tratamentos disponíveis. O sistema colinérgico anti-inflamatório é descrito como um mecanismo neural que suprime a resposta imune e controla a inflamação principalmente pelo efeito da acetilcolina em receptores nicotínicos do tipo alfa7 (alfa7nAChR) encontrados em células do sistema imune. A acetilcolina (ACh) exerce um importante efeito na asma e recentemente demonstramos que a redução parcial da liberação da acetilcolina induz per se a inflamação pulmonar. Embora se saiba que os receptores muscarínicos (mAChRs) exercem um efeito pró-inflamatório e broncoconstritor na asma, a ativação de receptores nicotínicos (nAChRs) poderia ter um efeito benéfico reduzindo a inflamação pulmonar, fato demonstrado em modelos de inflamação sistêmica e aguda. O efeito da ativação do alfa7nAChR na fisiopatologia da asma ainda não está claramente elucidado. Objetivo: Investigar o efeito do tratamento com PNU-282987 (PNU), um agonista específico do alfa7nAChR, em um modelo murino de inflamação alérgica crônica das vias aéreas. Metodologia: Camundongos BALB/c foram submetidos ao protocolo de indução alérgica crônica das vias aéreas com ovoalbumina (OVA) ou salina intraperitoneal (i.p.) e posterior desafios inalatórios. A partir do 22° dia, os animais receberam diariamente tratamento com PNU ou veículo (Ve) até o 28° dia. Foram testadas três doses de PNU (0,5, 1,0 e 2,0 mg/Kg). A fim de evidenciar se o efeito obtido no tratamento com PNU era dependente do receptor alfa7nAChR, um grupo de animais foi tratado com MLA (antagonista do alfa7nAChR), previamente ao tratamento com PNU. No 29° dia do protocolo, os animais foram eutanasiados e foram avaliados o número de células inflamatórias no lavado broncoalveolar (LBA) e no sangue, os níveis de citocinas no LBA, a expressão do alfa7nAChR e mAchRs do tipo 3 (M3) e a ativação do fator de transcrição nuclear kB (NF-kB) no pulmão. O remodelamento brônquico foi avaliado por morfometria. As análises estatísticas foram realizadas por meio do programa SigmaStat (Jandel Scientific, San Rafael, CA), onde um P < 0,05 foi considerado estatisticamente significativo. Resultados: Houve expressão do alfa7nAChR e M3 no homogenato de pulmão de animais controle e sensibilizados. Determinamos por meio da redução de eosinófilos que a dose de 0,5 mg/Kg do tratamento com PNU foi a mais efetiva. Assim, observamos que o tratamento com PNU0,5 nos animais sensibilizados reduziu o número de células totais, eosinófilos, neutrófilos, macrófagos e linfócitos no LBA, assim como número de eosinófilos no sangue periférico e ao redor das vias aéreas. O tratamento com PNU reduziu os níveis de IgE no sangue e as citocinas IL-4, IL-13 e IL-17 no LBA. Todos estes efeitos foram revertido com o pré-tratamento com MLA, exceto para a citocina IL-17. Alem disso, o tratamento com PNU reduziu o remodelamento brônquico (área de edema, de epitélio e de músculo liso e deposição de fibras colágenas) assim como o número de células positivas para MMP-9 e TIMP-1 ao redor das vias aéreas. No pulmão a expressão do p-65-NF-kB, STAT3 fosforilado e o SOCS3 foram inibidas pelo PNU. Conclusão: Estes dados claramente demonstram que o alfa7nAChR está envolvido no controle da resposta inflamatória pulmonar alérgica e de remodelamento brônquico em modelo experimental de asma alérgica e portanto é um novo alvo com potencial terapêutico a ser explorado na fisiopatologia da asma brônquica / Background: Inflammation is one of the most important features in asthma pathophysiology, characterized by eosinophilic response with production of Th2 cytokine profile. The persistence of this inflammation can induce a lung repair process associated with a progressive reduction in lung function, which is not always reversed by available treatments. The anti-inflammatory cholinergic system was described as a neural mechanism that suppresses the immune response and controls inflammation mainly by the activaction of acetylcholine alfa7 nicotinic receptors (alfa7nAChR) found on immune cells. Acetylcholine (ACh) is an important mediator in asthma and we recently demonstrated that partial reduction on ACh release induced lung inflammation per se. Although it is known that muscarinic receptors (mAChRs) has a pro-inflammatory action and causes bronchoconstriction in asthma, the activation of nicotinic receptors (nAChRs) could have a beneficial effect reducing pulmonary inflammation as demonstrated in models of acute and systemic inflammation. The effects of alfa7nAChR activation in the pathophysiology of asthma have not been clearly elucidated. Aim: To investigate the effects of PNU- 282987 (PNU) treatment, a specific alfa7nAChR agonist, in a murine model of chronic allergic airway inflammation. Methods: BALB/c mice were subjected to a protocol of chronic allergic inflammation induced by intraperitoneal ovalbumin (OVA) or saline and subsequent challenges with inhalation. From the 22th day, the animals daily received PNU or vehicle (Ve) until the 28th day. PNU were tested in three differents doses (0.5, 1.0 and 2.0 mg/kg). In order to demonstrate that the effects obtained by PNU treatment was dependent on alfa7nAChR, a group of animals was treated with MLA (antagonist of alfa7nAChR) prior to the PNU treatment. On the 29th day of the protocol, the animals were euthanised and the number of inflammatory cells in the bronchoalveolar lavage fluid(BALF) fluid and blood, cytokine levels in BALF, the expression of alfa7nAChR and mAChRs type 3 (M3), and activation of nuclear transcription factor kB (NF-kB) in the lung were evaluated. Bronchial remodeling was assessed by morfometric methods. Statistical analyses were performed using the SigmaStat (Jandel Scientific, San Rafael, CA) and P < 0.05 is considered statistically significant. Results: ?7nAChR and M3 expression was detected in control and sensitized lung homogenate. The most effective dose of PNU treatment was 0.5 mg/kg evaluated by the effects on eosinophil reduction. Thus, we observed that treatment with PNU0,5 reduced the number of total cells, eosinophils, neutrophils, macrophages and lymphocytes in BALF, as well as number of eosinophils in peripheral blood and around the airways of sensitized animals. The treatment with PNU also reduced IgE levels in the blood, and cytokines IL-4, IL-13 and IL-17 in BALF. All these effects were reversed by pretreatment with MLA, except for IL-17 cytokine. Furthermore, treatment with PNU reduced bronchial remodeling (edema, epithelium and smooth muscle area and airway collagen deposition) as well as the number of positive cells for MMP-9 and TIMP-1 around the airways. The lung p-65-NF-kB, phosphorylated STAT3 and the SOCS3 expression were inhibited by PNU-282987. Conclusion: These data clearly demonstrate that the alfa7nAChR is involved in the control of allergic pulmonary inflammatory response and in bronchial remodeling in an experimental model of allergic asthma and it can be a new target with therapeutic potential to be explored in the pathophysiology of asthma

Introdução: A inflamação constitui um dos fatores mais importantes da fisiopatologia da asma brônquica, caracterizada por uma resposta eosinofílica com produção de citocinas de perfil Th2. A persistência desta inflamação induz no pulmão um processo de reparo associado à redução progressiva da função pulmonar, que nem sempre é revertida pelos tratamentos disponíveis. O sistema colinérgico anti-inflamatório é descrito como um mecanismo neural que suprime a resposta imune e controla a inflamação principalmente pelo efeito da acetilcolina em receptores nicotínicos do tipo alfa7 (alfa7nAChR) encontrados em células do sistema imune. A acetilcolina (ACh) exerce um importante efeito na asma e recentemente demonstramos que a redução parcial da liberação da acetilcolina induz per se a inflamação pulmonar. Embora se saiba que os receptores muscarínicos (mAChRs) exercem um efeito pró-inflamatório e broncoconstritor na asma, a ativação de receptores nicotínicos (nAChRs) poderia ter um efeito benéfico reduzindo a inflamação pulmonar, fato demonstrado em modelos de inflamação sistêmica e aguda. O efeito da ativação do alfa7nAChR na fisiopatologia da asma ainda não está claramente elucidado. Objetivo: Investigar o efeito do tratamento com PNU-282987 (PNU), um agonista específico do alfa7nAChR, em um modelo murino de inflamação alérgica crônica das vias aéreas. Metodologia: Camundongos BALB/c foram submetidos ao protocolo de indução alérgica crônica das vias aéreas com ovoalbumina (OVA) ou salina intraperitoneal (i.p.) e posterior desafios inalatórios. A partir do 22° dia, os animais receberam diariamente tratamento com PNU ou veículo (Ve) até o 28° dia. Foram testadas três doses de PNU (0,5, 1,0 e 2,0 mg/Kg). A fim de evidenciar se o efeito obtido no tratamento com PNU era dependente do receptor alfa7nAChR, um grupo de animais foi tratado com MLA (antagonista do alfa7nAChR), previamente ao tratamento com PNU. No 29° dia do protocolo, os animais foram eutanasiados e foram avaliados o número de células inflamatórias no lavado broncoalveolar (LBA) e no sangue, os níveis de citocinas no LBA, a expressão do alfa7nAChR e mAchRs do tipo 3 (M3) e a ativação do fator de transcrição nuclear kB (NF-kB) no pulmão. O remodelamento brônquico foi avaliado por morfometria. As análises estatísticas foram realizadas por meio do programa SigmaStat (Jandel Scientific, San Rafael, CA), onde um P < 0,05 foi considerado estatisticamente significativo. Resultados: Houve expressão do alfa7nAChR e M3 no homogenato de pulmão de animais controle e sensibilizados. Determinamos por meio da redução de eosinófilos que a dose de 0,5 mg/Kg do tratamento com PNU foi a mais efetiva. Assim, observamos que o tratamento com PNU0,5 nos animais sensibilizados reduziu o número de células totais, eosinófilos, neutrófilos, macrófagos e linfócitos no LBA, assim como número de eosinófilos no sangue periférico e ao redor das vias aéreas. O tratamento com PNU reduziu os níveis de IgE no sangue e as citocinas IL-4, IL-13 e IL-17 no LBA. Todos estes efeitos foram revertido com o pré-tratamento com MLA, exceto para a citocina IL-17. Alem disso, o tratamento com PNU reduziu o remodelamento brônquico (área de edema, de epitélio e de músculo liso e deposição de fibras colágenas) assim como o número de células positivas para MMP-9 e TIMP-1 ao redor das vias aéreas. No pulmão a expressão do p-65-NF-kB, STAT3 fosforilado e o SOCS3 foram inibidas pelo PNU. Conclusão: Estes dados claramente demonstram que o alfa7nAChR está envolvido no controle da resposta inflamatória pulmonar alérgica e de remodelamento brônquico em modelo experimental de asma alérgica e portanto é um novo alvo com potencial terapêutico a ser explorado na fisiopatologia da asma brônquica / Background: Inflammation is one of the most important features in asthma pathophysiology, characterized by eosinophilic response with production of Th2 cytokine profile. The persistence of this inflammation can induce a lung repair process associated with a progressive reduction in lung function, which is not always reversed by available treatments. The anti-inflammatory cholinergic system was described as a neural mechanism that suppresses the immune response and controls inflammation mainly by the activaction of acetylcholine alfa7 nicotinic receptors (alfa7nAChR) found on immune cells. Acetylcholine (ACh) is an important mediator in asthma and we recently demonstrated that partial reduction on ACh release induced lung inflammation per se. Although it is known that muscarinic receptors (mAChRs) has a pro-inflammatory action and causes bronchoconstriction in asthma, the activation of nicotinic receptors (nAChRs) could have a beneficial effect reducing pulmonary inflammation as demonstrated in models of acute and systemic inflammation. The effects of alfa7nAChR activation in the pathophysiology of asthma have not been clearly elucidated. Aim: To investigate the effects of PNU- 282987 (PNU) treatment, a specific alfa7nAChR agonist, in a murine model of chronic allergic airway inflammation. Methods: BALB/c mice were subjected to a protocol of chronic allergic inflammation induced by intraperitoneal ovalbumin (OVA) or saline and subsequent challenges with inhalation. From the 22th day, the animals daily received PNU or vehicle (Ve) until the 28th day. PNU were tested in three differents doses (0.5, 1.0 and 2.0 mg/kg). In order to demonstrate that the effects obtained by PNU treatment was dependent on alfa7nAChR, a group of animals was treated with MLA (antagonist of alfa7nAChR) prior to the PNU treatment. On the 29th day of the protocol, the animals were euthanised and the number of inflammatory cells in the bronchoalveolar lavage fluid(BALF) fluid and blood, cytokine levels in BALF, the expression of alfa7nAChR and mAChRs type 3 (M3), and activation of nuclear transcription factor kB (NF-kB) in the lung were evaluated. Bronchial remodeling was assessed by morfometric methods. Statistical analyses were performed using the SigmaStat (Jandel Scientific, San Rafael, CA) and P < 0.05 is considered statistically significant. Results: ?7nAChR and M3 expression was detected in control and sensitized lung homogenate. The most effective dose of PNU treatment was 0.5 mg/kg evaluated by the effects on eosinophil reduction. Thus, we observed that treatment with PNU0,5 reduced the number of total cells, eosinophils, neutrophils, macrophages and lymphocytes in BALF, as well as number of eosinophils in peripheral blood and around the airways of sensitized animals. The treatment with PNU also reduced IgE levels in the blood, and cytokines IL-4, IL-13 and IL-17 in BALF. All these effects were reversed by pretreatment with MLA, except for IL-17 cytokine. Furthermore, treatment with PNU reduced bronchial remodeling (edema, epithelium and smooth muscle area and airway collagen deposition) as well as the number of positive cells for MMP-9 and TIMP-1 around the airways. The lung p-65-NF-kB, phosphorylated STAT3 and the SOCS3 expression were inhibited by PNU-282987. Conclusion: These data clearly demonstrate that the alfa7nAChR is involved in the control of allergic pulmonary inflammatory response and in bronchial remodeling in an experimental model of allergic asthma and it can be a new target with therapeutic potential to be explored in the pathophysiology of asthma

Abstract Collagen XIII is a transmembrane protein consisting of intracellular, transmembrane and extracellular domains. The latter can be cleaved by proteases of the furin family at the plasma membrane and in the trans-Golgi network. Both the transmembrane and shed collagen XIII are expressed at the neuromuscular junctions of mice and humans. Such motor synapse passes the contraction signal from the central nervous system to the muscles and brings about all voluntary movements. Loss of both forms of collagen XIII in mice and loss-of-function mutations in the COL13A1 gene in humans leads to congenital myasthenic syndrome characterized by decreased neuromuscular transmission and muscle weakness. To study the roles of the two collagen XIII forms, a novel mouse line was engineered to harbor only the transmembrane collagen XIII by mutating the furin cleavage site. Transmembrane collagen XIII was discovered to be sufficient to prevent adhesion defects, Schwann cell invagination, the ineffective vesicle accumulation and dispersion of both acetylcholinesterase and acetylcholine receptors, phenotypes seen in the complete lack of collagen XIII. On the other hand, lack of shedding led to acetylcholine receptor fragmentation, aberrantly increased neurotransmission and presynaptic complexity. Remarkably, in vivo and in vitro interaction of collagen XIII and acetylcholinesterase-anchoring ColQ was detected. Furthermore, muscle and neuromuscular junction phenotype in the lack of both forms of collagen XIII closely resembled those in the human patients harboring mutations in the COL13A1 gene and these mice were validated as a good model for studying the human disease. Misexpression of collagen XIII was studied with mice exhibiting transgenic overexpression of the protein. Overexpression of collagen XIII was detected to be mostly extrasynaptic in the muscles of such mice. Exogenous collagen XIII was found at the myotendinous junctions, tenocytes and fibroblast-like cells, in addition to some localization in the near vicinity of the neuromuscular junctions. Collagen XIII expression was found, for the most part, to be normal at the neuromuscular junctions, although some were devoid of collagen XIII. The neuromuscular junction phenotype resembled in many ways the findings made in the lack of collagen XIII. Furthermore, acetylcholine receptor and nerve pattern was discovered to be widened. / Tiivistelmä Kollageeni XIII on solukalvoproteiini, jonka rakenne koostuu solunsisäisestä, solukalvon läpäisevästä ja solun ulkoisesta osasta, joka pystytään entsymaattisesti irrottamaan solukalvoilta. Täten se esiintyy kahdessa eri muodossaan; solukalvomuotoisena ja soluvälitilan lihasperäisenä proteiinina hiirten ja ihmisten hermolihasliitoksessa. Tässä motorisessa synapsissa keskushermostosta peräisin oleva lihaksen supistumiskäsky välittyy lihakseen ja aikaan saa tahdonalaiset liikkeet. Molempien kollageeni XIII:n muotojen puute hiirillä ja COL13A1 geenin mutaatiot ihmisillä johtavat synnynnäiseen myasteeniseen oireyhtymään, jossa heikentynyt hermolihasliitoksen toiminta johtaa lihasheikkouteen. Kollageeni XIII:n eri muotojen hermolihasliitosvaikutusten selvittämiseksi luotiin hiirilinja, jossa kollageeni XIII ilmenee geneettisen manipulaation seurauksena ainoastaan solukalvomuodossaan. Tutkimukset osoittivat solukalvomuotoisen kollageeni XIII:n tarvittavan hermon ja lihaksen kiinnittymiseen toisiinsa, hermovälittäjäainerakkuloiden ankkuroimiseen hermopäätteeseen, estämään Schwannin solujen tunkeutuminen synapsirakoon, asetyylikoliiniesteraasin sitomiseen ja asetyylikoliinireseptorien vakaantumiseen. Soluvälitilan kollageeni XIII:n puutos puolestaan johti lihaksen puolen liitoksen pirstaloitumiseen sekä hermopäätteiden liialliseen kasvuun ja aktiivisuuteen. Kollageeni XIII todettiin sitoutuvan asetyylikoliiniesteraasia hermolihasliitokseen ankkuroivan kollageeni Q:n kanssa. Lisäksi molempien kollageeni XIII:n muotojen suhteen poistogeenisten hiirten hermolihas- ja lihaslöydökset todettiin muistuttavan COL13A1 geenin mutaatioista kärsivien ihmisten vastaavia löydöksiä todistaen nämä hiiret hyväksi tautimalliksi tulevaisuuden hoitomuotojen suunnitteluun. Kollageeni XIII:n ylimäärän vaikutusta hermolihasliitokseen ja lihaskudokseen tutkittiin kollageeni XIII:a ylenmäärin ilmentävillä hiirillä. Kollageeni XIII todettiin ilmentyvän ylenmäärin lihaksessa fibroblastinkaltaisissa soluissa, lihasjänneliitoksessa ja hermolihasliitoksen lähettyvillä, mutta ei hermolihasliitoksessa. Osa hermolihasliitoksista näissä hiirissä ilmensi jopa vähemmän kollageeni XIII:a kuin normaalisti. Asetyylikoliinireseptorien ja hermojen valtaama alue todettiin leventyneeksi ja hermolihasliitoslöydökset muistuttivat molempien kollageeni XIII:n muotojen suhteen poistogeenisien hiirten löydöksiä.

Pentameric ligand-gated ion channels (pLGICs) are membrane-embedded receptors found extensively in pre- and post-synaptic membranes throughout the nervous system where they play an important role in neurotransmission. The function of the prototypic pLGIC, the nicotinic acetylcholine receptor (nAChR) is highly sensitive to changes in its lipid environment, while other pLGICs display varying lipid sensitivities. This thesis presents a multidisciplinary investigation into the features of the transmembrane domain (TMD) that determine the unique functional and physical traits of different pLGICs. Using two prokaryotic homologues of the nAChR, ELIC and GLIC, as models, I focus on the outermost, lipid-exposed α-helix, M4, which, despite being distant from the primary allosteric pathway coupling agonist binding to channel gating, exercises significant control over channel function. Here, I present evidence that M4 acts as a lipid sensor, detecting changes in the surrounding lipids and transmitting these changes to the channel pore via contacts with the adjacent TMD α-helices, M1 and M3, and/or with structures in the extracellular domain. Using ELIC and GLIC chimeras, I first show that the TMD is the main driver of pLGIC thermal stability. I then demonstrate that the M4 α-helices in each channel play different roles in channel maturation and function, which suggests a divergent evolutionary path. Following this, I show that the M4 C-terminus is essential to both maturation and function in GLIC, while in ELIC its role is less defined, again showcasing possible evolutionary differences. Building on these findings, I examined the role of aromatic residues at the M4 – M1/M3 interface, and found that they predictably determine the interactions between M4 and M1/M3. Notably, the addition of aromatic residues to enhance M4-M1/M3 interactions in ELIC promotes channel function, while the elimination of aromatic residues at the M4-M1/M3 interface in GLIC is detrimental to channel function. Furthermore, I show that these same aromatics alter the strength of pLGIC lipid sensing and the sensitivity to certain disease-causing mutations, both indicating that aromatic residues are key players in channel function, stability and modulation. Finally, I and my collaborators identified and characterized a novel desensitization-linked lipid binding site in ELIC. Extensive mutagenesis studies coupled with biophysical measurements allowed us to develop a model describing how lipid binding influences the rates of ELIC desensitization to shape the agonist-induced response.

Alcohol, recently named the most dangerous drug in the world, contributes to nearly 40% of violent crimes and fatal traffic accidents, increases risk of roughly 60 different diseases and injuries, and is responsible for 2.5 million deaths each year worldwide. Despite these staggering figures, treatments remain ineffective and riddled with adverse side effects, making successful use of even the most effective treatments unlikely. Moreover, many of the treatments, and the supporting research, have focused only on male subjects, despite sex differences in various alcohol-related behaviors. Human alcohol use is frequently accompanied by nicotine use, and vice versa, suggesting a common mechanism of the two drugs. In fact, alcohol may act through the same family of receptors as nicotine, the nicotinic acetylcholine receptors (nAChRs), eliciting similar activation of the reward pathway as nicotine and other drugs of abuse. Studies have shown that nAChRs containing the α4 and/or α6 subunits are involved in nicotine-induced activation of the reward pathway, leading to the hypothesis that these same receptor subtypes may be important for alcohol effects in the brain as well. Using male and female genetic mouse models and various behavioral assays, we have shown not only that these α4 and/or α6-containing nAChRs are involved in alcohol- related behaviors and activation of the reward pathway, but also show sex differences in this involvement. Uncovering the mechanism of alcohol in the brain, in males as well as in females, is an important step in developing targeted treatments for alcohol abuse.

Indiana University-Purdue University Indianapolis (IUPUI) / Nicotine use among individuals with schizophrenia occurs at extremely high rates. The prevailing theory is that individuals with schizophrenia smoke as a form of self-medication to ameliorate sensory and cognitive deficits. However, these individuals also have enhanced rates of addiction to several drugs of abuse and may therefore smoke as a result of enhanced addiction liability. The experiments described herein explored these two hypotheses by assessing the effect that nicotine has on working memory, addiction vulnerability (locomotor sensitization and self-administration), and nicotinic acetylcholine receptor (nAChR) expression as well as the developmental expression of these characteristics in the neonatal ventral hippocampal (NVHL) neurodevelopmental animal model of schizophrenia. The results from these studies indicate that NVHLs had working memory impairments in both adolescence and adulthood, with nicotine having a negligible effect. Additionally, NVHLs displayed enhanced locomotor sensitization to nicotine which emerged in adulthood as well as an enhanced acquisition of nicotine self-administration, administering more nicotine overall. These behavioral differences cannot be attributed to nAChR expression as nicotine upregulated nAChR to a similar extent between NVHL and SHAM control animals. These data indicate that the enhanced rates of nicotine use among individuals with schizophrenia may occur as a result of an enhanced vulnerability to nicotine addiction.

Background: Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) constitute rare chronic inflammatory biliary diseases which likely comprise genetic, environmental and autoimmune factors. Specific inhibitory (auto-) antibodies against the muscarinic acetylcholine receptor type 3 (mAChR3 auto-ab) may contribute to the pathogenesis of chronic biliary inflammation by modulating mAChR3− mediated signaling. Aims: The aim of this study was to analyze the prevalence and relevance of inhibitory mAChR3 auto-ab (mAChR3inh+ auto-ab) in a large cohort of PBC patients from two independent tertiary centers in Berlin and Leipzig in comparison to a large PSC cohort. Baseline parameters and response rates to standard treatment with ursodeoxycholic acid (UDCA) were characterized with respect to the individual mAChR3 auto-ab status. Methods: In total, the study population comprised 437 PBC patients, 187 PSC patients and 80 healthy controls. Clinical and laboratory baseline characteristics were retrieved from medical records. The response to ursodeoxycholic acid (UDCA) therapy after 12 months of treatment was available in 176 PBC and 45 PSC patients. Results: The prevalence of mAChR3inh+ auto-ab was significantly higher among PBC patients (11.2%, 49/437; p = 0.008 vs. healthy controls) and PSC patients (33.6%, 63/187; p < 0.0001 vs. healthy controls) compared to healthy controls (2.5%, 2/80), respectively. PBC patients with mAChR3inh+ auto-ab exhibited significantly higher levels of alkaline phosphatase (ALP) and bilirubin, which constitute established parameters for PBC risk stratification. Moreover, mAChR3inh+ PBC patients tended to show decreased response rates to UDCA therapy compared to PBC patients without mAChR3inh+ auto-ab (mAChR3− PBC). In contrast, PSC patients with mAChR3inh+ auto-ab showed no significant differences in laboratory findings compared to mAChR3 auto-ab negative (mAChR3−) PSC patients. Conclusion: MAChR3inh+ auto-ab might be involved in the pathogenesis and treatment response of chronic biliary inflammation in patients with PBC but not in patients with PSC.

No description available.

Congenital myasthenic syndrome (CMS) and myasthenia gravis (MG) are, respectively, inherited or autoimmunological disorders caused by aberrant neuromuscular transmission, which manifests as fatiguable muscle weakness. A novel subtype of CMS, resulting from mutations in GFPT1 and characterised by a limb girdle pattern of muscle weakness, has been described. The gene encodes L glutamine:D fructose-6-phosphate amidotransferase 1 (GFAT1) – a key rate limiting enzyme in the hexosamine biosynthetic pathway, providing building blocks for glycosylation of proteins and lipids. The research focused on the molecular bases of the CMS resulting from mutations in the ubiquitously expressed gene, but with symptoms largely restricted to the neuromuscular junction (NMJ). The work has established a link between the NMJ and GFPT1 CMS by demonstrating that the AChR cell surface is decreased in GFPT1 patient muscle cells and in GFPT1-silenced cell lines. The decrease is likely to be caused by reduced steady-state levels of individual AChR α, δ and ε, but not β, subunits. To optimise treatment for myasthenic disorders, a comparative in vivo trial of therapy with pyridostigmine bromide and salbutamol sulphate, and pyridostigmine bromide alone, was conducted. Supplementation of the AChE inhibitor-based therapy with the β2-adrenergic receptor agonist had a beneficial effect. This offers promise for more effective treatments for CMS and MG affected individuals. Molecular causes of MG were also investigated. The search for novel antibody targets was conducted with the use of a designed cell-based assay for the detection of anti COLQ autoimmunoglobulins in MG patient sera. The antibodies were detected in 24 out of 418 analysed samples, but their pathogenicity has not been determined.

A sepse causa uma alta taxa de mortalidade no mundo. A fisiopatologia da doença envolve uma rede complexa de mediadores inflamatórios que promovem a lesão de diversos tecidos, além de diversas alterações hemodinâmicas e disfunção do sistema nervoso autonômico (SNA). Assim sabe-se que o sistema nervoso cumpre um papel importante no controle da inflamação sistêmica mediante a via colinérgica anti-inflamatória (VCA) através do receptor nicotínico de acetilcolina alfa7 (alfa7nAChR). O uso das células-tronco mesenquimais (CTM) tem mostrado efeitos benéficos em diversos ensaios clínicos de doenças inflamatórias. Neste contexto, as células-tronco mesenquimais derivadas da geleia de Wharton do cordão umbilical (CTM-GW) tornam-se promissórias, uma vez que essas células são reconhecidas pela regulação da resposta imunológica, reparação neural, efeito anti-apoptose, assim como a melhora da sobrevida na sepse, em modelos experimentais. Nossa hipótese foi de que as CTM-GW poderiam cumprir um papel neuroimunomodulador através da VCA e atenuar a disfunção de múltiplos órgãos em um modelo animal de sepse de ligadura e punção do ceco (LPC). Inicialmente células da matriz do cordão umbilical foram isoladas e caracterizadas de acordo com o consenso internacional vigente. Ratos Wistar machos adultos foram subdivididos em grupos: 1) sham (operação simulada); 2) LPC; 3) LPC+CTM-GW (injetado 106 CTM-GW via intraperitoneal, i.p. 6 h após LPC) e 4) LPC+MLA+CTM-GW (MLA: Metillicaconitine, antagonista do alfa7nAChR, i.p., 5:30 h após LPC e 106 CTM-GW 6h após). Às 24 horas após LPC, foram avaliadas a função cardiovascular, hemodinâmica assim como os outros parâmetros. Interessantemente, o tratamento com CTM-GW na sepse atenuou a disfunção diastólica e protegeu a sensibilidade baroreflexa. Além disso, as CTM-GW estimularam a atividade autonômica, simpática e parassimpática no coração. Observamos que o tratamento celular induziu uma regulação da expressão do receptor alfa7nAChR e TLR4 no baço e no coração, assim como a redução da relação p-STAT3TYR705 e STAT3 total no baço. Outros efeitos importantes e adicionais foram a diminuição da infiltração de leucócitos e a regulação das citocinas pró-inflamatórias pelas células. O bloqueio da VCA usando MLA confirmou que o receptor alfa7nAChR pode ser um provável alvo, chave da ação das CTM entre vários outros mecanismos envolvidos na resposta imune. Finalmente, as CTM-GW conseguiram reduzir a apoptose no pulmão e no baço independentemente da VAC reforçando o conceito de que as células-tronco tem efeitos diversos além da imuno-regulação. Em conclusão, as CTM-GW na sepse foram capazes de atenuar a lesão cardiopulmonar assim como modular a atividade autonômica, reduzindo a inflamação sistêmica, pelo menos em parte, através da via colinérgica anti-inflamatória. Indubitavelmente todos estes efeitos anteriormente descritos e em associação se demonstraram fundamentais no mecanismo de reparo e proteção tecidual em resposta a sepse. Mais estudos pré-clínicos e futuros testes clínicos precisam ser realizados para maior compreensão destes mecanismos bem como uma possível validação terapêutica / Sepsis induces organ dysfunction due to overexpression of the inflammatory host response, involving cardiorespiratory and autonomic dysregulation, thus increasing the associated morbidity and mortality. The cholinergic anti-inflammatory pathway (CAP) is mediated by nervous system through alpha7 nicotinic acetylcholine receptor (alpha7nAChR). This receptor has an important role in systemic inflammation control. Wharton\'s jelly-derived mesenchymal stem cells (WJ-MSCs) are known to express genes and secreted factors related to neurological and immunological protection, as well as to improve survival in experimental sepsis. We hypothesized that WJ-MSCs play a modulatory role through the CAP and attenuate sepsis-induced organ injury in a cecal ligation and puncture (CLP) model. Rats were randomly divided into 4 groups: 1) Control (sham-operated); 2) submitted to CLP without treatment; 3) submitted to CLP and treated with 106 WJ-MSCs 6 h later and 4) CLP+MLA+WJ-MSC group (MLA: Methyllycaconitine, alpha7nAChR antagonist). All experiments were performed 24 h post-surgery. Echocardiographic parameters and heart rate variability were assessed. Importantly, treatment with WJ-MSCs attenuated diastolic heart failure and recovered barorreflex sensitivity. Moreover, WJ-MSCs injection increased cardiac sympathetic and cardiovagal activity. In cardiac and splenic tissue, WJ-MSC treatment downregulated TLR4 and alpha7nAChR expression, as well as it reduced p-STAT3/Total STAT3 ratio in the spleen. In addition, WJ-MSC reduced leukocyte infiltration and pro-inflammatory cytokines, which only were abolished by MLA treatment. Finally, WJ-MSC treatment diminished apoptosis in lung and spleen tissue. Together these findings suggest that treatment with WJ-MSCs appears to protect against sepsis-induced organ injury reducing systemic inflammation, at least in part, through cholinergic anti-inflammatory pathway