A prevalência de Doença Mental Grave (do inglês Severe Mental Illness, SMI) atinge 5,4% em um ano segundo os estudos Baltimore Epidemiologic Catchment Area e National Comorbidity Survey. O conceito de SMI surgiu na década de 1970 para o planejamento dos serviços de saúde e apresentou importância crescente a partir do movimento de desinstitucionalização psiquiátrica. Uma das definições para SMI deriva do NIMH (National Institute of Mental Health) em 1987, e utiliza como critérios a presença de prejuízo funcional, decorrente de déficits em aspectos básicos do dia-a-dia, bem como a duração da doença. Casos agudos de SMI podem necessitar tratamento em Unidade de Internação Psiquiátrica em Hospital Geral (UIPHG). No entanto, há poucos estudos disponíveis no Brasil avaliando esta modalidade de tratamento e os desfechos destes pacientes. Evidências também apontam que os pacientes com transtornos psiquiátricos apresentam níveis reduzidos de Fator Neurotrófico Derivado do Cérebro (Brain-Derived Neurotrophic Factor, BDNF). O BDNF age no sistema nervoso central (SNC) promovendo crescimento e diferenciação de neurônios. Dentro deste contexto, a presente tese apresenta como objetivo principal a avaliação naturalística de desfechos clínicos e funcionais, associados à avaliação dos níveis séricos de BDNF, em pacientes com SMI. Os pacientes que foram encaminhados para tratamento na Unidade de Internação Psiquiátrica do Hospital de Clínicas de Porto Alegre foram incluídos se apresentassem os critérios de SMI: Avaliação Global de Funcionamento (Global Assessment of Functioning, GAF) menor ou igual a 50 e tempo de tratamento maior ou igual a dois anos. As avaliações ocorreram em dois momentos (admissão e alta). Compreenderam avaliação sociodemográfica, clínica e coleta de sangue (com dosagem de BDNF sérico). Foram realizadas avaliação diagnóstica pelo Mini-International Neuropsychiatric Interview (MINI) e aplicação das escalas Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression scale (CGI-S), GAF e World Health Organization Quality of Life Instrument—Short Version (WHOQOL-Bref). Ainda, foram aplicadas escalas específicas nos diagnósticos principais (i.e., depressão maior, depressão bipolar, episódio maníaco, esquizofrenia): Hamilton Depression Rating Scale (HAM-D); Young Mania Rating Scale (YMRS). O primeiro artigo desta tese descreve os desfechos clínicos, funcionais e também de qualidade de vida durante a internação psiquiátrica. Observou-se melhora significativa nos parâmetros avaliados nos pacientes com SMI como um todo. Os pacientes com episódio maníaco apresentaram maior chance (em relação aos com episódio depressivo) de atingir remissão pela CGI (OR: 4.03; 95% CI: 1.14-14.30; p=0.03). A duração média da hospitalização (LOS) foi 28,95 (± 19,86) dias. No segundo artigo, observou-se redução dos níveis séricos de BDNF nos pacientes com SMI em relação aos controles saudáveis, independentemente do diagnóstico. Houve aumento significativo no BDNF entre a admissão e a alta. Os resultados apresentados replicam dados previamente publicados a partir de amostra única de pacientes com SMI, sua característica diferencial. Estes resultados reforçam que a internação em UIPHG, uma intervenção relativamente breve, demonstra desfechos positivos e é alternativa bem estabelecida no tratamento da SMI. Além disso, a redução inespecífica do BDNF sérico seguida de um pequeno aumento associado ao tratamento reforçam a possibilidade do BDNF como marcador transdiagnóstico de transtorno mental. / The estimated prevalence of Severe Mental Illness (SMI) according to Baltimore Epidemiologic Catchment Area and National Comorbidity Survey studies is 5.4% in one year. One suggested definition of Severe Mental Illness (SMI) derives from the 1987 National Institute of Mental Health (NIMH) definition and is based on two criteria: 1. duration, characterized as involving “prolonged illness”, and 2. disability, which includes dangerous or disturbing social behavior, and mild impairment in achieving basic needs. These acute psychiatric conditions may require psychiatric inpatient treatment located in acute wards in General Hospitals. However, little data is currently available evaluating the characteristics and the outcomes during an acute inpatient stay in Brazil. Evidence also suggests that Brain-derived neurotrophic factor (BDNF) levels are significantly decreased in neuropsychiatric disorders. BDNF is found throughout the brain and is involved in neurogenesis and neuroplasticity. So, the main objectives of this work are to evaluate SMI patients’ outcomes during treatment in a psychiatric unit in a general hospital by symptomatology, functionality, quality of life and by the evaluation of BDNF serum levels. After the admission to a psychiatric unit in a general hospital in Brazil, patients were included and if they had two of the SMI criteria: Global Assessment of Functioning (GAF) ≤ 50 and duration of services contact ≥ 2 years. Patients were assessed in admission and upon discharge with Mini-International Neuropsychiatric Interview (MINI), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale (CGI), GAF, World Health Organization’s QOL Instrument—Short Version (WHOQOL-Bref) and diagnostic specific scales (Hamilton Depression Rating Scale, HAM-D; Young Mania Rating Scale, YMRS; and Hamilton Anxiety Rating Scale, HAM-A). Blood samples were also obtained. The first manuscript showed that SMI patients had marked and significant improvements in symptomatic and functional measures during psychiatric hospitalization. Patients with manic episode had higher chance of CGI remission (OR: 4.03; 95% CI: 1.14-14.30; p=0.03) when compared with patients with depressive episode. Mean LOS was 28.95 (± 19.86) days. The second manuscript showed that BDNF serum levels were equally reduced among different SMI diagnoses. Also, the observed improvements in SMI patients were associated with a significant, but small increase in mean serum BDNF levels. Therefore, the results replicate evidence from previous findings in single samples, suggesting that SMI patients can have marked acute improvements during a a relatively short intervention (approximately 1 month) represented by the psychiatric hospitalization in a general tertiary hospital. Also, the similar reduction observed in BDNF levels among SMI patients with different diagnoses and the significant increase but non-restoration indicate that BDNF serum levels could be considered a marker for the presence of an unspecific psychiatric disorder and possibly a transdiagnostic and unspecific marker of disease activity.

As leucemias correspondem a 30% dos tumores pediátricos, e constituem as neoplasias mais frequentes em indivíduos com menos de 15 anos. Apesar da elevada taxa de cura, frequentemente a ela está associada resistência à quimioterapia e efeitos colaterais tardios. Por isso, novas estratégias de tratamento, diagnóstico e prognóstico são necessárias. O fator neurotrófico derivado do cérebro (BDNF) e seus receptores de quinase relacionados à tropomiosina (tropomyosin related kinase, ou Trk) estão envolvidos com muitos processos na medula óssea (MO). Entretanto, o papel do BDNF em leucemias agudas (LA) pediátricas ainda não é bem conhecido. O objetivo desse estudo foi analisar os níveis de BDNF em amostras de MO ou sangue periférico (SP) de crianças com LA, e iniciar a caracterização dos efeitos de agonistas e antagonistas de neurotrofinas sobre culturas primárias de leucemias linfóides agudas em diferentes momentos terapêuticos Foram coletadas amostras de MO ou SP de crianças e adolescentes com leucemia linfóide aguda (LLA), crianças e adolescentes com leucemia mielóide aguda (LMA), e indivíduos saudáveis (IS) da mesma faixa etária. Para análise dos níveis séricos de BDNF utilizou-se kit de imuno-ensaio enzimático tipo sanduíche. Quando comparados aos IS os níveis de BDNF de pacientes com LA, ao diagnóstico, foram significativamente menores. Resultados similares foram observados nos pacientes durante indução, consolidação, diagnóstico e tratamento de recidiva. Da mesma forma, os níveis de BDNF foram inferiores em pacientes que receberam transfusão de plaquetas e, ao diagnóstico naqueles pacientes que foram a óbito. Para a caracterização dos efeitos de agonistas e antagonistas de neurotrofinas em cultura de células, amostras de pacientes ao momento do diagnóstico e no momento de indução do tratamento foram utilizadas. Os linfócitos foram extraídos e, após plaqueamento, as células foram tratadas com BDNF (Sigma, B3795), NGF (Sigma, SRP3015) e K252a (Sigma, 05288) por 72 horas. A viabilidade foi avaliada pelo método de exclusão por azul de Tripan. Devido às dificuldades no cultivo das células, esses dados ainda estão em análise. / Leukemias account for 30% of pediatric tumors and are the most frequent cancers in people under 15 years. Despite the high cure rate, often it is associated with resistance to chemotherapy and late side effects. Therefore, new strategies for treatment, diagnosis and prognosis are necessary. The brain-derived neurotrophic factor (BDNF) and their kinase receptor related tropomyosin (tropomyosin related kinase, and Trk) are involved in many processes in bone marrow (BM), however, the role of BDNF in acute leukemias (AL) pediatric it is not well known. The aim of this study was to analyze the BDNF levels in BM samples or peripheral blood (PB) of children with AL, and start the characterization of the effects of agonists and antagonists on neurotrophin primary cultures of acute lymphoblastic leukemias in different therapeutic moments. BM or PB samples were collected from children and adolescents with acute lymphoblastic leukemia (ALL), children and adolescents with acute myeloid leukemia (AML), and healthy individuals (HI) of the same age. For analysis of serum levels of BDNF was used sandwich enzyme immunoassay kit. When compared to HI, BDNF levels in patients with AL at diagnosis were significantly lower. Similar results were observed in patients during induction, consolidation, diagnosis and treatment of relapse. Similarly, BDNF levels were lower in patients receiving platelet transfusion and at diagnosis in patients that died. To characterize the effects of agonists and antagonists for neurotrophin in cell culture, samples of patients at diagnosis and at the time of induction treatment were used. Lymphocytes were extracted and, after plating, cells were treated with BDNF (Sigma B3795), NGF (Sigma, SRP3015) and K252a (Sigma, 05288) for 72 hours. Viability was assessed by exclusion of trypan blue method. Due to difficulties in cell culture, these data are still under analysis.

A hipermetioninemia é uma condição caracterizada por altos níveis de metionina no sangue e em outros tecidos, podendo causar danos neurológicos, hepáticos e musculares. Considerando que a placenta transfere a metionina do sangue materno para a circulação fetal e que pouco se sabe sobre o efeito da hipermetioninemia gestacional sobre o feto em desenvolvimento, o principal objetivo deste trabalho foi desenvolver um modelo animal de hipermetioninemia materna quimicamente induzido em ratas e utilizar o mesmo para investigar parâmetros bioquímicos (estresse oxidativo, atividade da Mg2+-ATPase, atividade e imunoconteúdo da Na+,K+-ATPase, número de neurônios, níveis de neurotrofinas, metabolismo energético, inflamação e apoptose), moleculares (expressão gênica da Na+,K+-ATPase) e histológicos (microscopia eletrônica) nos encéfalos da prole, bem como avaliar tarefas comportamentais (campo aberto, esquiva inibitória e reconhecimento de objetos). Também analisamos parâmetros de estresse oxidativo/nitrosativo no músculo esquelético e parâmetros de dano muscular e inflamação no soro da prole. A hipermetioninemia foi induzida em ratas através de duas injeções subcutâneas diárias de metionina durante todo o período gestacional. Um grupo de ratas recebeu a dose 1 (1,34 μmol/g peso corporal) e outro recebeu a dose 2 (2,68 μmol/g peso corporal). O grupo controle recebeu salina. Após o nascimento, um grupo de filhotes foi eutanasiado no sétimo dia de vida e outro grupo foi eutanasiado aos 21 dias. Ambas as doses aumentaram os níveis encefálicos de metionina das mães e a dose 2 aumentou os níveis de metionina nos encéfalos da prole. Após estabelecer o modelo, a dose 2 de metionina foi escolhida para estudar os efeitos do tratamento sobre a prole. Os testes bioquímicos subsequentes foram realizados nos filhotes de 21 dias, a histologia foi realizada na prole de 21 e 30 dias e os testes comportamentais foram realizados em filhotes de 30 dias. Os resultados demonstraram que a hipermetioninemia materna reduziu a atividade da Na+,K+-ATPase, Mg2+- ATPase, catalase e complexo II/succinato desidrogenase, o conteúdo de sulfidrilas, número de neurônios e níveis de NGF e BDNF, bem como aumentou os níveis de RNAm e imunoconteúdo da Na+,K+-ATPase nos encéfalos dos filhotes. Foram observados também alterações morfológicas, indicativas de degeneração celular nos neurônios da prole, e os testes comportamentais indicaram deficit de memória. Com relação aos danos musculares, houve um aumento na produção de espécies reativas de oxigênio e lipoperoxidação e uma redução do conteúdo de sulfidrilas, atividades das enzimas antioxidantes e nos níveis de nitritos no músculo esquelético da prole. A atividade da creatina cinase foi reduzida e os níveis de ureia e proteína C reativa foram aumentados no soro. Esses resultados foram acompanhados por perda de massa muscular. Tais achados mostraram que a hipermetioninemia gestacional induziu alterações bioquímicas, moleculares e histológicas no encéfalo e bioquímicas no músculo esquelético e soro dos filhotes, as quais podem contribuir para o entendimento dos mecanismos fisiopatológicos envolvidos nos danos neurológicos e musculares causados por essa condição. Ressaltamos a importância do desenvolvimento do referido modelo de hipermetioninemia gestacional que além de ampliar o entendimento da toxicidade de altos níveis metionina, também abriu perspectivas para novos estudos a respeito dos efeitos ocasionados pela exposição ao excesso de metionina devido a uma condição genética ou uma dieta rica em proteína durante a vida pré-natal. / Hypermethioninemia is a condition characterized by elevated levels of methionine in blood and other tissues and may cause neurological, hepatic and muscular damages. Considering that placenta transfers methionine from maternal blood to the fetal circulation and little is known about the effect of gestational hypermetioninemia on the developing fetus, the main objective of this work was to develop a chemically induced animal model of maternal hypermethioninemia in rats and to use it to investigate biochemical (oxidative stress, activity of Mg2+-ATPase, activity and immunocontent of Na+,K+-ATPase, number of neurons, neurotrophins levels, energy metabolism, inflammation, and apoptosis), molecular (gene expression of Na+,K+-ATPase) and histological parameters (electron microscopy) in encephalon of the offspring, as well as evaluate behavioral tasks (open field, inhibitory avoidance and object recognition). We also analyzed oxidative/nitrosative stress parameters in skeletal muscle and parameters of muscle damage and inflammation in serum of the offspring. Hypermethioninemia was induced in rats through two daily subcutaneous injections of methionine throughout the gestational period. A group of pregnant rats received dose 1 (1.34 μmol/g body weight) and the other received dose 2 (2.68 μmol/g body weight). The control group received saline. After birth, a first group of pups was euthanized at the 7th day of life and the second group at the 21st day of life. Both doses 1 and 2 increased methionine levels in the brain of the mother rats and dose 2 increased methionine levels in encephalon of the offspring. After establishing the experimental model, the highest dose of methionine was chosen to study the effects of treatment on offspring. The subsequent biochemical tests were performed on 21-day-old pups, histological analyses were performed on offspring of 21 and 30 days of age, and behavioral tests were performed on 30-day-old pups. The results demonstrated that maternal hypermethioninemia reduced Na+,K+-ATPase, Mg2+-ATPase, catalase and complex II/succinate dehydrogenase activities, sulfhydryl content, number of neurons and levels of NGF and BDNF, as well as increased levels of mRNA and immunocontent of Na+,K+-ATPase in the brains of the pups. Morphological changes indicative of cellular degeneration were also observed in offspring neurons, and behavioral tests indicated memory deficit. With regard to muscle damage, there was an increase in the production of reactive oxygen species and lipoperoxidation, and a reduction of the sulfhydryl content, antioxidant enzymes activities and in the levels of nitrites in skeletal muscle of the offspring. Creatine kinase activity was reduced and urea and C-reactive protein levels were increased in serum. These results were accompanied by loss of muscle mass. These findings showed that gestational hypermethioninemia induced biochemical, molecular and histological changes in the brain and biochemical changes in skeletal muscle and serum of pups, which may contribute to the understanding of the pathophysiological mechanisms involved in the neurological and muscular damages caused by this condition. We emphasize the importance of the development of this model of gestational hypermetioninemia that, in addition to increasing the understanding of toxicity of high methionine levels, also opened perspectives for new studies regarding the effects caused by exposure to excess methionine due to a genetic condition or a diet rich in protein during prenatal life.

Pang Petti. / "August 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Introdução: A cefaleia do tipo tensional crônica (CTTC) é caracterizada por dor de cabeça quase diária e sensibilização central. A acupuntura tem sido estudada no tratamento de diversos tipos de cefaleia, porém os resultados são controversos e apenas sugerem maior eficácia em relação ao placebo. A eletroacupuntura (EA) modula algumas das funções do sistema nervoso central (SNC), podendo modificar a neuroplasticidade. A plasticidade do SNC pode ser rastreada através dos níveis séricos do fator neurotrófico derivado do cérebro (BDNF), um mediador de neuroplasticidade. Objetivo: Este estudo testou a hipótese de que a analgesia pela EA na CTTC estaria relacionada à neuroplasticidade, avaliada através dos níveis séricos de BDNF. Métodos: Foram recrutadas mulheres, com idades entre 18-60 anos, portadoras de CTTC, para um ensaio clinico randomizado, cegado, controlado por placebo-sham. Foram aplicadas 10 sessões de EA, durante 30 minutos (2- 10 Hz, com intensidade conforme a tolerância) na cervical e áreas autonômicas, duas vezes por semana, que foram comparadas com placebosham. Os períodos de tratamento foram separados por duas semanas de intervalo. Avaliou-se dor (através de escala análoga visual (VAS) de 10 cm) e níveis séricos de BDNF como desfechos primários. Resultados: Trinta e quatro pacientes foram randomizadas e vinte e nove completaram o protocolo. Os escores da VAS foram menores durante o tratamento com EA, do que no tratamento com placebo-sham. (2.38±1.77, 3.02±2.49 respectivamente, P=0.005). Os escores de dor variaram conforme a sequência de intervenção, demonstrando efeito de carreamento (P<0.05). Utilizando regressão múltipla, os níveis séricos de BDNF foram ajustados para a escala de depressão de Hamilton e VAS (r-squared= 0.07, standard β coefficients= -0.2, -0.14, respectivamente). Ao final do período da primeira intervenção os valores de BDNF ajustados, foram maiores no grupo EA, (29.31±3.24, 27.53±2.94 ng/mL) a magnitude de efeito mensurada pela diferença na media padronizada expressou um efeito moderado (Cohen´s d= 0.55). Conclusão: A analgesia produzida pela EA pode estar relacionada à neuroplasticidade, avaliada através do BDNF ajustado para dor e depressão. A modulação pela EA na dor e BDNF depende da condição do SNC, uma vez que está relacionada à depressão e depende do momento da aplicação da intervenção. / Background: Chronic tension-type headache (CTTH) is characterized by almost daily headaches and central sensitization. Electroacupunture (EA) is effective for this condition and modules some central nervous system (CNS) functions. CNS plasticity could be tracked in serum using the brain derived neurotrophic factor (BDNF), a neuroplasticity mediator. Objective: We tested the hypothesis that EA analgesia in CTTH would be related to neuroplasticity indexed by the BDNF. Patients and methods: We enrolled females aging 18-60 with CTTH in a randomized, blinded, placebo-controlled crossover trial, comparing ten EA sessions applied during 30 minutes (2-10 Hz, intensity by tolerance) in cervical and autonomic areas twice per week, vs. placebo-sham (PS). Treatment periods were separated by two washout weeks. Pain on the 10 cm visual analog scale (VAS) and serum BDNF were assessed as primary outcomes. Results: Thirty-four subjects underwent randomization, twenty-nine completed the protocol. VAS during EA period was lower than during PS (2.38±1.77, 3.02±2.49 respectively, P=0.005). VAS differed according to intervention sequence demonstrating carry-over effect (P<0.05). Using multiple regression serum BDNF was adjusted for the Hamilton depression rating scale (HDRS) and VAS (r-squared=0.07, standard β coefficients=-0.2, -0.14, respectively; omnibus-test P<0.001). At the end of the first intervention period the adjusted BDNF was higher in the EA cohort (29.31±3.24, 27.53±2.94 ng/mL, Cohen´s d= 0.55). Conclusion: EA analgesia may relate to neuroplasticity indexed by the adjusted BDNF. EA modulation on pain and BDNF depends on the situation of the CNS, as is related to depression and depends on the timing of the intervention.

Major depressive disorder (MDD) affects 300 million people worldwide and is a major contributor to the global burden of disease. The aetiology of depression, emerging through a gene x environment interaction, is still incompletely understood which prevents tailoring of treatment approaches. In addition to MDD core symptoms, such as anhedonia (a diminished anticipation or experience of pleasure), depressed patients suffer from a plethora of manifestations including cognitive impairments, which occur primarily in the domains of executive function, attention and memory. Patients remitted from affective symptoms of MDD often continue to display cognitive impairments. These cognitive deficits are the longest present residual symptom, predict treatment response and increase risk of relapse. Consequently, cognitive impairments need to be targeted more effectively by antidepressants for complete remission from MDD. Clinically relevant animal models are essential for developing, tailoring and testing such novel, pro-cognitive antidepressants. This PhD project aimed to establish a preclinical screening platform for the testing of pro-cognitive antidepressants, to improve understanding of MDD risk factors and consequent symptom development, and finally, to focus on clinical relevance of the applied techniques. The chronic mild stress (CMS) rodent model of depression was used, known for displaying the core symptom anhedonia, but also for a high construct, face and predictive validity. The environmental MDD risk factor 'stress' induces an anhedonic-like phenotype in a subgroup of exposed rats, whereas another subgroup of rats is resilient, as determined by the sucrose consumption test. The cognitive performance of different rat strains, including CMS anhedonic-like and resilient rats, was assessed employing the touchscreen operant platform, which was developed based on the Cambridge neuropsychological test automated battery (CANTAB) for assessing cognition in humans. Furthermore, a group of anhedonic-like rats was treated with the antidepressant vortioxetine, which acts as both a pro-cognitive and antidepressant treatment. Our results showed that stress exposure induced anhedonia in albino and pigmented rat strains, although stress did not affect cognitive performance of pigmented rats in a simple pairwise discrimination touchscreen task. Applying a more complex pairedassociates learning touchscreen task revealed impaired cognitive performance in the CMS anhedonic-like but not in the resilient phenotype. Furthermore, vortioxetine treatment reversed anhedonia in the CMS model and altered executive functions in treated rats. The expression of genes involved in the stress response, affective disorders and neuronal plasticity was altered in the prefrontal cortex and hippocampus owned to treatment and hedonic state. Thus, we have demonstrated that the CMS model exhibits both stress-induced cognitive alterations and depression-associated cognitive impairments in touchscreen tasks. Furthermore, touchscreen testing was sufficiently sensitive to detect alterations in cognitive performance due to pharmacological intervention. Overall, we established a potential platform for pro-cognitive antidepressant drug screening. Furthermore, brain derived neurotrophic factor (BDNF), involved in learning and memory, was examined in the context of depression. BDNF is reduced in MDD patients as well as in preclinical models in response to stress. Although this suggests that BDNF contributes to the aetiology of depression, studies including mice heterozygous for BDNF (BDNF+/-) have generated conflicting results. BDNF+/- rats may provide a more suitable model as (1) rats have a greater behavioural repertoire than mice, (2) classical behaviour tests are designed for rats, and (3) rats, like humans, produce peripheral BDNF. We found anhedonia and mild signs of anxiety in BDNF+/- rats, accompanied by prefrontal and hippocampal changes in expression of genes relevant in psychiatric disorders and underpinning learning. Thus, behavioural and molecular findings in BDNF+/- rats complement existing literature and suggest that rats are a more suitable model in BDNF research than mice. Overall, the project uncovered environmental and genetic manifestations of risk factors in translational models and established a novel tool for translational pro-cognitive antidepressant drug screening.

Leung, Kin Ling. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 133-162). / Abstracts in English and Chinese. / CONTENTS --- p.i / ACKNOWLEDGEMENTS --- p.ii / ABBREVIATIONS --- p.iii / ABSTRACT --- p.vi / 論文摘要 --- p.ix / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- Obstructive sleep apnea syndrome --- p.1 / Chapter 1.1.1 --- Symptoms of OSA --- p.2 / Chapter 1.1.2 --- Causes of OSA --- p.5 / Chapter 1.1.3 --- Complications of OSA --- p.6 / Chapter 1.1.4 --- Episodic hypoxia profile --- p.9 / Chapter 1.2 --- Hippocampus --- p.12 / Chapter 1.2.1 --- General structure of hippocampus --- p.12 / Chapter 1.2.2 --- The neuronal circuitry of hippocampus --- p.17 / Chapter 1.2.3 --- Cell types of hippocampus --- p.21 / Chapter 1.2.4 --- Functions of hippocampus --- p.24 / Chapter 1.3 --- Memory Formation and long term potentiation --- p.27 / Chapter 1.4 --- Neurotrophins --- p.33 / Chapter 1.5 --- Brain-derived neurotrophic factor (BDNF) --- p.38 / Chapter 1.5.1 --- Molecular characteristics of BDNF --- p.38 / Chapter 1.5.3 --- Functions of BDNF --- p.46 / Chapter 1.5.4 --- BDNF and neuronal plasticity --- p.46 / Chapter 1.6 --- Tissue plasminogen activator - plasmin system --- p.51 / Chapter 1.6.1 --- Molecular characteristics of tissue plasminogen activator - plasmin system --- p.51 / Chapter 1.6.2 --- Functions of tissue plasminogen activator - plasmin system --- p.54 / Chapter 1.7 --- Aim of the study --- p.59 / Chapter CHAPTER 2 --- MATERIALS AND METHODS --- p.61 / Chapter 2.1 --- Animal model of obstructive sleep apnea --- p.61 / Chapter 2.1.1 --- Intermittent hypoxia --- p.61 / Chapter 2.2 --- Electrophysiological recordings --- p.65 / Chapter 2.2.1 --- Preparation of brain slices --- p.65 / Chapter 2.2.1 --- Visualization of hippocampus CA1 Neurons --- p.66 / Chapter 2.2.3 --- Patch-clamp recordings --- p.66 / Chapter 2.3 --- Protein analysis - ELISA --- p.71 / Chapter 2.3.1 --- Isolation of mouse hippocampus total protein --- p.71 / Chapter 2.3.2 --- ELISA --- p.72 / Chapter 2.3 --- Protein analysis (II) - Western blot --- p.74 / Chapter 2.4.1 --- Isolation of mouse hippocampus total protein --- p.74 / Chapter 2.4.2 --- Western blot analysis --- p.75 / Chapter 2.5 --- Data analysis --- p.78 / Chapter CHAPTER 3 --- RESULTS --- p.79 / Chapter 3.1 --- Effect of intermittent hypoxia on passive and active properties of hippocampal CA1 neurons --- p.79 / Chapter 3.1.1 --- Passive properties --- p.79 / Chapter 3.1.2 --- Membrane excitability --- p.83 / Chapter 3.1.3 --- Action potential characteristics --- p.93 / Chapter 3.2 --- Effect of intermittent hypoxia on the expression of BDNF and related proteins --- p.104 / Chapter 3.2.1 --- "Levels of total BDNF, NGF, NT-3 and NT-4/5" --- p.104 / Chapter 3.2.2 --- Recovery study of the expression of BDNF after IH treatment --- p.110 / Chapter 3.2.3 --- Differential effect of IH on pro-BDNF and mature BDNF --- p.114 / Chapter 3.2.4 --- "Expressions of tissue plasminogen activator, plasmin and plasminogen" --- p.117 / Chapter Chapter 4 --- Discussion --- p.121 / Chapter 4.1 --- Changes in neuronal excitability of CA1 neurons under intermittent hypoxia --- p.121 / Chapter 4.2 --- Intermittent hypoxia-induced changes in BDNF level --- p.127 / Chapter 4.3 --- Conclusion --- p.130 / REFERENCES --- p.133

The current study analyzed the effects of environmental enrichment versus isolation housing on the behavioral sensitization to nicotine in the neonatal quinpirole (NQ; dopamine D2-like agonist) model of dopamine D2 receptor supersensitivity, a rodent model of schizophrenia. NQ treatment in rats increases dopamine D2 receptor sensitivity throughout the animal's lifetime, consistent with schizophrenia. Animals were administered NQ (1 mg/kg) or saline (NS) from postnatal day (P)1 to P21, weaned, and immediately placed into enriched housing or isolated in wire cages throughout the experiment. Rats were behaviorally sensitized to nicotine (0.5 mg/kg base) or saline every consecutive day from P38 to P45, and brain tissue was harvested at P46. Results revealed that neither housing condition reduced nicotine sensitization in NQ rats, whereas enrichment reduced sensitization to nicotine in NS-treated animals. The nucleus accumbens (NAcc) was analyzed for glial cell line-derived neurotrophic factor (GDNF), a neurotrophin important in dopamine plasticity. Results were complex, and revealed that NAcc GDNF was increased in animals given nicotine, regardless of housing condition. Further, enrichment increased GDNF in NQ rats regardless of adolescent drug treatment and in NS-treated rats given nicotine, but did not increase GDNF in NS-treated controls compared to the isolated housing condition. This study demonstrates that environmental experience has a prominent impact on the behavioral and the neural plasticity NAcc response to nicotine in adolescence.

This study examined if multi-joint resistance exercises could elicit expression of biomarkers associated with neuroprotection. Thirteen well-trained males performed 4 sets to failure at 80% of a one-repetition maximum (1RM) on the back squat, bench press, and deadlift. The biomarkers measured immediately pre- and post-exercise were brain derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1), cathepsin B (CatB), and interleukin 6 (IL-6). There was a main time effect (p<0.01) for BDNF with significant increases in the deadlift (p=0.01) and bench press (p=0.01) conditions, but not the squat (p=0.21). There was a main time effect (p<0.01) for IL-6 with a significant increase in the squat (p<0.01). There was no significant increase in CatB or IGF-1 (p>0.05). Additionally, there was no significant relationship between BDNF and IL-6 response. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2019. / FAU Electronic Theses and Dissertations Collection

Neuropeptides, such as substance P (SP) and bombesin/gastrin-releasing peptide (BN/GRP), and neurotrophins are involved in neuro-immunomodulatory processes and have marked trophic, growth-promoting and inflammation-modulating properties. The impact of these modulators in rheumatoid arthritis (RA) is, however, unclear. An involvement of the innervation, including the peptidergic innervation, is frequently proposed as an important factor for arthritic disease. Many patients with RA, but not all, benefit from treatment with anti-TNF medications. The studies presented here aimed to investigate the roles of neuropeptides, with an emphasis on BN/GRP and SP, and neurotrophins, especially with attention to brain-derived neurotrophic factor (BDNF), in human and murine knee joint tissue. The expression patterns of these substances and their receptors in synovial tissue from patients with either RA or osteoarthritis (OA) were studied in parallel with the levels of these factors in blood and synovial fluid from patients with RA and from healthy controls. Correlation studies were also performed comparing the levels of neuropeptides with those of pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6)]. Furthermore, the impact of anti-TNF treatment on the levels of BDNF in blood was investigated. In a murine model of RA, the expression of these substances on articular chondrocytes along with their expression in synovial tissue was investigated. The expression of BN/GRP in human synovial tissue was confined to fibroblast-like and mononuclear-like cells whereas SP was detected in nerve-related structures. Receptors for these neuropeptides (GRP-R and NK-1R) were frequently present in blood vessel walls, and on fibroblast-like and mononuclear-like cells. The expression of BDNF and its receptors, p75 neurotrophin receptor and TrkB, was mainly confined to nerve structures. The levels of SP, and particularly those of BN/GRP, in synovial fluid and peripheral blood correlated with the levels of pro-inflammatory cytokines. There were clearly more correlations between SP-BN/GRP and inflammatory parameters than between BDNF and these factors. Plasma levels of BDNF were decreased following anti-TNF-treatment. In the joints of the murine model, there was a marked expression of neurotrophins, neurotrophin receptors and NK-1R/GRP-R in the articular chondrocytes. The expression was down-regulated in the arthritic animals. A neurotrophin system was found to develop in the inflammatory infiltrates of the synovium in the arthritic mice. The results presented suggest that there is a local, and not nerve-related, supply of BN/GRP in the human synovial tissue. Furthermore, BN/GRP and SP have marked effects in the synovial tissue of patients with RA, i.e., there were abundant receptor expressions, and these neuropeptides are, together with cytokines, likely to be involved in the neuro-immunomodulation that occurs in arthritis. The observations do on the whole suggest that the neuropeptides, rather than BDNF, are related to inflammatory processes in the human knee joint. A new effect of anti-TNF treatment; i.e., lowering plasma levels of BDNF, was observed. Severe arthritis, as in the murine model, lead to a decrease in the levels of neurotrophin, and neurotrophin and neuropeptide receptor expressions in the articular cartilage. This fact might be a drawback for the function of the chondrocytes. Certain differences between the expression patterns in the synovial tissue of the murine model and those of human arthritic synovial tissue were noted. It is obvious that local productions in the synovial tissue, nerve-related supply in this tissue and productions in chondrocytes to different extents occur for the investigated substances.