Alcohol is a commonly consumed beverage, a drug of abuse and an important molecule affecting nearly every organ-system in the body. This project seeks to investigate the interplay between alcohol’s effects on critical organ-systems making up gut-liver-brain axis. Alcohol initially interacts with the gastrointestinal tract. Our research describes the alterations seen in intestinal microbiota following alcohol consumption in an acute-on-chronic model of alcoholic hepatitis and indicates that reducing intestinal bacteria using antibiotics protects from alcohol-induced intestinal cytokine expression, alcoholic liver disease and from inflammation in the brain. Alcohol-induced liver injury can occur due to direct hepatocyte metabolic dysregulation and from leakage of bacterial products from the intestine that initiates an immune response. Here, we will highlight the importance of this immune response, focusing on the role of infiltrating immune cells in human patients with alcoholic hepatitis and alcoholic cirrhosis. Using a small molecule inhibitor of CCR2/CCR5 chemokine receptor signaling in mice, we can protect the liver from damage and alcohol-induced inflammation. In the brain, we observe that chronic alcohol leads to the infiltration of macrophages in a region-specific manner. CCR2/CCR5 inhibition reduced macrophage infiltration, alcohol-induced inflammation and microglial changes. We also report that chronic alcohol shifts excitatory/inhibitory synapses in the hippocampus, possibly through complement-mediated remodeling. Finally, we show that anti-inflammasome inhibitors altered behavior by reducing alcohol consumption in female mice. Together, these data advance our understanding of the gut-liver-brain axis in alcoholism and suggest novel avenues of therapeutic intervention to inhibit organ pathology associated with alcohol consumption and reduce drinking.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19403号 / 医博第4054号 / 新制||医||1012(附属図書館) / 32428 / 京都大学大学院医学研究科医学専攻 / (主査)教授 前川 平, 教授 平岡 眞寛, 教授 羽賀 博典 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

博士(理学) / Doctor of Philosophy in Science / 同志社大学 / Doshisha University

: Methamphetamine-related deaths have been rising along with those involving synthetic opioids, mostly fentanyl and fentanyl analogs (FAs). However, the extent to which methamphetamine involvement in deaths differs from those changes occurring in synthetic opioid involvement is unknown.: To determine the patterns and temporal changes in methamphetamine-related deaths with and without other drug involvement.: Data from all methamphetamine-related deaths in West Virginia from 2013 to 2018 were analyzed. Quasi-Poisson regression analyses over time were conducted to compare the rates of change in death counts among methamphetamine and fentanyl//FA subgroups.: A total of 815 methamphetamine-related deaths were analyzed; 572 (70.2%) were male and 527 (64.7%) involved an opioid. The proportion of methamphetamine only deaths stayed relatively flat over time although the actual numbers of deaths increased. Combined fentanyl/FAs and methamphetamine were involved in 337 deaths (41.3%) and constituted the largest increase from 2013 to 2018. The modeling of monthly death counts in 2017-2018 found that the average number of deaths involving fentanyl without methamphetamine significantly declined (rate of change -0.025, < .001), while concomitant fentanyl with methamphetamine and methamphetamine only death counts increased significantly (rate of change 0.056 and 0.057, respectively, < .001).: Fentanyl and FAs played an increasingly significant role in methamphetamine-related deaths. The accelerating number of deaths involving fentanyl/FAs and methamphetamine indicates the importance of stimulants and opioids in unintentional deaths. Comprehensive surveillance efforts should continue to track substance use patterns to ensure that appropriate prevention programs are undertaken.

La synaptogenèse est un processus biologique aboutissant à la mise en place d’un réseau de connexions neuronales, par la genèse de synapses. La mise en place de ce réseau de connexions est essentielle au développement du système nerveux central (SNC) et de ses fonctions. Tout comme les autres étapes du développement du SNC, la synaptogenèse est régulée par une multitude de signaux cellulaires, et le système endocannabinoïde en fait partie. Les dérivés du cannabis tel que le Δ-9-tétrahydrocannabinol (THC) et le cannabidiol (CBD) sont capables de traverser la barrière placentaire et de se retrouver dans le lait maternel. Par leur interaction avec le SNC, entre autres, ces phytocannabinoïdes sont capables d’influencer son développement. Le récepteur couplé à une protéine G 55 (GPR55) est catégorisé comme récepteur atypique du système endocannabinoïde, et il est capable d’être antagonisé par le CBD. Il a été prouvé par de précédentes études qu’il est lui aussi impliqué dans le développement du SNC, notamment dans le guidage et la croissance des axones durant les périodes fœtale et périnatale. Dans la littérature, il est souvent rapporté que les signaux impliqués dans le guidage axonal le sont aussi dans la synaptogenèse. C’est pourquoi le présent mémoire vise à examiner le rôle du récepteur GPR55 et l’effet de sa modulation par le CBD dans la formation de contacts synaptiques. Le modèle utilisé pour cette étude est la culture de neurones corticaux issus d’embryons de souris de génotypes gpr55+/+ et gpr55-/-. Pour comprendre le rôle physiologique de GPR55 dans la synaptogenèse nous avons étudié l’effet de la délétion du récepteur GPR55 à deux temps, Day In Vitro (DIV) 9-10 au début de la synaptogenèse, et à DIV14-15 un temps plus avancé. Ensuite pour comprendre comment le CBD est capable d’influencer la formation de contacts synaptiques de manière dépendante ou non de GPR55, les cultures de neurones corticaux de chaque génotype ont été exposées à DIV9 pour 24h à différentes concentrations du CBD (0,3uM ou 0,6uM ou 1uM). Les effets sur la formation de contacts synaptiques ont été étudiés en immunocytochimie, en immunobuvardage et en électrophysiologie de type patch clamp. Les résultats montrent que la délétion de GPR55 entraine à DIV14-15 une augmentation de la densité des contacts synaptiques, mais une réduction de leur aire et de l’expression de la synaptophysine, en affectant l’activité synaptique. L’exposition au CBD 0,6uM et 1uM entrainent de manière dépendante ou partiellement dépendante à GPR55, une augmentation de la densité des contacts synaptiques sans affecter leur aire, l’expression de protéines synaptiques ainsi que l’activité synaptique. La fréquence de décharge des neurones est diminuée de manière dépendante de GPR55 après l’exposition au CBD 1uM. Ces résultats suggèrent que GPR55 pourrait être un signal important pour l’arrêt de la formation de nouvelles synapses et un signal d’induction pour la maturation des synapses existantes. / Synaptogenesis is a biological process that leads to the establishment of a network of neuronal connections through the genesis of synapses. The formation of this network of connections is essential for the development of the central nervous system (CNS) and its functions. Like other stages of CNS development, synaptogenesis is regulated by multiple cellular signals, and the endocannabinoid system is part of it. Cannabis derivatives such as Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) can cross the placental barrier and be present in breast milk. Through their interaction with the endocannabinoid system, among others, these phytocannabinoids can influence CNS development. The G protein-coupled receptor 55 (GPR55) is categorized as an atypical receptor of the endocannabinoid system, and it can be antagonized by CBD. Previous studies have shown that GPR55 is also involved in CNS development, particularly in the guidance and growth of axons during fetal and perinatal periods. It is often reported in the literature that the signals involved in axonal guidance are also involved in synaptogenesis. Therefore, this study investigates the role of the GPR55 receptor and the effect of its modulation by CBD in the formation of synaptic contacts. The model used for this study consists of cortical neuron cultures from mouse embryos gpr55+/+ and gpr55-/- . To understand the physiological role of GPR55 in synaptogenesis, we studied the effect of gpr55 deletion at two-time points: Day In Vitro (DIV) 9- 10 at the beginning of synaptogenesis, and DIV14-15 at a later time point. Then, to understand how CBD can influence the formation of synaptic contacts, whether dependent or independent of GPR55, cortical neuron cultures of each genotype were exposed to different concentrations of CBD (0.3µM or 0.6µM or 1µM) at DIV9 for 24 hours. The effects on the formation of synaptic contacts were studied through immunocytochemistry, western blot, and patch clamp electrophysiology. The results show that gpr55 deletion leads to an increase in synaptic contact density at DIV14-15 but a reduction in their area and synaptophysin expression, by affecting synaptic activity. Exposure to 0.6µM and 1µM CBD results in a GPR55-dependent or partially dependent increase in synaptic contact density without affecting their area, expression of synaptic proteins, and synaptic activity. The firing frequency of neurons is decreased in a GPR55- dependent manner after exposure to 1µM CBD. These results suggest that GPR55 could be an important signal for stopping the formation of new synapses and an induction signal for the maturation of existing synapses.

After oral exposure of cattle with classical bovine spongiform encephalopathy (C-BSE), the infectious agent ascends from the gut to the central nervous system (CNS) primarily via the autonomic nervous system. However, the timeline of this progression has thus far remained widely undetermined. Previous studies were focused on later time points after oral exposure of animals that were already 4 to 6 months old when challenged. In contrast, in this present study, we have orally inoculated 4 to 6 weeks old unweaned calves with high doses of BSE to identify any possible BSE infectivity and/or PrPBSE in peripheral nervous tissues during the first eight months postinoculation (mpi). For the detection of BSE infectivity, we used a bovine PrP transgenic mouse bioassay, while PrPBSE depositions were analyzed by immunohistochemistry (IHC) and by protein misfolding cyclic amplification (PMCA). We were able to show that as early as 8 mpi the thoracic spinal cord as well as the parasympathetic nodal ganglion of these animals contained PrPBSE and BSE infectivity. This shows that the centripetal prion spread starts early after challenge at least in this age group, which represents an essential piece of information for the risk assessments for food, feed, and pharmaceutical products produced from young calves.

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No / Starting from the premise that people are essentially narrative beings, I argue that the onset of severe mental illness compromises the narrative enterprise of being able to construct one's Self and one's relationships inmeaningful and coherent ways. This is due to both the curtailment of opportunities for narrative engagement and the dispossession of those whose narratives do not conform to the current conceptualization of narrative and narrativity. In these circumstances, supporting the narrative enterprise is an ethical endeavour that requires that we examine not only which narratives we construct, but also how we construct them. This requires a re-thinking of what might constitute narrative and how we might facilitate or enhance the narrativity of people with severe mental illness. Following this, I suggest four means to support the narrativity of people with severe mental illness: through maintaining narrative continuity, maintaining narrative agency, countering master narratives and attention to small stories.

Glioblastoma (GBM) is the most common and deadliest of the malignant primary brain tumors in humans, with a reported 5-year survival rate of only 6.8% despite years of extensive research. Failure to improve local tumor control rates and overall patient outcome is attributed to GBM's inherent therapeutic resistance. Marked heterogeneity, extensive local invasion within the brain parenchyma, and profound immunosuppression within the tumor microenvironment (TME) are some of the unique features that drive GBM therapeutic resistance. Furthermore, tumor cells are sequestered behind the blood-brain barrier (BBB), limiting delivery of effective therapeutics and immune cell infiltration into the local tumor. Electroporation-based therapies, such as irreversible electroporation (IRE) and second generation, high-frequency IRE (H-FIRE) represent attractive alternative approaches to standard GBM therapy given their ability to induce transient BBB disruption (BBBD), achieve non-thermal tumor cell ablation and stimulate local and systemic anti-tumor immune responses without significant morbidity. The following work explores the use of H-FIRE to overcome GBM-induced therapeutic resistance and improve treatment success. Chapter 1 opens with an overview of GBM and known barriers to treatment success. Here, we emphasize the utility of spontaneous canine gliomas as an ideal translational model for investigations into novel treatment approaches. Chapter 2 introduces novel ablation methods (i.e. IRE/H-FIRE) capable of targeting treatment-resistant cancer stem cells. The focus of Chapter 3 is to highlight IRE applications in a variety of spontaneous tumor types. In Chapter 4, we investigate the feasibility and local immunologic response of percutaneous H-FIRE for treatment of primary liver tumors using a spontaneous canine hepatocellular carcinoma (HCC) model. In chapter 5, we characterize the mechanisms of H-FIRE-mediated BBBD in an in vivo healthy rodent model. In Chapter 6, we characterize the local and systemic immune responses to intracranial H-FIRE in rodent and canine glioma models to enhance the translational value of our work. Collectively, our work demonstrates the potential for H-FIRE to overcome therapeutic resistance in GBM, thereby supporting its use as a novel, alternative treatment approach to standard therapy. / Doctor of Philosophy / Glioblastoma (GBM) is the most common and deadliest form of primary brain cancer in humans, with only 6.8% of people surviving 5-years after their diagnosis. GBM is characterized by a number of unique features that make it resistant to standard treatments, such as surgery, radiation and chemotherapy. Examples include: (1) extensive invasion of tumor cells into the brain, making complete removal via surgery very difficult; (2) tumor cells are protected by a structure called the blood-brain barrier (BBB), which restricts the entry of most drugs (i.e. chemotherapy) and many immune cells, into the brain, thereby preventing them from reaching tumor cells; (3) tumor cells produce substances that block the immune system from being able to detect the tumor itself, which allows it to continue to grow undetected. High-frequency irreversible electroporation (H-FIRE) represents a new approach for the treatment of GBM. H-FIRE uses electric pulses to temporarily or permanently injure cell membranes without the use of heat, which allows for very precise treatment. The following work explores the ways in which H-FIRE can interfere with specific GBM features that drive its resistance to treatment. Here, we demonstrate that H-FIRE is capable of temporarily disrupting the BBB and characterize the mechanisms by which this occurs. This allows for drugs and immune cells within the blood to enter the brain and access the tumor cells, particularly those extending beyond the visible tumor mass and invading the brain. We also illustrate the potential for H-FIRE treatment within the brain to stimulate local and systemic immune responses by causing the release of proteins from injured cells. Similar to a vaccine, these proteins are recognized by the immune system, which becomes primed to help fight off cancer cells within the body. The end result is an anti-tumor immune response. Collectively, this work supports the use of H-FIRE as an alternative treatment approach to standard therapy for GBM given its potential to overcome certain causes of treatment resistance.