Experimental Modelling of Viscoelastic Self-Heating in Healthy and Degenerate Bovine Intervertebral Discs

Objectives Low back pain (LBP) is an increasing drain on developed economies due to direct medical costs and lost working days. The majority of medical costs can be attributed to long-term problems resulting from specific physiological conditions. Acute injury and/or chronic degeneration of the intervertebral disc (IVD) has been linked with long term pain with high levels of nerve in-growth in degenerate IVDs. The fact that disc degeneration is a structural failing and not just a pathogenesis of pain may lead to reduced mobility and quality of life (QOL). Degenerate IVDs have elevated levels of heat shock proteins (HSPs) and HSPs elevated temperatures and/or heat shock within the IVD is a potential mechanism for HSP upregulation. Is it possible that high temperatures are a precursor to degeneration? Could activities of daily living (ADL) result in elevated temperatures in the IVD? This study aims to determine if there is a significant generation of heat within the IVD when subjected to cyclic loading at levels and frequencies relevant to ADL and whether this is effected by degeneration. Materials and Methods Bovine coccygeal discs were removed whole from tail sections and half of the discs were injected with a 2mg/ml collagenase solution and incubated at 37°C for 2 hours to simulate moderate degeneration. Discs were then subjected to sinusoidal loading at 2Hz at force levels equivalent to those in the human spine during locomotion. Mechanical data was analysed with MATLAB software to determine the energy dissipated by the discs for each cycle of loading and an idealised thermal model was generated to predict temperature change within the disc. Results Under axial loading equivalent to that in the lumbar spine during walking degenerate discs showed greater average compression than healthy discs (0.108mm and 0.024mm respectively) and therefore substantially lower average stiffness (714N/mm and 3149N/mm). Average heat generation in degenerate IVDs (2.79mW) was lower than that in healthy discs (4.13mW). An idealised 3D model of heat loss from the disc showed no significant increase in disc temperature in either healthy or degenerate disc condition. Conclusions Heat generated due to dissipated energy from axial loading of intervertebral discs at loading equivalent to that in the lumbar spine when walking is not enough to induce significant temperature increases within the disc. If elevated levels of HSPs within degenerate discs are the result of high temperatures, heat generated within the disc due to activities of daily living such as walking are not the cause

Material Behaviours of Healthy, Degenerate and Hydrogel Injected Bovine Intervertebral Discs

Objectives Low back pain (LBP) is an increasing drain on developed economies due to direct medical costs and lost working days. The majority of medical costs can be attributed to long-term problems resulting from specific physiological conditions. Acute injury and/or chronic degeneration of the intervertebral disc (IVD) has been linked with long term pain with high levels of nerve in-growth in degenerate IVDs. The fact that disc degeneration is a structural failing and not just a pathogenesis of pain may lead to reduced mobility and quality of life (QOL). Mesenchymal stem cell (MSC) interventions have been proposed as a treatment for degenerate IVDs but little is known about how the injection of a hydrogel matrix required by such interventions affects the material properties of the intervertebral disc and what effects this might have on disc health. This study aims to determine the difference in material behaviours of healthy, degenerate and hydrogel injected IVDs subjected to cyclic loading simulating activities of daily living (ADL). Materials and Methods Bovine coccygeal discs were dissected whole from tail sections and split in to three equal test groups; healthy, degenerate and hydrogel injected. Degenerate and hydrogel injected groups were injected with a 2 mg/ml collagenase solution and incubated at 37°C for 2 hours to simulate moderate degeneration, the hydrogel injected group then received a hydrogel injection. All discs were then subjected to sinusoidal loading at 2Hz at force levels equivalent to those in the human spine during walking and mechanical data analysed to determine respective material behaviours of each group. Results Under axial loading simulating walking in the lumbar spine compression (absolute and relative strain) and stiffness of discs varied across all three test groups. Conclusions Cyclic loading simulating activities of daily living was found to result in different material behaviours in bovine intervertebral discs that were moderately degenerated and/or injected with hydrogel relative to healthy discs

Long-Range Activation of Systemic Immunity through Peptidoglycan Diffusion in Drosophila

The systemic immune response of Drosophila is known to be induced both by septic injury and by oral infection with certain bacteria, and is characterized by the secretion of antimicrobial peptides (AMPs) into the haemolymph. To investigate other possible routes of bacterial infection, we deposited Erwinia carotovora (Ecc15) on various sites of the cuticle and monitored the immune response via expression of the AMP gene Diptericin. A strong response was observed to deposition on the genital plate of males (up to 20% of a septic injury response), but not females. We show that the principal response to genital infection is systemic, but that some AMPs, particularly Defensin, are induced locally in the genital tract. At late time points we detected bacteria in the haemolymph of immune deficient RelishE20 flies, indicating that the genital plate can be a route of entry for pathogens, and that the immune response protects flies against the progression of genital infection. The protective role of the immune response is further illustrated by our observation that RelishE20 flies exhibit significant lethality in response to genital Ecc15 infections. We next show that a systemic immune response can be induced by deposition of the bacterial elicitor peptidoglycan (PGN), or its terminal monomer tracheal cytotoxin (TCT), on the genital plate. This immune response is downregulated by PGRP-LB and Pirk, known regulators of the Imd pathway, and can be suppressed by the overexpression of PGRP-LB in the haemolymph compartment. Finally, we provide strong evidence that TCT can activate a systemic response by crossing epithelia, by showing that radiolabelled TCT deposited on the genital plate can subsequently be detected in the haemolymph. Genital infection is thus an intriguing new model for studying the systemic immune response to local epithelial infections and a potential route of entry for naturally occurring pathogens of Drosophila

Evolutionary Dynamics of Human Toll-Like Receptors and Their Different Contributions to Host Defense

Infectious diseases have been paramount among the threats to health and survival throughout human evolutionary history. Natural selection is therefore expected to act strongly on host defense genes, particularly on innate immunity genes whose products mediate the direct interaction between the host and the microbial environment. In insects and mammals, the Toll-like receptors (TLRs) appear to play a major role in initiating innate immune responses against microbes. In humans, however, it has been speculated that the set of TLRs could be redundant for protective immunity. We investigated how natural selection has acted upon human TLRs, as an approach to assess their level of biological redundancy. We sequenced the ten human TLRs in a panel of 158 individuals from various populations worldwide and found that the intracellular TLRs—activated by nucleic acids and particularly specialized in viral recognition—have evolved under strong purifying selection, indicating their essential non-redundant role in host survival. Conversely, the selective constraints on the TLRs expressed on the cell surface—activated by compounds other than nucleic acids—have been much more relaxed, with higher rates of damaging nonsynonymous and stop mutations tolerated, suggesting their higher redundancy. Finally, we tested whether TLRs have experienced spatially-varying selection in human populations and found that the region encompassing TLR10-TLR1-TLR6 has been the target of recent positive selection among non-Africans. Our findings indicate that the different TLRs differ in their immunological redundancy, reflecting their distinct contributions to host defense. The insights gained in this study foster new hypotheses to be tested in clinical and epidemiological genetics of infectious disease

The presence of extracellular matrix degrading metalloproteinases during fetal development of the intervertebral disc

Matrix metalloproteinases (MMPs) regulate connective tissue architecture and cell migration through extracellular matrix (ECM) degradation and are associated with both physiological and pathological processes. Although they are known to play a role in skeletal development, little is known about the role of MMPs in intervertebral disc (IVD) development. Sixteen fetal human lumbar spine segments, obtained at autopsy, were compared with five normal, non-fetal L4–L5 IVDs. Intensity and/or localization of immunohistochemical staining for MMP-1, -2, -3 and -14 were evaluated by three independent observers. MMP-2 production and activation was quantified by gelatin zymography. MMP-1 and -14 were abundantly present in the nucleus pulposus (NP) and notochordal (NC) cells of the fetal IVDs. In non-fetal IVDs, MMP-1 and -14 staining was significantly less intense (p = 0.001 and p < 0.001, respectively). MMP-3 was found in almost the entire IVD with no significant difference from non-fetal IVDs. MMP-2 staining in the NC and NP cells of the fetal IVD was moderate, but weak in the non-fetal IVD. Gelatin zymography showed a negative correlation of age with MMP-2 activity (p < 0.001). MMP-14 immunostaining correlated positively with MMP-2 activity (p = 0.001). For the first time, the presence of MMP-1, -2, -3 and -14 in the fetal human IVD is shown and the high levels of MMP-1, -2 and -14 suggest a role in the development of the IVD. In particular, the gradual decrease in MMP-2 activation during gestation pinpoints this enzyme as key player in fetal development, possibly through activation by MMP-1 and -14

Hydrotherapy as a recovery strategy after exercise: a pragmatic controlled trial

Trial registration ClinicalTrials.gov Identifier: NCT01765387Background Our aim was to evaluate the recovery effects of hydrotherapy after aerobic exercise in cardiovascular, performance and perceived fatigue. Methods A pragmatic controlled repeated measures; single-blind trial was conducted. Thirty-four recreational sportspeople visited a Sport-Centre and were assigned to a Hydrotherapy group (experimental) or rest in a bed (control) after completing a spinning session. Main outcomes measures including blood pressure, heart rate, handgrip strength, vertical jump, self-perceived fatigue, and body temperature were assessed at baseline, immediately post-exercise and post-recovery. The hypothesis of interest was the session*time interaction. Results The analysis revealed significant session*time interactions for diastolic blood pressure (P=0.031), heart rate (P=0.041), self perceived fatigue (P=0.046), and body temperature (P=0.001); but not for vertical jump (P=0.437), handgrip (P=0.845) or systolic blood pressure (P=0.266). Post-hoc analysis revealed that hydrotherapy resulted in recovered heart rate and diastolic blood pressure similar to baseline values after the spinning session. Further, hydrotherapy resulted in decreased self-perceived fatigue after the spinning session. Conclusions Our results support that hydrotherapy is an adequate strategy to facilitate cardiovascular recovers and perceived fatigue, but not strength, after spinning exercise

Gamma-Linolenic and Stearidonic Acids Are Required for Basal Immunity in Caenorhabditis elegans through Their Effects on p38 MAP Kinase Activity

Polyunsaturated fatty acids (PUFAs) form a class of essential micronutrients that play a vital role in development, cardiovascular health, and immunity. The influence of lipids on the immune response is both complex and diverse, with multiple studies pointing to the beneficial effects of long-chain fatty acids in immunity. However, the mechanisms through which PUFAs modulate innate immunity and the effects of PUFA deficiencies on innate immune functions remain to be clarified. Using the Caenorhabditis elegans–Pseudomonas aeruginosa host–pathogen system, we present genetic evidence that a Δ6-desaturase FAT-3, through its two 18-carbon products—gamma-linolenic acid (GLA, 18:3n6) and stearidonic acid (SDA, 18:4n3), but not the 20-carbon PUFAs arachidonic acid (AA, 20:4n6) and eicosapentaenoic acid (EPA, 20:5n3)—is required for basal innate immunity in vivo. Deficiencies in GLA and SDA result in increased susceptibility to bacterial infection, which is associated with reduced basal expression of a number of immune-specific genes—including spp-1, lys-7, and lys-2—that encode antimicrobial peptides. GLA and SDA are required to maintain basal activity of the p38 MAP kinase pathway, which plays important roles in protecting metazoan animals from infections and oxidative stress. Transcriptional and functional analyses of fat-3–regulated genes revealed that fat-3 is required in the intestine to regulate the expression of infection- and stress-response genes, and that distinct sets of genes are specifically required for immune function and oxidative stress response. Our study thus uncovers a mechanism by which these 18-carbon PUFAs affect basal innate immune function and, consequently, the ability of an organism to defend itself against bacterial infections. The conservation of p38 MAP kinase signaling in both stress and immune responses further encourages exploring the function of GLA and SDA in humans

Drosophila melanogaster as an Animal Model for the Study of Pseudomonas aeruginosa Biofilm Infections In Vivo

Pseudomonas aeruginosa is an opportunistic pathogen capable of causing both acute and chronic infections in susceptible hosts. Chronic P. aeruginosa infections are thought to be caused by bacterial biofilms. Biofilms are highly structured, multicellular, microbial communities encased in an extracellular matrix that enable long-term survival in the host. The aim of this research was to develop an animal model that would allow an in vivo study of P. aeruginosa biofilm infections in a Drosophila melanogaster host. At 24 h post oral infection of Drosophila, P. aeruginosa biofilms localized to and were visualized in dissected Drosophila crops. These biofilms had a characteristic aggregate structure and an extracellular matrix composed of DNA and exopolysaccharide. P. aeruginosa cells recovered from in vivo grown biofilms had increased antibiotic resistance relative to planktonically grown cells. In vivo, biofilm formation was dependent on expression of the pel exopolysaccharide genes, as a pelB::lux mutant failed to form biofilms. The pelB::lux mutant was significantly more virulent than PAO1, while a hyperbiofilm strain (PAZHI3) demonstrated significantly less virulence than PAO1, as indicated by survival of infected flies at day 14 postinfection. Biofilm formation, by strains PAO1 and PAZHI3, in the crop was associated with induction of diptericin, cecropin A1 and drosomycin antimicrobial peptide gene expression 24 h postinfection. In contrast, infection with the non-biofilm forming strain pelB::lux resulted in decreased AMP gene expression in the fly. In summary, these results provide novel insights into host-pathogen interactions during P. aeruginosa oral infection of Drosophila and highlight the use of Drosophila as an infection model that permits the study of P. aeruginosa biofilms in vivo