Biology subjects

FitzGerald, G. A.

Publications and source records attributed to FitzGerald, G. A..

17 recordsLinked to original sources

bioRxiv2026

Enabling subcellular DESI-MSI for broad adoption: Acquisition, analysis, and application

Subcellular mass spectrometry imaging (MSI) has required specialized instrumentation and approaches. Additionally, data analysis has required expensive proprietary software, or code-based open-source tools. These barriers render spatial metabolomics less accessible than peer spatial omics techniques (transcriptomics, proteomics). Here we demonstrate subcellular MSI on standard commercial hardware, analyzed using code-free, open-source software. An inexpensive, fully reversible modification of a stock DESI source takes the platform past its typical 5-10 m pixels to routine 2x2 m pixels, and 1x1 m in proof-of-principle experiments. At a tissue-glass boundary imaged at 2x2 m, tissue-specific ions showed no measurable spillover onto the adjacent glass within the {+/-}4.4 m uncertainty of the edge position. To make these data interpretable, we extend MSI.EAGLE, an open-source, vendor-agnostic application with two new methods: i) Spatial UMAP preserves tissue architecture alongside subcellular detail, where conventional clustering breaks apart at high resolution; ii) Histology Fit performs landmark-free co-registration, and recovers synthetic misalignments of up to 8 m to within one pixel of a reference registration. Together, these enable previously high-burden spatial metabolomics experiments. In mouse brain tissue, we demonstrate genuine subcellular signal by resolving mitochondrial cardiolipin into perinuclear puncta, quantifying cytoplasmic enrichment across 6,073 cells. Cell identities are assigned to MSI pixels using histology-predicted transcriptomics, linking cell provenance to metabolism in 2D space directly. Finally, we recover cell-type-specific metabolomes consistent with the transcriptomic identities. This workflow allows cellular and subcellular spatial metabolomics linked to cell provenance, with only stock MSI hardware, open-source GUI-based software, and common histology techniques, putting it within reach of many researchers and laboratories.

molecular biology↗

bioRxiv2026

Single-cell transcriptomics reveals cell-type-specific circadian rhythms and their disruption by acute misalignment in mouse aorta

The circadian molecular clock is a 24 hour cellular timekeeper that influences many features of cardiovascular function. Disruption of the circadian clock via misalignment with the light dark cycle is associated with a higher incidence of cardiovascular disease and raises cardiovascular risk factors in humans. Nonetheless, the cell type specific molecular basis for how misalignment affects the vasculature remains poorly understood. To address this, we performed single cell RNA sequencing from whole mouse aorta at ZT0, ZT6, ZT12, and ZT18 under aligned and acutely misaligned (6 hour phase advance) light dark cycles in both male and female mice. Leveraging Bayesian variational inference, we estimated posterior waveforms for 141,752 cells across four major cell types and identified hundreds of cycling genes in vascular smooth muscle cells (SMCs) and fibroblasts. Pathway and transcription factor enrichment analyses revealed coordinated circadian activity in cholesterol biosynthesis, smooth muscle contraction, and extracellular matrix organization. Notably, SMC genes implicated in phenotypic switching showed coordinated temporal patterns, with genes promoting switching peaking at dusk and genes restraining switching peaking at dawn. Comparing males and females, we found that female SMCs are broadly more rhythmic, with higher amplitudes and nearly twice as many cycling genes after controlling for cell counts and library sizes, a sex difference that was cell type specific and not observed in fibroblasts. After acute misalignment, cycling genes showed reduced amplitudes, and peak times showed limited adaptation to the new light dark cycle. Given that the central clock is known to adapt near completely during this timeframe, these observations suggest internal misalignment between central and peripheral rhythms. Moreover, altered relative timing of core clock genes within cells indicates that misalignment is created at the intracellular level as well. In SMCs, gene expression patterns were consistent with proteostatic stress, including broad downregulation of protein chaperones and stress response genes, which cells appear to cope with by upregulating protein degradation pathways. In parallel, in vivo vascular phenotyping showed increased vascular permeability in both sexes, reduced urinary nitrate in males, and increased microvascular thrombus formation in males following acute misalignment. This atlas provides a resource for understanding how circadian misalignment disrupts vascular homeostasis and may contribute to cardiovascular disease risk.

genomics↗

bioRxiv2025

The Regulation of COX-2, ABCA1 and ABCG1 by the lncRNA PACERR links the inflammatory response and cholesterol homeostasis

Cyclooxygenase-2 (COX-2) has an established role in inflammation and its inhibition by non-steroidal anti-inflammatory drugs (NSAIDs) is clinically efficacious1,2. However, placebo-controlled trials of COX-2 inhibitors have revealed a cardiovascular hazard. This has been attributed to suppression of COX-2 dependent cardioprotective prostaglandins (PGs), especially prostacyclin, produced by endothelial (EC) and vascular smooth muscle cells (vSMC) 1-3. Upstream of these effects, we have found that the COX-2 antisense long non-coding RNA (lncRNA) PACERR interacts with discrete RNA binding proteins to mediate the cell specific COX-2 response to both anti-[high-density lipoprotein (HDL)] and pro-inflammatory [lipopolysaccharide (LPS)] stimuli. PACERR exerts its action both in cis and in trans, controlling the expression of COX-2 and the cholesterol transport genes, ABCA1 and ABCG1. When cells are exposed to HDL, PACERR is transcribed, leading to the release of bound histone acetyltransferase p300 and its relocation to the promoter of COX-2 which is then transcribed leading to PG formation. In concert, PACERR also releases heterogeneous nuclear ribonucleoprotein L (hnRNPL) which relocates to the ABCA1 and ABCG1 gene loci, controlling mRNA alternative splicing and subsequent cholesterol efflux to HDL. Silencing PACERR, with an antisense oligonucleotide (ASO), augments the COX-2 and cholesterol efflux in response to HDL. In response to HDL, PACERR associates with its neighboring gene, cytosolic phospholipase A2 (cPLA2/PLA2G4A) both interacting with an enhancer element affecting cPLA2 transcriptional activation and escorting the cPLA2 protein to the nuclear membrane. There, it releases arachidonic acid, further activating COX-2 but limiting ABCA1 and ABCG1 by suppressing the formation of the LXR/RXR heterodimers required for their transcription when cholesterol efflux is no longer required4. In response to LPS, PACERR controls the action of the NF{kappa}B repressive protein, I{kappa}B{zeta}. When PACERR is silenced in a humanized mouse model with the ASO, I{kappa}B{zeta} is free to bind to the NF{kappa}B site in the COX-2 promoter, suppressing transcription, PG formation and systemic inflammation. In summary, these studies reveal dual and complementary mechanisms by which PACERR modulates PG production by COX-2. In response to HDL, it enhances production of prostacyclin whereas it dampens production of the PG response to LPS.

cell biology↗

bioRxiv2024

Metabolomic Response to Non-Steroidal Anti-Inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are popular choices for the mitigation of pain and inflammation; however, they are accompanied by side effects in the gastrointestinal and cardiovascular systems. We compared the effects of naproxen, a traditional NSAID, and celecoxib, a cyclooxygenase -2 (Cox-2) inhibitor, in humans. Our findings showed a decrease in tryptophan and kynurenine levels in plasma of volunteers treated with naproxen. We further validated this result in mice. Additionally, we find that the depression of tryptophan was independent of both Cox-1 and Cox-2 inhibition, but rather was due to the displacement of bound tryptophan by naproxen. Supplementation of tryptophan in naproxen-treated mice rescued fecal blood loss and inflammatory gene expression driven by IL-1{beta} in the heart.

systems biology↗

bioRxiv2024

Concomitant suppression of COX-1 and COX-2 is insufficient to induce enteropathy associated with chronic NSAID use

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used medications for the management of chronic pain; however, they are associated with numerous gastrointestinal (GI) adverse events. Although many mechanisms have been suggested, NSAID-induced enteropathy has been thought to be primarily due to inhibition of both cyclooxygenases (COX) -1 and -2, which results in suppression of prostaglandin synthesis. Yet surprisingly, we found that concomitant postnatal deletion of Cox-1 and -2 over 10 months failed to cause intestinal injury in mice unless they were treated with naproxen or its structural analog, phenylpropionic acid, which is not a COX inhibitor. Cox double knockout mice exhibit a distinct gut microbiome composition and cohousing them with controls rescues their dysbiosis and delays the onset of NSAID-induced GI bleeding. In both the UK Biobank and All of Us human cohorts, coadministration of antibiotics with NSAIDs is associated with an increased frequency of GI bleeding. These results show that prostaglandin suppression plays a trivial role in NSAID-induced enteropathy. However, Cox deletion causes dysbiosis of the gut microbiome that amplifies the enteropathic response to NSAIDs.

pharmacology and toxicology↗

bioRxiv2024

Brown adipose tissue thermogenesis rhythms are driven by the SCN independent of adipocyte clocks

Circadian misalignment has been associated with obesity both in rodents and humans. Brown adipose tissue (BAT) thermogenesis contributes to energy expenditure and can be activated in adults to reduce body weight. Although previous studies suggest control of BAT thermogenesis by the circadian clock, the site and mechanisms of regulation remain unclear. We used mice with genetic disruption of the circadian clock in the suprachiasmatic nucleus (SCN) and peripheral tissues to delineate their role in BAT thermogenesis. Global post-natal deletion of Bmal1 in adult mice (Bmal1-/-) abolishes the rhythms of interscapular BAT temperature, a measure of thermogenesis, while normal locomotor activity rhythms are maintained under a regular 12h light-12h dark schedule. Activation of thermogenesis either by exposure to cold or adrenergic stimulation of BAT displays a diurnal rhythm with higher activation during the active period. Both the rhythm and the magnitude of the thermogenic response is preserved in Bmal1-/- mice. In contrast to mice with global deletion of Bmal1, mice with brown adipocyte (Ucp1-Bmal1-/-) or brown and white adipocyte (Ad-Bmal1-/-) deletion of Bmal1 show intact rhythms of BAT thermogenic activity. The capacity of Ucp1-Bmal1-/- mice to activate thermogenesis in response to exposure to cold is identical to WT mice, independent of time of stimulation. Circadian rhythmicity of interscapular BAT temperature is lost in mice with SCN deletion of Bmal1 (SCN-Bmal1-/-), indicating control of BAT thermogenesis rhythms by the SCN. Control mice exhibit rhythmic BAT glucose and fatty acid uptake - a rhythm that is not recapitulated in Bmal1-/- and SCN-Bmal1-/- mice but is present in Ucp1-Bmal1-/- and Ad-Bmal1-/- mice. BAT cAMP and phosphorylated hormone-sensitive lipase (pHSL) is reduced during the active period in Bmal1-/- and SCN-Bmal1-/- mice consistent with reduced sympathetic tone. Furthermore, sympathetic denervation of BAT ablates BAT temperature rhythms in WT mice. Taken together, our findings suggest that the SCN drives rhythms of BAT thermogenesis through adipocyte clock-independent, sympathetic signaling to the BAT.

physiology↗

bioRxiv2024

Cyclooxygenase-2 disruption predisposes to heart failure with preserved ejection fraction

Heart failure (HF) is one of the most strongly associated adverse cardiovascular events linked to the use of cyclooxygenase (COX)-2 selective and non-selective nonsteroidal anti-inflammatory drug (NSAID). Nevertheless, it remains uncertain whether NSAID exposure is more likely to lead to heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF). In adult mice, postnatal genetic deletion or pharmacological inhibition of COX-2 did not affect cardiac function. In contrast, aged female inducible COX-2 (iCOX-2) knockout (KO) mice displayed diastolic dysfunction, cardiac hypertrophy, pulmonary congestion, and elevated levels of plasma N-terminal pro B-type natriuretic peptide (BNP) when compared to age- and sex- matched controls, while their ejection fraction (EF) remained preserved ([≥] 50%). No such phenotype was observed in aged male iCox-2 KO mice. Aged female iCox-2 KO mice showed a shift from prostanoid to leukotriene biosynthesis, along with changes in the expression of mitochondrial genes and calcium-handling proteins in the myocardium. The ratio of phospholamban to SERCA2a was increased, indicating an inhibitory effect on SERCA2a activity, which may contribute to impaired myocardial relaxation. In larval zebrafish, COX-2 inhibition by celecoxib caused a modest yet significant reduction in heart rate and diastolic function, while EF was preserved. Additionally, celecoxib increased BNP expression and ventricular calcium transient amplitude. Diabetic patients in the Harvard-Partners electronic medical record exposed to NSAIDs selective for COX-2 inhibition were more strongly associated with an increased risk of HFpEF compared to HFrEF. Collectively, these findings indicate that COX-2 deletion or inhibition does not impair systolic cardiac function but instead leads to an HFpEF phenotype in mice, zebrafish, and humans. An imbalance in calcium handling may mediate the impairment of myocardial relaxation following COX-2 suppression. SummaryGenetic deletion or pharmacological inhibition of COX-2 results in heart failure with preserved ejection fraction across zebrafish, mice, and humans.

pharmacology and toxicology↗

bioRxiv2024

Disruption of the PGE2 synthesis / response pathway restrains atherogenesis in programmed cell death-1 (Pd-1) deficient hyperlipidemic mice

Immune checkpoint inhibitors (ICIs) that target programmed cell death 1 (PD-1) have revolutionized cancer treatment by enabling the restoration of suppressed T-cell cytotoxic responses. However, resistance to single-agent ICIs limits their clinical utility. Combinatorial strategies enhance their antitumor effects, but may also enhance the risk of immune related adverse effects of ICIs. Prostaglandin (PG) E2, formed by the sequential action of the cyclooxygenase (COX) and microsomal PGE synthase (mPGES-1) enzymes, acting via its E prostanoid (EP) receptors, EPr2 and EPr4, promotes lymphocyte exhaustion, revealing an additional target for ICIs. Thus, COX inhibitors and EPr4 antagonists are currently being combined with ICIs potentially to enhance antitumor efficacy in clinical trials. However, given the cardiovascular (CV) toxicity of COX inhibitors, such combinations may increase the risk particularly of CV AEs. Here, we compared the impact of distinct approaches to disruption of the PGE2 synthesis /response pathway - global or myeloid cell specific depletion of mPges-1 or global depletion of Epr4 - on the accelerated atherogenesis in Pd-1 deficient hyperlipidemic (Ldlr-/-) mice. All strategies restrained the atherogenesis. While depletion of mPGES-1 suppresses PGE2 biosynthesis, reflected by its major urinary metabolite, PGE2 biosynthesis was increased in mice lacking EPr4, consistent with enhanced expression of aortic Cox-1 and mPges-1. Deletions of mPges-1 and Epr4 differed in their effects on immune cell populations in atherosclerotic plaques; the former reduced neutrophil infiltration, while the latter restrained macrophages and increased the infiltration of T-cells. Consistent with these findings, chemotaxis by bone-marrow derived macrophages from Epr4-/- mice was impaired. Epr4 depletion also resulted in extramedullary lymphoid hematopoiesis and inhibition of lipoprotein lipase activity (LPL) with coincident spelenomegaly, leukocytosis and dyslipidemia. Targeting either mPGES-1 or EPr4 may restrain lymphocyte exhaustion while mitigating CV irAEs consequent to PD-1 blockade.

pharmacology and toxicology↗

bioRxiv2023

Disruption of Prostaglandin F2α Receptor Signaling Attenuates Fibrotic Remodeling and Alters Fibroblast Population Dynamics in A Preclinical Murine Model of Idiopathic Pulmonary Fibrosis

Idiopathic Pulmonary Fibrosis (IPF) is a chronic parenchymal lung disease characterized by repetitive alveolar cell injury, myofibroblast proliferation, and excessive extracellular matrix deposition for which unmet need persists for effective therapeutics. The bioactive eicosanoid, prostaglandin F2, and its cognate receptor FPr (Ptfgr) are implicated as a TGF{beta}1 independent signaling hub for IPF. To assess this, we leveraged our published murine PF model (IER -SftpcI73T) expressing a disease-associated missense mutation in the surfactant protein C (Sftpc) gene. Tamoxifen treated IER -Sftpc I73T mice develop an early multiphasic alveolitis and transition to spontaneous fibrotic remodeling by 28 days. IER -Sftpc I73T mice crossed to a Ptgfr null (FPr-/-) line showed attenuated weight loss and gene dosage dependent rescue of mortality compared to FPr+/+ cohorts. IER -Sftpc I73T /FPr-/- mice also showed reductions in multiple fibrotic endpoints for which administration of nintedanib was not additive. Single cell RNA sequencing, pseudotime analysis, and in vitro assays demonstrated Ptgfr expression predominantly within adventitial fibroblasts which were reprogrammed to an "inflammatory/transitional" cell state in a PGF2/ FPr dependent manner. Collectively, the findings provide evidence for a role for PGF2 signaling in IPF, mechanistically identify a susceptible fibroblast subpopulation, and establish a benchmark effect size for disruption of this pathway in mitigating fibrotic lung remodeling.

molecular biology↗

bioRxiv2022

Tempo: an unsupervised Bayesian algorithm for circadian phase inference in single-cell transcriptomics

The circadian clock is a 24-hour cellular timekeeping mechanism that temporally regulates human physiology. Answering several fundamental questions in circadian biology will require joint measures of single-cell circadian phases and transcriptomes. However, no widespread experimental approaches exist for this purpose. While computational approaches exist to infer cell phase directly from single-cell RNA-sequencing (scRNA-seq) data, existing methods yield poor circadian phase estimates, and do not quantify estimation uncertainty, which is essential for interpretation of results from highly sparse scRNA-seq data. To address these unmet needs, we developed Tempo, a Bayesian variational inference approach that incorporates domain knowledge of the clock and quantifies phase estimation uncertainty. Through simulations and analyses of real data, we demonstrate that Tempo yields more accurate estimates of circadian phase than existing methods and provides well-calibrated uncertainty quantifications. We further demonstrate that these properties generalize to the cell cycle. Tempo will facilitate large-scale studies of single-cell circadian transcription.

bioinformatics↗

bioRxiv2022

Engineered high-density lipoprotein particles that chaperone bioactive lipid mediators to combat endothelial dysfunction and thromboinflammation

High-density lipoprotein (HDL) particles suppress inflammation-induced tissue injury via vascular and myeloid cell-dependent mechanisms. As such, HDL-associated bioactive lipids such as sphingosine 1-phosphate (S1P) and prostacyclin (PGI2) signal via their respective G protein-coupled receptors on target cells to promote vascular endothelial function and suppress platelet and myeloid-dependent pathophysiology. Here we have constructed a fusion protein of apolipoprotein A1 (ApoA1) and apolipoprotein M (ApoM) (A1M) that forms HDL-like particles and chaperones S1P and Iloprost, stable PGI2 analog. The A1M/S1P complex activates S1P receptor-1 (S1PR1) as a Gi-biased agonist and attenuates the inflammation-induced NF{kappa}B pathway while A1M/Iloprost acts via IP receptor to inhibit platelet aggregation and promote endothelial barrier function. In addition to enhancing the endothelial barrier, A1M/S1P suppresses neutrophil influx, oxidative burst and inflammatory mediator secretion in a sterile inflammation model. We propose that A1M could be useful as a therapeutic to induce S1P and PGI2-dependent anti-inflammatory functions and suppress collateral tissue injury.

biochemistry↗

bioRxiv2021

Circadian regulation of lung repair and regeneration

Optimal lung repair and regeneration is essential for recovery from viral infections such as that induced by influenza A virus (IAV). We have previously demonstrated that lung inflammation induced by IAV is under circadian control. However, it is not known if the circadian clock exerts its influence on lung repair and regenerative processes independent of acute inflammation from IAV. Here, we demonstrate for the first time that lung organoids have a functional clock as they mature and that the absence of an intact circadian clock impairs regenerative capacity. Using several models of circadian disruption, we show that with the absence of an intact clock lung proliferation is disrupted. Further, we find that the circadian clock acts through direct control of the Wnt/{beta}-catenin pathway. We speculate, that adding the circadian dimension to the critical process of lung repair and regeneration will lead to novel therapies and improve outcomes. Finally, we use data from UK Biobank to demonstrate at the population level, the role of poor circadian rhythms in mediating negative outcomes following lung infection.

cell biology↗

bioRxiv2020

Myeloid cell mPGES-1 mediates inflammatory pain hypersensitivity in mice.

Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve inflammatory pain by predominant suppression of cyclooxygenase-2 derived prostaglandin (PG) E2. Innate immune cells contribute to inflammatory pain hypersensitivity and may be an attractive target for novel non-addictive approaches to pain management. We studied the contribution of PGE2 produced by myeloid cell microsomal prostaglandin E synthase -1 (mPGES-1) to peripheral inflammation and hyperalgesia in mice. Selective deletion of mPGES-1 in myeloid cells by crossing LysM-Cre mice with mPGES-1flox/flox mice (Mac-mPGES-1-KO) resulted in significantly reduced mechanical and thermal hyperalgesia in complete Freunds adjuvant (CFA)-evoked hind paw inflammation, zymosan-induced peri-articular inflammation and collagen II antibody-induced arthritis models. Systemic COX-2 inhibition or myeloid cell specific COX-2 deletion (by crossing LysM-Cre with COX-2 flox/flox mice) recapitulated reduction of CFA-induced inflammation and hyperalgesia. In contrast, deletion of mPGES-1 in neurons and glial cells by crossing mPGES-1flox/flox mice with Nestin-Cre mice had no detectable effect on inflammatory pain hypersensitivity. While macrophage recruitment was unaltered, tissue concentrations of PGE2, IL-1{beta} and TNF were significantly reduced in Mac-mPGES-1-KO paw tissues following CFA induction. Our results demonstrate that myeloid cell mPGES-1 is the dominant source of PGE2 in inflammatory pain hypersensitivity. Targeting myeloid cell mPGES-1 may afford a novel approach to inflammatory pain therapy.

pharmacology and toxicology↗

bioRxiv2020

Sex dependent compensatory mechanisms to preserve blood pressure homeostasis in PGI2 receptor deficient mice

Inhibitors of microsomal prostaglandin E synthase-1 (mPges-1) are in the early phase of clinical development. Deletion of mPges-1 confers analgesia, restrains atherogenesis and fails to accelerate thrombogenesis, while suppressing prostaglandin (PG) E2, but increasing biosynthesis of prostacyclin (PGI2). In hyperlipidemic mice, this last effect represents the dominant mechanism by which mPges-1 deletion restrains thrombogenesis, while suppression of PGE2 accounts for its anti-atherogenic effect. However, the impact of mPges-1 depletion on blood pressure (BP) in this setting remains unknown. To address how differential effects on PGE2 and PGI2 might modulate salt-evoked BP responses in the absence of mPges-1, we generated mice lacking the I prostanoid (Ipr) receptor or mPges-1 on a hyperlipidemic background caused by deletion of the low density lipoprotein receptor (Ldlr KOs). Here, mPges-1 depletion significantly increased the BP response to salt loading in male Ldlr KO mice, whereas, despite the direct vasodilator properties of PGI2, Ipr deletion suppressed it. Furthermore, combined deletion of the Ipr abrogated the exaggerated BP response in male mPges-1 KO mice. Suppression of PGE2 biosynthesis was enough to explain the exaggerated BP response to salt loading by either mPges-1/Ldlr depletion or by an MPGES-1 inhibitor in mice expressing human mPGES-1. However, the lack of a hypertensive response to salt in Ipr-deficient mice was attributable to reactive activation of the atrial natriuretic peptide pathway. Interestingly, these unexpected BP phenotypes were not observed in female mice fed a high salt diet. This is attributable to the protective effect of estrogen in Ldlr KO mice and in Ipr /Ldlr DKOs. Thus, estrogen compensates for a deficiency in PGI2 to maintain BP homeostasis in response to high salt in hyperlipidemic female mice. In males, by contrast, augmented formation of ANP plays a similar compensatory role, restraining hypertension and oxidant stress in the setting of Ipr depletion. Hyperlipidemic males on a high salt diet might be at risk of a hypertensive response to mPGES-1 inhibitors.

pharmacology and toxicology↗

bioRxiv2019

Dosing Time Matters

Trainees in medicine are taught to diagnose and administer treatment as needed; time-of-day is rarely considered. Yet accumulating evidence shows that [~]half of human genes and physiologic functions follow daily rhythms. Circadian medicine aims to incorporate knowledge of these rhythms to enhance diagnosis and treatment. Interest in this approach goes back at least six decades, but the path to the clinic has been marked by starts, stops, and ambiguity. How do we move the field forward to impact clinical practice? To gain insight into successful strategies, we studied the results of more than 100 human trials that evaluated time-of-administration of drugs.

epidemiology↗

bioRxiv2018

Variability in the Analgesic Response to Ibuprofen Following Third-Molar Extraction is Associated with Differences in Activation of the Cyclooxygenase Pathway

The analgesic efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) has long been recognized to be limited by substantial interindividual variability in pain relief, but the underlying mechanisms are not well understood. We performed pain phenotyping, functional neuroimaging, pharmacokinetic/pharmacodynamic assessments, inflammation biomarkers, and gene expression profiling in healthy subjects who underwent surgical extraction of bony impacted third molars, in order to characterize factors associated with heterogeneity in response to ibuprofen.\n\nSubjects were treated with rapid-acting ibuprofen (400 mg; N=19) or placebo (N=10) in a randomized, double-blind design. Compared to placebo, ibuprofen-treated subjects exhibited greater reduction in pain scores, alterations in regional cerebral blood flow in brain regions associated with pain processing, and inhibition of ex vivo cyclooxygenase activity and urinary prostaglandin metabolite excretion as indices of biochemical drug action (p<0.05). As expected, ibuprofen-treated subjects could be stratified into partial responders (N=9, required rescue medication within the dosing interval) and complete responders (N=10, no rescue medication). This was also reflected by differences in pain scores (p<0.01) as early as 30 minutes following drug administration (p<0.05). Variability in analgesic efficacy was not associated with demographic or clinical characteristics, ibuprofen pharmacokinetics, metabolizing enzyme genotype, or the degree of cyclooxygenase inhibition by ibuprofen. However, complete responders had higher concentrations of inflammatory biomarkers in urine and serum, than partial responders. Specifically, a stable urinary prostaglandin E2 metabolite, serum TNF and IL-8 were higher in patients who did not require rescue medication compared those who did (p < 0.05). RNAseq gene expression analysis in PBMCs collected after surgery and ibuprofen administration showed enrichment of inflammation related pathways among genes differentially expressed (q < 0.2) between complete and partial responders\n\nThese findings suggest that patients who receive substantial pain relief from ibuprofen have a more pronounced activation of the prostanoid biosynthetic pathway and regulation of the inflammatory pain phenotype differs from those patients who are insufficiently treated with ibuprofen alone and may require an opioid or other therapeutic intervention.

genomics↗

bioRxiv2018

Circadian control of lung inflammation in influenza infection

Influenza is a leading cause of respiratory mortality and morbidity. While inflammation is necessary for fighting infection, a fine balance of anti-viral defense and host tolerance is necessary for recovery. Circadian rhythms have been known to modulate inflammation. However, the importance of diurnal variability in the timing of influenza infection is not well understood. Here we demonstrate that endogenous rhythms influence the cellular response to infection in bronchoalveolar lavage (BAL), the pulmonary transcriptomic profile and lesional histology. This time dependent variability does not reflect alterations in viral replication. Rather, we found that better time-dependent outcomes were associated with a preponderance of NK and NKT cells and lower proportion of monocytes in the lung. Thus, host tolerance, rather than viral burden underlies the diurnal gating of influenza induced lung injury.\n\nSignificance statementOur work demonstrates the importance of circadian rhythms in influenza infection --a condition with significant public health implications. Our findings, which establish the role of the circadian rhythms in maintaining the balance between host tolerance pathways and anti-viral responses confers a new framework for evaluating the relevance of circadian influences on immunity.

immunology↗