29 results on '"Lampinen R"'
Search Results
2. P14-01: Emissions from modern engines induce distinct effects in human olfactory mucosa cells, depending on fuel and aftertreatment
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Mussalo, L., primary, Avesani, S., additional, Shahbaz, M.A., additional, Zavodna, T., additional, Saveleva, L., additional, Järvinen, A., additional, Lampinen, R., additional, Belaya, I., additional, Krejcik, Z., additional, Ivanova, M., additional, Hakkarainen, H., additional, Kalapudas, J., additional, Penttilä, E., additional, Löppönen, H., additional, Koivisto, A., additional, Malm, T., additional, Topinka, J., additional, Giugno, R., additional, Aakko-Saksa, P., additional, Chew, S., additional, Rönkkö, T., additional, Jalava, P., additional, and Kanninen, K., additional
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- 2023
- Full Text
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3. Would Environmental Diversity be a Good Surrogate for Species Diversity?
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Araújo, M. B., Humphries, C. J., Densham, P. J., Lampinen, R., Hagemeijer, W. J. M., Mitchell-Jones, A. J., and Gasc, J. P.
- Published
- 2001
4. Atlas Florae Europaeae, volume 16, Rosaceae
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Kurtto, A, Sennikov, A. N., and Lampinen, R.
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- 2015
5. Taxonomic Diversity of Vascular Plants in the European Alpine Areas
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Väre, H., Lampinen, R., Humphries, C., Williams, P., Baldwin, I. T., editor, Caldwell, M. M., editor, Heldmaier, G., editor, Lange, O. L., editor, Mooney, H. A., editor, Schulze, E.-D., editor, Sommer, U., editor, Nagy, Laszlo, editor, Grabherr, Georg, editor, Körner, Christian, editor, and Thompson, Desmond B. A., editor
- Published
- 2003
- Full Text
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6. Biometal Dyshomeostasis in Olfactory Mucosa of Alzheimer's Disease Patients.
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Lampinen, R, Górová, V, Avesani, S, Liddell, JR, Penttilä, E, Závodná, T, Krejčík, Z, Lehtola, J-M, Saari, T, Kalapudas, J, Hannonen, S, Löppönen, H, Topinka, J, Koivisto, AM, White, AR, Giugno, R, Kanninen, KM, Lampinen, R, Górová, V, Avesani, S, Liddell, JR, Penttilä, E, Závodná, T, Krejčík, Z, Lehtola, J-M, Saari, T, Kalapudas, J, Hannonen, S, Löppönen, H, Topinka, J, Koivisto, AM, White, AR, Giugno, R, and Kanninen, KM
- Abstract
Olfactory function, orchestrated by the cells of the olfactory mucosa at the rooftop of the nasal cavity, is disturbed early in the pathogenesis of Alzheimer's disease (AD). Biometals including zinc and calcium are known to be important for sense of smell and to be altered in the brains of AD patients. Little is known about elemental homeostasis in the AD patient olfactory mucosa. Here we aimed to assess whether the disease-related alterations to biometal homeostasis observed in the brain are also reflected in the olfactory mucosa. We applied RNA sequencing to discover gene expression changes related to metals in olfactory mucosal cells of cognitively healthy controls, individuals with mild cognitive impairment and AD patients, and performed analysis of the elemental content to determine metal levels. Results demonstrate that the levels of zinc, calcium and sodium are increased in the AD olfactory mucosa concomitantly with alterations to 17 genes related to metal-ion binding or metal-related function of the protein product. A significant elevation in alpha-2-macroglobulin, a known metal-binding biomarker correlated with brain disease burden, was observed on the gene and protein levels in the olfactory mucosa cells of AD patients. These data demonstrate that the olfactory mucosa cells derived from AD patients recapitulate certain impairments of biometal homeostasis observed in the brains of patients.
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- 2022
7. Urban air particulate matter induces mitochondrial dysfunction in human olfactory mucosal cells
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Chew, S, Lampinen, R, Saveleva, L, Korhonen, P, Mikhailov, N, Grubman, A, Polo, JM, Wilson, T, Komppula, M, Ronkko, T, Gu, C, Mackay-Sim, A, Malm, T, White, AR, Jalava, P, Kanninen, KM, Chew, S, Lampinen, R, Saveleva, L, Korhonen, P, Mikhailov, N, Grubman, A, Polo, JM, Wilson, T, Komppula, M, Ronkko, T, Gu, C, Mackay-Sim, A, Malm, T, White, AR, Jalava, P, and Kanninen, KM
- Abstract
BACKGROUND: The adverse effects of air pollutants including particulate matter (PM) on the central nervous system is increasingly reported by epidemiological, animal and post-mortem studies in the last decade. Oxidative stress and inflammation are key consequences of exposure to PM although little is known of the exact mechanism. The association of PM exposure with deteriorating brain health is speculated to be driven by PM entry via the olfactory system. How air pollutants affect this key entry site remains elusive. In this study, we investigated effects of urban size-segregated PM on a novel cellular model: primary human olfactory mucosal (hOM) cells. RESULTS: Metabolic activity was reduced following 24-h exposure to PM without evident signs of toxicity. Results from cytometric bead array suggested a mild inflammatory response to PM exposure. We observed increased oxidative stress and caspase-3/7 activity as well as perturbed mitochondrial membrane potential in PM-exposed cells. Mitochondrial dysfunction was further verified by a decrease in mitochondria-dependent respiration. Transient suppression of the mitochondria-targeted gene, neuronal pentraxin 1 (NPTX1), was carried out, after being identified to be up-regulated in PM2.5-1 treated cells via RNA sequencing. Suppression of NPTX1 in cells exposed to PM did not restore mitochondrial defects resulting from PM exposure. In contrast, PM-induced adverse effects were magnified in the absence of NPTX1, indicating a critical role of this protein in protection against PM effects in hOM cells. CONCLUSION: Key mitochondrial functions were perturbed by urban PM exposure in a physiologically relevant cellular model via a mechanism involving NPTX1. In addition, inflammatory response and early signs of apoptosis accompanied mitochondrial dysfunction during exposure to PM. Findings from this study contribute to increased understanding of harmful PM effects on human health and may provide information to support mitigation str
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- 2020
8. Olfactory cell cultures to investigate health effects of air pollution exposure: Implications for neurodegeneration
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Kanninen, K.M., primary, Lampinen, R., additional, Rantanen, L.M., additional, Odendaal, L., additional, Jalava, P., additional, Chew, S., additional, and White, A.R., additional
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- 2020
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9. The role of geodiversity in providing ecosystem services at broad scales
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Alahuhta, J. (Janne), Ala-Hulkko, T. (Terhi), Tukiainen, H. (Helena), Purola, L. (Laura), Akujärvi, A. (Anu), Lampinen, R. (Raino), and Hjort, J. (Jan)
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Ecosystem service trade-off ,Mapping of ecosystem services ,Geodiversity ,Spatial ,Biodiversity ,Boreal ,High-latitude - Abstract
Mapping of ecosystem services (ESs) provide valuable information on the geographical variation of ESs and their relation to overall diversity. Although the relationship between biodiversity and ESs has been intensively explored, little is known how geodiversity (i.e., variety of geological, geomorphological and soil features) is associated with different ESs. We studied 1) the spatial variation of geodiversity and biodiversity in relation to six ESs (i.e., forest carbon budget, potential supply of groundwater, milk and meat production, crop production, amount of free-time residences and nationally valuable landscapes) using variation partitioning (VP), and 2) the spatial overlap between geodiversity and biodiversity and ESs using generalized additive models (GAM) in 1006 intensively surveyed grid cells of 100 km² located across Finland. In the VP, biodiversity independently explained more of the variation than geodiversity for majority of the ESs. However, shared explanation ability of biodiversity and geodiversity was considerable for majority of ESs (forest carbon budget: 41.3%, crop production: 15.0%, free-time residences: 15.2% and valuable landscapes: 7.3%), often exceeding that of both independent contributions. GAMs indicated that increase in both biodiversity and geodiversity enhances forest carbon budget (D2 = 66.8% and 12.4%, respectively), potential production of groundwater (8.3% and 0.1%), crop production (35.7% and 8.9%), free-time residences (40.0% and 7.9%) and valuable landscapes (11.6% and 6.9%). However, the positive relationship between diversity and ESs levelled off for many of the ESs. Our findings suggest that geodiversity is an important complementing factor in explaining spatial variation of the ESs in high-latitude regions. We also found dominantly synergic effects between abiotic diversity and ESs. Thus, our study results highlight the need to more deeply incorporate abiotic diversity into ESs research. Environmental conservation and management would benefit from the more comprehensive integration of geodiversity to ESs research along with the changing environmental conditions of future decades.
- Published
- 2018
10. Targeting Nrf2 to Suppress Ferroptosis and Mitochondrial Dysfunction in Neurodegeneration
- Author
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Abdalkader, M, Lampinen, R, Kanninen, KM, Malm, TM, Liddell, JR, Abdalkader, M, Lampinen, R, Kanninen, KM, Malm, TM, and Liddell, JR
- Abstract
Ferroptosis is a newly described form of regulated cell death, distinct from apoptosis, necroptosis and other forms of cell death. Ferroptosis is induced by disruption of glutathione synthesis or inhibition of glutathione peroxidase 4, exacerbated by iron, and prevented by radical scavengers such as ferrostatin-1, liproxstatin-1, and endogenous vitamin E. Ferroptosis terminates with mitochondrial dysfunction and toxic lipid peroxidation. Although conclusive identification of ferroptosis in vivo is challenging, several salient and very well established features of neurodegenerative diseases are consistent with ferroptosis, including lipid peroxidation, mitochondrial disruption and iron dysregulation. Accordingly, interest in the role of ferroptosis in neurodegeneration is escalating and specific evidence is rapidly emerging. One aspect that has thus far received little attention is the antioxidant transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2). This transcription factor regulates hundreds of genes, of which many are either directly or indirectly involved in modulating ferroptosis, including metabolism of glutathione, iron and lipids, and mitochondrial function. This potentially positions Nrf2 as a key deterministic component modulating the onset and outcomes of ferroptotic stress. The minimal direct evidence currently available is consistent with this and indicates that Nrf2 may be critical for protection against ferroptosis. In contrast, abundant evidence demonstrates that enhancing Nrf2 signaling is potently neuroprotective in models of neurodegeneration, although the exact mechanism by which this is achieved is unclear. Further studies are required to determine to extent to which the neuroprotective effects of Nrf2 activation involve the prevention of ferroptosis.
- Published
- 2018
11. Spatial relationship between biodiversity and geodiversity across a gradient of land-use intensity in high-latitude landscapes
- Author
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Tukiainen, H. (Helena), Alahuhta, J. (Janne), Field, R. (Richard), Ala-Hulkko, T. (Terhi), Lampinen, R. (Raino), Hjort, J. (Jan), Tukiainen, H. (Helena), Alahuhta, J. (Janne), Field, R. (Richard), Ala-Hulkko, T. (Terhi), Lampinen, R. (Raino), and Hjort, J. (Jan)
- Abstract
Context: ‘Conserving Nature’s stage’ has been advanced as an important conservation principle because of known links between biodiversity and abiotic environmental diversity, especially in sensitive high-latitude environments and at the landscape scale. However these links have not been examined across gradients of human impact on the landscape. Objectives: To (1) analyze the relationships between land-use intensity and both landscape-scale biodiversity and geodiversity, and (2) assess the contributions of geodiversity, climate and spatial variables to explaining vascular plant species richness in landscapes of low, moderate and high human impact. Methods: We used generalized additive models (GAMs) to analyze relationships between land-use intensity and both geodiversity (geological, geomorphological and hydrological richness) and plant species richness in 6191 1-km² grid squares across Finland. We used linear regression-based variation partitioning (VP) to assess contributions of climate, geodiversity and spatial variable groups to accounting for spatial variation in species richness. Results: In GAMs, geodiversity correlated negatively, and plant species richness positively, with land-use intensity. Both relationships were non-linear. In VP, geodiversity best accounted for species richness in areas of moderate to high human impact. These overall contributions were mainly due to variation explained jointly with climate, which dominated the models. Independent geodiversity contributions were highest in pristine environments, but low throughout. Conclusions: Human action increases biodiversity but may reduce geodiversity, at landscape scale in high-latitude environments. Better understanding of the connections between biodiversity and abiotic environment along changing land-use gradients is essential in developing sustainable measures to conserve biodiversity under global change.
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- 2017
12. Influence of Fertilizer Use on the Quantity and Composition of Oil in Oats
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Lampinen, R., Lawes, Dudley A., editor, and Thomas, Hugh, editor
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- 1986
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13. Plant diversity in Europe: Atlas Florae Europaeae and WORLDMAP
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Humphries, C., Araújo, M., Williams, P., Lampinen, R., Lahti, T., and Uotila, P.
14. Rosaceae (Cydonia to Prunus, excl. Sorbus)
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Kurtto, Arto, Sennikov, Alexander N., Lampinen, Raino, Zając, Adam, Zając, Maria, Uotila, P., Kurtto, A., Sennikov, A., Ahti, T., Czopyk, V.I., Edmondson, J., Greuter, W., Montserrat, P., Niklfeld, H., Stevanović, V., Suominen, J., Shuka, L., Dubovik, D.V., Dzhus, M.A., Skuratovich, A.N., Tretyakov, D.I., Van, W., Brujić, J., Milanović, D., Stupar, V., Preston, C.D., Ames, S.L., Vladimirov, V., Zieliński, J., Ozimec, S., Zázvorka, J., Lepší, M., Lepší, P., Kukk, T., Lampinen, R., Lazare, J.-J., Jeanmonod, D., Jordan, D., Matevski, V., Kostadinovski, M., May, R., Buttler, K.P., Caspari, S., Kasperek, G., Constantinidis, T., Strid, A., Király, G., Barina, Z., Németh, C., Somlyay, L., Einarsson, E., Cuccuini, P., Argenti, C., Arrigoni, P.V., Baldini, M.R., Bartolucci, F., Bernardo, L., Bertolli, A., Bouvet, D., Brentan, M., Conti, F., Cornara, L., Domina, G., Fascetti, S., Festi, F., Gubellini, L., Guglielmone, L., Gudžinskas, Z., Helminger, T., Mârza, M., Ufimov, R.A., Caković, D., Abramov, †N.V., Baranova, O.G., Borisova, E.A., Chkalov, A.V., Demakhina, T.V., Glazkova, E.A., Grigorjevskaya, A.J., Gubareva, I.YU., Kalashnikova, O.V., Khapugin, A.A., Knjazev, M.S., Iberite, M., Marcucci, R., Krylov, A.V., La, A., Marsili, S., Holverda, W.J., Pedersen, O., Kulikov, P.V., Lastrucci, L., Medagli, P., Weeda, E.J., Majorov, S.R., Lattanzi, E., Olmo, M., Løfall, B.P., Peccenini, S., Pistarino, A., Poldini, L., Prosser, F., Raffaelli, M., Raimondo, F.M., Rinaldi, G., Ruocco, G., Santangelo, A., Siniscalco, C., Tognon, G., Vidali, M., Muldashev, A.A., Notov, A.A., Orlova, L.V., Ovesnov, S.A., Plaksina, T.I., Popchenko, M.I., Rakov, N.S., Reshetnikova, N.M., Saksonov, S.V., Sennikov, A.N., Oklejewicz, K., Danielewicz, W., Maliński, T., Stadnicka-futoma, A., Wolanin, M., Hinneri, S., Hyvärinen, M., Lahti, T., Rikkinen, J., Ulvinen, T., Väre, H., Wilhalm, T., Zappa, E., Almeida, R., Seregin, A.P., Alves, P.J., Vasjukov, V.M., Coutinho, A.X.P., Zhukova, O.V., Crespí, A.L., De, J.D., Honrado, J.P., Krasniqi, E., Gavrilova, Ģ., Šulcs, V., Dihoru, G., Dihoru, A., Drăgulescu, C., Oltu, E., Popescu, G., Sârbu, I., Mininzon, I.L., Niketić, M., Tomović, G., Vukojičić, S., Goliašová, K., Šipošová, H., Bernátová, D., Marhold, K., Vreš, B., Delgado, L., Devesa, J.A., De, M., Fraga, M.I., Rico, E., Ruiz, E., Ericsson, S., Ljungstrand, E., Gygax, A., Özhatay, N., Fedoronchuk, N.M., Kagalo, A.A., Sytschak, N.M., and Yena, A.V.
- Published
- 2013
15. Traffic-related ultrafine particles impair mitochondrial functions in human olfactory mucosa cells - Implications for Alzheimer's disease.
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Mussalo L, Lampinen R, Avesani S, Závodná T, Krejčík Z, Kalapudas J, Penttilä E, Löppönen H, Koivisto AM, Malm T, Topinka J, Giugno R, Jalava P, and Kanninen KM
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- Humans, Vehicle Emissions toxicity, Oxidative Stress drug effects, Male, Female, Aged, Reactive Oxygen Species metabolism, Air Pollutants toxicity, Air Pollutants adverse effects, Alzheimer Disease metabolism, Alzheimer Disease etiology, Alzheimer Disease pathology, Alzheimer Disease chemically induced, Mitochondria metabolism, Mitochondria drug effects, Particulate Matter adverse effects, Particulate Matter toxicity, Olfactory Mucosa metabolism, Olfactory Mucosa pathology, Olfactory Mucosa drug effects
- Abstract
Constituents of air pollution, the ultrafine particles (UFP) with a diameter of ≤0.1 μm, are considerably related to traffic emissions. Several studies link air pollution to Alzheimer's disease (AD), yet the exact relationship between the two remains poorly understood. Mitochondria are known targets of environmental toxicants, and their dysfunction is associated with neurodegenerative diseases. The olfactory mucosa (OM), located at the rooftop of the nasal cavity, is directly exposed to the environment and in contact with the brain. Mounting evidence suggests that the UFPs can impact the brain directly through the olfactory tract. By using primary human OM cultures established from nasal biopsies of cognitively healthy controls and individuals diagnosed with AD, we aimed to decipher the effects of traffic-related UFPs on mitochondria. The UFP samples were collected from the exhausts of a modern heavy-duty diesel engine (HDE) without aftertreatment systems, run with renewable diesel (A0) and petroleum diesel (A20), and from an engine of a 2019 model diesel passenger car (DI-E6d) equipped with state-of-the-art aftertreatment devices and run with renewable diesel (Euro6). OM cells were exposed to three different UFPs for 24-h and 72-h, after which cellular processes were assessed on the functional and transcriptomic levels. Our results show that UFPs impair mitochondrial functions in primary human OM cells by hampering oxidative phosphorylation (OXPHOS) and redox balance, and the responses of AD cells differ from cognitively healthy controls. RNA-Seq and IPA® revealed inhibition of OXPHOS and mitochondrial dysfunction in response to UFPs A0 and A20. Functional validation confirmed that A0 and A20 impair cellular respiration, decrease ATP levels, and disturb redox balance by altering NAD and glutathione metabolism, leading to increased ROS and oxidative stress. RNA-Seq and functional assessment revealed the presence of AD-related alterations in human OM cells and that different fuels and engine technologies elicit differential effects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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16. Exposure to urban particulate matter alters responses of olfactory mucosal cells to SARS-CoV-2 infection.
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Shahbaz MA, Kuivanen S, Mussalo L, Afonin AM, Kumari K, Behzadpour D, Kalapudas J, Koivisto AM, Penttilä E, Löppönen H, Jalava P, Vapalahti O, Balistreri G, Lampinen R, and Kanninen KM
- Subjects
- Humans, Air Pollutants toxicity, Aged, Male, Female, Alzheimer Disease immunology, Alzheimer Disease chemically induced, Alzheimer Disease virology, Middle Aged, Cytokines metabolism, Aged, 80 and over, Oxidative Stress drug effects, Particulate Matter toxicity, Olfactory Mucosa drug effects, Olfactory Mucosa virology, COVID-19 immunology, SARS-CoV-2
- Abstract
Respiratory viruses have a significant impact on health, as highlighted by the COVID-19 pandemic. Exposure to air pollution can contribute to viral susceptibility and be associated with severe outcomes, as suggested by recent epidemiological studies. Furthermore, exposure to particulate matter (PM), an important constituent of air pollution, is linked to adverse effects on the brain, including cognitive decline and Alzheimer's disease (AD). The olfactory mucosa (OM), a tissue located at the rooftop of the nasal cavity, is directly exposed to inhaled air and in direct contact with the brain. Increasing evidence of OM dysfunction related to neuropathogenesis and viral infection demonstrates the importance of elucidating the interplay between viruses and air pollutants at the OM. This study examined the effects of subacute exposure to urban PM 0.2 and PM 10-2.5 on SARS-CoV-2 infection using primary human OM cells obtained from cognitively healthy individuals and individuals diagnosed with AD. OM cells were exposed to PM and subsequently infected with the SARS-CoV-2 virus in the presence of pollutants. SARS-CoV-2 entry receptors and replication, toxicological endpoints, cytokine release, oxidative stress markers, and amyloid beta levels were measured. Exposure to PM did not enhance the expression of viral entry receptors or cellular viral load in human OM cells. However, PM-exposed and SARS-CoV-2-infected cells showed alterations in cellular and immune responses when compared to cells infected only with the virus or pollutants. These changes are highly pronounced in AD OM cells. These results suggest that exposure of human OM cells to PM does not increase susceptibility to SARS-CoV-2 infection in vitro, but it can alter cellular immune responses to the virus, particularly in AD. Understanding the interplay of air pollutants and COVID-19 can provide important insight for the development of public health policies and interventions to reduce the negative influences of air pollution exposure., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Katja Kannienen reports financial support was provided by Research Council of Finland. Katja Kannienen reports financial support was provided by Sigrid Jusélius Foundation. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2024
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17. Upregulation of Integrin beta-3 in astrocytes upon Alzheimer's disease progression in the 5xFAD mouse model.
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Ivanova M, Belaya I, Kucháriková N, de Sousa Maciel I, Saveleva L, Alatalo A, Juvonen I, Thind N, Andrès C, Lampinen R, Chew S, and Kanninen KM
- Subjects
- Animals, Mice, Amyloid beta-Peptides metabolism, Astrocytes metabolism, Disease Models, Animal, Mice, Transgenic, Neuroglia metabolism, Up-Regulation, Alzheimer Disease metabolism
- Abstract
Integrins are receptors that have been linked to various brain disorders, including Alzheimer's disease (AD), the most prevalent neurodegenerative disorder. While Integrin beta-3 (ITGB3) is known to participate in multiple cellular processes such as adhesion, migration, and signaling, its specific role in AD remains poorly understood, particularly in astrocytes, the main glial cell type in the brain. In this study, we investigated alterations in ITGB3 gene and protein expression during aging in different brain regions of the 5xFAD mouse model of AD and assessed the interplay between ITGB3 and astrocytes. Primary cultures from adult mouse brains were used to gain further insight into the connection between ITGB3 and amyloid beta (Aβ) in astrocytes. In vivo studies showed a correlation between ITGB3 and the astrocytic marker GFAP in the 5xFAD brains, indicating its association with reactive astrocytes. In vitro studies revealed increased gene expression of ITGB3 upon Aβ treatment. Our findings underscore the potential significance of ITGB3 in astrocyte reactivity in the context of Alzheimer's disease., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2024
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18. Emissions from modern engines induce distinct effects in human olfactory mucosa cells, depending on fuel and aftertreatment.
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Mussalo L, Avesani S, Shahbaz MA, Závodná T, Saveleva L, Järvinen A, Lampinen R, Belaya I, Krejčík Z, Ivanova M, Hakkarainen H, Kalapudas J, Penttilä E, Löppönen H, Koivisto AM, Malm T, Topinka J, Giugno R, Aakko-Saksa P, Chew S, Rönkkö T, Jalava P, and Kanninen KM
- Subjects
- Humans, Particulate Matter toxicity, Particulate Matter analysis, Vehicle Emissions toxicity, Vehicle Emissions analysis, Olfactory Mucosa chemistry, Xenobiotics, Air Pollutants toxicity, Air Pollutants analysis
- Abstract
Ultrafine particles (UFP) with a diameter of ≤0.1 μm, are contributors to ambient air pollution and derived mainly from traffic emissions, yet their health effects remain poorly characterized. The olfactory mucosa (OM) is located at the rooftop of the nasal cavity and directly exposed to both the environment and the brain. Mounting evidence suggests that pollutant particles affect the brain through the olfactory tract, however, the exact cellular mechanisms of how the OM responds to air pollutants remain poorly known. Here we show that the responses of primary human OM cells are altered upon exposure to UFPs and that different fuels and engines elicit different adverse effects. We used UFPs collected from exhausts of a heavy-duty-engine run with renewable diesel (A0) and fossil diesel (A20), and from a modern diesel vehicle run with renewable diesel (Euro6) and compared their health effects on the OM cells by assessing cellular processes on the functional and transcriptomic levels. Quantification revealed all samples as UFPs with the majority of particles being ≤0.1 μm by an aerodynamic diameter. Exposure to A0 and A20 induced substantial alterations in processes associated with inflammatory response, xenobiotic metabolism, olfactory signaling, and epithelial integrity. Euro6 caused only negligible changes, demonstrating the efficacy of aftertreatment devices. Furthermore, when compared to A20, A0 elicited less pronounced effects on OM cells, suggesting renewable diesel induces less adverse effects in OM cells. Prior studies and these results suggest that PAHs may disturb the inflammatory process and xenobiotic metabolism in the OM and that UFPs might mediate harmful effects on the brain through the olfactory route. This study provides important information on the adverse effects of UFPs in a human-based in vitro model, therefore providing new insight to form the basis for mitigation and preventive actions against the possible toxicological impairments caused by UFP exposure., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Katja Kanninen reports financial support was provided by The Academy of Finland. Katja Kanninen reports financial support was provided by The Sigrid Juselius Foundation. Katja Kanninen reports financial support was provided by Horizon 2020 European Innovation Council Fast Track to Innovation. Tarja Malm reports financial support was provided by Horizon 2020 European Innovation Council Fast Track to Innovation. Pasi Jalava reports financial support was provided by Horizon 2020 European Innovation Council Fast Track to Innovation. Laura Mussalo reports financial support was provided by Kuopio Area Respiratory Foundation. Laura Mussalo reports financial support was provided by Finnish Brain Foundation. Laura Mussalo reports financial support was provided by Yrjö Jahnsson Foundation. Laura Mussalo reports financial support was provided by Päivikki and Sakari Sohlberg Foundation. Laura Mussalo reports financial support was provided by University of Eastern Finland., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2023
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19. Human-derived air-liquid interface cultures decipher Alzheimer's disease-SARS-CoV-2 crosstalk in the olfactory mucosa.
- Author
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Shahbaz MA, Kuivanen S, Lampinen R, Mussalo L, Hron T, Závodná T, Ojha R, Krejčík Z, Saveleva L, Tahir NA, Kalapudas J, Koivisto AM, Penttilä E, Löppönen H, Singh P, Topinka J, Vapalahti O, Chew S, Balistreri G, and Kanninen KM
- Subjects
- Humans, SARS-CoV-2, Anosmia metabolism, Neuroinflammatory Diseases, Olfactory Mucosa metabolism, COVID-19, Alzheimer Disease metabolism
- Abstract
Background: The neurological effects of the coronavirus disease of 2019 (COVID-19) raise concerns about potential long-term consequences, such as an increased risk of Alzheimer's disease (AD). Neuroinflammation and other AD-associated pathologies are also suggested to increase the risk of serious SARS-CoV-2 infection. Anosmia is a common neurological symptom reported in COVID-19 and in early AD. The olfactory mucosa (OM) is important for the perception of smell and a proposed site of viral entry to the brain. However, little is known about SARS-CoV-2 infection at the OM of individuals with AD., Methods: To address this gap, we established a 3D in vitro model of the OM from primary cells derived from cognitively healthy and AD individuals. We cultured the cells at the air-liquid interface (ALI) to study SARS-CoV-2 infection under controlled experimental conditions. Primary OM cells in ALI expressed angiotensin-converting enzyme 2 (ACE-2), neuropilin-1 (NRP-1), and several other known SARS-CoV-2 receptor and were highly vulnerable to infection. Infection was determined by secreted viral RNA content and confirmed with SARS-CoV-2 nucleocapsid protein (NP) in the infected cells by immunocytochemistry. Differential responses of healthy and AD individuals-derived OM cells to SARS-CoV-2 were determined by RNA sequencing., Results: Results indicate that cells derived from cognitively healthy donors and individuals with AD do not differ in susceptibility to infection with the wild-type SARS-CoV-2 virus. However, transcriptomic signatures in cells from individuals with AD are highly distinct. Specifically, the cells from AD patients that were infected with the virus showed increased levels of oxidative stress, desensitized inflammation and immune responses, and alterations to genes associated with olfaction. These results imply that individuals with AD may be at a greater risk of experiencing severe outcomes from the infection, potentially driven by pre-existing neuroinflammation., Conclusions: The study sheds light on the interplay between AD pathology and SARS-CoV-2 infection. Altered transcriptomic signatures in AD cells may contribute to unique symptoms and a more severe disease course, with a notable involvement of neuroinflammation. Furthermore, the research emphasizes the need for targeted interventions to enhance outcomes for AD patients with viral infection. The study is crucial to better comprehend the relationship between AD, COVID-19, and anosmia. It highlights the importance of ongoing research to develop more effective treatments for those at high risk of severe SARS-CoV-2 infection., (© 2023. The Author(s).)
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- 2023
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20. Development of Lyophilised Eudragit ® Retard Nanoparticles for the Sustained Release of Clozapine via Intranasal Administration.
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Lombardo R, Ruponen M, Rautio J, Ghelardini C, Di Cesare Mannelli L, Calosi L, Bani D, Lampinen R, Kanninen KM, Koivisto AM, Penttilä E, Löppönen H, and Pignatello R
- Abstract
Clozapine (CZP) is the only effective drug in schizophrenia resistant to typical antipsychotics. However, existing dosage forms (oral or orodispersible tablets, suspensions or intramuscular injection) show challenging limitations. After oral administration, CZP has low bioavailability due to a large first-pass effect, while the i.m. route is often painful, with low patient compliance and requiring specialised personnel. Moreover, CZP has a very low aqueous solubility. This study proposes the intranasal route as an alternative route of administration for CZP, through its encapsulation in polymeric nanoparticles (NPs) based on Eudragit
® RS100 and RL100 copolymers. Slow-release polymeric NPs with dimensions around 400-500 nm were formulated to reside and release CZP in the nasal cavity, where it can be absorbed through the nasal mucosa and reach the systemic circulation. CZP-EUD-NPs showed a controlled release of CZP for up to 8 h. Furthermore, to reduce mucociliary clearance and increase the residence time of NPs in the nasal cavity to improve drug bioavailability, mucoadhesive NPs were formulated. This study shows that the NPs already exhibited strong electrostatic interactions with mucin at time zero due to the presence of the positive charge of the used copolymers. Furthermore, to improve the solubility, diffusion and adsorption of CZPs and the storage stability of the formulation, it was lyophilised using 5% ( w / v ) HP-β-CD as a cryoprotectant. It ensured the preservation of the NPs' size, PDI and charge upon reconstitution. Moreover, physicochemical characterisation studies of solid-state NPs were performed. Finally, toxicity studies were performed in vitro on MDCKII cells and primary human olfactory mucosa cells and in vivo on the nasal mucosa of CD-1 mice. The latter showed non-toxicity of B-EUD-NPs and mild CZP-EUD-NP-induced tissue abnormalities.- Published
- 2023
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21. An Alzheimer's Disease Patient-Derived Olfactory Stem Cell Model Identifies Gene Expression Changes Associated with Cognition.
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Rantanen LM, Bitar M, Lampinen R, Stewart R, Quek H, Oikari LE, Cunί-Lόpez C, Sutharsan R, Thillaiyampalam G, Iqbal J, Russell D, Penttilä E, Löppönen H, Lehtola JM, Saari T, Hannonen S, Koivisto AM, Haupt LM, Mackay-Sim A, Cristino AS, Kanninen KM, and White AR
- Subjects
- Humans, A Kinase Anchor Proteins genetics, Cells, Cultured, Alzheimer Disease genetics, Alzheimer Disease pathology, Cognition, Gene Expression, Stem Cells metabolism, Stem Cells pathology, Olfactory Mucosa metabolism, Olfactory Mucosa pathology
- Abstract
An early symptom of Alzheimer's disease (AD) is an impaired sense of smell, for which the molecular basis remains elusive. Here, we generated human olfactory neurosphere-derived (ONS) cells from people with AD and mild cognitive impairment (MCI), and performed global RNA sequencing to determine gene expression changes. ONS cells expressed markers of neuroglial differentiation, providing a unique cellular model to explore changes of early AD-associated pathways. Our transcriptomics data from ONS cells revealed differentially expressed genes (DEGs) associated with cognitive processes in AD cells compared to MCI, or matched healthy controls (HC). A-Kinase Anchoring Protein 6 ( AKAP6 ) was the most significantly altered gene in AD compared to both MCI and HC, and has been linked to cognitive function. The greatest change in gene expression of all DEGs occurred between AD and MCI. Gene pathway analysis revealed defects in multiple cellular processes with aging, intellectual deficiency and alternative splicing being the most significantly dysregulated in AD ONS cells. Our results demonstrate that ONS cells can provide a cellular model for AD that recapitulates disease-associated differences. We have revealed potential novel genes, including AKAP6 that may have a role in AD, particularly MCI to AD transition, and should be further examined.
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- 2022
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22. Neuron-astrocyte transmitophagy is altered in Alzheimer's disease.
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Lampinen R, Belaya I, Saveleva L, Liddell JR, Rait D, Huuskonen MT, Giniatullina R, Sorvari A, Soppela L, Mikhailov N, Boccuni I, Giniatullin R, Cruz-Haces M, Konovalova J, Koskuvi M, Domanskyi A, Hämäläinen RH, Goldsteins G, Koistinaho J, Malm T, Chew S, Rilla K, White AR, Marsh-Armstrong N, and Kanninen KM
- Subjects
- Amyloid beta-Peptides metabolism, Animals, Astrocytes metabolism, Mice, Mitophagy, Neurons metabolism, Alzheimer Disease metabolism
- Abstract
Under physiological conditions in vivo astrocytes internalize and degrade neuronal mitochondria in a process called transmitophagy. Mitophagy is widely reported to be impaired in neurodegeneration but it is unknown whether and how transmitophagy is altered in Alzheimer's disease (AD). Here we report that the internalization of neuronal mitochondria is significantly increased in astrocytes isolated from AD mouse brains. We also demonstrate that the degradation of neuronal mitochondria by astrocytes is increased in AD mice at the age of 6 months onwards. Furthermore, we demonstrate for the first time a similar phenomenon between human neurons and AD astrocytes, and in murine hippocampi in vivo. The results suggest the involvement of S100a4 in impaired mitochondrial transfer between neurons and AD astrocytes together with significant increases in the mitophagy regulator and reactive oxygen species in aged AD astrocytes. These findings demonstrate altered neuron-supporting functions of AD astrocytes and provide a starting point for studying the molecular mechanisms of transmitophagy in AD., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
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23. Biometal Dyshomeostasis in Olfactory Mucosa of Alzheimer's Disease Patients.
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Lampinen R, Górová V, Avesani S, Liddell JR, Penttilä E, Závodná T, Krejčík Z, Lehtola JM, Saari T, Kalapudas J, Hannonen S, Löppönen H, Topinka J, Koivisto AM, White AR, Giugno R, and Kanninen KM
- Subjects
- Calcium metabolism, Chelating Agents metabolism, Humans, Olfactory Mucosa metabolism, Zinc metabolism, Alzheimer Disease metabolism, Trace Elements metabolism
- Abstract
Olfactory function, orchestrated by the cells of the olfactory mucosa at the rooftop of the nasal cavity, is disturbed early in the pathogenesis of Alzheimer's disease (AD). Biometals including zinc and calcium are known to be important for sense of smell and to be altered in the brains of AD patients. Little is known about elemental homeostasis in the AD patient olfactory mucosa. Here we aimed to assess whether the disease-related alterations to biometal homeostasis observed in the brain are also reflected in the olfactory mucosa. We applied RNA sequencing to discover gene expression changes related to metals in olfactory mucosal cells of cognitively healthy controls, individuals with mild cognitive impairment and AD patients, and performed analysis of the elemental content to determine metal levels. Results demonstrate that the levels of zinc, calcium and sodium are increased in the AD olfactory mucosa concomitantly with alterations to 17 genes related to metal-ion binding or metal-related function of the protein product. A significant elevation in alpha-2-macroglobulin, a known metal-binding biomarker correlated with brain disease burden, was observed on the gene and protein levels in the olfactory mucosa cells of AD patients. These data demonstrate that the olfactory mucosa cells derived from AD patients recapitulate certain impairments of biometal homeostasis observed in the brains of patients.
- Published
- 2022
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24. Single-Cell RNA-Seq Analysis of Olfactory Mucosal Cells of Alzheimer's Disease Patients.
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Lampinen R, Fazaludeen MF, Avesani S, Örd T, Penttilä E, Lehtola JM, Saari T, Hannonen S, Saveleva L, Kaartinen E, Fernández Acosta F, Cruz-Haces M, Löppönen H, Mackay-Sim A, Kaikkonen MU, Koivisto AM, Malm T, White AR, Giugno R, Chew S, and Kanninen KM
- Subjects
- Amyloid beta-Peptides metabolism, Humans, Olfactory Mucosa metabolism, RNA, Sequence Analysis, RNA, Alzheimer Disease metabolism
- Abstract
Olfaction is orchestrated by olfactory mucosal cells located in the upper nasal cavity. Olfactory dysfunction manifests early in several neurodegenerative disorders including Alzheimer's disease, however, disease-related alterations to the olfactory mucosal cells remain poorly described. The aim of this study was to evaluate the olfactory mucosa differences between cognitively healthy individuals and Alzheimer's disease patients. We report increased amyloid-beta secretion in Alzheimer's disease olfactory mucosal cells and detail cell-type-specific gene expression patterns, unveiling 240 differentially expressed disease-associated genes compared to the cognitively healthy controls, and five distinct cell populations. Overall, alterations of RNA and protein metabolism, inflammatory processes, and signal transduction were observed in multiple cell populations, suggesting their role in Alzheimer's disease-related olfactory mucosa pathophysiology. Furthermore, the single-cell RNA-sequencing proposed alterations in gene expression of mitochondrially located genes in AD OM cells, which were verified by functional assays, demonstrating altered mitochondrial respiration and a reduction of ATP production. Our results reveal disease-related changes of olfactory mucosal cells in Alzheimer's disease and demonstrate the utility of single-cell RNA sequencing data for investigating molecular and cellular mechanisms associated with the disease.
- Published
- 2022
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25. Treatment of Breast Cancer-Related Lymphedema Using Negative Pressure Massage: A Pilot Randomized Controlled Trial.
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Lampinen R, Lee JQ, Leano J, Miaskowski C, Mastick J, Brinker L, Topp K, and Smoot B
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- Aged, Disability Evaluation, Female, Humans, Middle Aged, Pilot Projects, Single-Blind Method, Breast Cancer Lymphedema therapy, Massage methods
- Abstract
Objective: To evaluate the efficacy of negative pressure massage treatment (NPMT) compared with manual lymphatic drainage (MLD) in women with chronic breast cancer-related lymphedema (LE). We hypothesized that NPMT would result in greater improvements in LE and upper limb function., Design: Pilot single-blinded randomized controlled trial., Setting: Health sciences university., Participants: Of 64 women screened, 28 met eligibility requirements (ie, >18y of age; completed active treatment for breast cancer; had unilateral arm LE for ≥1y; were not receiving LE care; had stable LE) and were randomized to the NPMT (n=15) and control groups (n=13)., Interventions: The intervention group received NPMT and the control group received MLD; both received twelve 60-minute sessions over 4-6 weeks., Main Outcome Measures: Bioimpedance (lymphedema index [L-Dex] units]), limb volume (mL) calculated from limb circumference, and Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) score., Results: Outcomes were analyzed for 28 women. Compared to the MLD group, the NPMT group demonstrated greater improvement with a large effect size in L-Dex scores (P=.001; standardized mean difference [SMD]=-1.15; 95% confidence interval, -1.96 to -0.35) and interlimb volume differences (P=.038; SMD=-0.83; 95% confidence interval, -1.60 to -0.05). Differences in DASH scores were not statistically significant (P=.067)., Conclusions: Compared to MLD, treatment with NPMT resulted in greater improvement in L-Dex scores and interlimb volume differences in women with a duration of unilateral upper limb LE of >1 year. Our findings need to be confirmed in a larger randomized controlled trial., (Copyright © 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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26. Urban air particulate matter induces mitochondrial dysfunction in human olfactory mucosal cells.
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Chew S, Lampinen R, Saveleva L, Korhonen P, Mikhailov N, Grubman A, Polo JM, Wilson T, Komppula M, Rönkkö T, Gu C, Mackay-Sim A, Malm T, White AR, Jalava P, and Kanninen KM
- Subjects
- Aged, Animals, Apoptosis drug effects, C-Reactive Protein genetics, C-Reactive Protein metabolism, Cell Culture Techniques, Cells, Cultured, Cities, Cytokines metabolism, Humans, Inflammation, Male, Membrane Potential, Mitochondrial drug effects, Middle Aged, Mitochondria immunology, Mitochondria metabolism, Nerve Tissue Proteins genetics, Nerve Tissue Proteins metabolism, Olfactory Mucosa metabolism, Olfactory Mucosa pathology, Particle Size, Transcriptome drug effects, Urbanization, Air Pollutants toxicity, Mitochondria drug effects, Olfactory Mucosa drug effects, Oxidative Stress drug effects, Particulate Matter toxicity
- Abstract
Background: The adverse effects of air pollutants including particulate matter (PM) on the central nervous system is increasingly reported by epidemiological, animal and post-mortem studies in the last decade. Oxidative stress and inflammation are key consequences of exposure to PM although little is known of the exact mechanism. The association of PM exposure with deteriorating brain health is speculated to be driven by PM entry via the olfactory system. How air pollutants affect this key entry site remains elusive. In this study, we investigated effects of urban size-segregated PM on a novel cellular model: primary human olfactory mucosal (hOM) cells., Results: Metabolic activity was reduced following 24-h exposure to PM without evident signs of toxicity. Results from cytometric bead array suggested a mild inflammatory response to PM exposure. We observed increased oxidative stress and caspase-3/7 activity as well as perturbed mitochondrial membrane potential in PM-exposed cells. Mitochondrial dysfunction was further verified by a decrease in mitochondria-dependent respiration. Transient suppression of the mitochondria-targeted gene, neuronal pentraxin 1 (NPTX1), was carried out, after being identified to be up-regulated in PM
2.5-1 treated cells via RNA sequencing. Suppression of NPTX1 in cells exposed to PM did not restore mitochondrial defects resulting from PM exposure. In contrast, PM-induced adverse effects were magnified in the absence of NPTX1, indicating a critical role of this protein in protection against PM effects in hOM cells., Conclusion: Key mitochondrial functions were perturbed by urban PM exposure in a physiologically relevant cellular model via a mechanism involving NPTX1. In addition, inflammatory response and early signs of apoptosis accompanied mitochondrial dysfunction during exposure to PM. Findings from this study contribute to increased understanding of harmful PM effects on human health and may provide information to support mitigation strategies targeted at air pollution.- Published
- 2020
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27. PPARβ/δ-agonist GW0742 ameliorates dysfunction in fatty acid oxidation in PSEN1ΔE9 astrocytes.
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Konttinen H, Gureviciene I, Oksanen M, Grubman A, Loppi S, Huuskonen MT, Korhonen P, Lampinen R, Keuters M, Belaya I, Tanila H, Kanninen KM, Goldsteins G, Landreth G, Koistinaho J, and Malm T
- Subjects
- Adult, Animals, Astrocytes drug effects, Cell Differentiation drug effects, Cell Differentiation physiology, Cells, Cultured, Exons drug effects, Exons physiology, Female, Humans, Induced Pluripotent Stem Cells drug effects, Induced Pluripotent Stem Cells metabolism, Male, Mice, Mice, Inbred C57BL, Mice, Transgenic, Middle Aged, Oxidation-Reduction drug effects, PPAR delta agonists, PPAR-beta agonists, Random Allocation, Astrocytes metabolism, Fatty Acids metabolism, PPAR delta metabolism, PPAR-beta metabolism, Presenilin-1 metabolism, Thiazoles pharmacology
- Abstract
Astrocytes are the gatekeepers of neuronal energy supply. In neurodegenerative diseases, bioenergetics demand increases and becomes reliant upon fatty acid oxidation as a source of energy. Defective fatty acid oxidation and mitochondrial dysfunctions correlate with hippocampal neurodegeneration and memory deficits in Alzheimer's disease (AD), but it is unclear whether energy metabolism can be targeted to prevent or treat the disease. Here we show for the first time an impairment in fatty acid oxidation in human astrocytes derived from induced pluripotent stem cells of AD patients. The impairment was corrected by treatment with a synthetic peroxisome proliferator activated receptor delta (PPARβ/δ) agonist GW0742 which acts to regulate an array of genes governing cellular metabolism. GW0742 enhanced the expression of CPT1a, the gene encoding for a rate-limiting enzyme of fatty acid oxidation. Similarly, treatment of a mouse model of AD, the APP/PS1-mice, with GW0742 increased the expression of Cpt1a and concomitantly reversed memory deficits in a fear conditioning test. Although the GW0742-treated mice did not show altered astrocytic glial fibrillary acidic protein-immunoreactivity or reduction in amyloid beta (Aβ) load, GW0742 treatment increased hippocampal neurogenesis and enhanced neuronal differentiation of neuronal progenitor cells. Furthermore, GW0742 prevented Aβ-induced impairment of long-term potentiation in hippocampal slices. Collectively, these data suggest that PPARβ/δ-agonism alleviates AD related deficits through increasing fatty acid oxidation in astrocytes and improves cognition in a transgenic mouse model of AD., (© 2018 Wiley Periodicals, Inc.)
- Published
- 2019
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28. Targeting Nrf2 to Suppress Ferroptosis and Mitochondrial Dysfunction in Neurodegeneration.
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Abdalkader M, Lampinen R, Kanninen KM, Malm TM, and Liddell JR
- Abstract
Ferroptosis is a newly described form of regulated cell death, distinct from apoptosis, necroptosis and other forms of cell death. Ferroptosis is induced by disruption of glutathione synthesis or inhibition of glutathione peroxidase 4, exacerbated by iron, and prevented by radical scavengers such as ferrostatin-1, liproxstatin-1, and endogenous vitamin E. Ferroptosis terminates with mitochondrial dysfunction and toxic lipid peroxidation. Although conclusive identification of ferroptosis in vivo is challenging, several salient and very well established features of neurodegenerative diseases are consistent with ferroptosis, including lipid peroxidation, mitochondrial disruption and iron dysregulation. Accordingly, interest in the role of ferroptosis in neurodegeneration is escalating and specific evidence is rapidly emerging. One aspect that has thus far received little attention is the antioxidant transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2). This transcription factor regulates hundreds of genes, of which many are either directly or indirectly involved in modulating ferroptosis, including metabolism of glutathione, iron and lipids, and mitochondrial function. This potentially positions Nrf2 as a key deterministic component modulating the onset and outcomes of ferroptotic stress. The minimal direct evidence currently available is consistent with this and indicates that Nrf2 may be critical for protection against ferroptosis. In contrast, abundant evidence demonstrates that enhancing Nrf2 signaling is potently neuroprotective in models of neurodegeneration, although the exact mechanism by which this is achieved is unclear. Further studies are required to determine to extent to which the neuroprotective effects of Nrf2 activation involve the prevention of ferroptosis.
- Published
- 2018
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29. A review of pregnancy in women over 35 years of age.
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Lampinen R, Vehviläinen-Julkunen K, and Kankkunen P
- Abstract
Unlabelled: The objective of the present paper is to review how pregnant women over 35 years have been described in previous research, and to review the risks associated with pregnancy in those of advanced maternal age. Computerized searches of the Cinahl, PubMed, Medic and Cochrane Library databases were undertaken. Research articles in scientific journals, relevant to the objective, and published in English between 2000 and 2008, were included. Data were extracted based on the aims, sample, authors, year and results., Results: Advanced maternal age is associated with certain pregnancy-related risks. Being "at risk" causes anxiety and concern, which older pregnant women try to ease by being as well-informed as possible. This may be overwhelming to some women due to the large amount of information available., Conclusions: It is important for healthcare providers to be aware of the different feelings and experiences of older pregnant women in order to meet their individual needs within the maternity services.
- Published
- 2009
- Full Text
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