Burghard F. Klapp

Impact of a relaxation training on psychometric and immunologic parameters in tinnitus sufferers.

OBJECTIVE Tinnitus often entails severe psychological distress. Reversely, tinnitus may be considered as a chronic stressor. Based on this hypothesis, we investigated whether improving stress-managing capabilities would influence psychological and stress-related immunological parameters in chronic tinnitus sufferers. METHODS Tinnitus (TPs, n=26) and non-tinnitus participants (NTPs, n=13) took part in a standardised 10-week relaxation program. An additional group of tinnitus sufferers (n=18), randomly assigned to a waiting list, served as control (TC) subjects. Mood, perceived stress, global quality of life, and tinnitus disturbance were assessed before and after the intervention. The stress-sensitive immunological parameters TNF-alpha, IL-6, and IL-10 were measured before, during, and at the end of the intervention. RESULTS The program resulted in a significantly decreased perception of stress, anxious depression, anger, and tinnitus disturbance, paralleled by a reduction of TNF-alpha. No alterations were noted for IL-6 or IL-10. For the NTPs and TCs, no relevant psychological or immune changes could be observed. CONCLUSION The data suggest that (1) the training offered improved stress-managing capabilities in chronic tinnitus sufferers, and (2) TNF-alpha may be conceived as a stress marker.

Substance P expression in TRPV1 and trkA-positive dorsal root ganglion neurons innervating the mouse lung.

In the present study, the co-localisation of substance P (SP) with the vanilloid receptor TRPV1 and the neurotrophin receptor tyrosine kinase trkA was analysed in airway-specific murine dorsal root ganglion (DRG) neurons. DRG neurons labelled with Fast Blue were predominantly found at the segmental levels T2-T5. Immunoreactivity for the receptor TRPV1 was localized to 12% of Fast Blue labelled DRG neurons. Double-labelling immunohistochemistry revealed that a substantial number of them also co-express SP (7.6 +/- 1.1% (mean +/- S.E.M.)), whereas neurons with immunoreactivity for TRPV1 only were found in 4.4 +/- 1.3% of the retrogradely labelled neuronal population. Further analysis of retrogradely labelled neurons showed that their majority expressed trkA (62.8 +/- 1.4%), neurofilament protein 68-kDa (64.8 +/- 1.5%) or glutamate alone (19.5 +/- 1.9%). SP was always expressed in trkA-positive neurons. Based on the extent of co-localization of SP with the receptors TRPV1 and trkA in DRG airway neurons, the present study indicates that the DRG pathway may have effects on the magnitude of neurogenic inflammation in airway diseases such as asthma.

Levels and effects of different forms of anxiety during pregnancy after a prior miscarriage

OBJECTIVES The aim of the study was to assess the current level of pregnancy-related fear and state anxiety in pregnant women who experienced prior miscarriages and to explore the impact of higher levels of anxiety during the first trimester on the following course and outcome of the pregnancy. STUDY DESIGN One hundred forty-three pregnant women who had experienced prior miscarriage (sporadic or recurrent) were measured during each trimester and postpartum. Three independent control groups consisting of pregnant women without a history of miscarriage were recruited. For assessment, a battery of questionnaires including the STAI-state scale and various instruments were administered to record pregnancy-related fear, complications during pregnancy, the course of delivery and the health status of the neonate. Correlations, univariate logistic regression modelling, and ANOVA statistics including post hoc tests were conducted. RESULTS Compared to women without miscarriages, women with prior miscarriage had higher levels of pregnancy-related fear and state anxiety during the first trimester. The level of anxiety differed between pregnant women with a single as compared to those with recurrent miscarriage. Early pregnancy-related fear significantly correlated with complications during pregnancy and delivery. This effect was not found for state anxiety. CONCLUSIONS This study suggests that miscarriages may lead to higher levels of pregnancy-related fear and state anxiety. In particular, pregnancy-related fear may have a negative impact on the course of pregnancy and delivery. Thus, interventions to reduce pregnancy-related fear are highly recommended.

The impact of dendritic cells on angiogenic responses at the fetal-maternal interface

The success of mammalian pregnancy is highly dependent on the establishment of an adequate blood supply to support the metabolic demands of the growing embryo and fetus. New blood vessels develop from pre-existing vessels in a multi-step process called angiogenesis, which is tightly regulated in time and space and has proven to be crucial in several physiological situations such as wound healing, follicular development and cyclic endometrial growth. As in other tissues, the regulation of angiogenic responses in the decidua depends on a delicate balance between stimulatory and inhibitory signals. In particular, trophoblasts and decidual NK cells are well-recognized components of the uterine signaling network with a proven ability to produce growth factors and cytokines that modulate endothelial cell responsiveness during pregnancy. In mice and humans, dendritic cells are also considered an important regulatory component during pregnancy, mainly due to their role in the establishment of maternal immunologic tolerance. However, the recent finding that dendritic cell subsets can promote angiogenesis in a variety of physiopathological settings suggests that regulatory functions of these cells may go beyond the promotion of maternal tolerance, having impact on other processes such as decidualization and placentation and the vascular changes associated to them. Current evidence on dendritic cell-derived angiogenic signals and their potential implications in vascular development during gestation are reviewed and discussed herein.

Uterine NK Cells Are Critical in Shaping DC Immunogenic Functions Compatible with Pregnancy Progression

Dendritic cell (DC) and natural killer (NK) cell interactions are important for the regulation of innate and adaptive immunity, but their relevance during early pregnancy remains elusive. Using two different strategies to manipulate the frequency of NK cells and DC during gestation, we investigated their relative impact on the decidualization process and on angiogenic responses that characterize murine implantation. Manipulation of the frequency of NK cells, DC or both lead to a defective decidual response characterized by decreased proliferation and differentiation of stromal cells. Whereas no detrimental effects were evident upon expansion of DC, NK cell ablation in such expanded DC mice severely compromised decidual development and led to early pregnancy loss. Pregnancy failure in these mice was associated with an unbalanced production of anti-angiogenic signals and most notably, with increased expression of genes related to inflammation and immunogenic activation of DC. Thus, NK cells appear to play an important role counteracting potential anomalies raised by DC expansion and overactivity in the decidua, becoming critical for normal pregnancy progression.

Allergic airway inflammation induces tachykinin peptides expression in vagal sensory neurons innervating mouse airways

Background Allergic airway inflammation has been shown to induce pro‐inflammatory neuropeptides such as tachykinin peptides substance P (SP) and neurokinin A (NKA) together with related peptide like calcitonin gene‐related peptide (CGRP) in nodose sensory neurons innervating guinea‐pig airways.

Endometriosis research: animal models for the study of a complex disease

Endometriosis is a common gynaecological disease that is characterized and defined as the presence of endometrial tissue outside the uterus, causing painful periods and subfertility in approximately 10% of women. After more than 50 years of research, little is known about the mechanisms underlying the development and establishment of this condition. Animal models allow us to study the temporal sequence of events involved in disease establishment and progression. Also, because this disease occurs spontaneously only in humans and non-human primates and there are practical problems associated with studying the disease, animal models have been developed for the evaluation of endometriosis. This review describes the animal models for endometriosis that have been used to date, highlighting their importance for the investigation of disease mechanisms that would otherwise be more difficult to elucidate, and proposing new alternatives aimed at overcoming some of these limitations.

Correlation between immune and neuronal parameters and stress perception in allergic asthmatics

Background Asthma is a chronic disease defined by airway inflammation, increased airway hyperresponsiveness and episodes of airway obstruction. Although there are abundant clinical and experimental data showing that stress may worsen asthma, the mechanisms linking stress to asthma are not well understood. By inducing a pro‐inflammatory cytokine milieu, stress might enhance airway inflammation in bronchial asthma. We therefore investigated the correlation of stress perception and the cytokine profile of circulating lymphocytes in humans.

Protease-activated receptor 2 expression in trigeminal neurons innervating the rat nasal mucosa

Protease-activated receptor 2 (PAR2) is activated by trypsin and mast cell tryptase to induce widespread inflammation by unknown mechanisms. Trypsin and tryptase were shown to activate sensory neurons to release substance-P and related peptides to mediate neurogenic inflammation. In the present study, the expression of PAR2 and tachykinins were investigated in rat trigeminal neurons that were identified by retrograde labeling with rhodamine dye from the nasal mucosa by using neuronal tracing in combination with immunohistochemistry. We found that large subpopulation of all trigeminal neurons (43.5+/-2.6%) identified by the pan-neuronal marker PGP 9.5 were stained with PAR2-immunoreactivity. Of all trigeminal neurons, 7.5+/-2.1% were immunoreactive for tachykinins and PAR2, and only 3.9+/-1.7% of all trigeminal neurons expressed tachykinins, but not PAR2-immunoreactivity. The present study also found that a large number trigeminal neurons innervating the nasal mucosa expressed PAR2-immunoreactivity. Of the rhodamine-labeled trigeminal neurons, 52.5+/-1.8% were immunoreactive for only PAR2 expression, 7.3+/-1.9% contained tachykinins and PAR2, and 3.1+/-0.4 of the rhodamine-labeled trigeminal neurons were non-immunoreactive PAR2, but were positive for tachykinins-immunoreactivity. In conclusion, based on the co-localization of PAR2 and tachykinins in trigeminal sensory neurons innervating the nasal mucosa, the present study suggests that, following an activation of PAR2 receptor in tachykinergic neurons by trypsin and mast cell tryptase, there may be a triggering of tachykinin-mediated phenomena such as neurogenic inflammation in allergic or non-allergic rhinitis.

Surgeons’ work ability and performance in surgical care: relations between organisational predictors, work engagement and work ability

BackgroundThe aim of this study was to examine relations and influences between work-related factors, personal resources, work engagement and work ability of surgeons working in German hospitals.MethodsThe study was conducted as a cross-sectional survey investigation. We used the Utrecht Work Engagement Scale, the Copenhagen Psychosocial Questionnaire and the Work Ability Index to evaluate surgeons’ work engagement, working conditions and work ability. Bivariate analyses and a stepwise regression analysis were performed.ResultsSurgeons reported a moderate work ability and work engagement. The results indicated significant associations between surgeons’ sources of work engagement, work ability and work-related factors (e.g. job resources). Significant differences regarding these variables were also detected between males and females and the various age groups.ConclusionThe study results reflect the positive effect of supportive working conditions and work engagement on the preservation of work ability, indicating their importance in promoting surgeons’ work ability. Due to the elderly population and the continuing development of health care in Germany, the demand for surgeons increases. These circumstances give reasons for a strong need to preserve and restore surgeons’ work ability. New strategies for training and improving the capacity and performance of surgeons are necessary.