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Notes: The hair follicle offers an exquisite model for the experimental exploration of key issues of cutaneous neuroimmunology, for example, how local, intracutaneous and systemic stress–response systems are integrated with the skin immune system and with epithelial–mesenchymal interactions (as they occur during hair follicle growth and cycling). Previously, we had shown that skin mast cells, which operate as central switchboards of inflammation and tissue remodelling, also are important regulators of hair growth in mice and that endogenous, immunomodulatory mast cell secretagogues are potent hair growth modulators. This is true both for secretagogues that are generated by the hair follicle epithelium itself (e.g. ACTH) and for mast cell-activating neuropeptides synthesized by the sensory hair follicle innervation (e.g. SP). Also, we had shown that the prototypic stress-associated neuropeptide, SP, plays a crucial role in mediating the hair growth-inhibitory, mast cell-activating, inflammation- and catagen-promoting properties of chronic psychoemotional stress on murine hair follicles. Now, we show that the immunomodulatory and mast cell-activating neurotrophin, NGF, is also crucially involved in mediating the inhibitory effects of stress on murine hair growth. Furthermore, the central, stress-related neurohormone CRH, a recognized mast cell secretagogue which is expressed by the hair follicle epithelium, also is a hair growth inhibitor and activates a fully functional peripheral equivalent of the hypothalamic-pituitary-adrenal axis within organ-cultured human scalp hair follicles, including the synthesis and secretion of cortisol as well as the induction of classical feedback loops. We also demonstrate that one of the melanocortins whose intrafollicular synthesis is stimulated by CRH (α-MSH) is a potent suppressor of MHC class I expression in situ and is thus capable of restoring the collapsed immune privilege of human anagen hair bulbs, while SP upregulates the ectopic expression of MHC class I, thus endangering the hair follicle immune privilege. Finally, we show that vanilloids long exploited as experimental tools for neuroimmunological research in the skin (capsaicin) can, in fact, directly modulate human hair growth via the stimulation of vanilloid receptors (VR1) expressed by the follicle epithelium, in addition to stimulating vanilloid expressed by skin mast cells. Therefore, the hair follicle offers an ideal, highly instructive and clinically most relevant research model for dissecting how nervous system, central and peripheral (neuro-) endocrine signalling loops and the immune system interact in order to adapt skin functions to changing environmental conditions (e.g. in response to external stressors, by alterating, e.g. keratinocyte proliferation/apoptosis, skin immune status, as well as defined cutaneous metabolic and endocrine activities).

Notes: Recently, we introduced a mouse model launching experimental evidence for stress-induced hair growth inhibition (HGI), pointing to the existence of a brain-hair follicle axis (BFA). We suggested that nerve growth factor (NGF), besides neuropeptide substance P (SP), is a candidate mediator along the BFA. Published data further indicate that stress-related neuropeptides, e.g. calcitonin gene-related peptide (CGRP) and SP may be involved in HGI. SP and CGRP are synthesized in dorsal root ganglia (DRG) and released after axonal transport in the skin. Thus, aim of the present study was to investigate the effect of stress or subcutaneous injection of NGF, which mimics stress and regulates neuropeptide genes in sensory neurons, on the expression of SP and CGRP in DRG. Anagen was induced in C57BL/6 mice by depilation and retrograde tracing was employed on day 9 post-depilation (PD). On day 14 PD, mice were either exposed to sound stress (n = 4) injected subcutaneously with NGF (n = 4) or served as control (n = 4). On day 16 PD, DRG (mean of 30/mouse) were harvested and SP and CGRP in skin-specific sensory neurons, as identified by the tracer dye, were labelled by immunohistochemistry and counted. Stress exposure as well as NGF injection leads to a significant induction of SP and CGRP in retrograde-labelled neurons. This allows us to conclude that sensitive dermal nerve fibres are likely to originate from the presently identified neuropeptide-positive neurons. Peripheral activation of SP-expressing afferent nerve fibres via NGF-dependent pathways may cause neurogenic inflammation, eventually resulting in HGI.

Notes: Background Nerve growth factor (NGF) is elevated in allergic diseases such as bronchial asthma and can lead to an induction of substance P (SP) and related neuropeptides in guinea-pigs large-diameter, neurofilament-positive airway neurons.Objective In the present study, the effect of NGF on tyrosine kinase receptor trkA and the capsaicin receptor TRPV1 expression in airway-specific vagal sensory neurons located in the jugular–nodose ganglia complex (JNC) of mice was investigated.Methods Using retrograde neuronal tracing in combination with double-labelling immunohistochemistry, SP, trkA- and TRPV1-receptor expression was examined in airway-specific sensory neurons of BALB/c mice before and after NGF treatment.Results NGF injected into the lower airway was able to induce SP (13.0±2.03% vs. 5.9±0.33%) and trkA expression (78±2.66% vs. 60±2.11%) in larger diameter (〉25 μm), capsaicin-insensitive and trkA-positive vagal sensory neurons that were retrograde-labelled with Fast Blue dye from the main stem bronchi.Conclusion Based on the extent of SP and trkA co-expression in airway-specific neurons by NGF treatment, the present study suggests that, following a peripheral activation of trkA receptor on SP afferent by NGF which is elevated in allergic inflammation, there may be trkA-mediated SP induction to mediate neurogenic airway inflammation.

Notes: In the CBA × DBA/2 mouse model, stress-triggered abortions are mediated by a Th1-like cytokine response of decidual lymphocytes. The factors that determine the cytokine pattern leading to abortion are currently unknown. Dipeptidyl Peptidase IV (DP IV) enhances Th1-cytokine responses and impairs the evolvement of a Th2 cytokine profile. The T-cell-activation antigen, CD26, possesses DP IV activity. The aim of the present study was to investigate the role of DP IV activity and CD26-positive decidual lymphocytes in murine stress-triggered abortions by inhibition of DP IV activity. DBA/2-mated CBA mice were stressed on day 5.5 of pregnancy and received daily injections of an inhibitor of DP IV activity, Ile-thiazolidide (20 µmol/kg). On day 13 of gestation, the animals were sacrificed and the percentage of implants and abortions documented. CD26-positive lymphocytes in spleen and uterine decidua and the intracellular cytokines interferon (IFN)-γ and interleukin (IL)-10 were determined by flow cytometry. Stressed and nonstressed animals receiving an inactive stereoisomeric form were used as controls. In mice receiving the DP IV inhibitor, stress failed to boost the abortion rate (37.2% versus 13.6%, P 〈 0.01). IFN-γ producing cells were increased in stressed animals, but returned to the baseline upon the inhibition of DP IV. The number of IL-10 producing cells was reduced in stressed animals, independent from DP IV inhibition.

Notes: Heme oxygenases (HOs) are responsible for heme degradation. Besides their enzymatic activities, HOs are involved in tissue protection. Failing upregulation of HOs has been linked to increased necrosis in inflammatory tissues. Interestingly, previously published data indicated that mice exposed to sonic stress during early gestation show an augmented production of decidual inflammatory T-helper 1 (Th1) cytokines, thus resulting in increased abortion rate. No data linked the Th1-inducer interleukin (IL)-12 with the event of abortion. As little is known about the role of HO in pregnancy maintenance, we evaluated the expression of decidual and placental HO-1 and HO-2 in the abortion-prone murine mating combination CBA/J × DBA/2 J with (1) CBA/J female control mice, (2) CBA/J mice exposed to stress during early gestation and (3) CBA/J females injected with recombinant IL-12. Decidual and placental HOs protein expression was analysed by immunohistochemistry and mRNA levels by real time polymerase chain reaction (PCR).As expected, an increased abortion rate was present in mice exposed to stress compared with the control. IL-12 injections also boosted the abortion rate compared with control mice, mimicking the effect of stress. HOs' proteins could be detected in placenta and decidua. Real time PCR revealed lower levels of HO-1 and HO-2 mRNA in stress-triggered and IL-12-injected mice. We conclude that increased Th1-cytokine levels during murine pregnancy may result in low expression of HO-1 and HO-2, thus leading to placental necrosis and foetal rejection.

Notes: Dipeptidyl peptidase-IV (DPP-IV, CD26), a serine protease with broad distribution in mammalian tissues and known activity in serum, participates in T-cell activation and promotes a Th1-like cytokine response. Previous data on murine abortion indicate that DPP-IV may play a critical role in pregnancy failure by inducing a Th1 local response. Here, we investigated the possible participation of DPP-IV in the onset of human spontaneous abortion (SA).The systemic (peripheral blood) and local (decidua) percentages of CD4+, CD8+, CD26+ and CD56+ cells as well as the number of Th1 lymphocytes (CCR5+ cells) were assessed in samples from women after SAs (n = 20) and from women with normally progressing pregnancies (NPs) (n = 27) using flow cytometry and immunohistochemistry. We further measured the DPP-IV activity and concentrations of Th1 (interferon-γ and tumour necrosis factor-α), Th2 [interleukin-4 (IL-4), IL-10] and Th3 (transforming growth factor-β2) cytokines in serum samples.We could not find any difference in the number of CD4+, CD8+, CD26+, CD26+/CD4+ or CD8+/CD26+ blood cells between NP and SA patients. No differences in the Th1, Th2 or Th3 cytokine levels could be observed between both groups. However, the percentages of decidual CD26+ lymphocytes as well as the number of decidual Th1 cells were significantly higher in SA samples compared to samples from patients with NP.Our data support the hypothesis that CD26+ decidual lymphocytes with DPP-IV activity may play a critical role in SAs, as previously suggested in an abortion mice model. This abortive effect may be mediated by enhancing the levels of Th1 abortogenic cytokines only locally.

Notes: Stress is said to induce itchiness of the skin and exacerbate inflammatory skin diseases such as atopic dermatitis. In this context, stress mediators such as the neuropeptide substance P play a role as immunmodulators and in a wider sense growth factors. For example, we were recently able to show that stress or treatment of mice with substance P is associated with mast cell degranulation, increased cutaneous inflammation and increased apoptosis in the hair follicle. However, local interactions between the nervous and immune systems, especially under perceived stress, have rarely been reported. Here, we show for the first time, that 24 and 48 h after sonic stress exposure, the number of SP-immunoreactive nerve fibres in the back skin of C57BL/6 mice with all there hair follicles in the resting phase of the hair cycle (telogen, low numbers of cutaneous nerve fibres) increased significantly over non-stressed mice with the strongest increase after 24 h. Such substance P immunoreactive nerve fibres contacted mast cells more frequently, which became significant after 48 h. At the same time, the percentage of degranulated mast cells increased significantly after 24 and 48 h with the strongest increase after 48 h when apoptotic cells also became significantly upregulated. The same stressor increased dermal infiltration, e.g. by eosinophils in C57BL/6 mice with experimentally induced allergic dermatitis over mice that were either stressed or had allergic dermatitis as well as over untreated controls. Increased infiltration was associated with increased epidermal thickness in stressed mice with allergic dermatitis and with an increased number of VCAM-immunoreactive blood vessels. At the same time, the percentage of degranulated mast cells increased significantly, and the number of substance P-immunoreactive peptidergic sensory nerve fibres decreased in the acute allergic dermatitis lesions. By semiquantitative RT-PCR, allergic dermatitis increased cutaneous IL-4 and to a lesser degree IFN-γ production, but this was not affected by stress. Ultrastructural investigation showed unmyelinated peptidergic nerve fibres in a state of deterioration close to degranulating mast cells and eosinophils in the skin of stressed mice with allergic dermatitis, suggesting a decreased number of substance P-immunoreactive nerve fibres due to active release of SP. This may lead to an upregulation of endothelial adhesion molecules and increased infiltration by immunocytes to the skin but at mRNA level does not alter the production of classical atopy-related cytokines in skin. These data provide first evidence for stress-induced exacerbation of cutaneous allergic diseases such as atopic dermatitis by local interaction of the peripheral nervous system with substance P.

Notes: Recently, we have pointed to the existence of a brain-hair follicle axis (BFA), with neuropeptide substance P (SP) as one candidate mediator, to which stress-triggered hair loss is imputable. Based on findings indicating that levels of nerve growth factor (NGF) increase upon exposure to stressful events, which is particularly striking within the context of the BFA, because NGF is known to increase the release of SP, we then aimed at dissecting the role of NGF in stress-triggered hair loss. We observed increased expression of NGF, analyzed by real time PCR and immunohistochemistry, in stress-exposed mice with a depilation-induced hair cycle. Expression of NGF receptor p75 was also upregulated with stress, and TrkA receptor was moderately downregulated. Upon neutralization of NGF by antibody injection, stress-triggered premature onset of catagen, which was accompanied by apoptosis and increased number/activation of perifollicular mast cells and macrophages, was significantly inhibited. Interestingly, subcutaneous injection of recombinant NGF to mimick stress effects resulted in an increased percentage of SP-positive neurons in dorsal root ganglia. Taken together, our data indicate that an interactive communication network between sensory nerves and immune cells in the skin is promoted by stress-triggered release of NGF and results in mast cell activation and migration of macrophages, the release of proinflammatory neuropeptides, i.e. SP. Such disequilibrium, which may be referred to as neurogenic inflammation, constitutes the prerequisite of increased hair loss.