In Vitro Assessment of Tobacco Smoke Toxicity at the BBB: Do Antioxidant Supplements Have a Protective Role?
© Hossain et al; licensee BioMed Central Ltd. 2011
Received: 11 June 2011
Accepted: 24 September 2011
Published: 24 September 2011
Tobacco smoke (TS) contains highly reactive oxygen species (such as hydrogen peroxide, peroxynitrite, etc), which cause oxidative damage in vascular tissue and may exacerbate inflammatory events leading to the blood-brain barrier damage (BBBD) which accompanies the development of a variety of neurological disorders. Smokers often have elevated leukocyte counts (primarily neutrophils and monocytes), and significant decreases in plasma alpha-tocopherol (vitamin E) and ascorbic acid (vitamin C) levels due to increased anti-oxidative mobilization in response to oxidative stress evoked by TS. For this purpose, using static culture systems and a well-established dynamic in vitro BBB model (DIV-BBB) we tested the hypothesis that antioxidant vitamin supplementation (E and/or C) can protect the BBB during exposure to whole soluble TS.
TS exacerbates inflammatory events and leads to endothelial overexpression of vascular adhesion molecules (VCAM-1, P-selectin and E-selectin), release of pro-inflammatory cytokines (TNF-α and IL-6) and nitric oxide (NO), release and activation of matrix metalloproteinases (MMP-2 and MMP-9), monocytic maturation into macrophages, and adhesion to the vascular endothelium. Furthermore, TS altered the normal glucose metabolic behaviour of in vitro BBB capillaries and caused a period of transient anaerobic respiration to meet the cellular bioenergetic demand. Pre-treatment with antioxidant vitamins (C and/or E) effectively reduced the pro-inflammatory activity associated with TS, protecting the viability and functions of the BBB.
Our results have shown that loss of endothelial viability as well as BBB function and integrity caused by TS exposure can be prevented or at least reduced by normal physiologic concentrations of antioxidant vitamins in vitro.
Tobacco Smoke affects vascular endothelial physiology
Active and passive tobacco smoke are associated with dysfunction of vascular endothelial physiology [1–13] in a causative and dose-dependent way. In the brain, TS increases the risk of silent cerebral infarction (SCI)  and stroke which by approximately 50% [15, 16] due to its; pro-coagulant and atherogenic effects [17, 18]. The risk increases proportionally with the number of cigarettes smoked . Furthermore, oxidative stress caused by the exposure to TS can facilitate the pathogenesis and progression of several neurological disorders including Parkinson's and Alzheimer's diseases [20–24]. Previous study has shown that chronic smokers have a higher incidence of small vessel ischemic disease (SVID) than non-smokers . SVID is a pathological condition characterized by leaky brain microvessels and loss of BBB integrity. Since TS generates superoxide and other ROS, some of the adverse effects of smoking may result from oxidative damage to ECs, [4, 12, 13, 26–29], which may be aggravated by nitric oxide (NO) and antioxidant depletion (e.g., ascorbic acid). Recent observations strongly suggest that ROS are key mediators of BBB breakdown [25, 26, 30–33].
While the harmful effects of smoking on public health have been well demonstrated and detailed in many organs, the BBB has received much less attention despite the strong evidence for an association between tobacco smoke and vascular impairment [28, 34]. Our recently published data  have shown that TS promotes the pro-inflammatory activation of BBB EC and the release of pro-inflammatory mediators. This occurred in the absence of other pro-inflammatory stimuli and independently from the presence of peripheral blood cells. Furthermore; TS can significantly exacerbate the loss of BBB integrity caused by concurrent cerebrovascular rheological alterations, [25, 35] facilitating the further pathogenesis and progression of secondary brain injuries.
Tobacco smoke: A harmful cloud of Free Radicals
The role of free radicals in the pathogenesis of smoking-related diseases has been substantiated by a large number of studies. A free radical is a highly unstable and reactive molecule containing one or more unpaired electrons. Free radicals, despite being essential for biological systems  have a potential to cause extensive oxidative damage to cells and tissues if their levels become excessive [21, 22, 27, 37–41]. At the vascular level free radicals can lead to oxidative damage of endothelial cells [12, 13] (e.g., DNA strand breakage [3, 42–44]) and inflammation . Free radicals arise normally during cell metabolic activity and are also purposefully produced by immune cells to neutralize potentially harmful pathogens such as bacteria and viruses. In vivo, under normal circumstances the oxidative stress caused by naturally generated free radicals is counterbalanced by antioxidants [45, 46] (e.g., alpha-tocopherol, ascorbic acid, beta-carotene, glutathione, catalase, superoxide dismutase, etc.). However, environmental factors including active and passive tobacco smoking (a major exogenous source of free radicals contained in both gas phases and tar [47–49]) can spawn these highly reactive oxygen species (ROS; e.g., hydrogen peroxide, epoxides, nitric oxide (NO), nitrogen dioxide, peroxynitrite (ONOO-), etc ) beyond the levels which the human body can eliminate effectively. In fact, several studies have shown that 1) chronic smokers suffer of antioxidants shortage caused by the increased demand that the ROS derived from TS place on their cells [13, 50, 51]; 2) antioxidant supplementation reduces the oxidation and inflammation induced by tobacco smoke in animals and cells [13, 50, 52–55]. In response to these studies, the Food and Nutrition Board of the National Academy of Sciences has established a higher Recommended Dietary Allowance (RDA) of vitamin C for smokers, (more than 200 mg/day) versus the recommended 90 mg/day for non-smokers.
Is there a role for Antioxidant Vitamins Supplementation?
Antioxidants such as vitamin C (ascorbic acid) and E (α-tocopherol) are compounds that hinder the oxidative processes and thereby delay or prevent oxidative stress. Although there is still no unequivocal evidence that an increased intake of antioxidant nutrients can fully counteract TS toxicity, there are many supporting data suggesting that antioxidants may prove to be effective scavengers of exogenous-derived ROS . Previously, vitamin C has been shown to act not only as a potent reducing agent but also to play a role (currently not yet clearly understood) in modulating the production of lymphocytes and cytokines, the activity of phagocytes, and the expression of a number of cell adhesion molecules in monocytes . Furthermore, vitamin C seems to prevents histamine release and increases the detoxification of histamine , thus acting as an anti-inflammatory agent as well as a potent antioxidant. Considering the major role played by ROS in the pathogenesis of BBB impairment as well as that of neurological disorders [21–23, 32, 59] we evaluated the independent and complementary effectiveness of antioxidants vitamins supplementation, such as vitamin C (protection against protein oxidation [60–62] and vitamin E (counteract lipid peroxidation [63–65]), in shielding the BBB from the chronic exposure to TS-generated oxidative stress.
Tobacco Smoke pro-inflammatory response induced in brain microvascular endothelial cells was reduced by antioxidant vitamins supplementation
Pre-treatment with vitamins C and/or E (final physiological concentrations ≅ 80 and 40 μM respectively) significantly reduced the pro-inflammatory activity of TS on HBMEC. Specifically the over-expression of endothelial adhesion molecules during TS exposure (Figure 1A) was significantly reduced. This was paralleled by a decrease in the release of IL-6 and TNF-α (Figure 1B). MMP-2 release (Figure 1C) and activity (Figure 1D) were reduced in cultures pre-treated with vitamin E and E+C (combined treatment) but not vitamin C alone. Overall, the combined treatment showed the most effective protection against TS exposure.
Monocytes activation by Tobacco Smoke was partially inhibited by pre-treatment with vitamin C and/or vitamin E
TS-triggered release of pro-inflammatory cytokines was most significantly reduced by pre-treatment with vitamins C and E. In contrast to vitamin C, vitamin E alone also demonstrated significant anti-inflammatory protection.
The TS-induced release of MMP-2 and MMP-9 was also decrease by the antioxidant vitamins however, there were no statistical significant differences in terms of efficacy between individual (Vit. C or E) and combined pre-treatments. By contrast, the most effective blockade of MMPs activation was attained using combined (C + E) vitamins supplementation (Figure 2C). Vitamin E alone was also effective while only short term MMPs activity reduction was observed when using vitamin C (Figure 2C left panel).
Antioxidant vitamins reduced endothelial-monocytes adhesion and synergistically decreased the release of pro-inflammatory mediators during TS exposure
Ascorbic acid and α-tocopherol protect the BBB viability from the harmful exposure to Tobacco Smoke
Hydrogen peroxide impairs BBB integrity: Protective role of antioxidant vitamins
Tobacco smoke can impair BBB viability through alteration in nitric oxide bioavailability
During the recovery time (in the absence of TS) we observed a diametric decrease of NO, which also correlated with the concentration of TS to which the corresponding BBB modules were initially exposed (Figure 6A). NO remained below the baseline level for ≈ 23 hours before returning to normal. Pre-treatment with vitamins C and E did not prevent the reduction of NO bioavailability nor accelerated the return to a baseline level (Figure 6B).
Tobacco smoke can alter the normal BBB bioenergetic metabolism: role of antioxidant vitamins
The BBB maintains brain homeostasis and selectively excludes most blood-borne and xenobiotic substances from entering the brain, protecting it from systemic and exogenous influences [72, 73]. Deterioration in BBB functions have been clearly shown to play a major role in the pathogenesis and progression of a steadily increasing number of neurological disorders such as multiple sclerosis, Alzheimer's disease, neoplasia, hypertension, dementia, epilepsy, infection, and trauma . While the harmful effects of smoking on public health have been well demonstrated and detailed in many organs, the BBB has received much less attention despite the strong evidence for an association between tobacco smoke and vascular impairment. Recently published data  have shown that TS negatively affects vascular endothelial physiology and directly promotes the pro-inflammatory activation of BBB endothelium.
Many of the over 4000 components contained in TS are thought to facilitate the development of a proatherosclerotic environment [25, 28, 75–77] by triggering a complex pro-inflammatory response. This is mediated by the recruitment of leukocytes through cytokine signalling (e.g., IL-2, IL-4, IL-6, IL-8, INF-γ and GM-CSF), matrix metalloproteinase upregulation (e.g., MMP-1, MMP-8, and MMP-9), and by promoting the adherence of monocytes to the endothelial wall [25, 78].
TS's status as a powerful pro-inflammatory agent is suggested by the observation of elevated levels of white blood cells, primarily neutrophils and monocytes, in smokers . Elevated C-reactive protein (CRP) levels caused by TS promotes endothelial dysfunction by lowering the production of NO and diminishing its bioactivity , thereby limiting the smoker's ability to vasodilate via NO release.
One well accepted yet poorly understood mechanism by which smoking can directly hamper BBB viability and function relays upon oxidative stress caused by the many highly reactive oxygen species and free radicals of which TS is highly enriched. The gas-phase of tobacco smoke alone is a complex mixture of high concentrations of ROS and free radicals (approximately one quadrillion radicals per puff ). This represents an exorbitant load of oxidant to body tissues which can lead to BBB breakdown by oxidative damage, tight junction (TJ) modification, and matrix metalloproteinases (MMP) activation . The results presented herein suggest that antioxidant vitamins may provide an effective shielding against oxidative stress thus, protecting the BBB during TS exposure.
Our data have shown that the administration of physiological concentration of vitamin E and/or C reduced the BBB endothelial pro-inflammatory activation solicited by TS exposure (see Figure 1). While the precise mechanism/s by which TS triggers an immune vascular response at the BBB cannot be determined from these experiments, our data strongly suggest that: 1) the imbalance between tissue/plasma concentrations of antioxidants and reactive oxygen species caused by TS played a major role in the process; 2) this can be partially prevented by administration of antioxidant vitamins.
The BBB endothelium is not the only tissue affected by TS. Our data also showed that TS directly activated monocytes which resulted in the release of IL-1β and TNF-α and MMPs (see Figure 2). We also observed a time dependent increase in the activity of MMP-2 and MMP-9 which initiated as early as 15 minutes of TS exposure and increased substantially after 60 minutes. The increased activity of matrix metalloproteinases reflected the continuous release of these enzymes during TS exposure suggesting an ongoing pro-inflammatory stimulation of the cells. Similar to what observed in BBB ECs cultures, pre-treatment with antioxidant vitamins reduced monocytes pro-inflammatory activation by TS.
In this study we used a final concentration of vitamin C (80 μM) equivalent to that found independently of gender in healthy non-smoker subject (35.3-107.1 μM; 6.2-18.8 mg/L ) according to literature data . Not surprisingly the anti-inflammatory activity of vitamin C was limited to the initial 15 minutes of TS exposure. Vitamin C is an hydrophilic reducing agent making it the first line of defense against ROS and the first to be consumed in the process. Therefore, it very likely that higher concentrations and/or a sustained supplementation of vitamin C are necessary to maintain a protective effect for a longer period of time. This is agreement with the decision of Food and Nutrition Board of the National Academy of Sciences to raise the RDA of vitamin C for smokers to over 200 mg/day (≅ 160 μM/l cconsidering an estimated 70% absorption which decreases as intake increases) versus the recommended 90 mg/day for non-smokers. This help counteracting vitamin C depletion caused by TS-derived ROS over time.
On the other hand, when vitamin C was co-administered with vitamin E (a powerful fat soluble reducing agent and the primary antioxidant present in the lipid-rich cell membranes; see also Figure 3) the protective effect was significantly enhanced both in efficacy and duration. The interaction between vitamins E and C has been recognized and extensively studied showing an ascorbate-mediated regeneration of oxidized membrane alpha-tocopherol back to its reduced form. A process that extends the protective effect of vitamin E against oxidative stress .
Whether ROS can directly hamper BBB viability was also clearly demonstrated. Our results showed a time and dose dependent loss of BBB viability when in the absence of physiological antioxidants protection the DIV-BBB modules were exposed to H2O2 levels comparable to those a chronic smoker is routinely exposed (see Figure 5). Our findings are in agreement with studies by others showing that plasma antioxidant vitamins (especially ascorbic acid) levels in chronic smokers are significant decreased due to accelerated turnover in response to TS-evoked oxidative stress . This is also in agreement with the fact that administration of antioxidant vitamins C and E (particularly when combined) prevented the loss of BBB integrity.
Not surprisingly, direct BBB exposure to TS showed similar results. We observed a similar time and dose dependent pattern of BBB impairment (see Figure 4A), which was paralleled by the release of adenylate kinase (a well-established marker of cell damage; see Figure 4B). This suggests that the increased paracellular permeability is not exclusively dependent (at least in the short term) on the exposure to nicotine  contained in TS but also to cell damage caused by ROS. This hypothesis is supported by the fact that pre-treatment with antioxidant vitamins significantly reduced the loss of BBB viability during TS exposure (see Figure 4C). This was accompanied by a similar decreased in the release of AK (see Figure 4D) and that of pro-inflammatory cytokines (see Figure 4E). The latter is also in agreement with previous studies showing that vitamin C plays an important (yet not fully understood) role in the modulation of cytokines release as well as other immune surveillance activities .
Another mechanism through which tobacco smoke can impair BBB viability is through the alteration of nitric oxide bioavailability. NO is a molecular mediator involved in a variety of physiologic and pathological processes. Three isoforms of NOS have been described: neuronal NOS (nNOS), endothelial (eNOS) and inducible or immunological NOS (iNOS). Vascular endothelial cells generate small bursts of NO from L-arginine via increase in intracellular Ca2+ through a calcium-dependent constitutive NO synthase (eNOS). In contrast, iNOS induced in pathological/inflammatory state is Ca-independent manner and releases NO continuously in large amounts. Our data showed a sudden burst in NO (see Figure 6A) immediately after the initial exposure to tobacco smoke. Consequent to the sudden raise of NO we observed a steady decline on NO levels which suggests a rapid reaction of NO with other TS-released ROS and its conversion in peroxynitrite (ONOO-) . This hypothesis is in agreement with the fact that NO decline was prevented by pre-administration of antioxidant vitamins, which neutralized the ROS contained in TS. This being the case, it is possible that antioxidant treatments may indeed prolong the initial NO-dependent vasodilatation experience by smokers during TS exposure.
By contrast, during the recovery time (in the absence of TS) NO dropped below the baseline level. The magnitude of this decline appeared to be proportional to the amount of TS to which the corresponding BBB modules were previously exposed. While the precise mechanisms by which TS affected NO bioavailability cannot be entirely determined from these experiments, some inferences can be still derived. Nicotine contained in TS has been shown to inhibit eNOS activity, thus decreasing the constitutive level of NO release by the vascular endothelium [86, 87]. As shown in Figure 6B pre-treatment with antioxidant vitamins did not affect the decline of NO during the recovery phase. This supports the hypothesis that perhaps nicotine rather than ROS are responsible for the observed decline of NO during this phase leading to vasoconstriction and aggravating the vascular impairment of the brain [88, 89].
Tobacco smoking has also been associated with impairments of glucose metabolism and glycemic regulation . Our data have clearly shown that TS exposure determined a decrease in glucose consumption (Figure 7B left panel), paralleled by an increase in lactate production. This is indicative of a potential change in the BBB bioenergetic behaviour toward a more predominant anaerobic metabolism (see Figure 7B right panel). The mechanisms through which TS affect glucose metabolism may be related to free radicals and other ROS contained in tobacco smoke . In vivo, this effect can be further exacerbated by the carbon monoxide (CO) also contained in tobacco smoke. CO through binding to hemoglobin, myoglobin and mitochondrial cytochrome oxidase can cause a relatively prolonged impairment of glucose oxidative metabolism and a decrease in glucose utilization [92, 93]
One way through which BBB endothelial cells can try to counteract the increased levels of ROS is through the generation of reductant equivalents such as glutathione peroxidase (of the principal antioxidant defense enzymes). Generation of glutathione peroxidase requires oxidized glutathione to be reduced by glutathione reductase using NADPH generated in the pentose phosphate pathway (also called the phosphogluconate pathway). This process generates NADPH (oxidative phase) and pentoses (5-carbon sugars; non-oxidative synthesis) . A shift toward the pentose phosphate pathway to compensate for the excess of ROS would explain the reduced glucose consumption we observed during TS exposure.
Furthermore, BBB endothelial cells could also use the Krebs cycle reducing agents (normally utilized to sustain the energy-producing pathway based on oxidative phosphorylation) to counteract TS-derived ROS. This would leave the cellular mitochondria underequipped to sustain the oxidative glucose metabolism and would explain the increased lactate production also observed during TS exposure. This hypothesis is supported by our data which showed that administration of antioxidant vitamins C and E gradually restore the normal bioenergetic metabolism of the BBB (see Figure 7B) [11, 94]. However, a more specific and detailed study will be necessary to confirm this hypothesis and unravel the underlining mechanism/s.
Our data indicate that loss of endothelial viability as well as BBB function and integrity in vitro caused by TS exposure can be significantly reduced by pre-treatment with physiologic concentrations of α-tocopherol and ascorbic acid. These antioxidant vitamins may act synergistically in preventing oxidative damage and pro-inflammatory stimulation induced by tobacco smoking exposure, thereby reducing TS toxicity at the BBB level.
In vitro toxicology studies of tobacco and tobacco smoke have been used widely used to assess the toxicologic impact of tobacco product. However, there are limitations with respect to the generality of the findings inherited in such studies which reflect the inability of any in vitro model to fully recapitulate the biological and physiological make up a living organism. In this study we used an artificial vascular system to assess the effect of TS exposure on the BBB and whether administration of vitamin C and/or E can reduce TS toxicity. However, our model cannot reproduce for example, the effect of hepatic clearance and peripheral metabolism on the concentration of TS components to which the BBB and the immune system are exposed. This can lead to a relative over-exposure of the BBB and its constituents (including circulating monocytes) to TS thus, exaggerating its acute harmful effects. In vitro studies on TS toxicity (such the one reported in here) more likely reflect the impact of chronic smoking over a long period of time (in general several years) were cumulative harmful effect builds up overtime.
Concentrated smoke solution was prepared from 2R4F research cigarettes, which are high nicotine, high tar, filter cigarettes (University of Kentucky). The cigarettes were smoked using a Borgwaldt RM2 apparatus according to ISO determination parameters. These require a puff volume for each cigarette of 35 mL with duration of 2s at intervals of 60s, with an airflow surrounding the cigarette of ≅ 200 ± 30 mm/s. This protocol resulted in approximately 8 puffs/cigarette. Stocks of smoke solution were obtained by drowning (using a vacuum pump) the mainstream smoke from 40 cigarettes through 10 ml of sterile phosphate buffered saline (PBS) (abbreviated TS1). Tobacco smoke was then quantified as cigarette/mL (c/mL). The resulting concentration of the stoke solutions was ≅ 4c/mL. The stock solutions were used immediately after preparation. Note that cells were put in contact with the soluble smoke extract in cycles of 120 minutes for a total period of 12 hours/day where each cycle was divided as described: 0-15 minutes (vitamin pre-treatment or nothing); 15-75 minutes (TS exposure or nothing if control), 75-120 exchange with TS-free medium (including controls). Each set of cycles was designed to deliver exposure to TS equivalent to that yielded by ≅ 20 cigarettes per day or ≅ 1.67c/cycle. Media samples (TS and TS-free) were collected throughout the cycles and stored for analysis.
Hydrogen peroxide preparation
Hydrogen peroxide solution (PERDROGEN® 30% H2O2) was purchased from Sigma-Aldrich (St. Louis, MO 63178; cat# 31642) and diluted to achieve the appropriate final experimental concentrations (55, 220, and 385 μM respectively which are comparable to that yield by 5, 20, and 35 2R24 research cigarettes; 2-4 μM/mg of tar [69, 70]). Dulbecco's Phosphate Buffered Saline (Sigma-Aldrich, St. Louis, MO 63178; cat# D4031) containing 36 mg sodium pyruvate, 50 mg streptomycin sulfate, 100 mg kanamycin monosulfate, 1000 mg glucose/L and CaCl2 adjusted to a pH ≅ 7.5 was used to make dilutions of hydrogen peroxide. The solutions were prepared fresh before the experiment and maintained at 37°C.
Ascorbic acid and α-tocopherol preparation
α-tocopherol (vitamin E, cat# AC42103-1000) and ascorbic acid (vitamin C, cat# AC40147-1000), were purchased from Fischer Scientific Pittsburgh, PA. 43.07 mg of α-tocopherol were dissolved in 10 mL of ethanol yielding a stock solution of 10 mM. The experimental concentration of α-tocopherol (40 μM) was achieved by diluting 4 μL of the stock solution in 1 mL of the specific growth medium. Ascorbic acid (35.22 mg) was instead dissolved in 10 mL of PBS yielding a stock solution of 20 mM. Final experimental concentration of ascorbic acid (80 μM ) was achieved by diluting 4 μL of the stock solution in 1 mL of the specific growth medium. In the described experiments cells were pre-treated with vitamin C and E (at a final concentration of 80 μM and 40 μM respectively) prior exposure to soluble tobacco smoke extract.
Normal human brain microvascular endothelial cells (HBMEC, cat# 1000), and human astrocytes (HA, cat# 1800) were purchased from ScienCell Research Laboratories, San Diego, CA 92121. HBMEC were expanded in 75 cm2 flasks pre-coated with fibronectin (3 μg/cm2) using Endothelial Basal Medium MCDB 105 (Sigma, Cat# M6395) containing 10% human AB serum (SIGMA, Cat# S-7148), 15 mg/100 ml of endothelial cell growth supplement (ECGS, Cat.# 1052), 800 units/ml of heparin (Sigma, cat# H3393), 100 units/ml penicillin G sodium and 100 mcg/ml streptomycin sulfate. Prior to use HBMEC were characterized by immunocytochemistry using sheep polyclonal antibodies that recognized the human Von Willebrand Factor Antigen VIII (vWF/Factor VIII, US biological, Swampscott, MA, cat# F0016-13A).
HA were grown in Poly-d-Lysine pre-coated flasks (3 μg/cm2) with Dulbecco's modified essential media (DMEM-F12) supplemented with 2mM glutamine, 5% fetal bovine serum (FBS), 100 units of sodium penicillin G per ml, and 100 mcg of streptomycin sulfate per ml. To obtain a highly purified astrocytic population Cytosine arabinoside and L-leucine methyl ester (Sigma-Aldrich, MO, USA) were added  and HA cultures were agitated overnight at 37°C. We used rabbit polyclonal antibodies specific for the glial cell marker glial fibrillary acidic protein (GFAP, Dako Corporation, Carpentaria, CA, USA) to assess the purity of the HA cultures which resulted > 95%. Both endothelial cells and astrocytes were maintained at 37°C in a humidified atmosphere with 5% CO2. Note that cells were not expanded for more than 2 cycles to minimize cell dedifferentiation.
The human monocytic leukemia cell line (THP-1, Cat# TIB-202) was purchased from American Type Culture Collection (ATCC, Manassas, VA). THP-1 cells were grown at 37 °C in 95% air-5%CO2 in basal medium (ATCC-formulated RPMI-1640 Medium, Catalog No. 30-2001) plus 0.05mM 2-mercaptoethanol and 10% fetal bovine serum as specified by the vendor.
TEER measurement provides a rapid, simple evaluation of the integrity of the DIV-BBB. Our TEER measurement device was purchased from Flocel (Flocel Inc., Cleveland, OH 44103). This system utilizes electronic multiplexing to test multiple DIV-BBB modules in rapid succession and deliver data to a computer. Details on the core system are available on the website of the maker of the device (http://www.Flocel.com). We have previously verified that this method documents a strong inverse relationship between TEER and permeability across the EC monolayer in the DIV-BBB modules [66–68].
Measurement of nitric oxide (NO)
Changes in nitric oxide (NO) were measured by amperometric determination using an optically isolated multi-channel free radical analyser (World Precision Instruments, Sarasota, FL). The NO measuring probe is inserted into the lumen downstream from the hollow fiber apparatus and another probe in the ECS compartment. NO is detected as previously described [96, 97]. The on-line changes in NO were continuously measured using a PC-driven system. Based on internal calibration reading conversion of the NO sensors was ≅ 1.5pA/nM of NO. Max sensitivity ≅ 50 fA according to the manufacturer.
Measurement of cytokines and MMPs
Samples of medium from the luminal compartment were centrifuged at 5,000 g for 5 min and stored at -20 °C until analysis. Levels of IL-6, IL-1β, and TNF-α were measured by ELISA (cat# IB39673 (IL-6); # IB39654 (IL-1β; # IB39699 (TNF-α); IBL America, Minneapolis, MN) according to the manufacturer's protocols. MMP-2 and MMP-9 were also quantified by ELISA (cat# QIA63-1EA (MMP-2) and QIA56-1EA (MMP-9); Calbiochem, San Diego, CA). Final calculation of cytokine levels (pg/mL) took into consideration time and volume of the luminal compartment according to the formula: (VtxCc)-(VnxCn)+(VtotalxCp)/Tc-Tp, where V represents added volume of media (mL); C refers to the concentration of a cytokine/MMP level (pg/mL); T is time of sampling (in fraction of days: c and p indicate the current and previous samples, respectively; and n represents cytokine values in the fresh medium added after each sampling.
Flow cytometry (FACS) and data analysis
TS-exposed and control endothelial cells were rinsed with PBS. Cells were then gently mixed with chelation buffer (1mM EDTA prepared in Ca2+/Mg2+ free PBS) using a pipette tip washed in FACS buffer. (PBS+0.5% BSA+0.02% NaN3) and resuspended to approx. 1 million cells/100 μl. Cells were incubated with fluorescein di-isothiocyanate conjugated anti-P-selectin, phycoerythrin-conjugated anti-E-selectin, or alkaline phosphatases conjugated anti-VCAM-1 (respectively, cat.#555524; # 551144; #551146; BD Biosciences, San Jose, CA) for 20 minutes in the dark. Unbound antibody was removed by several washes with FACS buffer. Cells were then resuspended in 200 μl of FACS buffer/sample for analysis and data were calculated by Flow Jo 6.1.1 (Tree Star) for Mac OS X. THP-1 cell suspensions were similarly tested for CD45/CD14 (cat. #340040; BD Biosciences)
Matrix metalloproteinase activity
Aliquots of medium from the luminal compartment were centrifuged at 14,000 g for 15 min at 4 °C and any cell pellet discarded. Total protein content of the medium was determined by Bradford assay. Gelatin zymography of electrophoresed medium samples was carried out on 7.5% polyacrylamide gels copolymerized with 2 g/L 90 Bloom Type A gelatin from porcine skin (Sigma). After electrophoresis, gels were washed in Triton X-100 (2.5 mL/L) and incubated for 24 h (37 °C) in enzyme buffer (50 mM Tris-HCl, pH 7.5; 5 mM CaCl2; 100mM NaCl; 1mM ZnCl2; 0.2 g/L Brij®-35; 2.5 mL Triton X-100; and 0.02 g/Lf NaN3). Gels were stained with 0.5% Coomassie Blue R-250. Lysis bands were measured densitometrically with an image analyzer.
For parametric variables (e.g., TEER levels, glucose consumption, lactate production, cytokines levels), differences between populations were analysed by ANOVA. p values < 0.05 were considered statistically significant. Bonferroni analysis was used to account for comparisons of multiple parameters among groups. For non-parametric indices (e.g. densitometries for zymogram), we used the Kruskal-Wallis test followed by Mann-Whitney U-test. We used four cartridges per data point. Based upon previous experiments, this number of cartridges provided sufficient power to demonstrate statistical significance.
Disclosure/Conflict Of Interest
Dr. Cucullo has reported the following financial relationships with the companies listed below.
Equity: Dr. Cucullo owns stocks in Flocel Inc.
This work was supported by NIH/NIDA R01-DA029121-01A1 and Alternative Research Development Foundation (A.R.D.F.) to Dr. Luca Cucullo.
- Adams MR, Jessup W, Celermajer DS: Cigarette smoking is associated with increased human monocyte adhesion to endothelial cells: reversibility with oral L-arginine but not vitamin C. J Am Coll Cardiol. 1997, 29: 491-497. 10.1016/S0735-1097(96)00537-2.View ArticlePubMedGoogle Scholar
- Brennan JA, Boyle JO, Koch WM, Goodman SN, Hruban RH, Eby YJ, Couch MJ, Forastiere AA, Sidransky D: Association between cigarette smoking and mutation of the p53 gene in squamous-cell carcinoma of the head and neck. N Engl J Med. 1995, 332: 712-717. 10.1056/NEJM199503163321104.View ArticlePubMedGoogle Scholar
- Chen HW, Chien ML, Chaung YH, Lii CK, Wang TS: Extracts from cigarette smoke induce DNA damage and cell adhesion molecule expression through different pathways. Chem Biol Interact. 2004, 150: 233-241. 10.1016/j.cbi.2004.09.014.View ArticlePubMedGoogle Scholar
- Davis JW: Some acute effects of smoking on endothelial cells and platelets. Adv Exp Med Biol. 1990, 273: 107-118.View ArticlePubMedGoogle Scholar
- Freed BM, Ouyang Y, McCue JM: Mechanisms of altered transcription by cigarette smoke. Toxicol Sci. 2001, 59: 1-2. 10.1093/toxsci/59.1.1.View ArticlePubMedGoogle Scholar
- Freeman DJ, Packard CJ: Smoking and plasma lipoprotein metabolism. Clin Sci (Lond). 1995, 89: 333-342.View ArticleGoogle Scholar
- Henningfield JE, Stapleton JM, Benowitz NL, Grayson RF, London ED: Higher levels of nicotine in arterial than in venous blood after cigarette smoking. Drug Alcohol Depend. 1993, 33: 23-29. 10.1016/0376-8716(93)90030-T.View ArticlePubMedGoogle Scholar
- Li XY, Rahman I, Donaldson K, MacNee W: Mechanisms of cigarette smoke induced increased airspace permeability. Thorax. 1996, 51: 465-471. 10.1136/thx.51.5.465.PubMed CentralView ArticlePubMedGoogle Scholar
- Morrison D, Rahman I, Lannan S, MacNee W: Epithelial permeability, inflammation, and oxidant stress in the air spaces of smokers. Am J Respir Crit Care Med. 1999, 159: 473-479.View ArticlePubMedGoogle Scholar
- Nagy J, Demaster EG, Wittmann I, Shultz P, Raij L: Induction of endothelial cell injury by cigarette smoke. Endothelium. 1997, 5: 251-263. 10.3109/10623329709052590.View ArticlePubMedGoogle Scholar
- Noronha-Dutra AA, Epperlein MM, Woolf N: Effect of cigarette smoking on cultured human endothelial cells. Cardiovasc Res. 1993, 27: 774-778. 10.1093/cvr/27.5.774.View ArticlePubMedGoogle Scholar
- Raij L, Demaster EG, Jaimes EA: Cigarette smoke-induced endothelium dysfunction: role of superoxide anion. J Hypertens. 2001, 19: 891-897. 10.1097/00004872-200105000-00009.View ArticlePubMedGoogle Scholar
- Tsuchiya M, Asada A, Kasahara E, Sato EF, Shindo M, Inoue M: Smoking a single cigarette rapidly reduces combined concentrations of nitrate and nitrite and concentrations of antioxidants in plasma. Circulation. 2002, 105: 1155-1157. 10.1161/hc1002.105935.View ArticlePubMedGoogle Scholar
- Howard G, Wagenknecht LE, Cai J, Cooper L, Kraut MA, Toole JF: Cigarette smoking and other risk factors for silent cerebral infarction in the general population. Stroke. 1998, 29: 913-917. 10.1161/01.STR.29.5.913.View ArticlePubMedGoogle Scholar
- Shinton R, Beevers G: Meta-analysis of relation between cigarette smoking and stroke. BMJ. 1989, 298: 789-794. 10.1136/bmj.298.6676.789.PubMed CentralView ArticlePubMedGoogle Scholar
- Mannami T, Iso H, Baba S, Sasaki S, Okada K, Konishi M, Tsugane S: Cigarette smoking and risk of stroke and its subtypes among middle-aged Japanese men and women: the JPHC Study Cohort I. Stroke. 2004, 35: 1248-1253. 10.1161/01.STR.0000128794.30660.e8.View ArticlePubMedGoogle Scholar
- Miller GJ, Bauer KA, Cooper JA, Rosenberg RD: Activation of the coagulant pathway in cigarette smokers. Thromb Haemost. 1998, 79: 549-553.PubMedGoogle Scholar
- Mast H, Thompson JL, Lin IF, Hofmeister C, Hartmann A, Marx P, Mohr JP, Sacco RL: Cigarette smoking as a determinant of high-grade carotid artery stenosis in Hispanic, black, and white patients with stroke or transient ischemic attack. Stroke. 1998, 29: 908-912. 10.1161/01.STR.29.5.908.View ArticlePubMedGoogle Scholar
- Gill JS, Shipley MJ, Tsementzis SA, Hornby R, Gill SK, Hitchcock ER, Beevers DG: Cigarette smoking. A risk factor for hemorrhagic and nonhemorrhagic stroke. Arch Intern Med. 1989, 149: 2053-2057. 10.1001/archinte.149.9.2053.View ArticlePubMedGoogle Scholar
- Epperlein MM, Nourooz-Zadeh J, Noronha-Dutra AA, Woolf N: Nitric oxide in cigarette smoke as a mediator of oxidative damage. Int J Exp Pathol. 1996, 77: 197-200.PubMed CentralView ArticlePubMedGoogle Scholar
- Baldeiras I, Santana I, Proenca MT, Garrucho MH, Pascoal R, Rodrigues A, Duro D, Oliveira CR: Oxidative Damage and Progression to Alzheimer's Disease in Patients with Mild Cognitive Impairment. J Alzheimers Dis. 2010Google Scholar
- Seet RC, Lee CY, Lim EC, Tan JJ, Quek AM, Chong WL, Looi WF, Huang SH, Wang H, Chan YH, et al.: Oxidative damage in Parkinson disease: Measurement using accurate biomarkers. Free Radic Biol Med. 2010, 48: 560-566. 10.1016/j.freeradbiomed.2009.11.026.View ArticlePubMedGoogle Scholar
- Dal Pizzol F, Ritter C, Cassol-Jr OJ, Rezin GT, Petronilho F, Zugno AI, Quevedo J, Streck EL: Oxidative mechanisms of brain dysfunction during sepsis. Neurochem Res. 2010, 35: 1-12. 10.1007/s11064-009-0043-4.View ArticlePubMedGoogle Scholar
- Stangherlin EC, Luchese C, Ardais AP, Nogueira CW: Passive smoke exposure induces oxidative damage in brains of rat pups: Protective role of diphenyl diselenide. Inhal Toxicol. 2009, 21: 868-874. 10.1080/08958370802526881.View ArticlePubMedGoogle Scholar
- Hossain M, Sathe T, Fazio V, Mazzone P, Weksler B, Janigro D, Rapp E, Cucullo L: Tobacco smoke: a critical etiological factor for vascular impairment at the blood-brain barrier. Brain Res. 2009, 1287: 192-205.PubMed CentralView ArticlePubMedGoogle Scholar
- Schreibelt G, Kooij G, Reijerkerk A, van Doorn R, Gringhuis SI, van der PS, Weksler BB, Romero IA, Couraud PO, Piontek J, et al.: Reactive oxygen species alter brain endothelial tight junction dynamics via RhoA, PI3 kinase, and PKB signaling. FASEB J. 2007, 21: 3666-3676. 10.1096/fj.07-8329com.View ArticlePubMedGoogle Scholar
- Rao R: Oxidative stress-induced disruption of epithelial and endothelial tight junctions. Front Biosci. 2008, 13: 7210-7226.View ArticlePubMedGoogle Scholar
- Zou N, Hong J, Dai QY: Passive cigarette smoking induces inflammatory injury in human arterial walls. Chin Med J (Engl ). 2009, 122: 444-448.Google Scholar
- Westbrook DG, Anderson PG, Pinkerton KE, Ballinger SW: Perinatal tobacco smoke exposure increases vascular oxidative stress and mitochondrial damage in non-human primates. Cardiovasc Toxicol. 2010, 10: 216-226. 10.1007/s12012-010-9085-8.PubMed CentralView ArticlePubMedGoogle Scholar
- Haorah J, Ramirez SH, Schall K, Smith D, Pandya R, Persidsky Y: Oxidative stress activates protein tyrosine kinase and matrix metalloproteinases leading to blood-brain barrier dysfunction. J Neurochem. 2007, 101: 566-576. 10.1111/j.1471-4159.2006.04393.x.View ArticlePubMedGoogle Scholar
- Hutamekalin P, Farkas AE, Orbok A, Wilhelm I, Nagyoszi P, Veszelka S, Deli MA, Buzas K, Hunyadi-Gulyas E, Medzihradszky KF, et al.: Effect of nicotine and polyaromtic hydrocarbons on cerebral endothelial cells. Cell Biol Int. 2008, 32: 198-209. 10.1016/j.cellbi.2007.08.026.View ArticlePubMedGoogle Scholar
- Pun PB, Lu J, Moochhala S: Involvement of ROS in BBB dysfunction. Free Radic Res. 2009, 43: 348-364. 10.1080/10715760902751902.View ArticlePubMedGoogle Scholar
- Van der GA, Wouters D, Van Der Pol SM, Huizinga R, Ronken E, Adamson P, Greenwood J, Dijkstra CD, de Vries HE: Reactive oxygen species enhance the migration of monocytes across the blood-brain barrier in vitro. FASEB J. 2001, 15: 1852-1854.Google Scholar
- Whincup PH, Gilg JA, Emberson JR, Jarvis MJ, Feyerabend C, Bryant A, Walker M, Cook DG: Passive smoking and risk of coronary heart disease and stroke: prospective study with cotinine measurement. BMJ. 2004, 329: 200-205. 10.1136/bmj.38146.427188.55.PubMed CentralView ArticlePubMedGoogle Scholar
- Paulson JR, Yang T, Selvaraj PK, Mdzinarishvili A, Van der Schyf CJ, Klein J, Bickel U, Abbruscato TJ: Nicotine exacerbates brain edema during in vitro and in vivo focal ischemic conditions. J Pharmacol Exp Ther. 2010, 332: 371-379. 10.1124/jpet.109.157776.PubMed CentralView ArticlePubMedGoogle Scholar
- Djordjevic VB: Free radicals in cell biology. Int Rev Cytol. 2004, 237: 57-89.View ArticlePubMedGoogle Scholar
- Klaunig JE, Kamendulis LM, Hocevar BA: Oxidative stress and oxidative damage in carcinogenesis. Toxicol Pathol. 2010, 38: 96-109. 10.1177/0192623309356453.View ArticlePubMedGoogle Scholar
- Kong Q, Lin CL: Oxidative damage to RNA: mechanisms, consequences, and diseases. Cell Mol Life Sci. 2010, 67: 1817-1829. 10.1007/s00018-010-0277-y.PubMed CentralView ArticlePubMedGoogle Scholar
- Reuter S, Gupta SC, Chaturvedi MM, Aggarwal BB: Oxidative stress, inflammation, and cancer: How are they linked?. Free Radic Biol Med. 2010Google Scholar
- Uttara B, Singh AV, Zamboni P, Mahajan RT: Oxidative stress and neurodegenerative diseases: a review of upstream and downstream antioxidant therapeutic options. Curr Neuropharmacol. 2009, 7: 65-74. 10.2174/157015909787602823.PubMed CentralView ArticlePubMedGoogle Scholar
- Tabet N, Mantle D, Orrell M: Free radicals as mediators of toxicity in Alzheimer's disease: a review and hypothesis. Adverse Drug React Toxicol Rev. 2000, 19: 127-152.PubMedGoogle Scholar
- Valko M, Izakovic M, Mazur M, Rhodes CJ, Telser J: Role of oxygen radicals in DNA damage and cancer incidence. Mol Cell Biochem. 2004, 266: 37-56.View ArticlePubMedGoogle Scholar
- Pryor WA, Stone K, Zang LY, Bermudez E: Fractionation of aqueous cigarette tar extracts: fractions that contain the tar radical cause DNA damage. Chem Res Toxicol. 1998, 11: 441-448. 10.1021/tx970159y.View ArticlePubMedGoogle Scholar
- DeMarini DM: Genotoxicity of tobacco smoke and tobacco smoke condensate: a review. Mutat Res. 2004, 567: 447-474. 10.1016/j.mrrev.2004.02.001.View ArticlePubMedGoogle Scholar
- Fang YZ, Yang S, Wu G: Free radical homeostasis. Sheng Li Ke Xue Jin Zhan. 2004, 35: 199-204.PubMedGoogle Scholar
- Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J: Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol. 2007, 39: 44-84. 10.1016/j.biocel.2006.07.001.View ArticlePubMedGoogle Scholar
- Varela-Carver A, Parker H, Kleinert C, Rimoldi O: Adverse effects of cigarette smoke and induction of oxidative stress in cardiomyocytes and vascular endothelium. Curr Pharm Des. 2010, 16: 2551-2558. 10.2174/138161210792062830.View ArticlePubMedGoogle Scholar
- Valavanidis A, Vlachogianni T, Fiotakis K: Tobacco smoke: involvement of reactive oxygen species and stable free radicals in mechanisms of oxidative damage, carcinogenesis and synergistic effects with other respirable particles. Int J Environ Res Public Health. 2009, 6: 445-462. 10.3390/ijerph6020445.PubMed CentralView ArticlePubMedGoogle Scholar
- Pryor WA, Stone K: Oxidants in cigarette smoke. Radicals, hydrogen peroxide, peroxynitrate, and peroxynitrite. Ann N Y Acad Sci. 1993, 686: 12-27. 10.1111/j.1749-6632.1993.tb39148.x.View ArticlePubMedGoogle Scholar
- Sobczak A, Golka D, Szoltysek-Boldys I: The effects of tobacco smoke on plasma alpha- and gamma-tocopherol levels in passive and active cigarette smokers. Toxicol Lett. 2004, 151: 429-437. 10.1016/j.toxlet.2004.03.010.View ArticlePubMedGoogle Scholar
- Dietrich M, Block G, Norkus EP, Hudes M, Traber MG, Cross CE, Packer L: Smoking and exposure to environmental tobacco smoke decrease some plasma antioxidants and increase gamma-tocopherol in vivo after adjustment for dietary antioxidant intakes. Am J Clin Nutr. 2003, 77: 160-166.PubMedGoogle Scholar
- Willcox JK, Ash SL, Catignani GL: Antioxidants and prevention of chronic disease. Crit Rev Food Sci Nutr. 2004, 44: 275-295. 10.1080/10408690490468489.View ArticlePubMedGoogle Scholar
- Kelly G: The interaction of cigarette smoking and antioxidants. Part III: ascorbic acid. Altern Med Rev. 2003, 8: 43-54.PubMedGoogle Scholar
- Kelly GS: The interaction of cigarette smoking and antioxidants. Part 2: alpha-tocopherol. Altern Med Rev. 2002, 7: 500-511.PubMedGoogle Scholar
- Kelly GS: The interaction of cigarette smoking and antioxidants. Part I: diet and carotenoids. Altern Med Rev. 2002, 7: 370-388.PubMedGoogle Scholar
- Traber MG, van d V, Reznick AZ, Cross CE: Tobacco-related diseases. Is there a role for antioxidant micronutrient supplementation?. Clin Chest Med. 2000, 21: 173-87. 10.1016/S0272-5231(05)70016-2. x.View ArticlePubMedGoogle Scholar
- Preedy VR, Watson RR, Sherma Z: 2010, Humana Press
- Johnston CS, Martin LJ, Cai X: Antihistamine effect of supplemental ascorbic acid and neutrophil chemotaxis. J Am Coll Nutr. 1992, 11: 172-176.PubMedGoogle Scholar
- van Horssen J, Schreibelt G, Drexhage J, Hazes T, Dijkstra CD, van d V, de Vries HE: Severe oxidative damage in multiple sclerosis lesions coincides with enhanced antioxidant enzyme expression. Free Radic Biol Med. 2008, 45: 1729-1737. 10.1016/j.freeradbiomed.2008.09.023.View ArticlePubMedGoogle Scholar
- Montecinos V, Guzman P, Barra V, Villagran M, Munoz-Montesino C, Sotomayor K, Escobar E, Godoy A, Mardones L, Sotomayor P, et al.: Vitamin C is an essential antioxidant that enhances survival of oxidatively stressed human vascular endothelial cells in the presence of a vast molar excess of glutathione. J Biol Chem. 2007, 282: 15506-15515. 10.1074/jbc.M608361200.View ArticlePubMedGoogle Scholar
- Smith AR, Visioli F, Hagen TM: Vitamin C matters: increased oxidative stress in cultured human aortic endothelial cells without supplemental ascorbic acid. FASEB J. 2002, 16: 1102-1104.PubMedGoogle Scholar
- Panda K, Chattopadhyay R, Ghosh MK, Chattopadhyay DJ, Chatterjee IB: Vitamin C prevents cigarette smoke induced oxidative damage of proteins and increased proteolysis. Free Radic Biol Med. 1999, 27: 1064-1079. 10.1016/S0891-5849(99)00154-9.View ArticlePubMedGoogle Scholar
- van Dam B, van Hinsbergh VW, Stehouwer CD, Versteilen A, Dekker H, Buytenhek R, Princen HM, Schalkwijk CG: Vitamin E inhibits lipid peroxidation-induced adhesion molecule expression in endothelial cells and decreases soluble cell adhesion molecules in healthy subjects. Cardiovasc Res. 2003, 57: 563-571. 10.1016/S0008-6363(02)00699-5.View ArticlePubMedGoogle Scholar
- Wagner BA, Buettner GR, Burns CP: Vitamin E slows the rate of free radical-mediated lipid peroxidation in cells. Arch Biochem Biophys. 1996, 334: 261-267. 10.1006/abbi.1996.0454.View ArticlePubMedGoogle Scholar
- Brown KM, Morrice PC, Duthie GG: Vitamin E supplementation suppresses indexes of lipid peroxidation and platelet counts in blood of smokers and nonsmokers but plasma lipoprotein concentrations remain unchanged. Am J Clin Nutr. 1994, 60: 383-387.PubMedGoogle Scholar
- Cucullo L, Hossain M, Rapp E, Manders T, Janigro D: Development of a humanized in vitro blood-brain barrier model to screen for brain penetration of antiepileptic drugs. Epilepsia. 2006Google Scholar
- Cucullo L, McAllister M, Kight K, Krizanac-Bengez L, Marroni M, Mayberg M, Stanness K, Janigro D: A new dynamic in vitro model for the multidimensional study of astrocyte-endothelial cell interactions at the blood-brain barrier. Brain Res. 2002, 951: 243-10.1016/S0006-8993(02)03167-0.View ArticlePubMedGoogle Scholar
- Santaguida S, Janigro D, Hossain M, Oby E, Rapp E, Cucullo L: Side by side comparison between dynamic versus static models of blood-brain barrier in vitro: A permeability study. Brain Res. 2006, 1109: 1-13. 10.1016/j.brainres.2006.06.027.View ArticlePubMedGoogle Scholar
- Nakayama T, Church DF, Pryor WA: Quantitative analysis of the hydrogen peroxide formed in aqueous cigarette tar extracts. Free Radic Biol Med. 1989, 7: 9-15. 10.1016/0891-5849(89)90094-4.View ArticlePubMedGoogle Scholar
- Takanami Y, Moriyama T, Kosaka Y, Nakayama T: Analysis of hydrogen peroxide in an aqueous extract of cigarette smoke and effect of pH on the yield. Biosci Biotechnol Biochem. 2009, 73: 2222-2225. 10.1271/bbb.90324.View ArticlePubMedGoogle Scholar
- Cucullo L, Hossain M, Puvenna V, Marchi N, Janigro D: The role of shear stress in Blood-Brain Barrier endothelial physiology. BMC Neurosci. 2011, 12: 40-10.1186/1471-2202-12-40.PubMed CentralView ArticlePubMedGoogle Scholar
- Bernacki J, Dobrowolska A, Nierwinska K, Malecki A: Physiology and pharmacological role of the blood-brain barrier. Pharmacol Rep. 2008, 60: 600-622.PubMedGoogle Scholar
- Weiss N, Miller F, Cazaubon S, Couraud PO: The blood-brain barrier in brain homeostasis and neurological diseases. Biochim Biophys Acta. 2009, 1788: 842-857. 10.1016/j.bbamem.2008.10.022.View ArticlePubMedGoogle Scholar
- Abbott NJ, Revest PA, Romero IA: Astrocyte-endothelial interaction: physiology and pathology. Neuropathol Appl Neurobiol. 1992, 18: 424-433. 10.1111/j.1365-2990.1992.tb00808.x.View ArticlePubMedGoogle Scholar
- Arnson Y, Shoenfeld Y, Amital H: Effects of tobacco smoke on immunity, inflammation and autoimmunity. J Autoimmun. 2009Google Scholar
- Vajdovich P: Free radicals and antioxidants in inflammatory processes and ischemia-reperfusion injury. Vet Clin North Am Small Anim Pract. 2008, 38: 31-123. 10.1016/j.cvsm.2007.11.008. v.View ArticlePubMedGoogle Scholar
- Khanna AK, Xu J, Uber PA, Burke AP, Baquet C, Mehra MR: Tobacco smoke exposure in either the donor or recipient before transplantation accelerates cardiac allograft rejection, vascular inflammation, and graft loss. Circulation. 2009, 120: 1814-1821. 10.1161/CIRCULATIONAHA.108.840223.View ArticlePubMedGoogle Scholar
- Nordskog BK, Blixt AD, Morgan WT, Fields WR, Hellmann GM: Matrix-degrading and pro-inflammatory changes in human vascular endothelial cells exposed to cigarette smoke condensate. Cardiovasc Toxicol. 2003, 3: 101-117. 10.1385/CT:3:2:101.View ArticlePubMedGoogle Scholar
- Masubuchi T, Koyama S, Sato E, Takamizawa A, Kubo K, Sekiguchi M, Nagai S, Izumi T: Smoke extract stimulates lung epithelial cells to release neutrophil and monocyte chemotactic activity. Am J Pathol. 1998, 153: 1903-1912. 10.1016/S0002-9440(10)65704-5.PubMed CentralView ArticlePubMedGoogle Scholar
- Verma S, Wang CH, Li SH, Dumont AS, Fedak PW, Badiwala MV, Dhillon B, Weisel RD, Li RK, Mickle DA, et al.: A self-fulfilling prophecy: C-reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation. 2002, 106: 913-919. 10.1161/01.CIR.0000029802.88087.5E.View ArticlePubMedGoogle Scholar
- Rahman I, MacNee W: Role of oxidants/antioxidants in smoking-induced lung diseases. Free Radic Biol Med. 1996, 21: 669-681. 10.1016/0891-5849(96)00155-4.View ArticlePubMedGoogle Scholar
- Pincemail J, Vanbelle S, Degrune F, Cheramy-Bien JP, Charlier C, Chapelle JP, Giet D, Collette G, Albert A, Defraigne JO: Lifestyle Behaviours and Plasma Vitamin C and beta-Carotene Levels from the ELAN Population (Liege, Belgium). J Nutr Metab. 2011, 2011: 494370.PubMed CentralView ArticlePubMedGoogle Scholar
- Sharma MK, Buettner GR: Interaction of vitamin C and vitamin E during free radical stress in plasma: an ESR study. Free Radic Biol Med. 1993, 14: 649-653. 10.1016/0891-5849(93)90146-L.View ArticlePubMedGoogle Scholar
- Abbruscato TJ, Lopez SP, Mark KS, Hawkins BT, Davis TP: Nicotine and cotinine modulate cerebral microvascular permeability and protein expression of ZO-1 through nicotinic acetylcholine receptors expressed on brain endothelial cells. J Pharm Sci. 2002, 91: 2525-2538. 10.1002/jps.10256.View ArticlePubMedGoogle Scholar
- Darley-Usmar VM, Hogg N, O'Leary VJ, Wilson MT, Moncada S: The simultaneous generation of superoxide and nitric oxide can initiate lipid peroxidation in human low density lipoprotein. Free Radic Res Commun. 1992, 17: 9-20. 10.3109/10715769209061085.View ArticlePubMedGoogle Scholar
- Su Y, Han W, Giraldo C, De Li Y, Block ER: Effect of cigarette smoke extract on nitric oxide synthase in pulmonary artery endothelial cells. Am J Respir Cell Mol Biol. 1998, 19: 819-825.View ArticlePubMedGoogle Scholar
- Toda N, Toda H: Nitric oxide-mediated blood flow regulation as affected by smoking and nicotine. Eur J Pharmacol. 2010, 649: 1-13. 10.1016/j.ejphar.2010.09.042.View ArticlePubMedGoogle Scholar
- Leone A: Does Smoking Act as a Friend or Enemy of Blood Pressure? Let Release Pandora's Box. Cardiol Res Pract. 2011, 2011: 264894.PubMed CentralPubMedGoogle Scholar
- Chalon S, Moreno H, Benowitz NL, Hoffman BB, Blaschke TF: Nicotine impairs endothelium-dependent dilatation in human veins in vivo. Clin Pharmacol Ther. 2000, 67: 391-397. 10.1067/mcp.2000.105153.View ArticlePubMedGoogle Scholar
- Jensen EX, Fusch C, Jaeger P, Peheim E, Horber FF: Impact of chronic cigarette smoking on body composition and fuel metabolism. J Clin Endocrinol Metab. 1995, 80: 2181-2185. 10.1210/jc.80.7.2181.PubMedGoogle Scholar
- Gorman D, Drewry A, Huang YL, Sames C: The clinical toxicology of carbon monoxide. Toxicology. 2003, 187: 25-38. 10.1016/S0300-483X(03)00005-2.View ArticlePubMedGoogle Scholar
- Stoller KP: Hyperbaric oxygen and carbon monoxide poisoning: a critical review. Neurol Res. 2007, 29: 146-155. 10.1179/016164107X181770.View ArticlePubMedGoogle Scholar
- Shimosegawa E, Hatazawa J, Nagata K, Okudera T, Inugami A, Ogawa T, Fujita H, Itoh H, Kanno I, Uemura K: Cerebral blood flow and glucose metabolism measurements in a patient surviving one year after carbon monoxide intoxication. J Nucl Med. 1992, 33: 1696-1698.PubMedGoogle Scholar
- Rizzo MR, Abbatecola AM, Barbieri M, Vietri MT, Cioffi M, Grella R, Molinari A, Forsey R, Powell J, Paolisso G: Evidence for anti-inflammatory effects of combined administration of vitamin E and C in older persons with impaired fasting glucose: impact on insulin action. J Am Coll Nutr. 2008, 27: 505-511.View ArticlePubMedGoogle Scholar
- Meyer J, Tauh J, Galla HG: The susceptibility of cerebral endothelial cells to astroglial induction of blood-brain barrier enzymes depends on their proliferative state. J Neurochem. 1991, 57: 1971-1977. 10.1111/j.1471-4159.1991.tb06411.x.View ArticlePubMedGoogle Scholar
- Barth A, Newell DW, Nguyen LB, Winn HR, Wender R, Meno JR, Janigro D: Neurotoxicity in organotypic hippocampal slices mediated by adenosine analogues and nitric oxide. Brain Res. 1997, 762: 79-88. 10.1016/S0006-8993(97)00348-X.View ArticlePubMedGoogle Scholar
- Janigro D, Nguyen TS, Gordon EL, Winn HR: Physiological properties of ATP-activated cation channels in rat brain microvascular endothelial cells. Am J Physiol. 1996, 270: H1423-H1434.PubMedGoogle Scholar