The Experts below are selected from a list of 204 Experts worldwide ranked by ideXlab platform
Davide Martelli - One of the best experts on this subject based on the ideXlab platform.
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sympathetic Nerves control bacterial clearance
Scientific Reports, 2020Co-Authors: Yugeesh R Lankadeva, Clive N May, M J Mckinley, Melanie R Neeland, Dianna M Hocking, Roy M Robinsbrowne, Sammy Bedoui, David G S Farmer, S R Bailey, Davide MartelliAbstract:A neural reflex mediated by the Splanchnic sympathetic Nerves regulates systemic inflammation in negative feedback fashion, but its consequences for host responses to live infection are unknown. To test this, conscious instrumented sheep were infected intravenously with live E. coli bacteria and followed for 48 h. A month previously, animals had undergone either bilateral Splanchnic nerve section or a sham operation. As established for rodents, sheep with cut Splanchnic Nerves mounted a stronger systemic inflammatory response: higher blood levels of tumor necrosis factor alpha and interleukin-6 but lower levels of the anti-inflammatory cytokine interleukin-10, compared with sham-operated animals. Sequential blood cultures revealed that most sham-operated sheep maintained high circulating levels of live E. coli throughout the 48-h study period, while all sheep without Splanchnic Nerves rapidly cleared their bacteraemia and recovered clinically. The sympathetic inflammatory reflex evidently has a profound influence on the clearance of systemic bacterial infection.
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the Splanchnic anti inflammatory pathway could it be the efferent arm of the inflammatory reflex
Experimental Physiology, 2016Co-Authors: David G S Farmer, Davide Martelli, Song T YaoAbstract:What is the topic of this review? We review the current literature on the neural reflex termed the 'inflammatory reflex' that inhibits an excessive release of inflammatory mediators in response to an immune challenge. What advances does it highlight? The original model proposed that the inflammatory reflex is a vago-vagal reflex that controls immune function. We posit that, in the endotoxaemic animal model, the vagus Nerves do not appear to play a role. The evidence suggests that the efferent motor pathway, termed here the 'Splanchnic anti-inflammatory pathway', is purely sympathetic, travelling via the greater Splanchnic Nerves to regulate the ensuing inflammatory response to immune challenges. Exposure to immune challenges results in the development of inflammation. An insufficient inflammatory response can be life-threatening, whereas an exaggerated response is also detrimental because it causes tissue damage and, in extreme cases, septic shock that can lead to death. Hence, inflammation must be finely regulated. It is generally accepted that the brain inhibits inflammation induced by an immune challenge in two main ways: humorally, by activating the hypothalamic-pituitary-adrenal axis to release glucocorticoids; and neurally, via a mechanism that has been termed the 'inflammatory reflex'. The efferent arm of this reflex (the neural-to-immune link) was thought to be the 'cholinergic anti-inflammatory pathway'. Here, we discuss data that support the hypothesis that the vagus Nerves play no role in the control of inflammation in the endotoxaemic animal model. We have shown and posit that it is the greater Splanchnic Nerves that are activated in response to the immune challenge and that, in turn, drive postganglionic sympathetic neurons to inhibit inflammation.
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neural control of inflammation by the greater Splanchnic Nerves
Temperature (Austin Tex.), 2014Co-Authors: Davide Martelli, M J Mckinley, Song T Yao, Robin M McallenAbstract:The brain influences immune function through a powerful neural reflex that suppresses the release of a key pro-inflammatory cytokine, tumor necrosis factor α, after immune challenge. The efferent motor pathway of this reflex is in the Splanchnic Nerves, not the vagi. This reflex regulates inflammation but does not suppress fever.
Song T Yao - One of the best experts on this subject based on the ideXlab platform.
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the Splanchnic anti inflammatory pathway could it be the efferent arm of the inflammatory reflex
Experimental Physiology, 2016Co-Authors: David G S Farmer, Davide Martelli, Song T YaoAbstract:What is the topic of this review? We review the current literature on the neural reflex termed the 'inflammatory reflex' that inhibits an excessive release of inflammatory mediators in response to an immune challenge. What advances does it highlight? The original model proposed that the inflammatory reflex is a vago-vagal reflex that controls immune function. We posit that, in the endotoxaemic animal model, the vagus Nerves do not appear to play a role. The evidence suggests that the efferent motor pathway, termed here the 'Splanchnic anti-inflammatory pathway', is purely sympathetic, travelling via the greater Splanchnic Nerves to regulate the ensuing inflammatory response to immune challenges. Exposure to immune challenges results in the development of inflammation. An insufficient inflammatory response can be life-threatening, whereas an exaggerated response is also detrimental because it causes tissue damage and, in extreme cases, septic shock that can lead to death. Hence, inflammation must be finely regulated. It is generally accepted that the brain inhibits inflammation induced by an immune challenge in two main ways: humorally, by activating the hypothalamic-pituitary-adrenal axis to release glucocorticoids; and neurally, via a mechanism that has been termed the 'inflammatory reflex'. The efferent arm of this reflex (the neural-to-immune link) was thought to be the 'cholinergic anti-inflammatory pathway'. Here, we discuss data that support the hypothesis that the vagus Nerves play no role in the control of inflammation in the endotoxaemic animal model. We have shown and posit that it is the greater Splanchnic Nerves that are activated in response to the immune challenge and that, in turn, drive postganglionic sympathetic neurons to inhibit inflammation.
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neural control of inflammation by the greater Splanchnic Nerves
Temperature (Austin Tex.), 2014Co-Authors: Davide Martelli, M J Mckinley, Song T Yao, Robin M McallenAbstract:The brain influences immune function through a powerful neural reflex that suppresses the release of a key pro-inflammatory cytokine, tumor necrosis factor α, after immune challenge. The efferent motor pathway of this reflex is in the Splanchnic Nerves, not the vagi. This reflex regulates inflammation but does not suppress fever.
Alexis Kelekis - One of the best experts on this subject based on the ideXlab platform.
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computed tomography guided percutaneous radiofrequency ablation of the Splanchnic Nerves as a single treatment for pain reduction in patients with pancreatic cancer
Diagnostics (Basel Switzerland), 2021Co-Authors: Stavros Grigoriadis, Maria Tsitskari, Maria Ioannidi, Periklis Zavridis, Ioannis Kotsantis, Alexis Kelekis, Dimitrios FilippiadisAbstract:The aim of this paper is to prospectively evaluate the efficacy and safety of percutaneous computed tomography (CT)-guided radiofrequency (RF) neurolysis of Splanchnic Nerves as a single treatment for pain reduction in patients with pancreatic cancer. Patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication who underwent CT-guided neurolysis of Splanchnic Nerves by means of continuous radiofrequency were prospectively evaluated for pain and analgesics reduction as well as for survival. In all patients, percutaneous neurolysis was performed with a bilateral retrocrural paravertebral approach at T12 level using a 20 Gauge RF blunt curved cannula with a 1cm active tip electrode. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with numeric visual scale (NVS) units. The mean patient age was 65.4 ± 10.8 years (male-female: 19-11). The mean pain score prior to RF neurolysis of Splanchnic Nerves was 9.0 NVS units; this score was reduced to 2.9, 3.1, 3.6, 3.8, and 3.9 NVS units at 1 week, 1, 3, 6, and 12 months respectively (p < 0.001). Significantly reduced analgesic usage was reported in 28/30 patients. Two grade I complications were reported according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system. According to the results of the present study, solely performed computed tomography-guided radiofrequency neurolysis of Splanchnic Nerves can be considered a safe and efficacious single-session technique for pain palliation in patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication. Although effective in pain reduction the technique seems to have no effect upon survival improvement.
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a technical report on the performance of percutaneous cryoneurolysis of Splanchnic Nerves for the treatment of refractory abdominal pain in patients with pancreatic cancer initial experience
CardioVascular and Interventional Radiology, 2021Co-Authors: Dimitrios Filippiadis, Nikolaos Ptohis, Evgenia Efthymiou, Alexis KelekisAbstract:To report our preliminary results upon feasibility, efficacy and safety of percutaneous Splanchnic Nerves cryoneurolysis for the treatment of abdominal pain refractory to conservative medication in patients with pancreatic cancer Institutional database research (retrospective review of prospectively collected data from April 2019 till August 2020) identified 5 patients with pancreatic cancer and pain refractory to conservative medication who underwent percutaneous cryoneurolysis of Splanchnic Nerves. In all patients, percutaneous cryoneurolysis was performed with posterolateral paravertebral approach using a 17 Gauge cryoprobe under computed tomography guidance and local anesthesia. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with visual analog scale (VAS) units. Mean patient age was 63.81 years (male–female: 3–2). Mean pain score prior to cryoanalgesia of Splanchnic Nerves was 9.4 VAS units. This score was reduced to a mean value of 2.6, 2.6 and 3 VAS units at 1, 3 and 6 months of follow-up, respectively. All patients reported significantly reduced analgesic usage. No complication was reported according to the CIRSE classification system. The mean procedure time was 44.4 min (range 39–50 min), including local anesthesia, cryoprobe(s) placement, ablation and post-procedural CT evaluation. Percutaneous cryoanalgesia of the Splanchnic Nerves is a minimally invasive, safe and effective procedure for pancreatic cancer pain relief. A larger, randomized trial is justified to substantiate these findings.
Dimitrios Filippiadis - One of the best experts on this subject based on the ideXlab platform.
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computed tomography guided percutaneous radiofrequency ablation of the Splanchnic Nerves as a single treatment for pain reduction in patients with pancreatic cancer
Diagnostics (Basel Switzerland), 2021Co-Authors: Stavros Grigoriadis, Maria Tsitskari, Maria Ioannidi, Periklis Zavridis, Ioannis Kotsantis, Alexis Kelekis, Dimitrios FilippiadisAbstract:The aim of this paper is to prospectively evaluate the efficacy and safety of percutaneous computed tomography (CT)-guided radiofrequency (RF) neurolysis of Splanchnic Nerves as a single treatment for pain reduction in patients with pancreatic cancer. Patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication who underwent CT-guided neurolysis of Splanchnic Nerves by means of continuous radiofrequency were prospectively evaluated for pain and analgesics reduction as well as for survival. In all patients, percutaneous neurolysis was performed with a bilateral retrocrural paravertebral approach at T12 level using a 20 Gauge RF blunt curved cannula with a 1cm active tip electrode. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with numeric visual scale (NVS) units. The mean patient age was 65.4 ± 10.8 years (male-female: 19-11). The mean pain score prior to RF neurolysis of Splanchnic Nerves was 9.0 NVS units; this score was reduced to 2.9, 3.1, 3.6, 3.8, and 3.9 NVS units at 1 week, 1, 3, 6, and 12 months respectively (p < 0.001). Significantly reduced analgesic usage was reported in 28/30 patients. Two grade I complications were reported according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system. According to the results of the present study, solely performed computed tomography-guided radiofrequency neurolysis of Splanchnic Nerves can be considered a safe and efficacious single-session technique for pain palliation in patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication. Although effective in pain reduction the technique seems to have no effect upon survival improvement.
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a technical report on the performance of percutaneous cryoneurolysis of Splanchnic Nerves for the treatment of refractory abdominal pain in patients with pancreatic cancer initial experience
CardioVascular and Interventional Radiology, 2021Co-Authors: Dimitrios Filippiadis, Nikolaos Ptohis, Evgenia Efthymiou, Alexis KelekisAbstract:To report our preliminary results upon feasibility, efficacy and safety of percutaneous Splanchnic Nerves cryoneurolysis for the treatment of abdominal pain refractory to conservative medication in patients with pancreatic cancer Institutional database research (retrospective review of prospectively collected data from April 2019 till August 2020) identified 5 patients with pancreatic cancer and pain refractory to conservative medication who underwent percutaneous cryoneurolysis of Splanchnic Nerves. In all patients, percutaneous cryoneurolysis was performed with posterolateral paravertebral approach using a 17 Gauge cryoprobe under computed tomography guidance and local anesthesia. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with visual analog scale (VAS) units. Mean patient age was 63.81 years (male–female: 3–2). Mean pain score prior to cryoanalgesia of Splanchnic Nerves was 9.4 VAS units. This score was reduced to a mean value of 2.6, 2.6 and 3 VAS units at 1, 3 and 6 months of follow-up, respectively. All patients reported significantly reduced analgesic usage. No complication was reported according to the CIRSE classification system. The mean procedure time was 44.4 min (range 39–50 min), including local anesthesia, cryoprobe(s) placement, ablation and post-procedural CT evaluation. Percutaneous cryoanalgesia of the Splanchnic Nerves is a minimally invasive, safe and effective procedure for pancreatic cancer pain relief. A larger, randomized trial is justified to substantiate these findings.
David G S Farmer - One of the best experts on this subject based on the ideXlab platform.
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sympathetic Nerves control bacterial clearance
Scientific Reports, 2020Co-Authors: Yugeesh R Lankadeva, Clive N May, M J Mckinley, Melanie R Neeland, Dianna M Hocking, Roy M Robinsbrowne, Sammy Bedoui, David G S Farmer, S R Bailey, Davide MartelliAbstract:A neural reflex mediated by the Splanchnic sympathetic Nerves regulates systemic inflammation in negative feedback fashion, but its consequences for host responses to live infection are unknown. To test this, conscious instrumented sheep were infected intravenously with live E. coli bacteria and followed for 48 h. A month previously, animals had undergone either bilateral Splanchnic nerve section or a sham operation. As established for rodents, sheep with cut Splanchnic Nerves mounted a stronger systemic inflammatory response: higher blood levels of tumor necrosis factor alpha and interleukin-6 but lower levels of the anti-inflammatory cytokine interleukin-10, compared with sham-operated animals. Sequential blood cultures revealed that most sham-operated sheep maintained high circulating levels of live E. coli throughout the 48-h study period, while all sheep without Splanchnic Nerves rapidly cleared their bacteraemia and recovered clinically. The sympathetic inflammatory reflex evidently has a profound influence on the clearance of systemic bacterial infection.
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THE ANTI-INFLAMMATORY REFLEX ACTION OF THE Splanchnic SYMPATHETIC Nerves IS DISTRIBUTED ACROSS ABDOMINAL ORGANS
2019Co-Authors: Martelli Davide, David G S Farmer, Mckinley, Michael J, Yao, Song Tieng, Mcallen, Robin MichaelAbstract:The Splanchnic anti-inflammatory pathway has been proposed as the efferent arm of the inflammatory reflex. While much evidence points to the spleen as the principal target organ where sympathetic Nerves inhibit immune function, a systematic study to locate the target organ(s) of the Splanchnic anti-inflammatory pathway has not yet been made. In anaesthetised rats made endotoxemic with lipopolysaccharide (LPS, 60µg/Kg i.v.), plasma levels of tumor necrosis factor α (TNF) were measured in animals with cut (SplancX) or sham-cut (Sham) Splanchnic Nerves. We confirm here that disengagement of the Splanchnic anti-inflammatory pathway in SplancX rats (17.01±0.95 ng/ml) strongly enhances LPS-induced plasma TNF levels compared to Shams (3.76±0.95 ng/ml). In paired experiments, the responses of SplancX and Sham animals were compared after the single or combined removal of organs innervated by the Splanchnic Nerves. Removal of target organ(s) where the Splanchnic Nerves inhibit systemic inflammation should abolish any difference in LPS-induced plasma TNF levels, between Sham and SplancX rats. Any secondary effects of extirpating organs should apply to both groups. Surprisingly, removal of the spleen and/or the adrenal glands did not prevent the reflex Splanchnic anti-inflammatory action; nor did the following removals: spleen + adrenals + intestine; spleen + intestine + stomach and pancreas; spleen + intestine + stomach and pancreas + liver. Only when spleen, adrenals, intestine, stomach, pancreas and liver were all removed, did the difference between SplancX and Sham animals disappear. We conclude that the reflex anti-inflammatory action of the Splanchnic Nerves is distributed widely across abdominal organs
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the Splanchnic anti inflammatory pathway could it be the efferent arm of the inflammatory reflex
Experimental Physiology, 2016Co-Authors: David G S Farmer, Davide Martelli, Song T YaoAbstract:What is the topic of this review? We review the current literature on the neural reflex termed the 'inflammatory reflex' that inhibits an excessive release of inflammatory mediators in response to an immune challenge. What advances does it highlight? The original model proposed that the inflammatory reflex is a vago-vagal reflex that controls immune function. We posit that, in the endotoxaemic animal model, the vagus Nerves do not appear to play a role. The evidence suggests that the efferent motor pathway, termed here the 'Splanchnic anti-inflammatory pathway', is purely sympathetic, travelling via the greater Splanchnic Nerves to regulate the ensuing inflammatory response to immune challenges. Exposure to immune challenges results in the development of inflammation. An insufficient inflammatory response can be life-threatening, whereas an exaggerated response is also detrimental because it causes tissue damage and, in extreme cases, septic shock that can lead to death. Hence, inflammation must be finely regulated. It is generally accepted that the brain inhibits inflammation induced by an immune challenge in two main ways: humorally, by activating the hypothalamic-pituitary-adrenal axis to release glucocorticoids; and neurally, via a mechanism that has been termed the 'inflammatory reflex'. The efferent arm of this reflex (the neural-to-immune link) was thought to be the 'cholinergic anti-inflammatory pathway'. Here, we discuss data that support the hypothesis that the vagus Nerves play no role in the control of inflammation in the endotoxaemic animal model. We have shown and posit that it is the greater Splanchnic Nerves that are activated in response to the immune challenge and that, in turn, drive postganglionic sympathetic neurons to inhibit inflammation.
