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    28 October 2015, Volume 10 Issue 10 Previous Issue    Next Issue
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    Does being female provide a neuroprotective advantage following spinal cord injury?
    Jeffrey P. Datto, Jackie Yang, W. Dalton Dietrich, Damien D. Pearse
    2015, 10 (10):  1533-1536.  doi: 10.4103/1673-5374.165213
    Abstract ( 300 )   PDF (300KB) ( 726 )   Save

    It has been controversial whether gender has any effect on recovery following spinal cord injury (SCI). Past experimental and clinical research aimed at addressing this subject has led to constrasting
    findings on whether females hold any advantage in locomotor recovery. Additionally, for studies supporting the notion of a female gender related advantage, a definite cause has not been explained. In a recent study, using large sample sizes for comparative male and female spinal cord injury cohorts, we reported that a significant gender advantage favoring females existed in both tissue preservation and functional recovery after taking into consideration discrepancies in age and weight of the animals across sexes. Prior animal research frequently used sample sizes that were too small to determine significance with certainty and also did not account for two other factors that influence locomotor performance: age and weight. Our finding is important in light of controversy surrounding the effect of gender on outcome and the fact that SCI affects more than ten thousand new individuals annually, a population that is disproportionately male. By deepening our understanding of why a gender advantage exists, potential new therapeutics can be designed to improve recovery for the male population following the initial trauma or putatively
    augment the neuroprotective privilege in females for enhanced outcomes.

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    Ischemic long-term-potentiation (iLTP): perspectives to set the threshold of neural plasticity toward therapy
    Maximilian Lenz, Andreas Vlachos, Nicola Maggio
    2015, 10 (10):  1537-1539.  doi: 10.4103/1673-5374.165215
    Abstract ( 420 )   PDF (153KB) ( 708 )   Save

    The precise role of neural plasticity under pathological conditions remains not well understood. It appears to be well accepted, however, that changes in the ability of neurons to express plasticity accompany neurological diseases. Here, we discuss recent experimental evidence, which suggests that synaptic plasticity induced by a pathological stimulus, i.e., ischemic long-term-potentiation (iLTP) of excitatory synapses, could play an important role for post-stroke recovery by influencing the post-lesional reorganization of surviving neuronal networks.

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    Delayed peripheral nerve repair: methods, including surgical ‘cross-bridging’ to promote nerve regeneration
    Tessa Gordon, Placheta Eva, Gregory H. Borschel
    2015, 10 (10):  1540-1544.  doi: 10.4103/1673-5374.167747
    Abstract ( 386 )   PDF (606KB) ( 739 )   Save

    Despite the capacity of Schwann cells to support peripheral nerve regeneration, functional recovery after nerve injuries is frequently poor, especially for proximal injuries that require regenerating
    axons to grow over long distances to reinnervate distal targets. Nerve transfers, where small fascicles from an adjacent intact nerve are coapted to the nerve stump of a nearby denervated
    muscle, allow for functional return but at the expense of reduced numbers of innervating nerves. A 1-hour period of 20 Hz electrical nerve stimulation via electrodes proximal to an injury site accelerates axon outgrowth to hasten target reinnervation in rats and humans, even after delayed surgery. A novel strategy of enticing donor axons from an otherwise intact nerve to grow through small nerve grafts (cross-bridges) into a denervated nerve stump, promotes improved axon regeneration after delayed nerve repair. The efficacy of this technique has been demonstrated
    in a rat model and is now in clinical use in patients undergoing cross-face nerve grafting for facial paralysis. In conclusion, brief electrical stimulation, combined with the surgical technique of promoting the regeneration of some donor axons to ‘protect’ chronically denervated Schwann cells, improves nerve regeneration and, in turn, functional outcomes in the management of peripheral nerve injuries.

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    Neuroprotection and recovery from early-life adversity: considerations for environmental enrichment
    Amanda C. Kentner
    2015, 10 (10):  1545-1547.  doi: 10.4103/1673-5374.165315
    Abstract ( 433 )   PDF (421KB) ( 716 )   Save

    Enriched laboratory housing has also been utilized to evaluate its neuroprotective and rehabilitative potential as a translational intervention for complications associated with stroke, Huntington’s disease, traumatic brain injury (TBI), and even psychological stressors. In order to evaluate the ‘preventative’ effects of EE an animal is reared in this condition prior to the beginning of disease progression, or before encountering a challenge. The purpose is to determine if there is either a delay or inhibition of pathology. The ‘rehabilitative’ potential of EE is assessed by placing an animal into this housing after the initiation of the pathology, or challenge, to determine if there is a reversal of the associated adverse consequences. The benefits afforded to animals reared in EE suggest that this housing condition is akin to the clinical rehabilitation process. Despite there being a paucity of clinical trials to validate EE in either neuroprotection or recovery following human disease or trauma it is believed that the cognitive, physical and/or social stimulation that accompany the rehabilitative processes is enriching and advantageous to patients.

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    The emerging roles of transplanted radial glial cells in regenerating the central nervous system
    Robin E. White, Denis S. Barry
    2015, 10 (10):  1548-1551.  doi: 10.4103/1673-5374.165317
    Abstract ( 297 )   PDF (195KB) ( 635 )   Save

    In a rapidly advancing field, biomaterial based transplantation platforms such as hydrogels and nanofibre scaffolds are enhancing engraftment by allowing multiple cell matrixes to be implanted, thereby replacing both the cells lost due to injury and the neurotrophic populations necessary to enrich them and modulate immune responses at the injury site. For example, we are currently successfully growing radial glial rich cultures isolated from the embryonic spinal cord on specialized biopolymers, and aim to apply these to spinal cord injury loci recreating the embryonic CNS microenvironment (unpublished). It is clear that intricate networks of radial glial cells or their progeny form scaffolds that segregate/guide growing axons, while contributing to gliogenesis and neurogenesis during development. Recent reports describing the ability of radial glial cells to re-differentiate at injury loci, and offer neurotrophic support to surviving cells in both amphibians and mammals, will ensure attention will continually be placed on radial glia and their derivatives. By combining this research with technological developments in neural tissue engineering to support the growth and transplantation of CNS progenitors, we are confident that radial glial cells, and in particular ES cell derivatives such as RG3.6 cells, will play significant roles in advancing cell replacement and regeneration therapies.

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    Targeting α7 nicotinic acetylcholine receptors: a future potential for neuroprotection from traumatic brain injury
    Samuel S. Shin, C. Edward Dixon
    2015, 10 (10):  1552-1554.  doi: 10.4103/1673-5374.165309
    Abstract ( 226 )   PDF (343KB) ( 933 )   Save

    Traumatic brain injury poses a significant socioeconomic burden in the United States. Not only the immediate management for traumatic injury but also the rehabilitation for motor deficits and cognitive impairments amount to tremendous cost of medical care for these individuals. Moreover, the loss of potential human resource among these individuals is innumerable. Since the causes of TBI are varied, such as motor vehicle accident, falls, violence, and sports related injury, the mechanisms of injury are also diverse. However, these injuries all amount to deficits in cognitive functions. The long lasting consequences in cognitive impairments are often under reported and its mechanisms are unclear. Individuals who have suffered TBI in the past have high incidence personality changes and psychiatric issues such as depression, hostility, anxiety disorders, and post traumatic stress disorder. These individuals also have decreased informational processing speed and lower intellectual functioning amounting to difficulty in learning and social interaction.
    Cholinergic system is regarded as an important modulator of cognitive function, by its role in learning and memory formation and attention. Thus, in pathologic neurodegenerative diseases such as Alzheimer’s disease (AD), loss of cholinergic functions are believed to be an important contributor to cognitive deficits. Similarly, traumatic brain injury (TBI) induces dysregulation of the cholinergic system, and this is believed to be one of the significant underlying mechanism of cognitive deficits. With recent advancements in pharmacological science, novel agents that target specific receptor subtypes of the cholinergic system have been developed. The possible use and benefits of these agents in TBI will be discussed. Specifically α7 nicotinic acetylcholine receptors have been shown to be major player in both the neuronal injury as well as cognitive dysfunction after TBI. Agents that target these specific receptors are promising potential future targets in both animal studies and clinical trials.

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    Regulation of axonal remodeling following spinal cord injury
    Anne Jacobi, Florence M. Bareyre
    2015, 10 (10):  1555-1557.  doi: 10.4103/1673-5374.167748
    Abstract ( 239 )   PDF (490KB) ( 714 )   Save

    Timely and accurate axonal remodeling is key to functional recovery following spinal cord injury. To therapeutically support such remodeling processes in the future we first have to unravel the molecular signals that govern their endogenous formation. Recent studies such as the ones described here identify first molecular clues but much more work is required to obtain a comprehensive molecular understanding of circuit remodeling in the injured spinal cord.

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    Handling iron in restorative neuroscience
    Lisa Junl Routhe, Torben Moos
    2015, 10 (10):  1558-1559.  doi: 10.4103/1673-5374.165316
    Abstract ( 246 )   PDF (144KB) ( 653 )   Save

    The transient metal iron exerts essential roles in the central nervous system (CNS) for oxygen transport, myelin formation, and synthesis of neurotransmitters. Being redox active, iron switches between ferrous and ferric states. Switching between oxygen states also makes iron an important inducer of reactive oxygen species through the Fenton and Haber-Weiss reactions. Such reactive oxygen species are potentially damaging to nucleic acids, proteins, and fatty acids, which makes the handling of iron very important. Both iron overload and iron deficiency are detrimental to cells of the nervous system. Iron overload increases the formation of oxidative species and thereby increasing risks for neuronal death, and regional iron accumulation in brain is associated with neurodegenerative disorders like Alzheimer’s disease and Parkinson’s disease. Systemic iron overloading causes hemochromatosis with the surprising absence of brain impairment, which is attributed to down-regulation of the iron uptake and transport at the blood-brain barrier (BBB). Conversely, limited access to iron leads to systemic iron deficiency that may affect the iron levels in the CNS and peripheral nervous system, which can cause cell growth arrest or even cell death. This suggests that maternal iron-deficiency seriously can affect the developing foetus, including the brain.

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    Old dogs with new tricks: intra-axonal translation of nuclear proteins
    Jeffery L. Twiss, Tanuja T. Merianda
    2015, 10 (10):  1560-1562.  doi: 10.4103/1673-5374.165264
    Abstract ( 198 )   PDF (461KB) ( 644 )   Save

    Many different types of polarized eukaryotic cells have been shown to segregatesynthesis for some protein subpopulations to cytoplasmic domains distant from their nucleus. For neurons, these distances can be tens-to-thousands fold more than the diameter of the cell body. Both axons and dendrites make use of this localized protein synthesis to bring autonomy to these far reaches of the cytoplasm. Oftentimes this local mRNA translation is used to mount a rapid response to extracellular stimuli encountered by the distal axon and dendrite. Indeed, activating translation of mRNAs residing locally at the synapse or growth cone brings a much more rapid response than could be achieved by transporting new proteins from the cell body. The neuron likely reapsa cost benefit from this mechanism in terms of energy consumption, since multiple protein copies can be generated from a single mRNA through sequential rounds of translation. Localized protein synthesis could also more effectively positiona protein near its site of action or even bring an unanticipated novel function to the protein.

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    Schwann cell Miz without POZ: degeneration
    meets regeneration
    David Fuhrmann, Hans-Peter Elsässer
    2015, 10 (10):  1563-1564.  doi: 10.4103/1673-5374.165263
    Abstract ( 197 )   PDF (322KB) ( 1247 )   Save

    Peripheral motor and sensory neuropathies are diseases with different etiologies emerging from genetic disorders, diabetes, infection or inflammation, paraneoplastic damage or intoxications including alcohol abuse. Hereditary neuropathies, most of which are subsumed under the hypernym Charcot-Marie Tooth (CMT) disease, are clinically heterogeneous: about 50 affected gene loci encoding about 30 genes have been so far identified to be involved in the pathogenesis of different CMTs. Depending on structural and electrophysiological features CMTs are divided into axonal and demyelinating forms. Peripheral myelin protein 22 (PMP22), myelin protein zero (MPZ) and connexin 32 (GJB1) are the most frequently affected genes in human demyelinating neuropathies and a variety of animal models have been designed to mimic these human disorders. These models rely on the deletion, overexpression or mutation of the gene relevant for a human neuropathy and usually clinical symptoms occur early in life and the course of disease is progressive. Recently, Sanz-Moreno et al. published the partial deletion of the transcription factor Myc interacting zinc finger protein 1 (Miz1) in Schwann cells of mice and observed a late onset demyelinating neuropathy with a spontaneous clinical remission, introducing a unique new model to study peripheral nerve regeneration.

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    Exosomes in neurological disease, neuroprotection, repair and therapeutics: problems and perspectives
    Anuradha Kalani, Neetu Tyagi
    2015, 10 (10):  1565-1567.  doi: 10.4103/1673-5374.165305
    Abstract ( 519 )   PDF (302KB) ( 733 )   Save

    Exosomes have special cellular functions and neovascularization properties, angiogenetic potential and rejuvenating powers as stem cells do. Hence, devastating cerebral diseases can be challenged with exosomes in an individual-specific manner. Considering the enormous intriguing paracrine properties of exosomes, there is future probability of constructing an individual specific nano-vesicle banks that could help as therapy in lifetime of humans.

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    Superparamagnetic iron oxide nanoparticles: promote neuronal regenerative capacity?
    Jenni Neubert, Anja U. Bräuer
    2015, 10 (10):  1568-1569.  doi: 10.4103/1673-5374.165306
    Abstract ( 249 )   PDF (150KB) ( 696 )   Save

    Based on our findings and those of other investigators, we postulate that there are a variety of possibilities for promoting neuronal regeneration using SPIOs. Compared to in vivo testing, our in vitro studies do have some limitations, e.g., they do not permit the assessment of three-dimensional network interaction. However, in vitro SPIO studies are certainly necessary to clarify particle- and cell type-induced effects that exclude external stimuli. In addition, the benefits of nanoparticles must be weighed against their potential adverse effects. In particular, it is essential to refer more to physicochemical features including size, surface coating and SPIO charge as these strongly influence e.g. their degradation, target specificity, and long-term storage. Furthermore, SPIOs may induce the release of mediators for inflammation, apoptosis and oxidative stress through microglial and astrocyte activation. The complex interaction of signaling molecules at both the inter- and intracellular levels is challenging for precisely determining SPIO-induced effects. We need a deeper understanding of the molecular mechanisms induced by SPIOs to develop safety guidelines for their clinical application. Nevertheless, nanoparticles have already proven to be powerful tools for basic research and offer many advantages. This trend is expected to expand in terms of their fields of application.

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    Role of myelin sheath energy metabolism in neurodegenerative diseases
    Silvia Ravera, Isabella Panfoli
    2015, 10 (10):  1570-1571.  doi: 10.4103/1673-5374.167749
    Abstract ( 241 )   PDF (247KB) ( 718 )   Save

    More than any other organs, brain energy demand is entirely dependent on glucose catabolism through the oxidative phosphorylation (OXPHOS). Glucose is the major cerebral energy substrate in the nervous system (NS). Ketone bodies can utilized as an additional substrate, but in any case, neurons critically depend on oxygen supply. This sounds quite surprising considering that NS contains few mitochondria, which are universally considered the exclusive site of OXPHOS.

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    Effects of cancer therapy on hippocampus-related function
    Miyoung Yang, Changjong Moon
    2015, 10 (10):  1572-1573.  doi: 10.4103/1673-5374.165234
    Abstract ( 282 )   PDF (260KB) ( 704 )   Save

    The process of generating new neurons in the hippocampus, or hippocampal neurogenesis, is putatively regarded as a principle target of chemotherapy- and radiotherapy-induced side effects, particularly in relation to cognitive deficits. Following chemotherapy or radiotherapy, experimental animals exhibit significant reductions in neurogenesis and cell proliferation in the dentate gyrus of the hippocampus in conjunction with memory impairments across diverse behavioral paradigms. Reductions in neurogenesis and diminished memory capabilities have also been observed following relatively low doses of ionizing radiation (e.g., 2 Gy of γ-ray and 0.8 Gy of neutrons) or cyclophosphamide treatment (40 mg/kg, intraperitoneal [i.p.]), but these changes are reversible over time. However, exposure to relatively high doses of γ-ray (10 Gy) irradiation or methotrexate (MTX; 40 mg/kg, i.p.) treatment results in long-lasting alterations of neurogenesis and memory function.

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    Insights of the brain damage response using antibodies identifying surface antigens on neural stem cells and neuroblasts
    Silvia Santamaria, Jose A. Garcia-Sanz
    2015, 10 (10):  1574-1575.  doi: 10.4103/1673-5374.165266
    Abstract ( 238 )   PDF (435KB) ( 661 )   Save

    Similarly to other adult tissues, a hierarchical structure has been established for the brain, where the differentiated cell types (neurons, oligodendrocytes and astrocytes) are generated from primary progenitor cells, known as type B astrocytes or neural stem cells (NSC), through one or multiple stages of amplification (transient amplifying cells) that generate precursors (iPC) with more restricted potential nIPCs (neural), aIPCs (astrocytes), oIPC (oligodendrocytes). In the adult rodent brain, NSCs and iPCs are mainly restricted to the niches on the subventricular zone (SVZ) of the lateral ventricles. This hierarchical structure of the brain is critical for the understanding brain development and adult neurogenesis, to develop new strategies for brain repair, or for the understanding of brain tumor development. In conclusion, the use of mAbs recognizing surface markers on either NSC or neuroblasts open up a series of possibilities, for example, they allow to purify these cells from cell suspensions, identify them cells in their niches, or demonstrate in vivo their migration towards damage sites. In addition allows envisaging the possibility of identifying the focal sites on epileptic brains after a seizure, or on initial stages of Parkinson or Alzheimer’s. Finally, if the mAb anti-NSC recognizes the CSC in human gliomas, it might turn out as the first therapeutic drug targeting neural CSC.

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    Glypican 4 down-regulation in pluripotent stem cells as a potential strategy to improve differentiation and to impair tumorigenicity of cell transplants
    Rosanna Dono
    2015, 10 (10):  1576-1577.  doi: 10.4103/1673-5374.165274
    Abstract ( 236 )   PDF (155KB) ( 682 )   Save

    Glypican 4 down-regulation in pluripotent stem cells as a potential strategy to improve differentiation and to impair tumorigenicity of cell transplants
    Recent advances in stem cell technologies have opened new avenues for the treatment of a number of diseases that still lack effective therapeutic options. In this regard, cell transplantation has emerged as the most promising clinical medical intervention for the repair, replacement, and regeneration of dysfunctional or dead cells. Examples of specific disorders that might benefit from stem cell-based therapies are injuries, diabetes, liver and retinal diseases, neurological disorders and possibly heart failure. To date much attention has been given to the potential application of human pluripotent stem cells (hPSCs) including both embryonic (hESCs) and the induced pluripotent stem cells (hiPSCs) for regenerative medicine. Besides being considered particularly relevant for disease modeling, drug discovery and for pharmaceutical applications, extensive research is underway to determine whether hPSCs can become a potent and safe resource of transplantable therapeutics. Owing to their remarkable ability to self-renewal indefinitely and to differentiate into all mature cell types hPSCs would be of great advantage to generate an unlimited number of disease-relevant cells. From a clinical perspective, it is likely that hPSC-derivatives such as progenitor cells and/or more differentiated somatic cell types rather than the “bonafide” hPSCs will be transplanted. Although the risk of having tumor-promoting cells in grafts might be relatively low when transplanting small cell numbers (e.g., for retinal regeneration), the greatest challenge occurs when treating diseases requiring large quantities of hPSC-derived cells. Also, as knowledge on transplantation-based therapies will advance, new set of variables such as batch-to-batch differences in hPSC differentiation efficacy might arise. As discussed above, a variety of approaches are being developed to ensure that no self-renewing cells remain in the graft. However, there is an ongoing need to improve these methods in order to achieve realistic, cost effective and clinically applicable strategies. It will be important to evaluate whether the most stringent safety procedure arise from combining different technologies that can be shaped according to disease and cell graft needs.

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    Transforming growth factor β1-mediated anti-inflammation slows progression of midbrain dopaminergic neurodegeneration in Parkinson’s disease?
    Björn Spittau
    2015, 10 (10):  1578-1580.  doi: 10.4103/1673-5374.165228
    Abstract ( 273 )   PDF (822KB) ( 873 )   Save

    Parkinson´s disease (PD) is characterized by the progressive loss of midbrain dopaminergic (mDA) neurons and a subsequent decrease in striatal dopamine levels which cause the typical clinical motor symptoms such as muscle rigidity, bradykinesia and tremor. Although a subset of PD cases has been described to arise from inherited mutations of genes such as α-Synuclein or Lrkk2, the majority of PD cases develop spontaneously. Despite intensive research, the molecular mechanisms underlying degeneration of mDA neurons are only poorly understood. Interestingly, a common hallmark of virtually all PD cases is a neuroinflammatory response that is predominantly mediated by microglia - the resident immune cells of the central nervous system (CNS). Among the endogenous factors that are capable of regulating microglia activation states, Transforming growth factor β1 (TGFβ1) has been shown to be one of the most potent factors in vivo and in vitro. TGFβ1 immunoreactivity is detectable in midbrain neurons but not in microglia which extend their processes towards TGFβ1-positive midbrain neurons and are located in close proximity to these neurons. This expression pattern suggests, that neuron-derived TGFβ1 might be important to maintain microglia homeostasis under physiological conditions. Indeed, Butovsky and colleagues (2014) have reported that lack of TGFβ1 in the CNS resulted in functional and morphological impairment of microglia. However, it has to be mentioned that the authors used TGFβ1-deficient mice which were crossed to mice expressing TGFβ1 under the control of the IL2-promoter. This approach prevents the lethal postnatal phenotype of TGFβ1-/- mice, which die due to a systemic inflammation mediated by T cells. It remains to be established whether neuron-derived TGFβ1 is essential to mediate microglia maintenance or whether peripheral effects of TGFβ1-deletion are responsible for the microglia phenotype observed by Butovsky et al. (2014).

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    Neurodegeneration and neuroinflammation: two processes, one target
    Paulina Carriba, Joan X. Comella
    2015, 10 (10):  1581-1583.  doi: 10.4103/1673-5374.165269
    Abstract ( 319 )   PDF (580KB) ( 590 )   Save

    The etiology of neurodegenerative diseases is diverse, however most of them share common characteristics: accumulation of misfolded proteins, chronic and sustained neuroinflammation, and the dysfunction and death of certain populations of neurons. The brain of Alzheimer’s disease (AD) patients presents amyloid plaques and aggregation of hyperphosphorylated Tau. The latter is also present in neurodegenerative tauopathies and in Parkinson’s disease (PD). Aggregates of ?-synuclein is the characteristic hallmark of PD. In amyotrophic lateral sclerosis (ALS), the mutation of SOD1 promotes its accumulation; and the polyglutamine expansion in huntingtin protein favors its aggregation in Huntington’s disease (HD). Thus, the initial proteinopathy could be responsible for triggering the activation of the immunological defenses in the nervous system, as it has been demonstrated in some cases. Microglia and astrocytes are the main glial cells involved in the innate inflammatory response in the central nervous system (CNS). These cells are capable of detecting danger signals, and when activated they secrete inflammatory mediators to try to protect or prevent damage. However, in some cases the inflammatory response becomes sustained by an amplified feedback of release of factors between microglia and astrocytes that further activates these cells. This promotes the recruitment of more glial cells that prolongs and up-regulates the neuroinflammatory response contributing to the progression of the disease. Neurodegeneration has a remarkable apoptotic component; sustained neuroinflammatory response along with the deregulation of protective mechanisms trigger neuronal death.

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    Myelin morphology and axon pathology in demyelination during experimental autoimmune encephalomyelitis
    Yoshio Bando
    2015, 10 (10):  1584-1585.  doi: 10.4103/1673-5374.165287
    Abstract ( 353 )   PDF (289KB) ( 575 )   Save

    In the central nervous system (CNS), oligodendrocytes are responsible for myelination by wrapping around the axon and maintaining saltatory conduction. Damage to oligodendrocytes and the myelin sheath around nerves is termed demyelination. Multiple Sclerosis (MS) is an inflammatory demyelinating disease in the CNS characterized by immune-mediated disease, with autoimmune responses against myelin antigens and inflammation contributing to the pathogenesis of demyelination in the CNS. Although various genetic and/or non-genetic triggers such as viral infections, metabolism, or environmental factors have been associated with the pathogenesis of MS, the major cause of the disease remains unknown. To date, it is widely accepted that immune cells attack myelinated axons in the CNS, followed by demyelination and axonal degeneration. For instance, activated autoreactive T cells and myelin-specific T cells can facilitate the recruitment of macrophages by producing various cytokines and chemokines. Infiltrating inflammatory cells are activated within the CNS and interact with other immune cells and neuronal cells, resulting in oligodendroglial cell death-mediated demyelination, glial cell activation and axonal degeneration. Therefore, it has been suggested that demyelination and oligodendroglial cell death in MS is passively induced by infiltrating immune cells.

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    Gene therapy for Parkinson’s disease: a decade of progress supported by posthumous contributions from volunteer subjects
    Raymond T. Bartus
    2015, 10 (10):  1586-1588.  doi: 10.4103/1673-5374.167783
    Abstract ( 296 )   PDF (974KB) ( 607 )   Save

    Over the past decade, nine separate gene therapy clinical trials for advanced Parkinson’s disease (PD) have been launched and completed, involving the dosing of nearly 12-dozen PD volunteers who incurred significant risks to hopefully reduce symptoms and gain a better life. Each attempted to directly or indirectly correct or compensate for the dysfunction and death of dopamine neurons that originate in the substantia nigra (located in the brain stem), projecting their axon terminals to the putamen (centrally located within each cerebrum). All told, incalculable hours were spent planning and executing these clinical trials, collectively costing hundreds of millions of dollars. After all is said and done- what has been gained? It would be understandable if one answered that question by pointing out that treatments for PD have not improved following these efforts, for advanced patients are left with the same choices- and the same disappointing prognosis- faced a decade ago. However, as with any nascent and highly complicated endeavor, especially one also applying highly innovative and unproven technology, initial progress is often better measured by how much new information has been gained to guide further efforts, rather than how closely the ultimate goals may have been met.

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    Fortuitous benefits of activity-based rehabilitation in stem cell-based therapy for spinal cord repair:enhancing graft survival
    Dong Hoon Hwang, Hae Young Shin, Byung Gon Kim
    2015, 10 (10):  1589-1590.  doi: 10.4103/1673-5374.167750
    Abstract ( 202 )   PDF (426KB) ( 563 )   Save

    Traumatic injuries to spinal cord elicit diverse signaling pathways leading to unselective and complex pathological outcomes: death of multiple classes of neural cells, formation of cystic cavities and glial scars, disruption of axonal connections, and demyelination of spared axons, all of which can contribute more or less to debilitating functional impairments found in patients with spinal cord injury. The multitude of pathobiological processes involved in spinal cord trauma may make it highly challenging to develop a clinically meaningful therapeutic approach targeting only a specific molecule or signaling pathway. A hopeful alternative might be a cell therapy, especially a transplantation approach using neural stem cells (NSC) with a clear potential to differentiate into various neural cell types. Provision of NSCs with capacity to differentiate into mature neural cells can ideally replace lost segmental neurons and dying oligodendrocytes around surviving axons. Furthermore, NSCs secrete various growth factors that provide protective or pro-regenerative effects. It has been also demonstrated that NSCs can exert powerful modulatory effects on immune cells ameliorating secondary degenerative processes.

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    Repositioning imatinib for spinal cord injury
    Jacob Kjell, Lars Olson
    2015, 10 (10):  1591-1593.  doi: 10.4103/1673-5374.167751
    Abstract ( 300 )   PDF (351KB) ( 598 )   Save

    There are currently a number of drugs in clinical trial or close to it, several of them repositioned. In imatinib we believe we have found an additional promising therapeutic candidate, together with candidate efficacy biomarkers. Previous trials have proved the challenge is daunting. Nevertheless, taking all current approaches into account, there is now room for cautious optimism that there will be drugs available in the not too distant future, able to dampen the lasting effects of acute spinal cord damage.

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    Neural prostheses for restoring functions lost after spinal cord injury
    Marc Fakhoury
    2015, 10 (10):  1594-1595.  doi: 10.4103/1673-5374.165267
    Abstract ( 407 )   PDF (184KB) ( 648 )   Save

    This disorder is typically classified into complete and incomplete SCI. Individuals suffering from a complete SCI have little prospect of rehabilitation, whereas motor recovery can still take place in patients with incomplete SCI. Damage to the spinal cord can lead to a variety of different outcomes, depending on the severity and location of the injury. For instance, high cervical lesions lead to paralysis of the four limbs (tetraplegia), whereas lower lesions lead to paralysis of the lower part of the body (paraplegia).The majority of patients with SCI also experience complications such as respiratory infections, urinary tract infections, cardiovascular diseases, as well as comorbid psychiatric symptoms such as depression and anxiety. At the molecular level, SCI causes biochemical changes leading to the death of a variety of cells, including neurons and astrocytes. Ongoing demyelination and apoptosis of oligodendrocytes are also commonly observed following damage to the spinal cord. One of the key events mediating motor recovery in patients with incomplete SCI is neural regeneration, which occurs during the first days after injury and can take months to years to fully develop. It is well known that primates and humans subjected to spinal cord hemisection lesions typically exhibit an extensive ability to recover volitionally guided locomotion, due to spontaneous plasticity of corticospinal axons at the level of the injury. In the past few years, continued research in the field of neural regeneration has helped researchers identified specific targets that may mitigate the symptoms of SCI and promote long-term functional recovery. However, despite the tremendous growth in the number of nonoperative and operative treatment strategies, neural regeneration and functional recovery after damage to the spinal cord remains very limited. This field of research would clearly benefit from ongoing development of new therapeutic approaches that could facilitate functional rehabilitation.

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    Targeting acute inflammation to complement spinal cord repair
    Faith H. Brennan, Marc J. Ruitenberg
    2015, 10 (10):  1596-1598.  doi: 10.4103/1673-5374.165268
    Abstract ( 278 )   PDF (346KB) ( 612 )   Save

    Immune effector mechanisms play key roles in the progressive (secondary) neurodegenerative changes that follow spinal cord injury (SCI). In our recent paper, we showed that the inflammatory response to SCI includes rapid and robust activation of the innate immune complement system, with tissue levels of complement component 5a (C5a – an activation product that is generated by the proteolysis of complement factor 5 (C5)) peaking between 12 and 24 hours post-injury. Activation of the complement system normally forms the frontline of host defense to microbial challenges. It is now widely recognized, however, that the activation of complement can also modify disease course and/or disease outcomes in sterile inflammatory conditions, including those that affect the nervous system like SCI. Complement activation in such conditions has been mostly thought of as detrimental, but several reports have emerged in recent years also ascribing positive roles to at least some components of the complement cascade in tissue regeneration and repair. In studying the role of C5a in SCI, we generated novel insights regarding how this particular complement activation product is involved in endogenous repair processes. Specifically, we showed that engagement of the primary receptor for C5a, C5aR1 (also known as C5aR or CD88), during the post-acute phase regulates injury-induced astrocyte proliferation. Here, we overview these newly identified mechanisms and also highlight a number of outstanding questions that remain to be addressed when considering the therapeutic targeting of C5a-C5aR1 axis for the treatment of central nervous system (CNS) injury.

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    Acute optic neuritis: a clinical paradigm for evaluation of neuroprotective and restorative strategies?
    Sara S. Qureshi, Elliot M. Frohman
    2015, 10 (10):  1599-1601.  doi: 10.4103/1673-5374.165286
    Abstract ( 233 )   PDF (1364KB) ( 635 )   Save

    Acute optic neuritis (AON) is a common, and often the earliest manifestation of central nervous system (CNS) inflammatory demyelinating disorders like multiple sclerosis (MS) and neuromyelitis optica. It affects at least half the patients with MS and is the presenting feature in 15-20% of patients Several unique features of the afferent visual pathway (AVP) make the AON model an ideal system to study disease pathogenesis and evaluate potential neuroprotective and myelin repair strategies. Over the past decade, advancements in technology have made precise structural, functional and electrophysiological characterization of the AVP possible, using sensitive and largely non-invasive methods. These techniques, now validated, have confirmed correlation of structural, functional and electrophysiological measures of the AVP. Furthermore, investigations have established association of clinical and radiologic non-ocular disease activity in MS with accelerated loss of retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layers (GCIPL) of the retina, as measured by optical coherence tomography (OCT). Since, retinal changes in MS appear to reflect global CNS processes, it appears reasonable to generalize lessons learnt from the AVP to the CNS as a whole in CNS inflammatory demyelinating disorders. The presence of axons and glia in the absence of myelin is a feature unique to the retina in the CNS. This allows for independent monitoring of the derivative elements of CNS inflammatory injury; demyelination, axon loss and neuronal degeneration. Cases with relative axon preservation, ideal candidates for myelin repair, can be differentiated from those with axon involvement that require reconstitution of axon circuitry before myelin repair is attempted. Similarly, neuroprotective and even regenerative capabilities can be detected and monitored longitudinally using sensitive techniques to quantify RNFL and GCIPL thickness. In this article, we will describe the modern, high precision, para-clinical tools that enable precise structural, functional and electrophysiological analysis of the AVP. This is followed by a discussion of the current and potential future applications of novel technology to study putative neuroprotective and myelin repair strategies, in an attempt to identify agents that preserve and repair tissue architecture, electrophysiology, and ultimately function.

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    Role of GSK3 in peripheral nerve regeneration
    Heike Diekmann, Dietmar Fischer
    2015, 10 (10):  1602-1603.  doi: 10.4103/1673-5374.167753
    Abstract ( 237 )   PDF (284KB) ( 585 )   Save

    GSK3 phosphorylation reportedly supports regeneration-promoting gene transcription (e.g., SMAD expression). Therefore, opposing GSK3 regulation in different neuronal compartments (e.g., soma vs. growth cone) or direct manipulation of downstream GSK3 targets instead of GSK3 itself may further increase the regenerative response in comparison to globally increased GSK3 activity. Finally, it needs to be investigated whether GSK3 DKI mice show improved axon regeneration also in the CNS. We envisage that increased microtubule dynamics might be rather unfavorable for regenerating axons that encounter an inhibitory (thus microtubule-depolymerizing) environment as in the CNS. Therefore, negligible or even opposite effects of GSK3S/A on CNS axonal regeneration are equally expectable and further experiments are required to address these possibilities. Surely, the complexity of GSK3 signaling will provide more interesting features in the future, which could then potentially be developed into novel therapeutic treatment options for nerve injuries.

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    Monocarboxylate transporter 4 plays a significant role in the neuroprotective mechanism of ischemic preconditioning in transient cerebral ischemia
    Seongkweon Hong, Ji Yun Ahn, Geum-Sil Cho, In Hye Kim, Jeong Hwi Cho, Ji Hyeon Ahn, Joon Ha Park, Moo-Ho Won,Bai Hui Chen, Bich-Na Shin, Hyun-Jin Tae, Seung Min Park, Jun Hwi Cho, Soo Young Choi, Jae-Chul Lee
    2015, 10 (10):  1604-1611.  doi: 10.4103/1673-5374.167757
    Abstract ( 276 )   PDF (1988KB) ( 1175 )   Save

    Monocarboxylate transporters (MCTs), which carry monocarboxylates such as lactate across biological membranes, have been associated with cerebral ischemia/reperfusion process. In this study, we studied the effect of ischemic preconditioning (IPC) on MCT4 immunoreactivity after 5 minutes of transient cerebral ischemia in the gerbil. Animals were randomly designated to four groups (sham-operated group, ischemia only group, IPC + sham-operated group and IPC + ischemia group). A serious loss of neuron was found in the stratum pyramidale of the hippocampal CA1 region (CA1), not CA2/3, of the ischemia-only group at 5 days post-ischemia;
    however, in the IPC + ischemia groups, neurons in the stratum pyramidale of the CA1 were well protected. Weak MCT4 immunoreactivity was found in the stratum pyramidale of the CA1 in the sham-operated group. MCT4 immunoreactivity in the stratum pyramidale began to decrease at 2 days post-ischemia and was hardly detected at 5 days post-ischemia; at this time point, MCT4 immunoreactivity was newly expressed in astrocytes. In the IPC + sham-operated group, MCT4 immunoreactivity in the stratum pyramidale of the CA1 was increased compared with the sham-operated group, and, in the IPC + ischemia group, MCT4 immunoreactivity was also increased in the stratum pyramidale compared with the ischemia only group. Briefly, present findings show that IPC apparently protected CA1 pyramidal neurons and increased or maintained
    MCT4 expression in the stratum pyramidale of the CA1 after transient cerebral ischemia. Our findings suggest that MCT4 appears to play a significant role in the neuroprotective mechanism
    of IPC in the gerbil with transient cerebral ischemia.

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    Co-culture of oligodendrocytes and neurons can be used to assess drugs for axon regeneration in the central nervous system
    Lin Gang, Yu-chen Yao, Ying-fu Liu, Yi-peng Li, Kai Yang, Lei Lu, Yuan-chi Cheng, Xu-yi Chen, Yue Tu
    2015, 10 (10):  1612-1616.  doi: 10.4103/1673-5374.167759
    Abstract ( 405 )   PDF (814KB) ( 1047 )   Save

    We present a novel in vitro model in which to investigate the efficacy of experimental drugs for the promotion of axon regeneration in the central nervous system. We co-cultured rat hippocampal
    neurons and cerebral cortical oligodendrocytes, and tested the co-culture system using a Nogo-66 receptor antagonist peptide (NEP1–40), which promotes axonal growth. Primary cultured oligodendrocytes suppressed axonal growth in the rat hippocampus, but NEP1–40 stimulated axonal growth in the co-culture system. Our results confirm the validity of the neuron-oligodendrocyte co-culture system as an assay for the evaluation of drugs for axon regeneration
    in the central nervous system.

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    Geniposide prevents rotenone-induced apoptosis in primary cultured neurons
    Lin Li, Juan Zhao, Ke Liu, Guang-lai Li, Yan-qing Han, Yue-ze Liu
    2015, 10 (10):  1617-1621.  doi: 10.4103/1673-5374.167760
    Abstract ( 197 )   PDF (826KB) ( 780 )   Save

    Geniposide, a monomer extracted from gardenia and widely used in Chinese medicine, is a novel agonist at the glucagon-like peptide-1 receptor. This receptor is involved in neuroprotection. In the present study, we sought to identify an anti-apoptotic mechanism for the treatment of neurodegenerative diseases. Primary cultured neurons were treated with different concentrations of rotenone for 48 hours. Morphological observation, cell counting kit-8 assay, lactate dehydrogenase detection and western blot assay demonstrated that 0.5 nM rotenone increased lactate dehydrogenase release, decreased the expression of procaspase-3 and Bcl-2, and increased cleaved caspase-3 expression in normal neurons. All these effects were prevented by geniposide. Our results indicate that geniposide diminished rotenone-induced injury in primary neurons by suppressing apoptosis. This may be one of the molecular mechanisms underlying the efficacy of geniposide in the treatment of neurodegenerative diseases.

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    Decoding brain responses to pixelized images in the primary visual cortex: implications for visual cortical prostheses
    Bing-bing Guo, Xiao-lin Zheng, Zhen-gang Lu, Xing Wang, Zheng-qin Yin, Wen-sheng Hou, Ming Meng
    2015, 10 (10):  1622-1627.  doi: 10.4103/1673-5374.167761
    Abstract ( 162 )   PDF (578KB) ( 688 )   Save

    Visual cortical prostheses have the potential to restore partial vision. Still limited by the low-resolution visual percepts provided by visual cortical prostheses, implant wearers can currently only “see” pixelized images, and how to obtain the specific brain responses to different pixelized images in the primary visual cortex (the implant area) is still unknown. We conducted a functional magnetic resonance imaging experiment on normal human participants to investigate the brain activation patterns in response to 18 different pixelized images. There were 100 voxels in the brain activation pattern that were selected from the primary visual cortex, and voxel size was 4 mm × 4 mm × 4 mm. Multi-voxel pattern analysis was used to test if these 18 different brain activation patterns were specific. We chose a Linear Support Vector Machine (LSVM) as the classifier in this study. The results showed that the classification accuracies of different brain activation patterns were significantly above chance level, which suggests that the classifier can successfully distinguish the brain activation patterns. Our results suggest that the specific brain activation patterns to different pixelized images can be obtained in the primary visual cortex using a 4 mm × 4 mm × 4 mm voxel size and a 100-voxel pattern.

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    Neuroprotective effects of electroacupuncture on early- and late-stage spinal cord injury
    Min-fei Wu, Shu-quan Zhang, Jia-bei Liu3, Ye Li, Qing-san Zhu, Rui Gu
    2015, 10 (10):  1628-1634.  doi: 10.4103/1673-5374.167762
    Abstract ( 197 )   PDF (1537KB) ( 953 )   Save

    Previous studies have shown that the neurite growth inhibitor Nogo-A can cause secondary neural damage by activating RhoA. In the present study, we hypothesized that electroacupuncture promotes neurological functional recovery after spinal cord injury by inhibiting RhoA expression. We established a rat model of acute spinal cord injury using a modification of Allen’s method. The rats were given electroacupuncture treatment at Dazhui (Du14), Mingmen (Du4), Sanyinjiao (SP6), Huantiao (GB30), Zusanli (ST36) and Kunlun (BL60) acupoints with a sparse-dense wave at a frequency of 4 Hz for 30 minutes, once a day, for a total of 7 days. Seven days after injury, the Basso, Beattie and Bresnahan (BBB) locomotor scale and inclined plane test scores were significantly increased, the number of apoptotic cells in the spinal cord tissue was significantly reduced, and RhoA and Nogo-A mRNA and protein expression levels were decreased in rats given electroacupuncture compared with rats not given electroacupuncture. Four weeks after injury, pathological tissue damage in the spinal cord at the site of injury was alleviated, the numbers of glial fibrillary acidic protein- and neurofilament 200-positive fibers were increased, the latencies of somatosensory-evoked and motor-evoked potentials were shortened, and their amplitudes were increased in rats given electroacupuncture. These findings suggest that electroacupuncture
    treatment reduces neuronal apoptosis and decreases RhoA and Nogo-A mRNA and protein expression at the site of spinal cord injury, thereby promoting tissue repair and neurological functional recovery.

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    Electrospun and woven silk fibroin/poly(lactic-co- glycolic acid) nerve guidance conduits for repairing peripheral nerve injury
    Ya-ling Wang, Xiao-mei Gu, Yan Kong, Qi-lin Feng, Yu-min Yang
    2015, 10 (10):  1635-1642.  doi: 10.4103/1673-5374.167763
    Abstract ( 162 )   PDF (2097KB) ( 1007 )   Save

    We have designed a novel nerve guidance conduit (NGC) made from silk fibroin and poly(lactic-co-glycolic acid) through electrospinning and weaving (ESP-NGCs). Several physical and biological properties of the ESP-NGCs were assessed in order to evaluate their biocompatibility. The physical properties, including thickness, tensile stiffness, infrared spectroscopy, porosity, and water absorption were determined in vitro. To assess the biological properties, Schwann cells were cultured in ESP-NGC extracts and were assessed by morphological observation, the MTT assay, and immunohistochemistry. In addition, ESP-NGCs were subcutaneously implanted in the backs of rabbits to evaluate their biocompatibility in vivo. The results showed that ESP-NGCs have high porosity, strong hydrophilicity, and strong tensile stiffness. Schwann cells cultured in the ESP-NGC extract fluids showed no significant differences compared to control cells in their morphology or viability. Histological evaluation of the ESP-NGCs implanted in vivo indicated a mild inflammatory reaction and high biocompatibility. Together, these data suggest that these novel ESP-NGCs are biocompatible, and may thus provide a reliable scaffold for peripheral nerve repair in clinical application.

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    Does glioblastoma cyst fluid promote sciatic nerve regeneration?
    Rafet Özay, Abit Aktaş, Mevlüt Özgür Taşkapılıoğlu, Bora Gürer, Bülent Erdoğan, Yusuf Şükrü Çağlar
    2015, 10 (10):  1643-1649.  doi: 10.4103/1673-5374.167764
    Abstract ( 246 )   PDF (1359KB) ( 757 )   Save

    Glioblastoma cyst fluid contains growth factors and extracellular matrix proteins which are known as neurotrophic and neurite-promoting agents. Therefore, we hypothesized that glioblastoma cyst fluid can promote the regeneration of injured peripheral nerves. To validate this hypothesis, we transected rat sciatic nerve, performed epineural anastomosis, and wrapped the injured sciatic nerve with glioblastoma cyst fluid- or saline-soaked gelatin sponges. Neurological function and histomorphological examinations showed that compared with the rats receiving local saline treatment, those receiving local glioblastoma cyst fluid treatment had better sciatic nerve function, fewer scars, greater axon area, counts and diameter as well as fiber diameter. These findings suggest that glioblastoma cyst fluid can promote the regeneration of injured sciatic nerve and has the potential for future clinical application in patients with peripheral nerve injury.

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    Pulsed electrical stimulation protects neurons in the dorsal root and anterior horn of the spinal cord after peripheral nerve injury
    Bao-an Pei, Jin-hua Zi, Li-sheng Wu, Cun-hua Zhang, Yun-zhen Chen
    2015, 10 (10):  1650-1655.  doi: 10.4103/1673-5374.167765
    Abstract ( 161 )   PDF (3120KB) ( 937 )   Save

    Most studies on peripheral nerve injury have focused on repair at the site of injury, but very few have examined the effects of repair strategies on the more proximal neuronal cell bodies. In this study, an approximately 10-mm-long nerve segment from the ischial tuberosity in the rat was transected and its proximal and distal ends were inverted and sutured. The spinal cord was subjected to pulsed electrical stimulation at T10 and L3, at a current of 6.5 mA and a stimulation frequency of 15 Hz, 15 minutes per session, twice a day for 56 days. After pulsed electrical stimulation, the number of neurons in the dorsal root ganglion and anterior horn was increased in rats with sciatic nerve injury. The number of myelinated nerve fibers was increased in the sciatic nerve. The ultrastructure of neurons in the dorsal root ganglion and spinal cord was noticeably improved. Conduction velocity of the sciatic nerve was also increased. These results show that pulsed electrical stimulation protects sensory neurons in the dorsal root ganglia as well as motor neurons in the anterior horn of the spinal cord after peripheral nerve injury, and that it promotes the regeneration of peripheral nerve fibers.

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    A novel therapeutic target for peripheral nerve injury-related diseases: aminoacyl-tRNA synthetases
    Byung Sun Park, Seung Geun Yeo, Junyang Jung, Na Young Jeong
    2015, 10 (10):  1656-1662.  doi: 10.4103/1673-5374.167766
    Abstract ( 214 )   PDF (3338KB) ( 692 )   Save

    Aminoacyl-tRNA synthetases (AminoARSs) are essential enzymes that perform the first step of protein synthesis. Beyond their original roles, AminoARSs possess non-canonical functions, such as cell cycle regulation and signal transduction. Therefore, AminoARSs represent a powerful pharmaceutical target if their non-canonical functions can be controlled. Using AminoARSs-specific primers, we screened mRNA expression in the spinal cord dorsal horn of rats with peripheral nerve injury created by sciatic nerve axotomy. Of 20 AminoARSs, we found that phenylalanyl-tRNA synthetase beta chain (FARSB), isoleucyl-tRNA synthetase (IARS) and methionyl-tRNA synthetase (MARS) mRNA expression was increased in spinal dorsal horn neurons on the injured side, but not in glial cells. These findings suggest the possibility that FARSB, IARS and MARS, as a neurotransmitter, may transfer abnormal sensory signals after peripheral nerve damage and become a new target for drug treatment.

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    The longitudinal epineural incision and complete nerve transection method for modeling sciatic nerve injury
    Xing-long Cheng, Pei Wang, Bo Sun, Shi-bo Liu, Yun-feng Gao, Xin-ze He, Chang-yu Yu
    2015, 10 (10):  1663-1668.  doi: 10.4103/1673-5374.167767
    Abstract ( 259 )   PDF (2828KB) ( 766 )   Save

    Injury severity, operative technique and nerve regeneration are important factors to consider when constructing a model of peripheral nerve injury. Here, we present a novel peripheral nerve injury model and compare it with the complete sciatic nerve transection method. In the experimental
    group, under a microscope, a 3-mm longitudinal incision was made in the epineurium of the sciatic nerve to reveal the nerve fibers, which were then transected. The small, longitudinal incision in the epineurium was then sutured closed, requiring no stump anastomosis. In the control group, the sciatic nerve was completely transected, and the epineurium was repaired by anastomosis. At 2 and 4 weeks after surgery, Wallerian degeneration was observed in both groups. In the experimental group, at 8 and 12 weeks after surgery, distinct medullary nerve fibers and axons were observed in the injured sciatic nerve. Regular, dense myelin sheaths were visible, as well as some scarring. By 12 weeks, the myelin sheaths were normal and intact, and a tight lamellar structure was observed. Functionally, limb movement and nerve conduction recovered in the injured region between 4 and 12 weeks. The present results demonstrate that longitudinal
    epineural incision with nerve transection can stably replicate a model of Sunderland grade IV peripheral nerve injury. Compared with the complete sciatic nerve transection model, our method reduced the difficulties of micromanipulation and surgery time, and resulted in good stump restoration, nerve regeneration, and functional recovery.

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    Femoral nerve regeneration and its accuracy under different injury mechanisms
    Aikeremujiang·Muheremu, Qiang Ao, Yu Wang, Peng Cao, Jiang Peng
    2015, 10 (10):  1669-1673.  doi: 10.4103/1673-5374.167768
    Abstract ( 300 )   PDF (129KB) ( 914 )   Save

    Surgical accuracy has greatly improved with the advent of microsurgical techniques. However, complete functional recovery after peripheral nerve injury has not been achieved to date. The mechanisms hindering accurate regeneration of damaged axons after peripheral nerve injury are in urgent need of exploration. The present study was designed to explore the mechanisms of peripheral
    nerve regeneration after different types of injury. Femoral nerves of rats were injured by crushing or freezing. At 2, 3, 6, and 12 weeks after injury, axons were retrogradely labeled using 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate (Dil) and True Blue, and motor and sensory axons that had regenerated at the site of injury were counted. The number and percentage of Dil-labeled neurons in the anterior horn of the spinal cord increased over time. No significant differences were found in the number of labeled neurons between the freeze and crush injury groups at any time point. Our results confirmed that the accuracy of peripheral nerve regeneration increased with time, after both crush and freeze injury, and indicated that axonal regeneration accuracy was still satisfactory after freezing, despite the prolonged damage.

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    Comparison of short- with long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits
    Jennifer Lynn Schiefer, Lukas Schulz, Rebekka Rath, Stéphane Stahl, Hans-Eberhard Schaller, Theodora Manoli
    2015, 10 (10):  1674-1677.  doi: 10.4103/1673-5374.165321
    Abstract ( 233 )   PDF (243KB) ( 641 )   Save

    Muscle-in-vein conduits are used alternatively to nerve grafts for bridging nerve defects. The purpose of this study was to examine short- and long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits. Static and moving two-point discriminations and Semmes-Weinstein Monofilaments were used to evaluate sensory recovery 6–12 months and 14–35 months after repair of digital nerves with muscle-in-vein in 7 cases. Both follow-ups were performed after clinical signs of progressing regeneration disappeared. In 4 of 7 cases, a further recovery of both two-point discriminations and in another case of only the static two-point discrimination of 1–3 mm could be found between the short-term and long-term follow-up examination. Moreover, a late recovery of both two-point discriminations was demonstrated in another case. Four of 7 cases showed a sensory improvement by one Semmes-Weinstein Monofilaments.
    This pilot study suggests that sensory recovery still takes place even when clinical signs of progressing regeneration disappear.

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    Inflammation and cutaneous nervous system involvement in hypertrophic scarring
    Shao-hua Li, Heng-lian Yang, Hu Xiao, Yi-bing Wang, De-chang Wang, Ran Huo
    2015, 10 (10):  1678-1682.  doi: 10.4103/1673-5374.167769
    Abstract ( 197 )   PDF (786KB) ( 915 )   Save

    This study aimed to use a mouse model of hypertrophic scarring by mechanical loading on the dorsum of mice to determine whether the nervous system of the skin and inflammation participates in hypertrophic scarring. Results of hematoxylin-eosin and immunohistochemical staining demonstrated that inflammation contributed to the formation of a hypertrophic scar and increased the nerve density in scar tissue.Western blot assay verified that interleukin-13 expression was increased in scar tissue. These findings suggest that inflammation and the cutaneous nervous system play a role in hypertrophic scar formation.

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    An efficient strategy for establishing a model of sensorineural deafness in rats
    Long Ma, Hai-jin Yi, Fen-qian Yuan, Wei-wei Guo, Shi-ming Yang
    2015, 10 (10):  1683-1689.  doi: 10.4103/1673-5374.153704
    Abstract ( 320 )   PDF (2205KB) ( 846 )   Save

    Ototoxic drugs can be used to produce a loss of cochlear hair cells to create animal models of deafness. However, to the best of our knowledge, there is no report on the establishment of a rat deafness model through the combined application of aminoglycosides and loop diuretics. The aim of this study was to use single or combined administration of furosemide and kanamycin sulfate to establish rat models of deafness. The rats received intravenous injections of different
    doses of furosemide and/or intramuscular injections of kanamycin sulfate. The auditory brainstem response was measured to determine the hearing threshold after drug application. Immunocytochemistry and confocal microscopy were performed to evaluate inner ear morphology.
    In the group receiving combined administration of furosemide and kanamycin, the auditory brainstem response threshold showed significant elevation 3 days after administration, higher than that produced by furosemide or kanamycin alone. The hair cells showed varying degrees of injury, from the apical turn to the basal turn of the cochlea and from the outer hair cells to the inner hair cells. The spiral ganglion cells maintained a normal morphology during the first week after the hair cells completely disappeared, and then gradually degenerated. After 2 months, the majority of spiral ganglion cells disappeared, but a few remained. These findings demonstrate that the combined administration of furosemide and kanamycin has a synergistic ototoxic effect, and that these drugs can produce hair cell loss and hearing loss in rats. These findings suggest that even in patients with severe deafness, electronic cochlear implants may partially restore hearing.

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    Anterior subcutaneous transposition of the ulnar nerve improves neurological function in patients with cubital tunnel syndrome
    Wei Huang, Pei-xun Zhang, Zhang Peng, Feng Xue, Tian-bing Wang, Bao-guo Jiang
    2015, 10 (10):  1690-1695.  doi: 10.4103/1673-5374.167770
    Abstract ( 268 )   PDF (257KB) ( 921 )   Save

    Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients (65 elbows) diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial
    severity of the disease was evaluated using the McGowan scale as modified by Goldberg: 18 patients (28%) had grade IIA neuropathy, 20 (31%) had grade IIB, and 27 (42%) had grade III. Postoperatively, according to the Wilson & Krout criteria, treatment outcomes were excellent in 38 patients (58%), good in 16 (25%), fair in 7 (11%), and poor in 4 (6%), with an excellent and good rate of 83%. A negative correlation was found between the preoperative McGowan grade and the postoperative Wilson & Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.

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    Coexistent Charcot-Marie-Tooth type 1A and type 2 diabetes mellitus neuropathies in a Chinese family
    A-ping Sun, Lu Tang, Qin Liao, Hui Zhang, Ying-shuang Zhang, Jun Zhang
    2015, 10 (10):  1696-1697.  doi: 10.4103/1673-5374.167771
    Abstract ( 331 )   PDF (530KB) ( 709 )   Save

    Charcot-Marie-Tooth disease type 1A (CMT1A) is caused by duplication of the peripheral myelin protein 22 (PMP22) gene on chromosome 17. It is the most common inherited demyelinating
    neuropathy. Type 2 diabetes mellitus is a common metabolic disorder that frequently causes predominantly sensory neuropathy. In this study, we report the occurrence of CMT1A in a Chinese family affected by type 2 diabetes mellitus. In this family, seven individuals had duplication
    of the PMP22 gene, although only four had clinical features of polyneuropathy. All CMT1A patients with a clinical phenotype also presented with type 2 diabetes mellitus. The other three individuals had no signs of CMT1A or type 2 diabetes mellitus. We believe that there may be a genetic link between these two diseases.

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    Comparison of commonly used retrograde tracers in rat spinal motor neurons
    You-lai Yu, Hai-yan Li, Pei-xun Zhang, Xiao-feng Yin, Na Han, Yu-hui Kou, Bao-guo Jiang
    2015, 10 (10):  1700-1705.  doi: 10.4103/1673-5374.167772
    Abstract ( 395 )   PDF (668KB) ( 1260 )   Save

    The purpose of this study was to investigate the effect of four fluorescent dyes, True Blue (TB), Fluoro-Gold (FG), Fluoro-Ruby (FR), and 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate (DiI), in retrograde tracing of rat spinal motor neurons. We transected the muscle branch of the rat femoral nerve and applied each tracer to the proximal stump in single labeling experiments, or combinations of tracers (FG-DiI and TB-DiI) in double labeling experiments.
    In the single labeling experiments, significantly fewer labeled motor neurons were observed after FR labeling than after TB, FG, or DiI, 3 days after tracer application. By 1 week, there were no significant differences in the number of labeled neurons between the four groups. In the double-labeling experiment, the number of double-labeled neurons in the FG-DiI group was not significantly different from that in the TB-DiI group 1 week after tracer application. Our findings indicate that TB, FG, and DiI have similar labeling efficacies in the retrograde labeling of spinal motor neurons in the rat femoral nerve when used alone. Furthermore, combinations of DiI and TB or FG are similarly effective. Therefore, of the dyes studied, TB, FG and DiI, and combinations of DiI with TB or FG, are the most suitable for retrograde labeling studies of motor neurons in the rat femoral nerve.

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    The HMGB1 signaling pathway activates the inflammatory response in Schwann cells
    Li-li Man, Fan Liu, Ying-jie Wang, Hong-hua Song, Hong-bo Xu, Zi-wen Zhu1 Qing Zhang, Yong-jun Wang
    2015, 10 (10):  1706-1712.  doi: 10.4103/1673-5374.167773
    Abstract ( 223 )   PDF (1851KB) ( 906 )   Save

    Schwann cells are not only myelinating cells, but also function as immune cells and express numerous innate pattern recognition receptors, including the Toll-like receptors. Injury to peripheral nerves activates an inflammatory response in Schwann cells. However, it is unclear whether specific endogenous damage-associated molecular pattern molecules are involved in the inflammatory response following nerve injury. In the present study, we demonstrate that a key damage-associated molecular pattern molecule, high mobility group box 1 (HMGB1), is upregulated following rat sciatic nerve axotomy, and we show colocalization of the protein with Schw-ann cells. HMGB1 alone could not enhance expression of Toll-like receptors or the receptor for advanced glycation end products (RAGE), but was able to facilitate migration of Schwann cells. When Schwann cells were treated with HMGB1 together with lipopolysaccharide, the expression levels of Toll-like receptors and RAGE, as well as inflammatory cytokines were upregulated. Our novel findings demonstrate that the HMGB1 pathway activates the inflammatory response in Schwann cells following peripheral nerve injury.

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