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Table of Content

    15 April 2023, Volume 18 Issue 4 Previous Issue    Next Issue
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    Neural and Müller glial adaptation of the retina to photoreceptor degeneration
    Henri O. Leinonen, Edward Bull, Zhongjie Fu
    2023, 18 (4):  701-707.  doi: 10.4103/1673-5374.354511
    Abstract ( 152 )   PDF (2332KB) ( 64 )   Save
    The majority of inherited retinal degenerative diseases and dry age-related macular degeneration are characterized by decay of the outer retina and photoreceptors, which leads to progressive loss of vision. The inner retina, including second- and third-order retinal neurons, also shows aberrant structural changes at all stages of degeneration. Müller glia, the major glial cells maintain retinal homeostasis, activating and rearranging immediately in response to photoreceptor stress. These phenomena are collectively known as retinal remodeling and are anatomically well described, but their impact on visual function is less well characterized. Retinal remodeling has traditionally been considered a detrimental chain of events that decreases visual function. However, emerging evidence from functional assays suggests that remodeling could also be a part of a survival mechanism wherein the inner retina responds plastically to outer retinal degeneration. The visual system´s first synapses between the photoreceptors and bipolar cells undergo rewiring and functionally compensate to maintain normal signal output to the brain. Distinct classes of retinal ganglion cells remain even after the massive loss of photoreceptors. Müller glia possess the regenerative potential for retinal recovery and possibly exert adaptive transcriptional changes in response to neuronal loss. These types of homeostatic changes could potentially explain the well-maintained visual function observed in patients with inherited retinal degenerative diseases who display prominent anatomic retinal pathology. This review will focus on our current understanding of retinal neuronal and Müller glial adaptation for the potential preservation of retinal activity during photoreceptor degeneration. Targeting retinal self-compensatory responses could help generate universal strategies to delay sensory disease progression.
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    Targeting neuroinflammation in Alzheimer’s disease: from mechanisms to clinical applications
    Zi-Zhen Si, Chen-Jun Zou, Xi Mei, Xiao-Fang Li, Hu Luo, Yao Shen, Jun Hu, Xing-Xing Li, Lun Wu, Yu Liu
    2023, 18 (4):  708-715.  doi: 10.4103/1673-5374.353484
    Abstract ( 393 )   PDF (2052KB) ( 163 )   Save
    Alzheimer’s disease is characterized by sustained neuroinflammation leading to memory loss and cognitive decline. The past decade has witnessed tremendous efforts in Alzheimer’s disease research; however, no effective treatment is available to prevent disease progression. An increasing body of evidence suggests that neuroinflammation plays an important role in Alzheimer’s disease pathogenesis, alongside the classical pathological hallmarks such as misfolded and aggregated proteins (e.g., amyloid-beta and tau). Firstly, this review summarized the clinical and pathological characteristics of Alzheimer’s disease. Secondly, we outlined key aspects of glial cell-associated inflammation in Alzheimer’s disease pathogenesis and provided the latest evidence on the roles of microglia and astrocytes in Alzheimer’s disease pathology. Then, we revealed the double-edged nature of inflammatory cytokines and inflammasomes in Alzheimer’s disease. In addition, the potential therapeutic roles of innate immunity and neuroinflammation for Alzheimer’s disease were also discussed through these mechanisms. In the final section, the remaining key problems according to the current research status were discussed.
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    MicroRNAs as potential biomarkers in temporal lobe epilepsy and mesial temporal lobe epilepsy
    Bridget Martinez, Philip V. Peplow
    2023, 18 (4):  716-726.  doi: 10.4103/1673-5374.354510
    Abstract ( 96 )   PDF (623KB) ( 105 )   Save
    Temporal lobe epilepsy is the most common form of focal epilepsy in adults, accounting for one third of all diagnosed epileptic patients, with seizures originating from or involving mesial temporal structures such as the hippocampus, and many of these patients being refractory to treatment with anti-epileptic drugs. Temporal lobe epilepsy is the most common childhood neurological disorder and, compared with adults, the symptoms are greatly affected by age and brain development. Diagnosis of temporal lobe epilepsy relies on clinical examination, patient history, electroencephalographic recordings, and brain imaging. Misdiagnosis or delay in diagnosis is common. A molecular biomarker that could distinguish epilepsy from healthy subjects and other neurological conditions would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated. Among possible biomarkers of pathological changes as well as potential therapeutic targets in the epileptic brain are microRNAs. Most of the recent studies had performed microRNA profiling in body fluids such as blood plasma and blood serum and brain tissues such as temporal cortex tissue and hippocampal tissue. A large number of microRNAs were dysregulated when compared to healthy controls and with some overlap between individual studies that could serve as potential biomarkers. For example, in adults with temporal lobe epilepsy, possible biomarkers are miR-199a-3p in blood plasma and miR-142-5p in blood plasma and blood serum. In adults with mesial temporal lobe epilepsy, possible biomarkers are miR-153 in blood plasma and miR-145-3p in blood serum. However, in many of the studies involving patients who receive one or several anti-epileptic drugs, the influence of these on microRNA expression in body fluids and brain tissues is largely unknown. Further studies are warranted with children with temporal lobe epilepsy and consideration should be given to utilizing mouse or rat and non-human primate models of temporal lobe epilepsy. The animal models could be used to confirm microRNA findings in human patients and to test the effects of targeting specific microRNAs on disease progression and behavior.
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    Agomelatine: a potential novel approach for the treatment of memory disorder in neurodegenerative disease
    Qiang Su, Tian Li, Guo-Wei Liu, Yan-Li Zhang, Jun-Hong Guo, Zhao-Jun Wang, Mei-Na Wu, Jin-Shun Qi
    2023, 18 (4):  727-733.  doi: 10.4103/1673-5374.353479
    Abstract ( 686 )   PDF (1512KB) ( 187 )   Save
    Agomelatine is a selective agonist of melatonin receptor 1A/melatonin receptor 1B (MT1/MT2) and antagonist of 5-hydroxytryptamine 2C receptors. It is used clinically to treat major depressive episodes in adults. The pro-chronobiological activity of agomelatine reconstructs sleep-wake rhythms and normalizes circadian disturbances via its agonistic effect of melatonin receptor 1A/melatonin receptor 1B, which work simultaneously to counteract depression and anxiety disorder. Moreover, by antagonizing neocortical postsynaptic 5-hydroxytryptamine 2C receptors, agomelatine enhances the release of dopamine and noradrenaline in the prefrontal cortex, increases the activity of dopamine and noradrenaline, and thereby reduces depression and anxiety disorder. The combination of these two effects means that agomelatine exhibits a unique pharmacological role in the treatment of depression, anxiety, and disturbance of the circadian rhythm. Emotion and sleep are closely related to memory and cognitive function. Memory disorder is defined as any forms of memory abnormality, which is typically evident in a broad range of neurodegenerative diseases, including Alzheimer’s disease. Memory impairment and cognitive impairment are common symptoms of neurodegenerative and psychiatric diseases. Therefore, whether agomelatine can improve memory and cognitive behaviors if used for alleviating depression and circadian-rhythm sleep disorders has become a research “hotspot”. This review presents the latest findings on the effects of agomelatine in the treatment of psychologic and circadian-rhythm sleep disorders in clinical trials and animal experiments. Our review evaluates recent studies on treatment of memory impairment and cognitive impairment in neurodegenerative and psychiatric diseases.
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    MicroRNAs: protective regulators for neuron growth and development
    Zhi-Xuan Ma, Zhen Liu, Hui-Hui Xiong, Zong-Pu Zhou, Li-Si Ouyang, Fu-Kang Xie, Ya-Mei Tang, Zhong-Dao Wu, Ying Feng
    2023, 18 (4):  734-745.  doi: 10.4103/1673-5374.353481
    Abstract ( 146 )   PDF (1874KB) ( 128 )   Save
    MicroRNAs (miRNAs) play an important regulatory role in neuronal growth and development. Different miRNAs target different genes to protect neurons in different ways, such as by avoiding apoptosis, preventing degeneration mediated by conditional mediators, preventing neuronal loss, weakening certain neurotoxic mechanisms, avoiding damage to neurons, and reducing inflammatory damage to them. The high expression of miRNAs in the brain has significantly facilitated their development as protective targets for therapy, including neuroprotection and neuronal recovery. miRNA is indispensable to the growth and development of neurons, and in turn, is beneficial for the development of the brain and checking the progression of various diseases of the nervous system. It can thus be used as an important therapeutic target for models of various diseases. This review provides an introduction to the protective effects of miRNA on neurons in case of different diseases or damage models, and then provides reference values and reflections on the relevant treatments for the benefit of future research in the area. 
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    Novel insights into the mechanism of reactive oxygen species-mediated neurodegeneration
    Shuji Wakatsuki, Toshiyuki Araki
    2023, 18 (4):  746-749.  doi: 10.4103/1673-5374.354509
    Abstract ( 143 )   PDF (670KB) ( 49 )   Save
    Neurite degeneration, a major component of many neurodegenerative diseases, such as Parkinson’s disease, Alzheimer’s disease, and amyotrophic lateral sclerosis, is not part of the typical apoptosis signaling mechanism, but rather it appears that a self-destructive process is in action. Oxidative stress is a well-known inducer of neurodegenerative pathways: neuronal cell death and neurite degeneration. Although oxidative stress exerts cytotoxic effects leading to neuronal loss, the pathogenic mechanisms and precise signaling pathways by which oxidative stress causes neurite degeneration have remained entirely unknown. We previously reported that reactive oxygen species generated by NADPH oxidases induce activation of the E3 ubiquitin ligase ZNRF1 in neurons, which promotes neurite degeneration. In this process, the phosphorylation of an NADPH oxidase subunit p47-phox at the 345th serine residue serves as an important checkpoint to initiate the ZNRF1-dependent neurite degeneration. Evidence provides new insights into the mechanism of reactive oxygen species-mediated neurodegeneration. In this review, we focus specifically on reactive oxygen species-induced neurite degeneration by highlighting a phosphorylation-dependent regulation of the molecular interaction between ZNRF1 and the NADPH oxidase complex.
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    In vivo astrocyte-to-neuron reprogramming for central nervous system regeneration: a narrative review
    Zuliyaer Talifu, Jia-Yi Liu, Yun-Zhu Pan, Han Ke, Chun-Jia Zhang, Xin Xu, Feng Gao, Yan Yu, Liang-Jie Du, Jian-Jun Li
    2023, 18 (4):  750-755.  doi: 10.4103/1673-5374.353482
    Abstract ( 275 )   PDF (608KB) ( 177 )   Save
    The inability of damaged neurons to regenerate within the mature central nervous system (CNS) is a significant neuroscientific challenge. Astrocytes are an essential component of the CNS and participate in many physiological processes including blood-brain barrier formation, axon growth regulation, neuronal support, and higher cognitive functions such as memory. Recent reprogramming studies have confirmed that astrocytes in the mature CNS can be transformed into functional neurons. Building on in vitro work, many studies have demonstrated that astrocytes can be transformed into neurons in different disease models to replace damaged or lost cells. However, many findings in this field are controversial, as the source of new neurons has been questioned. This review summarizes progress in reprogramming astrocytes into neurons in vivo in animal models of spinal cord injury, brain injury, Huntington’s disease, Parkinson’s disease, Alzheimer’s disease, and other neurodegenerative conditions. 
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    Potential physiological and pathological roles for axonal ryanodine receptors
    David P. Stirling
    2023, 18 (4):  756-759.  doi: 10.4103/1673-5374.354512
    Abstract ( 109 )   PDF (597KB) ( 36 )   Save
    Clinical disability following trauma or disease to the spinal cord often involves the loss of vital white matter elements including axons and glia.  Although excessive Ca2+ is an established driver of axonal degeneration, therapeutically targeting externally sourced Ca2+ to date has had limited success in both basic and clinical studies. Contributing factors that may underlie this limited success include the complexity of the many potential sources of Ca2+ entry and the discovery that axons also contain substantial amounts of stored Ca2+ that if inappropriately released could contribute to axonal demise. Axonal Ca2+ storage is largely accomplished by the axoplasmic reticulum that is part of a continuous network of the endoplasmic reticulum that provides a major sink and source of intracellular Ca2+ from the tips of dendrites to axonal terminals. This “neuron-within-a-neuron” is positioned to rapidly respond to diverse external and internal stimuli by amplifying cytosolic Ca2+ levels and generating short and long distance regenerative Ca2+ waves through Ca2+ induced Ca2+ release. This review provides a glimpse into the molecular machinery that has been implicated in regulating ryanodine receptor mediated Ca2+ release in axons and how dysregulation and/or overstimulation of these internodal axonal signaling nanocomplexes may directly contribute to Ca2+-dependent axonal demise. Neuronal ryanodine receptors expressed in dendrites, soma, and axonal terminals have been implicated in synaptic transmission and synaptic plasticity, but a physiological role for internodal localized ryanodine receptors remains largely obscure. Plausible physiological roles for internodal ryanodine receptors and such an elaborate internodal binary membrane signaling network in axons will also be discussed. 
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    Melatonin, tunneling nanotubes, mesenchymal cells, and tissue regeneration
    Francesca Luchetti, Silvia Carloni, Maria G. Nasoni, Russel J. Reiter, Walter Balduini
    2023, 18 (4):  760-762.  doi: 10.4103/1673-5374.353480
    Abstract ( 129 )   PDF (3344KB) ( 116 )   Save
    Mesenchymal stem cells are multipotent stem cells that reside in many human tissues and organs. Mesenchymal stem cells are widely used in experimental and clinical regenerative medicine due to their capability to transdifferentiate into various lineages. However, when transplanted, they lose part of their multipotency and immunomodulatory properties, and most of them die after injection into the damaged tissue. In this review, we discuss the potential utility of melatonin in preserving mesenchymal stem cells’ survival and function after transplantation. Melatonin is a pleiotropic molecule regulating critical cell functions including apoptosis, endoplasmic reticulum stress, and autophagy. Melatonin is also synthesized in the mitochondria where it reduces oxidative stress, the opening of the mitochondrial permeability transition pore and the downstream caspase activation, activates uncoupling proteins, and curtails the proinflammatory response. In addition, recent findings showed that melatonin also promotes the formation of tunneling nanotubes and the transfer of mitochondria between cells through the connecting tubules. As mitochondrial dysfunction is a primary cause of mesenchymal stem cells death and senescence and a critical issue for survival after transplantation, we propose that melatonin by favoring mitochondria functionality and their transfer through tunneling nanotubes from healthy to suffering cells could improve mesenchymal stem cell-based therapy in a large number of diseases for which basic and clinical trials are underway. 
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    Emerging roles of GPR109A in regulation of neuroinflammation in neurological diseases and pain
    Kyle Taing, Lawrence Chen, Han-Rong Weng
    2023, 18 (4):  763-768.  doi: 10.4103/1673-5374.354514
    Abstract ( 220 )   PDF (754KB) ( 128 )   Save
    Neuroinflammation plays a critical role in the pathological process of multiple neurological disorders and pathological pain conditions. GPR109A, a Gi protein-coupled receptor, has emerged as an important therapeutic target for controlling inflammation in various tissues and organs. In this review, we summarized current data about the role of GPR109A in neuroinflammation. Specifically, we focused on the pharmacological features of GPR109A and signaling pathways used by GPR109A to ameliorate neuroinflammation and symptoms in Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, stroke, and pathological pain conditions.
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    Roles of constitutively secreted extracellular chaperones in neuronal cell repair and regeneration
    Sandeep Satapathy, Mark R. Wilson
    2023, 18 (4):  769-772.  doi: 10.4103/1673-5374.353483
    Abstract ( 133 )   PDF (1036KB) ( 49 )   Save
    Protein quality control involves many processes that jointly act to regulate the expression, localization, turnover, and degradation of proteins, and has been highlighted in recent studies as critical to the differentiation of stem cells during regeneration. The roles of constitutively secreted extracellular chaperones in neuronal injury and disease are poorly understood. Extracellular chaperones are multifunctional proteins expressed by many cell types, including those of the nervous system, known to facilitate protein quality control processes. These molecules exert pleiotropic effects and have been implicated as playing important protective roles in a variety of stress conditions, including tissue damage, infections, and local tissue inflammation. This article aims to provide a critical review of what is currently known about the functions of extracellular chaperones in neuronal repair and regeneration and highlight future directions for this important research area. We review what is known of four constitutively secreted extracellular chaperones directly implicated in processes of neuronal damage and repair, including transthyretin, clusterin, α2-macroglobulin, and neuroserpin, and propose that investigation into the effects of these and other extracellular chaperones on neuronal repair and regeneration has the potential to yield valuable new therapies. 
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    Intranasal nerve growth factor for prevention and recovery of the outcomes of traumatic brain injury
    Luigi Manni, Giorgio Conti, Antonio Chiaretti, Marzia Soligo
    2023, 18 (4):  773-778.  doi: 10.4103/1673-5374.354513
    Abstract ( 109 )   PDF (1397KB) ( 86 )   Save
    Traumatic brain injury is one of the main causes of mortality and disability worldwide. Traumatic brain injury is characterized by a primary injury directly induced by the impact, which progresses into a secondary injury that leads to cellular and metabolic damages, starting in the first few hours and days after primary mechanical injury. To date, traumatic brain injury is not targetable by therapies aimed at preventing and/or limiting the outcomes of secondary damage but only by palliative therapies. Nerve growth factor is a neurotrophin targeting neuronal and non-neuronal cells, potentially useful in preventing/limiting the outcomes of secondary damage in traumatic brain injury. This potential has further increased in the last two decades since the possibility of reaching neurotrophin targets in the brain through its intranasal delivery has been exploited. Indeed, molecules intranasally delivered to the brain parenchyma may easily bypass the blood-brain barrier and reach their therapeutic targets in the brain, with favorable kinetics, dynamics, and safety profile. In the first part of this review, we aimed to report the traumatic brain injury-induced dysfunctional mechanisms that may benefit from nerve growth factor treatment. In the second part, we then exposed the experimental evidence relating to the action of nerve growth factor (both in vitro and in vivo, after administration routes other than intranasal) on some of these mechanisms. In the last part of the work, we, therefore, discussed the few manuscripts that analyze the effects of treatment with nerve growth factor, intranasally delivered to the brain parenchyma, on the outcomes of traumatic brain injury.
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    Altered O-GlcNAcylation and mitochondrial dysfunction, a molecular link between brain glucose dysregulation and sporadic Alzheimer’s disease 
    Chia-Wei Huang, Nicholas C. Rust, Hsueh-Fu Wu, Gerald W. Hart
    2023, 18 (4):  779-783.  doi: 10.4103/1673-5374.354515
    Abstract ( 120 )   PDF (561KB) ( 129 )   Save
    Alzheimer’s disease is a neurodegenerative disease that affected over 6.5 million people in the United States in 2021, with this number expected to double in the next 40 years without any sort of treatment. Due to its heterogeneity and complexity, the etiology of Alzheimer’s disease, especially sporadic Alzheimer’s disease, remains largely unclear. Compelling evidence suggests that brain glucose hypometabolism, preceding Alzheimer’s disease hallmarks, is involved in the pathogenesis of Alzheimer’s disease. Herein, we discuss the potential causes of reduced glucose uptake and the mechanisms underlying glucose hypometabolism and Alzheimer’s disease pathology. Specifically, decreased O-GlcNAcylation levels by glucose deficiency alter mitochondrial functions and together contribute to Alzheimer’s disease pathogenesis. One major problem with Alzheimer’s disease research is that the disease progresses for several years before the onset of any symptoms, suggesting the critical need for appropriate models to study the molecular changes in the early phase of Alzheimer’s disease progression. Therefore, this review also discusses current available sporadic Alzheimer’s disease models induced by metabolic abnormalities and provides novel directions for establishing a human neuronal sporadic Alzheimer’s disease model that better represents human sporadic Alzheimer’s disease as a metabolic disease.
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    Signaling interactions among neurons impact cell fitness and death in Alzheimer’s disease
    Catherine Yeates, Prajakta Deshpande, Madhuri Kango-Singh, Amit Singh
    2023, 18 (4):  784-789.  doi: 10.4103/1673-5374.354516
    Abstract ( 107 )   PDF (4034KB) ( 122 )   Save
    The pathology of Alzheimer’s disease involves a long preclinical period, where the characteristic clinical symptoms of the changes in the brain are undetectable. During the preclinical period, homeostatic mechanisms may help prevent widespread cell death. Evidence has pointed towards selective cell death of diseased neurons playing a potentially protective role. As the disease progresses, dysregulation of signaling pathways that govern cell death contributes to neurodegeneration. Aberrant activation of the c-Jun N-terminal kinase pathway has been established in human and animal models of Alzheimer’s disease caused by amyloid-beta 42- or tau-mediated neurodegeneration. Clonal mosaic studies in Drosophila that examine amyloid-beta 42 in a subset of neurons suggest complex interplay between amyloid-beta 42-expressing and wild-type cells. This review examines the role of c-Jun N-terminal kinase signaling in the context of cell competition and short-range signaling interactions between amyloid-beta 42-expressing and wild-type neurons. Cell competition is a conserved phenomenon regulating tissue integrity by assessing the fitness of cells relative to their neighbors and eliminating suboptimal cells. Somatic clones of amyloid-beta 42 that juxtapose genetically distinct neuronal cell populations show promise for studying neurodegeneration. Generating genetic mosaics with labeled clones of amyloid-beta 42- or tau-expressing and wild-type neurons will allow us to understand how short-range signaling alterations trigger cell death in neurons and thereby contribute to the progression of Alzheimer’s disease. These approaches have the potential to uncover biomarkers for early Alzheimer’s disease detection and new therapeutic targets for intervention. 
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    Pathophysiological mechanisms of chronic compressive spinal cord injury due to vascular events
    Zhen-Xiao Ren, Jing-Hui Xu, Xing Cheng, Gui-Xing Xu, Hou-Qing Long
    2023, 18 (4):  790-796.  doi: 10.4103/1673-5374.353485
    Abstract ( 97 )   PDF (4004KB) ( 48 )   Save
    Cervical spondylotic myelopathy is the main cause of non-traumatic spinal cord injury, with chronic static and/or dynamic compressive spinal cord injury as the unique pathogenesis. In the progression of this condition, the microvascular network is compressed and destroyed, resulting in ischemia and hypoxia. The main pathological changes are inflammation, damage to the blood spinal cord barriers, and cell apoptosis at the site of compression. Studies have confirmed that vascular regeneration and remodeling contribute to neural repair by promoting blood flow and the reconstruction of effective circulation to meet the nutrient and oxygen requirements for nerve repair. Surgical decompression is the most effective clinical treatment for this condition; however, in some patients, residual neurological dysfunction remains after decompression. Facilitating revascularization during compression and after decompression is therefore complementary to surgical treatment. In this review, we summarize the progress in research on chronic compressive spinal cord injury, covering both physiological and pathological changes after compression and decompression, and the regulatory mechanisms of vascular injury and repair.
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    Next generation drug connectivity mapping for acquiring therapeutic agents to differentially regulate myelination
    Kasum Azim, Andrea Domenico Rivera, Arthur Morgan Butt
    2023, 18 (4):  797-798.  doi: 10.4103/1673-5374.353486
    Abstract ( 96 )   PDF (2092KB) ( 47 )   Save
    The need for new therapeutic approaches: Conventional drug discovery is a lengthy and expensive process, taking decades and billions of dollars to get a drug from bench to bedside. Much of the costs incurred are at the pre-clinical stages, between drug design and synthesis to delineating the cellular “Mechanisms of Action” (MoA). Notably, there is a very high risk of failure, and only a very small proportion of therapeutic agents reach later-phase clinical trials. Accordingly, drug repositioning has become a valuable strategy aimed at fast-tracking treatments into clinical use and improving the chances of therapeutic success. A novel addition to this approach is connectivity mapping, which defines cell-specific transcriptional responses to small molecules in disease-dependent contexts. This commentary outlines how some of the latest innovations in connectivity mapping can be exploited for drug repurposing.
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    Acute and long-term changes in blood flow after ischemic stroke: challenges and opportunities
    Dino Premilovac, Brad A. Sutherland
    2023, 18 (4):  799-800.  doi: 10.4103/1673-5374.350699
    Abstract ( 93 )   PDF (327KB) ( 55 )   Save
    The brain has a high metabolic rate and consumes approximately 20% of the total energy in the body at any given time. Although it requires a large amount of energy to function, the brain cannot store significant amounts of energy making it exquisitely dependent on constant nutrient supply via blood flow. When blood flow to the brain is impaired, such as during stroke, there are rapid and severe consequences for the neurons that depend on this constant energy supply. 
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    Pathology-induced NG2 proteoglycan expression in microglia
    Erika Meyer, Anja Scheller
    2023, 18 (4):  801-802.  doi: 10.4103/1673-5374.353488
    Abstract ( 92 )   PDF (2769KB) ( 74 )   Save
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    Nilotinib: from animal-based studies to clinical investigation in Alzheimer’s disease patients
    Annalisa Nobili, Marcello D’Amelio, Maria Teresa Viscomi
    2023, 18 (4):  803-804.  doi: 10.4103/1673-5374.350700
    Abstract ( 100 )   PDF (884KB) ( 32 )   Save
    Since their first description in the brains of patients suffering from Alzheimer’s disease (AD), more than 100 years ago, extracellular amyloid-β (Aβ) plaques and intracellular neurofibrillary tangles have been the principal focus of AD research. However, this focus has led to the failure of several long and promising clinical trials, and the efficacy of new Aβ-targeting drugs to slow down the disease progression is still controversial despite being successful in reducing the Aβ load.
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    Multi-targeted anti-inflammatory drugs for the treatment of neurological disorders
    Austin Lui, Omar Alzayat, Timothy Do, David Perekopskiy, Meghan Gann, Taiseer Saad Elgokhy, Jie Gao, DaZhi Liu
    2023, 18 (4):  805-806.  doi: 10.4103/1673-5374.353489
    Abstract ( 96 )   PDF (388KB) ( 40 )   Save
    Inflammation and kinase pathophysiology in neurological disorders: Inflammation is one of the common features of various acute and degenerative neurological disorders, such as stroke, traumatic brain injury (TBI), Alzheimer’s disease (AD), Parkinson’s disease (PD), and others. The inflammatory responses are manifested as the synthesis of inflammation mediators, recruitment of leukocytes, and other secondary injuries. Compelling evidence shows that a large number of inflammation mediators (e.g., thrombin, reactive oxygen species, cytokines, chemokines, and other molecules) are implicated in the pathophysiological processes in neurological disorders (Liu and Ander, 2012) (Figure 1). These increased inflammation mediators stimulate their downstream transmembrane receptors (e.g., protease-activated receptors, cytokine receptors, and others), and further activate the intracellular downstream effector kinases, such as Src family kinase, Rho-associated protein kinase, Jun N-terminal kinase, extracellular signal-regulated kinase, cyclin-dependent kinase (CDK), and others (Liu and Ander, 2012) (Figure 1). Aside from overlapping in different neurological disorders, numerous inflammatory molecules and multiple kinase-involved signaling pathways can be linked to a single neurological disorder such as AD (Heneka et al., 2015). Because of their pivot roles in the process of inflammation, kinases have been regarded as anti-inflammatory targets to improve outcomes of neurological disorders.
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    Taurine: an essential amino sulfonic acid for retinal health
    Johnny Di Pierdomenico, Ana Martínez-Vacas, Serge Picaud, María P. Villegas-Pérez, Diego García-Ayuso
    2023, 18 (4):  807-808.  doi: 10.4103/1673-5374.353491
    Abstract ( 174 )   PDF (491KB) ( 60 )   Save
    Taurine (2-amino-ethanesulfonic acid) is a naturally occurring amino sulfonic acid derived from cysteine and methionine metabolism. Its common name derives from the ox, as it was first isolated from the bile of an ox (Froger et al., 2014). The molecular structure of taurine differs from that of amino acids by the presence of a sulfonic acid, instead of the more common carboxylic acid group in the structure of amino acids. Despite this, taurine is considered a non-essential amino acid because it can be synthesized endogenously in the liver of most mammals. However, the endogenous synthesis of taurine is insufficient to supply the needs and most of it is obtained through diet. 
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    Emerging non-invasive therapeutic approaches targeting hypocholinergic neural systems in Parkinson’s disease
    Nicolaas I. Bohnen, Alison J. Yarnall
    2023, 18 (4):  809-810.  doi: 10.4103/1673-5374.353490
    Abstract ( 134 )   PDF (1367KB) ( 55 )   Save
    Cholinergic system associated DOPA-refractory motor and cognitive symptoms – a need for novel therapeutic approaches: Accumulating evidence points to significant motor and non-motor morbidities associated with hypocholinergic deficits in central and peripheral neural systems in Parkinson’s disease (PD) (Bohnen et al., 2018, 2022). This so-called “malignant” hypocholinergic disease phenotype is associated with DOPA-refractory dementia and mobility disturbances, such as falls and freezing of gait, and augur novel therapeutic approaches targeting cholinergic systems in PD. Cholinergic pharmacotherapy in PD has been an interest for a long time. However, the development of cholinergic augmentation pharmacotherapy has been hampered by limited clinical efficacy, the presumption that changes in cholinergic activity are homogeneous in the central nervous system (CNS) and peripheral nervous system, tolerance or safety of cholinesterase inhibitor drugs, low CNS penetrance, high rate of peripheral autonomic side-effects and clinical contra-indications. The development of nicotinic or muscarinic receptor modulating drugs appears more promising but is still in the development stage. Given the current unmet need for managing DOPA-refractory cognitive and mobility impairments associated with hypocholinergic neural systems, there is a need for novel and complementary therapeutic and more personalized approaches.
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    Functional phenotyping of microglia highlights the dark relationship between chronic traumatic brain injury and normal age-related pathology
    Rodney M. Ritzel, Junfang Wu
    2023, 18 (4):  811-813.  doi: 10.4103/1673-5374.353487
    Abstract ( 99 )   PDF (629KB) ( 40 )   Save
    Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Age-related TBI differences demonstrate the third peak of prevalence and incidence of TBI within the elderly population. This is due to the elderly being at a higher risk of sustaining falls, which have been identified as the main cause (40–50%) of TBI. With advances in healthcare and technology, millions of TBI survivors live for decades after the initial injury; however, these individuals suffer from varying degrees of neurological impairment, including long-term cognitive deficits. Epidemiological studies show that the occurrence of TBI significantly increases the risk for the development of Alzheimer’s disease (AD) or non-AD forms of dementia, with the latter appearing to be most prevalent. Although aging is considered a key risk factor for AD/AD-related dementias (ADRD), age-associated neuropathology and neurobehavioral abnormalities can be potentiated both during aging after TBI and in patients sustaining TBI at an older age. Thus, there is an emerging confluence of TBI and AD/ADRD in the older adult population, as well as an increased risk of ADRD in patients aging after TBI, both of which reflect significant unmet healthcare challenges. 
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    Regenerative peripheral nerve interface prevents neuroma formation after peripheral nerve transection
    Zheng Wang, Xin-Zeyu Yi, Ai-Xi Yu
    2023, 18 (4):  814-818.  doi: 10.4103/1673-5374.353498
    Abstract ( 185 )   PDF (14025KB) ( 34 )   Save
    Neuroma formation after peripheral nerve transection often leads to severe neuropathic pain. Regenerative peripheral nerve interface has been shown to reduce painful neuroma in the clinic. However, no reports have investigated the underlying mechanisms, and no comparative animal studies on regenerative peripheral nerve interface and other means of neuroma prevention have been conducted to date. In this study, we established a rat model of left sciatic nerve transfection, and subsequently interfered with the model using the regenerative peripheral nerve interface or proximal nerve stump implantation inside a fully innervated muscle. Results showed that, compared with rats subjected to nerve stump implantation inside the muscle, rats subjected to regenerative peripheral nerve interface intervention showed greater inhibition of the proliferation of collagenous fibers and irregular regenerated axons, lower expressions of the fibrosis marker α-smooth muscle actin and the inflammatory marker sigma-1 receptor in the proximal nerve stump, lower autophagy behaviors, lower expressions of c-fos and substance P, higher expression of glial cell line-derived neurotrophic factor in the ipsilateral dorsal root ganglia. These findings suggested that regenerative peripheral nerve interface inhibits peripheral nerve injury-induced neuroma formation and neuropathic pain possibly via the upregulation of the expression of glial cell line-derived neurotrophic factor in the dorsal root ganglia and reducing neuroinflammation in the nerve stump.  
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    Safety and effectiveness of electromyography-induced rehabilitation treatment after epidural electrical stimulation for spinal cord injury: study protocol for a prospective, randomized, controlled trial
    Xiao-Pei Sun, Jie-Jian Shi, Yong Bao, Jie Zhang, Hui-Juan Pan, Dian-You Li, Yu Liang, Qing Xie
    2023, 18 (4):  819-824.  doi: 10.4103/1673-5374.353507
    Abstract ( 145 )   PDF (562KB) ( 48 )   Save
    Epidural electrical stimulation is a new treatment method for spinal cord injury (SCI). Its efficacy and safety have previously been reported. Rehabilitation treatment after epidural electrical stimulation is important to ensure and improve the postoperative efficacy of epidural electrical stimulation in patients with SCI. Considering that electromyography (EMG)-induced rehabilitation treatment can accurately match the muscle contraction of patients with SCI, we designed a study protocol for a prospective, randomized controlled trial. In this trial, on the premise of adjusting the spinal cord electrical stimulator to obtain the maximum EMG signal of the target muscle, patients with SCI receiving epidural electrical stimulation will undergo EMG-induced rehabilitation treatment. Recovery of muscle strength of key muscles, quality of life, safety and therapeutic effects will be monitored. Twenty patients with SCI who are scheduled to undergo epidural electrical stimulation in Shanghai Ruijin Rehabilitation Hospital will be randomly divided into two groups with 10 patients per group. The control group will receive conventional rehabilitation treatment. The EMG-induced rehabilitation group will receive EMG-induced rehabilitation treatment of the target muscles of the upper and lower limbs based on conventional rehabilitation treatment. After rehabilitation treatment, follow up for all patients will occur at 2 weeks and 1, 3 and 6 months. The primary outcome measure of this trial will be evaluation of target muscle recovery using the Manual Muscle Testing grading scale. Secondary outcome measures will include modified Barthel Index scores, integrated EMG values, the visual analogue scale, Spinal Cord Independence Measure scores, and modified Ashworth scale scores. The safety indicator will be the incidence of adverse events. This trial will collect data regarding the therapeutic effects of EMG-induced rehabilitation in patients with SCI receiving epidural electrical stimulation for 6 months after rehabilitation treatment. Findings from this trial will help develop rehabilitation methods in patients with SCI after epidural electrical stimulation. This study protocol was approved by Ethics Committee of Shanghai Ruijin Rehabilitation Hospital (Approval No. RKIRB2022-12) on February 15, 2022 and was registered with Chinese Clinical Trial Registry (registration number: ChiCTR2200061674; date: June 30, 2022). Study protocol version: 1.0.  
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    Vagus nerve stimulation is a potential treatment for ischemic stroke
    Yi-Lin Liu, San-Rong Wang, Jing-Xi Ma, Le-Hua Yu, Gong-Wei Jia
    2023, 18 (4):  825-831.  doi: 10.4103/1673-5374.350698
    Abstract ( 222 )   PDF (4848KB) ( 127 )   Save
    Microglia are the brain’s primary innate immune cells, and they are activated and affect pro-inflammatory phenotype or regulatory phenotype after ischemic stroke. Vagus nerve stimulation was shown to activate microglial phenotypic changes and exhibit neuroprotective effects in ischemia/reperfusion injury. In this study, we established rat models of ischemic stroke by occlusion of the middle cerebral artery and performed vagus nerve stimulation 30 minutes after modeling. We found that vagus nerve stimulation caused a shift from a pro-inflammatory phenotype to a regulatory phenotype in microglia in the ischemic penumbra. Vagus nerve stimulation decreased the levels of pro-inflammatory phenotype markers inducible nitric oxide synthase and tumor necrosis factor α and increased the expression of regulatory phenotype markers arginase 1 and transforming growth factor β through activating α7 nicotinic acetylcholine receptor expression. Additionally, α7 nicotinic acetylcholine receptor blockade reduced the inhibition of Toll-like receptor 4/nuclear factor kappa-B pathway-associated proteins, including Toll-like receptor 4, myeloid differentiation factor 88, I kappa B alpha, and phosphorylated-I kappa B alpha, and also weakened the neuroprotective effects of vagus nerve stimulation in ischemic stroke. Vagus nerve stimulation inhibited Toll-like receptor 4/nuclear factor kappa-B expression through activating α7 nicotinic acetylcholine receptor and regulated microglial polarization after ischemic stroke, thereby playing a role in the treatment of ischemic stroke. Findings from this study confirm the mechanism underlying vagus nerve stimulation against ischemic stroke.
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    Poly-L-ornithine blocks the inhibitory effects of fibronectin on oligodendrocyte differentiation and promotes myelin repair 
    Ya-Jie Xiong, Shahid Hussain Soomro, Zhong-Hai Huang, Pan-Pan Yu, Jie Ping, Hui Fu
    2023, 18 (4):  832-839.  doi: 10.4103/1673-5374.353493
    Abstract ( 165 )   PDF (5440KB) ( 118 )   Save
    The extracellular matrix surrounding oligodendrocytes plays an important role during myelination and remyelination in the brain. In many cases, the microenvironment surrounding demyelination lesions contains inhibitory molecules, which lead to repair failure. Accordingly, blocking the activity of these inhibitory factors in the extracellular matrix should lead to more successful remyelination. In the central nervous system, oligodendrocytes form the myelin sheath. We performed primary cell culture and found that a natural increase in fibronectin promoted the proliferation of oligodendrocyte progenitors during the initial stage of remyelination while inhibiting oligodendrocyte differentiation. Poly-L-ornithine blocked these inhibitory effects without compromising fibronectin’s pro-proliferation function. Experiments showed that poly-L-ornithine activated the Erk1/2 signaling pathway that is necessary in the early stages of differentiation, as well as PI3K signaling pathways that are needed in the mid-late stages. When poly-L-ornithine was tested in a lysolecithin-induced animal model of focal demyelination, it enhanced myelin regeneration and promoted motor function recovery. These findings suggest that poly-L-ornithine has the potential to be a treatment option for clinical myelin sheath injury.
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    Siponimod exerts neuroprotective effects on the retina and higher visual pathway through neuronal S1PR1 in experimental glaucoma
    Devaraj Basavarajappa, Vivek Gupta, Nitin Chitranshi, Roshana Vander Wall, Rashi Rajput, Kanishka Pushpitha, Samridhi Sharma, Mehdi Mirzaei, Alexander Klistorner, Stuart L. Graham
    2023, 18 (4):  840-848.  doi: 10.4103/1673-5374.344952
    Abstract ( 130 )   PDF (58047KB) ( 25 )   Save
    Sphingosine-1-phosphate receptor (S1PR) signaling regulates diverse pathophysiological processes in the central nervous system. The role of S1PR signaling in neurodegenerative conditions is still largely unidentified. Siponimod is a specific modulator of S1P1 and S1P5 receptors, an immunosuppressant drug for managing secondary progressive multiple sclerosis. We investigated its neuroprotective properties in vivo on the retina and the brain in an optic nerve injury model induced by a chronic increase in intraocular pressure or acute N-methyl-D-aspartate excitotoxicity. Neuronal-specific deletion of sphingosine-1-phosphate receptor (S1PR1) was carried out by expressing AAV-PHP.eB-Cre recombinase under Syn1 promoter in S1PR1flox/flox mice to define the role of S1PR1 in neurons. Inner retinal electrophysiological responses, along with histological and immunofluorescence analysis of the retina and optic nerve tissues, indicated significant neuroprotective effects of siponimod when administered orally via diet in chronic and acute optic nerve injury models. Further, siponimod treatment showed significant protection against trans-neuronal degenerative changes in the higher visual center of the brain induced by optic nerve injury. Siponimod treatment also reduced microglial activation and reactive gliosis along the visual pathway. Our results showed that siponimod markedly upregulated neuroprotective Akt and Erk1/2 activation in the retina and the brain. Neuronal-specific deletion of S1PR1 enhanced retinal and dorsolateral geniculate nucleus degenerative changes in a chronic optic nerve injury condition and attenuated protective effects of siponimod. In summary, our data demonstrated that S1PR1 signaling plays a vital role in the retinal ganglion cell and dorsolateral geniculate nucleus  neuronal survival in experimental glaucoma, and siponimod exerts direct neuroprotective effects through S1PR1 in neurons in the central nervous system independent of its peripheral immuno-modulatory effects. Our findings suggest that neuronal S1PR1 is a neuroprotective therapeutic target and its modulation by siponimod has positive implications in glaucoma conditions. 
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    Cyclophilin D-induced mitochondrial impairment confers axonal injury after intracerebral hemorrhage in mice
    Yang Yang, Kai-Yuan Zhang, Xue-Zhu Chen, Chuan-Yan Yang, Ju Wang, Xue-Jiao Lei, Yu-Lian Quan, Wei-Xiang Chen, Heng-Li Zhao, Li-Kun Yang, Yu-Hai Wang, Yu-Jie Chen, Hua Feng
    2023, 18 (4):  849-855.  doi: 10.4103/1673-5374.353495
    Abstract ( 130 )   PDF (4372KB) ( 107 )   Save
    The mitochondrial permeability transition pore is a nonspecific transmembrane channel. Inhibition of mitochondrial permeability transition pore opening has been shown to alleviate mitochondrial swelling, calcium overload, and axonal degeneration. Cyclophilin D is an important component of the mitochondrial permeability transition pore. Whether cyclophilin D participates in mitochondrial impairment and axonal injury after intracerebral hemorrhage is not clear. In this study, we established mouse models of intracerebral hemorrhage in vivo by injection of autologous blood and oxyhemoglobin into the striatum in Thy1-YFP mice, in which pyramidal neurons and axons express yellow fluorescent protein. We also simulated intracerebral hemorrhage in vitro in PC12 cells using oxyhemoglobin. We found that axonal degeneration in the early stage of intracerebral hemorrhage depended on mitochondrial swelling induced by cyclophilin D activation and mitochondrial permeability transition pore opening. We further investigated the mechanism underlying the role of cyclophilin D in mouse models and PC12 cell models of intracerebral hemorrhage. We found that both cyclosporin A inhibition and short hairpin RNA interference of cyclophilin D reduced mitochondrial permeability transition pore opening and mitochondrial injury. In addition, inhibition of cyclophilin D and mitochondrial permeability transition pore opening protected corticospinal tract integrity and alleviated motor dysfunction caused by intracerebral hemorrhage. Our findings suggest that cyclophilin D is used as a key mediator of axonal degeneration after intracerebral hemorrhage; inhibition of cyclophilin D expression can protect mitochondrial structure and function and further alleviate corticospinal tract injury and motor dysfunction after intracerebral hemorrhage. Our findings provide a therapeutic target for preventing axonal degeneration of white matter injury and subsequent functional impairment in central nervous diseases.
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    Spliceosomal GTPase Eftud2 regulates microglial activation and polarization
    Guo-Chao Yang, Yuan Shi, Chao-Nan Fan, Ying Li, Meng-Qi Yuan, Jie Pei, Yan Wu, Hai-Tao Wu
    2023, 18 (4):  856-862.  doi: 10.4103/1673-5374.347739
    Abstract ( 197 )   PDF (6704KB) ( 78 )   Save
    Elongation factor Tu GTP binding domain protein 2 (Eftud2) is a spliceosomal GTPase that serves as an innate immune modulator restricting virus infection. Microglia are the resident innate immune cells and the key players of immune response in the central nervous system. However, the role of Eftud2 in microglia has not been reported. In this study, we performed immunofluorescent staining and western blot assay and found that Eftud2 was upregulated in microglia of a 5xFAD transgenic mouse model of Alzheimer’s disease. Next, we generated an inducible microglia-specific Eftud2 conditional knockout mouse line (CX3CR1-CreER; Eftud2f/f cKO) via Cre/loxP recombination and found that Eftud2 deficiency resulted in abnormal proliferation and promoted anti-inflammatory phenotype activation of microglia. Furthermore, we knocked down Eftud2 in BV2 microglia with siRNA specifically targeting Eftud2 and found that Eftud2-mediated regulation of microglial proinflammatory/anti-inflammatory phenotype activation in response to inflammation might be dependent on the NF-κB signaling pathway. Our findings suggest that Eftud2 plays a key role in regulating microglial polarization and homeostasis possibly through the NF-κB signaling pathway.
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    DNA hypomethylation promotes learning and memory recovery in a rat model of cerebral ischemia/reperfusion injury
    Guang Shi, Juan Feng, Ling-Yan Jian, Xin-Yu Fan
    2023, 18 (4):  863-868.  doi: 10.4103/1673-5374.353494
    Abstract ( 173 )   PDF (1806KB) ( 136 )   Save
    Cerebral ischemia/reperfusion injury impairs learning and memory in patients. Studies have shown that synaptic function is involved in the formation and development of memory, and that DNA methylation plays a key role in the regulation of learning and memory. To investigate the role of DNA hypomethylation in cerebral ischemia/reperfusion injury, in this study, we established a rat model of cerebral ischemia/reperfusion injury by occlusion of the middle cerebral artery and then treated the rats with intraperitoneal 5-aza-2′-deoxycytidine, an inhibitor of DNA methylation. Our results showed that 5-aza-2′-deoxycytidine markedly improved the neurological function, and cognitive, social and spatial memory abilities, and dose-dependently increased the synaptic density and the expression of SYP and SHANK2 proteins in the hippocampus in a dose-dependent manner in rats with cerebral ischemia/reperfusion injury. The effects of 5-aza-2′-deoxycytidine were closely related to its reduction of genomic DNA methylation and DNA methylation at specific sites of the Syp and Shank2 genes in rats with cerebral ischemia/reperfusion injury. These findings suggest that inhibition of DNA methylation by 5-aza-2′-deoxycytidine promotes the recovery of learning and memory impairment in a rat model of cerebral ischemia/reperfusion injury. These results provide theoretical evidence for stroke treatment using epigenetic methods.
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    Fingolimod protects against neurovascular unit injury in a rat model of focal cerebral ischemia/reperfusion injury
    Xiao-Yu Zhu, Ting-Ting Ma, Yang Li, Ming-Qi Zhang, Liang Zhao, Jia Liang, Lian-Qiu Min
    2023, 18 (4):  869-874.  doi: 10.4103/1673-5374.353500
    Abstract ( 134 )   PDF (5041KB) ( 62 )   Save
    Recent research on the underlying mechanisms of cerebral ischemia indicates that the neurovascular unit can be used as a novel subject for general surveys of neuronal damage and protein mechanisms. Fingolimod (FTY-720) is a newly developed immunosuppressant isolated from Cordyceps sinensis that exhibits a wide range of biological activities, and has recently attracted much attention for the treatment of ischemic cerebrovascular diseases. In the current research, the role of FTY-720 and its possible mechanisms were assessed from an neurovascular unit perspective using a rat cerebral ischemia model. Our results revealed that FTY-720 markedly decreased infarct volume, promoted neurological function recovery, and weakened the blood-brain barrier permeability of ischemic rats. The protective roles of FTY-720 in ischemic stroke are ascribed to a combination of sphingosin-1-phosphate receptor-1 and reduced expression of sphingosin-1-phosphate receptor-1 in microvessels and reduction of interleukin-17A protein levels. These findings indicate that FTY-720 has promise as a new therapy for neurovascular protection and functional recovery after ischemic stroke.
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    Alpha2-adrenergic receptor activation reinstates motor deficits in rats recovering from cortical injury
    Gabriela García-Díaz, Laura E. Ramos-Languren, Carmen Parra-Cid, Joel Lomelí, Sergio Montes, Camilo Ríos, Antonio Bueno-Nava, Ignacio Valencia-Hernández, Rigoberto González-Piña
    2023, 18 (4):  875-880.  doi: 10.4103/1673-5374.353501
    Abstract ( 147 )   PDF (2511KB) ( 103 )   Save
    Norepinephrine plays an important role in motor functional recovery after a brain injury caused by ferrous chloride. Inhibition of norepinephrine release by clonidine is correlated with motor deficits after motor cortex injury. The aim of this study was to analyze the role of α2-adrenergic receptors in the restoration of motor deficits in recovering rats after brain damage. The rats were randomly assigned to the sham and injury groups and then treated with the following pharmacological agents at 3 hours before and 8 hours, 3 days, and 20 days after ferrous chloride-induced cortical injury: saline, clonidine, efaroxan (a selective antagonist of α2-adrenergic receptors) and clonidine + efaroxan. The sensorimotor score, the immunohistochemical staining for α2A-adrenergic receptors, and norepinephrine levels were evaluated. Eight hours post-injury, the sensorimotor score and norepinephrine levels in the locus coeruleus of the injured rats decreased, and these effects were maintained 3 days post-injury. However, 20 days later, clonidine administration diminished norepinephrine levels in the pons compared with the sham group. This effect was accompanied by sensorimotor deficits. These effects were blocked by efaroxan. In conclusion, an increase in α2-adrenergic receptor levels was observed after injury. Clonidine restores motor deficits in rats recovering from cortical injury, an effect that was prevented by efaroxan. The underlying mechanisms involve the stimulation of hypersensitive α2-adrenergic receptors and inhibition of norepinephrine activity in the locus coeruleus. The results of this study suggest that α2 receptor agonists might restore deficits or impede rehabilitation in patients with brain injury, and therefore pharmacological therapies need to be prescribed cautiously to these patients. 
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    Erythropoietin inhibits ferroptosis and ameliorates neurological function after spinal cord injury
    Yu Kang, Rui Zhu, Shuang Li, Kun-Peng Qin, Hao Tang, Wen-Shan Shan, Zong-Sheng Yin
    2023, 18 (4):  881-888.  doi: 10.4103/1673-5374.353496
    Abstract ( 198 )   PDF (6914KB) ( 92 )   Save
    Ferroptosis is one of the critical pathological events in spinal cord injury. Erythropoietin has been reported to improve the recovery of spinal cord injury. However, whether ferroptosis is involved in the neuroprotective effects of erythropoietin on spinal cord injury has not been examined. In this study, we established rat models of spinal cord injury by modified Allen’s method and intraperitoneally administered 1000 and 5000 IU/kg erythropoietin once a week for 2 successive weeks. Both low and high doses of erythropoietin promoted recovery of hindlimb function, and the high dose of erythropoietin led to better outcome. High dose of erythropoietin exhibited a stronger suppressive effect on ferroptosis relative to the low dose of erythropoietin. The effects of erythropoietin on inhibiting ferroptosis-related protein expression and restoring mitochondrial morphology were similar to those of Fer-1 (a ferroptosis suppressor), and the effects of erythropoietin were largely diminished by RSL3 (ferroptosis activator). In vitro experiments showed that erythropoietin inhibited RSL3-induced ferroptosis in PC12 cells and increased the expression of xCT and Gpx4. This suggests that xCT and Gpx4 are involved in the neuroprotective effects of erythropoietin on spinal cord injury. Our findings reveal the underlying anti-ferroptosis role of erythropoietin and provide a potential therapeutic strategy for treating spinal cord injury.
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    Circulating exosomal lncRNA contributes to the pathogenesis of spinal cord injury in rats
    Jian-An Li, Ming-Peng Shi, Lin Cong, Ming-Yu Gu, Yi-Heng Chen, Si-Yi Wang, Zhen-Hua Li, Chun-Fang Zan, Wan-Fu Wei
    2023, 18 (4):  889-894.  doi: 10.4103/1673-5374.353504
    Abstract ( 118 )   PDF (8758KB) ( 66 )   Save
    Exosome-derived long non-coding RNAs (lncRNAs) are extensively engaged in recovery and repair of the injured spinal cord, through different mechanisms. However, to date no study has systematically evaluated the differentially expressed lncRNAs involved in the development of spinal cord injury. Thus, the aim of this study was to identify key circulating exosome-derived lncRNAs in a rat model of spinal cord injury and investigate their potential actions. To this end, we established a rat model of spinal cord hemisection. Circulating exosomes were extracted from blood samples from spinal cord injury and control (sham) rats and further identified through Western blotting and electron microscopy. RNA was isolated from the exosomes and sequenced. The enrichment analysis demonstrated that there were distinctively different lncRNA and mRNA expression patterns between the two groups. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and Gene Ontology (GO) functional analysis were performed to determine the possible involvements of upregulated and downregulated lncRNAs in various pathways and different biological processes, as well as their cellular locations and molecular functions. Furthermore, quantitative reverse transcription-polymerase chain reaction showed that the expression of five lncRNAs––ENSRN0T00000067908, XR_590093, XR_591455, XR_360081, and XR_346933––was increased, whereas the expression of XR_351404, XR_591426, XR_353833, XR_590076, and XR_590719 was decreased. Of note, these 10 lncRNAs were at the center of the lncRNA-miRNA-mRNA coexpression network, which also included 198 mRNAs and 41 miRNAs. Taken together, our findings show that several circulating exosomal lncRNAs are differentially expressed after spinal cord injury, suggesting that they may be involved in spinal cord injury pathology and pathogenesis. These lncRNAs could potentially serve as targets for the clinical diagnosis and treatment of spinal cord injury.
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    Oscillating field stimulation promotes neurogenesis of neural stem cells through miR-124/Tal1 axis to repair spinal cord injury in rats
    Chao Fang, Jian Sun, Jun Qian, Cai-Liang Shen
    2023, 18 (4):  895-900.  doi: 10.4103/1673-5374.353505
    Abstract ( 147 )   PDF (2885KB) ( 55 )   Save
    Spinal cord injury often leads to severe motor and sensory deficits, and prognosis using the currently available therapies remains poor. Therefore, we aimed to explore a novel therapeutic approach for improving the prognosis of spinal cord injury. In this study, we implanted oscillating field stimulation devices and transplanted neural stem cells into the thoracic region (T9–T10) of rats with a spinal cord contusion. Basso-Beattie-Bresnahan scoring revealed that oscillating field stimulation combined with neural stem cells transplantation promoted motor function recovery following spinal cord injury. In addition, we investigated the regulation of oscillating field stimulation on the miR-124/Tal1 axis in neural stem cells. Transfection of lentivirus was performed to investigate the role of Tal1 in neurogenesis of neural stem cells induced by oscillating field stimulation. Quantitative reverse transcription-polymerase chain reaction, immunofluorescence and western blotting showed that oscillating field stimulation promoted neurogenesis of neural stem cells in vitro and in vivo. Hematoxylin and eosin staining showed that oscillating field stimulation combined with neural stem cells transplantation alleviated cavities formation after spinal cord injury. Taking the results together, we concluded that oscillating field stimulation decreased miR-124 expression and increased Tal1 content, thereby promoting the neurogenesis of neural stem cells. The combination of oscillating field stimulation and neural stem cells transplantation improved neurogenesis, and thereby promoted structural and functional recovery after spinal cord injury.
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    Sex modulates the outcome of subthalamic nucleus deep brain stimulation in patients with Parkinson’s disease
    Tian-Shuo Yuan, Ying-Chuan Chen, De-Feng Liu, Ruo-Yu Ma, Xin Zhang, Ting-Ting Du, Guan-Yu Zhu, Jian-Guo Zhang
    2023, 18 (4):  901-907.  doi: 10.4103/1673-5374.353506
    Abstract ( 132 )   PDF (1602KB) ( 90 )   Save
    There are many documented sex differences in the clinical course, symptom expression profile, and treatment response of Parkinson’s disease, creating additional challenges for patient management. Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson’s disease, the effects of sex on treatment outcome are still unclear. The aim of this retrospective observational study, was to examine sex differences in motor symptoms, non-motor symptoms, and quality of life after subthalamic nucleus deep brain stimulation. Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation aged 63.00 ± 8.01 years (55 men and 35 women). Outcomes of clinical evaluations were compared between sexes via a Student’s t-test and within sex via a paired-sample t-test, and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex. We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation. Restless legs syndrome was alleviated to a greater extent in men than in women. Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation. Furthermore, Hoehn-Yahr stage was positively correlated with the treatment response in men, while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women. In conclusion, women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms, non-motor symptoms, and quality of life. We found sex-specific factors, i.e., Hoehn-Yahr stage and levodopa equivalent dose, that were related to motor improvements. These findings may help to guide subthalamic nucleus deep brain stimulation patient selection, prognosis, and stimulation programming for optimal therapeutic efficacy in Parkinson’s disease.
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    Promising application of a new ulnar nerve compound muscle action potential measurement montage in amyotrophic lateral sclerosis: a prospective cross-sectional study
    Yi-Xuan Zhang, Jing-Yue Ma, Xiang-Yi Liu, Shuo Zhang, Zhou Yu, Dong-Sheng Fan
    2023, 18 (4):  908-912.  doi: 10.4103/1673-5374.353499
    Abstract ( 150 )   PDF (2691KB) ( 77 )   Save
    Previous studies have shown that ulnar nerve compound muscle action potential recorded by the conventional “belly-tendon” montage does not accurately and completely reflect the action potential of the ulnar nerve dominating the abductor digiti minimi muscle due to the effects of far-field potentials of intrinsic hand muscles. A new method of ulnar nerve compound muscle action potential measurement was developed in 2020, which adjusts the E2 electrode from the distal tendon of the abductor digitorum to the middle of the back of the proximal wrist. This new method may reduce the influence of the reference electrode and better reflect the actual ulnar nerve compound muscle action potential. In this prospective cross-sectional study, we included 64 patients with amyotrophic lateral sclerosis and 64 age- and sex-matched controls who underwent conventional and novel ulnar nerve compound muscle action potential measurement between April 2020 and May 2021 in Peking University Third Hospital. The compound muscle action potential waveforms recorded by the new montage were unimodal and more uniform than those recorded by traditional montage. In the controls, no significant difference in the compound muscle action potential waveforms was found between the traditional montage and new montage recordings. In amyotrophic lateral sclerosis patients presenting with abductor digiti minimi spontaneous activity and muscular atrophy, the amplitude of compound muscle action potential-pE2 was significantly lower than that of compound muscle action potential-dE2 (P < 0.01). Using the new method, damaged axons were more likely to exhibit more severe amplitude decreases than those measured with the traditional method, in particular for patients in early stage amyotrophic lateral sclerosis. In addition, the decline in compound muscle action potential amplitude measured by the new method was correlated with a decrease in Revised Amyotrophic Lateral Sclerosis Functional Rating Scale scores. These findings suggest that the new ulnar nerve compound muscle action potential measurement montage reduces the effects of the reference electrode through altering the E2 electrode position, and that this method is more suitable for monitoring disease progression than the traditional montage. This method may be useful as a biomarker for longitudinal follow-up and clinical trials in amyotrophic lateral sclerosis. 
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    Use of a tissue clearing technique combined with retrograde trans-synaptic viral tracing to evaluate changes in mouse retinorecipient brain regions following optic nerve crush
    Zong-Yi Zhan, Yi-Ru Huang, Lu-Wei Zhao, Ya-Dan Quan, Zi-Jing Li, Di-Fang Sun, Ya-Li Wu, Hao-Yuan Wu, Zi-Tian Liu, Kai-Li Wu, Yu-Qing Lan, Min-Bin Yu
    2023, 18 (4):  913-921.  doi: 10.4103/1673-5374.353852
    Abstract ( 198 )   PDF (5078KB) ( 132 )   Save
    Successful establishment of reconnection between retinal ganglion cells and retinorecipient regions in the brain is critical to optic nerve regeneration. However, morphological assessments of retinorecipient regions are limited by the opacity of brain tissue. In this study, we used an innovative tissue cleaning technique combined with retrograde trans-synaptic viral tracing to observe changes in retinorecipient regions connected to retinal ganglion cells in mice after optic nerve injury. Specifically, we performed light-sheet imaging of whole brain tissue after a clearing process. We found that pseudorabies virus 724 (PRV724) mostly infected retinal ganglion cells, and that we could use it to retrogradely trace the retinorecipient regions in whole tissue-cleared brains. Unexpectedly, PRV724-traced neurons were more widely distributed compared with data from previous studies. We found that optic nerve injury could selectively modify projections from retinal ganglion cells in the hypothalamic paraventricular nucleus, intergeniculate leaflet, ventral lateral geniculate nucleus, central amygdala, basolateral amygdala, Edinger-Westphal nucleus, and oculomotor nucleus, but not the superior vestibular nucleus, red nucleus, locus coeruleus, gigantocellular reticular nucleus, or facial nerve nucleus. Our findings demonstrate that the tissue clearing technique, combined with retrograde trans-synaptic viral tracing, can be used to objectively and comprehensively evaluate changes in mouse retinorecipient regions that receive projections from retinal ganglion cells after optic nerve injury. Thus, our approach may be useful for future estimations of optic nerve injury and regeneration.
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    Necroptosis plays a crucial role in the exacerbation of retinal injury after blunt ocular trauma
    Yu Huan, Xiu-Quan Wu, Tao Chen, Ya-Nan Dou, Bo Jia, Xin He, Dong-Yu Wei, Zhou Fei, Fei Fei
    2023, 18 (4):  922-928.  doi: 10.4103/1673-5374.353848
    Abstract ( 154 )   PDF (3675KB) ( 61 )   Save
    Retinal injury after blunt ocular trauma may directly affect prognosis and lead to vision loss. To investigate the pathological changes and molecular mechanisms involved in retinal injury after blunt ocular trauma, we established a weight drop injury model of blunt ocular trauma in male Beagle dogs. Hematoxylin-eosin staining, immunofluorescence staining, western blotting, and TUNEL assays were performed to investigate retinal injury within 14 days after blunt ocular trauma. Compared with the control group, the thicknesses of the inner and outer nuclear layers, as well as the number of retinal ganglion cells, gradually decreased within 14 days after injury. The number of bipolar cells in the inner nuclear layer began to decrease 1 day after injury, while the numbers of cholinergic and amacrine cells in the inner nuclear layer did not decrease until 7 days after injury. Moreover, retinal cell necroptosis increased with time after injury; it progressed from the ganglion cell layer to the outer nuclear layer. Visual electrophysiological findings indicated that visual impairment began on the first day after injury and worsened over time. Additionally, blunt ocular trauma induced nerve regeneration and Müller glial hyperplasia; it also resulted in the recruitment of microglia to the retina and polarization of those microglia to the M1 phenotype. These findings suggest that necroptosis plays an important role in exacerbating retinal injury after blunt ocular trauma via gliosis and neuroinflammation. Such a role has important implications for the development of therapeutic strategies.
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