Neurologic disease

神经系统疾病
  • 文章类型: Journal Article
    随着全球人口老龄化,神经退行性疾病的患病率正在激增。这些疾病有多方面的发病机制,与遗传和环境因素交织在一起。新兴的研究强调了饮食对健康状况的发展和进展的深远影响。间歇性禁食(IF),一种越来越被接受和推荐的饮食模式,已证明在改善神经生理功能和减轻病理损伤方面具有潜力,而不良反应很少。虽然IF的有益影响的确切机制尚未完全了解,肠道微生物群及其代谢物被认为是介导这些作用的关键。这篇综述试图彻底检查当前关于由IF引起的肠道微生物群和代谢物谱变化的研究,以及它们对神经健康的可能后果。它还强调了饮食策略作为神经系统疾病患者的临床考虑的重要性。
    As the global population ages, the prevalence of neurodegenerative diseases is surging. These disorders have a multifaceted pathogenesis, entwined with genetic and environmental factors. Emerging research underscores the profound influence of diet on the development and progression of health conditions. Intermittent fasting (IF), a dietary pattern that is increasingly embraced and recommended, has demonstrated potential in improving neurophysiological functions and mitigating pathological injuries with few adverse effects. Although the precise mechanisms of IF\'s beneficial impact are not yet completely understood, gut microbiota and their metabolites are believed to be pivotal in mediating these effects. This review endeavors to thoroughly examine current studies on the shifts in gut microbiota and metabolite profiles prompted by IF, and their possible consequences for neural health. It also highlights the significance of dietary strategies as a clinical consideration for those with neurological conditions.
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  • 文章类型: Journal Article
    中风是世界上第三个长期残疾的原因。大约80%的中风患者有生物运动功能受损,超过一半的患者无法恢复手臂功能,导致运动控制障碍,严重丧失社会独立性。因此,康复在减少患者残疾方面起着关键作用,3D打印(3DP)在相关领域显示出有趣的改进,由于生产定制的可能性,生态可持续和成本有效的矫形器。这项研究调查了3DP矫形器在康复中的临床使用与传统矫形器相比,关注3DP技术之间的相关性,治疗和结果。我们筛选了来自PubMed的138篇文章,Scopus和WebofScience,选择符合纳入标准的10篇文章,随后对其进行了系统审查。结果表明,3DP提供了大量的优势,在上肢矫形器设计的病人的需要。此外,七项研究活动使用可生物降解/可回收材料,强调经过验证的3DP解决方案在临床康复环境中的巨大潜力。这项研究的目的是强调3DP如何克服标准医疗设备的局限性,以支持临床医生。实施医疗保健4.0期间的生物工程师和创新经理。
    Stroke represents the third cause of long-term disability in the world. About 80% of stroke patients have an impairment of bio-motor functions and over half fail to regain arm functionality, resulting in motor movement control disorder with serious loss in terms of social independence. Therefore, rehabilitation plays a key role in the reduction of patient disabilities, and 3D printing (3DP) has showed interesting improvements in related fields, thanks to the possibility to produce customized, eco-sustainable and cost-effective orthoses. This study investigated the clinical use of 3DP orthosis in rehabilitation compared to the traditional ones, focusing on the correlation between 3DP technology, therapy and outcomes. We screened 138 articles from PubMed, Scopus and Web of Science, selecting the 10 articles fulfilling the inclusion criteria, which were subsequently examined for the systematic review. The results showed that 3DP provides substantial advantages in terms of upper limb orthosis designed on the patient\'s needs. Moreover, seven research activities used biodegradable/recyclable materials, underlining the great potential of validated 3DP solutions in a clinical rehabilitation setting. The aim of this study was to highlight how 3DP could overcome the limitations of standard medical devices in order to support clinicians, bioengineers and innovation managers during the implementation of Healthcare 4.0.
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  • 文章类型: Journal Article
    血清流行病学研究证明,蜱传脑炎病毒(TBEV)对马的感染经常发生在TBEV流行地区。然而,只有很少的临床病例报告。可能的漏报可能是由于各种诊断挑战。在这项研究中,对血清样品进行ELISA和中和试验。研究了脑组织样品中TBEV核酸的存在,马术甲疱疹病毒1型,博尔纳病病毒1型,西尼罗河病毒和乌斯图病毒,Rustrela病毒,和东方一样,西方,和委内瑞拉马脑炎病毒的RT-qPCR,RT-PCR,和qPCR,分别。对TBEV特异性扩增产物进行Sanger测序。此外,对狂犬病进行了直接荧光抗体测试。报告了临床和病理组织学发现。使用特异性RT-qPCR和RT-PCR分析,在脑组织样品中证明了TBEV核酸。测序显示,EBEV的西部(以前是中部)欧洲亚型是病因。在血清中发现了高滴度的TBEV特异性中和抗体。RNAscope原位杂交显示TBEVRNA仅限于神经元细胞体和过程。不能检测到其它病原体或其核酸。诊断程序需要在神经体征出现后的早期进行,以便对马的急性TBEV感染进行最终的病因诊断。
    As evidenced by sero-epidemiological studies, infections of horses with the tick-borne encephalitis virus (TBEV) occur frequently in TBEV-endemic areas. However, there are only very few reports of clinical cases. A possible underreporting may be due to a variety of diagnostic challenges. In this study, ELISA and neutralization tests were applied to serum samples. Brain tissue samples were investigated for the presence of nucleic acids of TBEV, Equid alphaherpesvirus 1, Borna disease virus 1, West Nile and Usutu viruses, rustrela virus, as well as Eastern, Western, and Venezuelan equine encephalitis viruses with RT-qPCR, RT-PCR, and qPCR, respectively. TBEV-specific amplification products were subjected to Sanger sequencing. In addition, a direct fluorescent antibody test for rabies was performed. Clinical and patho-histological findings are reported. Using specific RT-qPCR and RT-PCR assays, TBEV nucleic acids were demonstrated in brain tissue samples. Sequencing revealed the Western (formerly Central) European subtype of TBEV as the etiological agent. A high titer of TBEV-specific neutralizing antibodies was found in the serum. RNAscope in situ hybridization revealed TBEV RNA confined to neuronal cell bodies and processes. No other pathogens or nucleic acids thereof could be detected. Diagnostic procedures need to be carried out early after the onset of neurological signs to allow for a final etiological diagnosis of acute TBEV infections in horses.
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  • 文章类型: Journal Article
    双酚A(BPA)是一种内分泌干扰化学物质(EDC),是全球生产最多的合成化合物之一。BPA可以在环氧树脂和聚碳酸酯塑料中找到,经常用于食品储存和婴儿奶瓶。然而,BPA可以主要与雌激素受体结合,干扰各种神经功能,它的使用是一个备受关注的话题。尽管如此,尽管对BPA的破坏性作用进行了大量研究,但尚未完全了解其神经毒性.因此,这篇综述旨在强调BPA对神经系统影响的最新研究。我们的研究结果表明,BPA暴露会损害大脑的各种结构和分子变化,促进氧化应激,改变几个关键基因和蛋白质的表达水平,对神经递质的破坏性影响,兴奋性毒性和神经炎症,血脑屏障功能受损,神经元损伤,凋亡效应,细胞内Ca2+稳态的破坏,增加活性氧,促进细胞凋亡和细胞内乳酸脱氢酶释放,轴突长度的减少,小胶质细胞DNA损伤,星形胶质增生,并显著减少髓鞘形成。此外,BPA暴露会增加患神经系统疾病的风险,包括神经血管疾病(如中风)和神经退行性疾病(如阿尔茨海默病和帕金森病)。此外,流行病学研究表明,BPA对儿童神经发育的不利影响导致了严重的神经系统疾病的出现,如注意力缺陷/多动障碍(ADHD),自闭症谱系障碍(ASD),抑郁症,情绪问题,焦虑,和认知障碍。总之,BPA暴露危害人类健康,促进神经系统疾病的发展和进展。需要更多的研究来充分了解BPA诱导的神经毒性如何影响人类健康。
    Bisphenol A (BPA) is an endocrine-disrupting chemical (EDC) and one of the most produced synthetic compounds worldwide. BPA can be found in epoxy resins and polycarbonate plastics, which are frequently used in food storage and baby bottles. However, BPA can bind mainly to estrogen receptors, interfering with various neurologic functions, its use is a topic of significant concern. Nonetheless, the neurotoxicity of BPA has not been fully understood despite numerous investigations on its disruptive effects. Therefore, this review aims to highlight the most recent studies on the implications of BPA on the neurologic system. Our findings suggest that BPA exposure impairs various structural and molecular brain changes, promoting oxidative stress, changing expression levels of several crucial genes and proteins, destructive effects on neurotransmitters, excitotoxicity and neuroinflammation, damaged blood-brain barrier function, neuronal damage, apoptosis effects, disruption of intracellular Ca2+ homeostasis, increase in reactive oxygen species, promoted apoptosis and intracellular lactate dehydrogenase release, a decrease of axon length, microglial DNA damage, astrogliosis, and significantly reduced myelination. Moreover, BPA exposure increases the risk of developing neurologic diseases, including neurovascular (e.g. stroke) and neurodegenerative (e.g. Alzheimer\'s and Parkinson\'s) diseases. Furthermore, epidemiological studies showed that the adverse effects of BPA on neurodevelopment in children contributed to the emergence of serious neurological diseases like attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), depression, emotional problems, anxiety, and cognitive disorders. In summary, BPA exposure compromises human health, promoting the development and progression of neurologic disorders. More research is required to fully understand how BPA-induced neurotoxicity affects human health.
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  • 文章类型: Case Reports
    II型裸型淋巴细胞综合征(BLSII)是由CIITA基因突变引起的严重联合免疫缺陷的一种罕见形式,它调节主要组织相容性复合体II类(MHCII)的表达。
    我们报告了一个沙特男孩的病例,该男孩在CIITA基因中出现了新的突变,他患有急性和晚期脑膜脑脊髓炎,导致严重的神经发育退化。
    我们回顾了从病历中获得的患者的临床和实验室数据,并对BLSII进行了文献检索。
    患者表现为急性脑膜脑脊髓炎,经MRI检查结果证实,随后发现在CIITA基因p中携带纯合致病变异体。(Leu473Hisfs*15)。患者无MCHII表达,证实常染色体隐性BLSII的遗传诊断。令人惊讶的是,患者既往临床病史无明显感染或自身免疫。
    我们报告了一例新的ITA基因突变,表现为非典型的晚期和孤立的严重感染。孤立的严重脑膜脑脊髓炎可能是原发性免疫缺陷的表现。
    UNASSIGNED: Bare lymphocyte syndrome type II (BLS II) is a rare form of severe combined immunodeficiency caused by mutations in the CIITA gene, which regulates major histocompatibility complex class II (MHC II) expression.
    UNASSIGNED: We report the case of a Saudi boy with a novel mutation in the CIITA gene who presented with acute and late meningoencephalomyelitis, resulting in severe neurodevelopmental regression.
    UNASSIGNED: We reviewed the patient\'s clinical and laboratory data obtained from medical records and performed a literature search on BLS II.
    UNASSIGNED: The patient presented with acute meningoencephalomyelitis confirmed by MRI findings and was later found to carry a homozygous pathogenic variant in the CIITA gene p.(Leu473Hisfs*15). The patient had no MCH II expression, confirming the genetic diagnosis of autosomal recessive BLS II. Surprisingly, the patient\'s prior clinical history was unremarkable for significant infections or autoimmunity.
    UNASSIGNED: We report a case with a novel CIITA gene mutation presenting atypically with a late and isolated severe infection. Isolated severe meningoencephalomyelitis may be a manifestation of primary immunodeficiency.
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  • 文章类型: Journal Article
    在红袋鼠(Macropusrufus)中未报告与慢性中耳炎相关的中枢神经系统病变,我们的知识。在这里,我们描述了一个6岁的雌性红袋鼠中继发于慢性中耳炎的颅内炎性息肉,右耳廓放电,失去平衡,和头部倾斜。尸检显示一个浅黄色,公司,颅内息肉样生长,从右鼓室通过内耳道和颅内延伸,右小脑桥脑角受压。厌氧细菌培养从新鲜的大脑和右外耳拭子中产生化脓性拟杆菌。组织学上,鼓室被淋巴细胞和浆细胞包围的中性粒细胞和巨噬细胞清除,以及水肿的纤维血管组织。粘膜骨膜的上皮内膜增生,上皮假功能区被纤维血管组织包围。颞骨溶解和重塑区域与炎症改变有关,偶尔会包围相邻的神经。纤维血管组织和炎症细胞从鼓腔通过内耳道延伸到颅内腔,形成大致观察到的息肉样生长;息肉由纤维血管组织的致密核心组成,中性粒细胞和泡沫巨噬细胞分散。淋巴细胞和浆细胞包围脑干的软脑膜血管周围间隙,小脑,和枕叶.
    CNS lesions associated with chronic otitis have not been reported in red kangaroos (Macropus rufus), to our knowledge. Here we describe an intracranial inflammatory polyp secondary to chronic otitis in a 6-y-old female red kangaroo with right auricular discharge, loss of balance, and head tilt. Autopsy highlighted a pale-yellow, firm, intracranial polypoid growth that extended from the right tympanic cavity through the internal acoustic meatus and intracranially, with compression of the right cerebellopontine angle. Anaerobic bacterial culture yielded Bacteroides pyogenes from fresh brain and a right external ear swab. Histologically, the tympanic cavity was effaced by neutrophils and macrophages surrounded by lymphocytes and plasma cells, as well as edematous fibrovascular tissue. The epithelial lining of the mucoperiosteum was hyperplastic, with epithelial pseudoglands surrounded by fibrovascular tissue. Areas of temporal bone lysis and remodeling were associated with the inflammatory changes, which occasionally surrounded adjacent nerves. Fibrovascular tissue and inflammatory cells extended from the tympanic cavity through the internal acoustic meatus and into the intracranial cavity, forming the polypoid growth observed grossly; the polyp consisted of a dense core of fibrovascular tissue with scattered clusters of neutrophils and foamy macrophages. Lymphocytes and plasma cells surrounded the leptomeningeal perivascular spaces in the brainstem, cerebellum, and occipital lobe.
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  • 文章类型: Journal Article
    背景:球形细胞脑白质营养不良(GCL)是由半乳糖基神经酰胺酶(GALC)基因变异引起的致命性常染色体隐性遗传疾病。报告了两种狗品种特异性变体。
    目的:表征一个狗家族中GCL的推定致病GALC变异体,并确定群体等位基因频率。
    方法:对4只相关的具有神经系统疾病体征的混种幼犬进行了评估。随后,测试了33只相关狗的亲子关系遗传标记和鉴定的GALC变体。对来自不同品种的278个库存样品进行了额外的GALC基因分型。
    方法:4只受影响的幼犬进行了神经系统检查和尸检。从血液样品中分离DNA。通过Sanger测序鉴定GALC中的变体。使用短串联重复标记进行亲子鉴定。在其他品种中研究了感兴趣的GALC变体的患病率。
    结果:GCL在组织病理学上得到证实。GALC中的新错义变体(NC_006590.4:g.58893972G>A)在所有受影响的动物中是纯合的(n=4)。通过亲子鉴定确认了隐性遗传方式,与表型的变异连锁也得到了证实(LOD=3.36)。在相关的狗中(n=33),3条狗是纯合的,7条是杂合的。在来自5个品种的278只狗的筛选中未检测到变异等位基因。该新变体是该家族独有的,或者在普通人群中具有极低的等位基因频率。
    结论:发现了一种新的GALC变体,可能解释了该队列中的GCL。狗中GCL的多个因果变异的鉴定与人类中的发现一致。
    BACKGROUND: Globoid cell leukodystrophy (GCL) is a fatal autosomal recessive disease caused by variants in the galactosylceramidase (GALC) gene. Two dog breed-specific variants are reported.
    OBJECTIVE: Characterize the putatively causative GALC variant for GCL in a family of dogs and determine population allele frequency.
    METHODS: Four related mixed-breed puppies with signs of neurologic disease were evaluated. Subsequently, 33 related dogs were tested for genetic markers for parentage and the identified GALC variant. Additional GALC genotyping was performed on 278 banked samples from various breeds.
    METHODS: The 4 affected puppies had neurological exams and necropsies. DNA was isolated from blood samples. Variants in GALC were identified via Sanger sequencing. Parentage testing was performed using short tandem repeat markers. Prevalence of the GALC variant of interest was investigated in other breeds.
    RESULTS: GCL was confirmed histopathologically. A novel missense variant in GALC (NC_006590.4:g.58893972G>A) was homozygous in all affected animals (n = 4). A recessive mode of inheritance was confirmed by parentage testing as was variant linkage with the phenotype (LOD = 3.36). Among the related dogs (n = 33), 3 dogs were homozygous and 7 heterozygous. The variant allele was not detected in screening 278 dogs from 5 breeds. The novel variant is either unique to this family or has an extremely low allele frequency in the general population.
    CONCLUSIONS: A novel GALC variant was identified that likely explains GCL in this cohort. The identification of multiple causal variants for GCL in dogs is consistent with findings in humans.
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  • 文章类型: Systematic Review
    大疱性类天疱疮是工业化国家中最常见的自身免疫性起泡疾病,尤其影响老年人。在这个患者群体中,合并症很常见,可能使大疱性类天疱疮的管理和治疗复杂化。更好地理解为什么不同的疾病在大疱性类天疱疮患者中更常见,可能会导致新的病理生理学见解,并因此导致更好的患者护理。大疱性类天疱疮与神经和精神疾病的关系是众所周知的,并得到了一些病例对照研究的证实。与其他疾病如恶性肿瘤和代谢性疾病的关系仍有争议。近年来,已经报道了大疱性类天疱疮与自身免疫性和炎症性皮肤病之间的新关系。这篇综述提供了有关大疱性类天疱疮患者合并症的研究的系统概述。提高双方的认识,常见和罕见的共病,可能使临床医生能够优化大疱性类天疱疮的患者支持和个性化治疗。
    Bullous pemphigoid is the most common autoimmune blistering disease in industrialized countries and particularly affects the elderly. In this patient population, comorbid diseases are frequent and may complicate management and treatment of bullous pemphigoid. A better understanding why distinct diseases are more frequent in bullous pemphigoid patients may lead to new pathophysiological insights and - as a consequence - result in better patient care. The association of bullous pemphigoid with neurological and psychiatric diseases is well known and confirmed by several case-control studies. Association with further diseases such as malignancy and metabolic diseases are still discussed controversially. In recent years new relationships between bullous pemphigoid and autoimmune as well as inflammatory skin diseases have been reported. This review provides a systematic overview on studies addressing comorbidity in bullous pemphigoid patients. Increasing the awareness of both, common and rare comorbid diseases, may enable clinicians to optimize patient support and individualized treatment of bullous pemphigoid.
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  • 文章类型: Journal Article
    Perlecan是一种500kDa的蛋白聚糖,位于内皮基底膜的细胞外基质中,具有五个不同的蛋白质结构域和三个硫酸乙酰肝素链。perlecan的复杂结构及其与局部环境的相互作用解释了其各种细胞和组织相关的影响,包括软骨,骨头,神经和心脏发育,血管生成,和血脑屏障的稳定性。由于perlecan是参与整个身体许多组织和过程的细胞外基质健康的关键贡献者,perlecan的失调有可能导致各种神经和肌肉骨骼疾病。在这里,我们回顾了与疾病背景下的Perlecan失调相关的关键发现。这是一篇叙述性综述文章,研究了Perlecan在神经和多骨骼病理学疾病中的作用及其作为治疗指标的潜力。文献检索在PubMed数据库上进行,专注于Perlecan对神经系统疾病的影响,包括缺血性中风,阿尔茨海默病(AD)和脑动静脉畸形(BAVM),以及肌肉骨骼病理学,包括节段失调性发育不良Silverman-Handmaker型(DDSH),Schwartz-Jampel综合征(SJS),少肌症,骨关节炎(OA)。在文章的搜索和最终选择中使用了PRISMA指南。Perlecan水平升高与肌肉减少症有关,OA,和BAVM,虽然Perlecan减少与DDSH有关,和SJS。我们还研究了perlecan信号在缺血性中风中的治疗潜力,AD,和骨关节炎动物模型。Perlecan通过实验改善了缺血性卒中和AD模型的结果,我们发现,它可能是未来治疗这种病理的一个有希望的组成部分。在治疗肌肉减少症的病理生理学中,OA,和BAVM,抑制Perlecan的作用可能是有益的。由于Perlecan与β±-5整合素和VEGFR2受体结合,这些蛋白质的组织特异性抑制剂值得进一步研究。此外,对实验数据的分析揭示了Perlecan结构域V作为缺血性中风和AD的广泛治疗的潜在用途。由于这些疾病的治疗选择有限,应认真考虑对perlecan或其衍生物的进一步研究,以及将其用作这些疾病和其他疾病的新型治疗剂的潜力。
    Perlecan is a 500 kDa proteoglycan residing in the extracellular matrix of endothelial basement membranes with five distinct protein domains and three heparan sulfate chains. The complex structure of perlecan and the interaction it has with its local environment accounts for its various cellular and tissue-related effects, to include cartilage, bone, neural and cardiac development, angiogenesis, and blood brain barrier stability. As perlecan is a key contributor to extracellular matrix health involved in many tissues and processes throughout the body, dysregulation of perlecan has the potential to contribute to various neurological and musculoskeletal diseases. Here we review key findings associated with perlecan dysregulation in the context of disease. This is a narrative review article examining perlecan’s role in diseases of neural and musucloskeletal pathology and its potential as a therapeutic index. Literature searches were conducted on the PubMed database, and were focused on perlecan\'s impact in neurological disease, to include ischemic stroke, Alzheimer\'s Disease (AD) and brain arteriovenous malformation (BAVM), as well as musculoskeletal pathology, including Dyssegmental Dysplasia Silverman-Handmaker type (DDSH), Schwartz-Jampel syndrome (SJS), sarcopenia, and osteoarthritis (OA). PRISMA guidelines were utilized in the search and final selection of articles.Increased perlecan levels were associated with sarcopenia, OA, and BAVM, while decreased perlecan was associated with DDSH, and SJS. We also examined the therapeutic potential of perlecan signaling in ischemic stroke, AD, and osteoarthritic animal models. Perlecan experimentally improved outcomes in such models of ischemic stroke and AD, and we found that it may be a promising component of future therapeutics for such pathology. In treating the pathophysiology of sarcopenia, OA, and BAVM, inhibiting the effect of perlecan may be beneficial. As perlecan binds to both α-5 integrin and VEGFR2 receptors, tissue specific inhibitors of these proteins warrant further study. In addition, analysis of experimental data revealed promising insight into the potential uses of perlecan domain V as a broad treatment for ischemic stroke and AD. As these diseases have limited therapeutic options, further study into perlecan or its derivatives and its potential to be used as novel therapeutic for these and other diseases should be seriously considered.
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  • 文章类型: Editorial
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