NMDA, N-methyl-d-aspartate

NMDA,N - 甲基 - D - 天冬氨酸
  • 文章类型: Journal Article
    精神障碍(MD)是非常普遍的,并且可能使人衰弱的复杂疾病,其原因仍然难以捉摸。研究这些疾病的病因或病理生理学的更深层次方面将是非常有益的,作为稀缺的知识在机械和分子途径肯定代表了一个重要的限制。MD和炎症/神经炎症之间的关联已被许多人广泛讨论和接受,据报道,在几个MD的患者中,有高水平的促炎细胞因子,如精神分裂症(SCZ),双相情感障碍(BD)和重度抑郁障碍(MDD),在其他人中。还报道了促炎标志物与症状强度的相关性。然而,在MD中观察到的炎症功能障碍的潜在机制尚未完全了解。在这种情况下,小胶质细胞功能障碍最近已经成为一个可能的关键因素,在神经炎症反应期间,小胶质细胞可以被过度激活,和过度产生促炎细胞因子,可以改变犬尿氨酸和谷氨酸信号,据报道。此外,小胶质细胞激活也导致增加的星形胶质细胞活性和随之而来的谷氨酸释放,它们都对中枢神经系统(CNS)有毒。此外,由于MD中的小胶质细胞活化增加,犬尿氨酸途径的产物显示出变化,然后影响多巴胺能,血清素能,和谷氨酸能信号通路。因此,在本次审查中,我们的目的是讨论神经炎症如何影响谷氨酸和犬尿氨酸信号通路,以及它们如何影响单胺能信号。随后还讨论了与MD主要症状的关联。因此,这项工作旨在通过提供对这些替代途径的见解,并通过揭示可能改善药物干预和/或治疗方案的策略以对抗MD的主要药理学上不匹配的症状的潜在靶标,从而为该领域做出贡献。作为SCZ。
    Mental disorders (MDs) are highly prevalent and potentially debilitating complex disorders which causes remain elusive. Looking into deeper aspects of etiology or pathophysiology underlying these diseases would be highly beneficial, as the scarce knowledge in mechanistic and molecular pathways certainly represents an important limitation. Association between MDs and inflammation/neuroinflammation has been widely discussed and accepted by many, as high levels of pro-inflammatory cytokines were reported in patients with several MDs, such as schizophrenia (SCZ), bipolar disorder (BD) and major depression disorder (MDD), among others. Correlation of pro-inflammatory markers with symptoms intensity was also reported. However, the mechanisms underlying the inflammatory dysfunctions observed in MDs are not fully understood yet. In this context, microglial dysfunction has recently emerged as a possible pivotal player, as during the neuroinflammatory response, microglia can be over-activated, and excessive production of pro-inflammatory cytokines, which can modify the kynurenine and glutamate signaling, is reported. Moreover, microglial activation also results in increased astrocyte activity and consequent glutamate release, which are both toxic to the Central Nervous System (CNS). Also, as a result of increased microglial activation in MDs, products of the kynurenine pathway were shown to be changed, influencing then the dopaminergic, serotonergic, and glutamatergic signaling pathways. Therefore, in the present review, we aim to discuss how neuroinflammation impacts on glutamate and kynurenine signaling pathways, and how they can consequently influence the monoaminergic signaling. The consequent association with MDs main symptoms is also discussed. As such, this work aims to contribute to the field by providing insights into these alternative pathways and by shedding light on potential targets that could improve the strategies for pharmacological intervention and/or treatment protocols to combat the main pharmacologically unmatched symptoms of MDs, as the SCZ.
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  • 文章类型: Journal Article
    近年来,科学研究已经确定神经和免疫系统具有共享的分子信号传导成分。免疫细胞的天然蛋白质,它们也存在于大脑中,在神经系统中具有神经元功能,它们会影响突触可塑性,轴突再生,神经发生,和神经传递。某些天然免疫分子,如主要组织相容性复合物I(MHC-I),配对免疫球蛋白受体B(PirB),toll样受体(TLR),分化簇-3ζ(CD3ζ),CD4共受体,和T细胞受体β(TCR-β)在神经元中的表达已被广泛记录。在这次审查中,我们提供了我们的观点,并讨论了T细胞受体β亚基在调节中枢神经系统神经元功能中的可能作用。基于Syken和Shatz之前的发现。,2003;Nishiyori等人。,2004年;罗德里格斯等。,1993年和Komal等人。,2014年;我们讨论了在选定的大脑区域中TCR-β亚基的限制性表达是否可能与神经系统疾病的病理学有关,以及它们的表达异常增强是否可以被认为是衰老或神经退行性疾病如亨廷顿病(HD)的合适生物标志物。
    In recent years scientific research has established that the nervous and immune systems have shared molecular signaling components. Proteins native to immune cells, which are also found in the brain, have neuronal functions in the nervous system where they affect synaptic plasticity, axonal regeneration, neurogenesis, and neurotransmission. Certain native immune molecules like major histocompatibility complex I (MHC-I), paired immunoglobulin receptor B (PirB), toll-like receptor (TLR), cluster of differentiation-3 zeta (CD3ζ), CD4 co-receptor, and T-cell receptor beta (TCR-β) expression in neurons have been extensively documented. In this review, we provide our opinion and discussed the possible roles of T-cell receptor beta subunits in modulating the function of neurons in the central nervous system. Based on the previous findings of Syken and Shatz., 2003; Nishiyori et al., 2004; Rodriguez et., 1993 and Komal et., 2014; we discuss whether restrictive expression of TCR-β subunits in selected brain regions could be involved in the pathology of neurological disorders and whether their aberrant enhancement in expression may be considered as a suitable biomarker for aging or neurodegenerative diseases like Huntington\'s disease (HD).
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  • 文章类型: Journal Article
    酒精戒断综合征(AWS)是一种常见病,见于酒精使用障碍(AUD)和酒精性肝病(ALD)的寻求治疗的患者。AWS,通常在最后一次使用酒精的4-6小时内开始,可以从轻微的症状,如失眠,震颤,和自主神经多动,更严重的症状,如癫痫发作和震颤谵妄。临床研究所戒断评估量表-酒精修订(CIWA-Ar)是临床实践中评估AWS最常用的量表。超过8分的中度戒断的存在是药物治疗的指征。劳拉西泮和奥沙西泮是ALD环境中AWS管理的首选药物。在严重的ALD中,由于存在过度镇静或诱发肝性脑病的风险,因此在监测时应谨慎使用苯二氮卓类药物。
    Alcohol withdrawal syndrome (AWS) is a common condition that is seen in treatment-seeking patients with Alcohol use disorder (AUD) and alcoholic liver disease (ALD). AWS, which typically starts within 4-6 h of the last alcohol use, can range from mild symptoms such as insomnia, tremors, and autonomic hyperactivity to more severe symptoms such as seizures and delirium tremens. Clinical Institute Withdrawal Assessment Scale-Alcohol Revised (CIWA-Ar) is the most commonly used scale to assess AWS in clinical practice. The presence of moderate withdrawal as indicated by a score of more than 8 is an indication for pharmacotherapy. Lorazepam and oxazepam are preferred agents for the management of AWS in the setting of ALD. In severe ALD, benzodiazepines should be used cautiously with monitoring due to the risk of excessive sedation or precipitating hepatic encephalopathy.
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  • 文章类型: Journal Article
    酒精使用障碍(AUD)是在大量饮酒的背景下发展的常见病症,其特征是对酒精使用失去控制和强制使用酒精,通常尽管有负面后果。AUD是治疗后酒精性肝病(ALD)患者恢复饮酒的主要原因。因此,必须筛查所有ALD患者是否存在AUD。使用酒精使用障碍识别测试(AUDIT)和AUDIT-C等筛查工具,随后使用DSM-5标准确定AUD的诊断和严重程度。ALD患者的AUD管理最好使用包括精神科医生和胃肠病学家/肝病学家的综合方法进行。治疗通常涉及药物治疗和社会心理干预的组合,试图实现和保持禁欲。虽然,证据有限,巴氯芬是长期治疗ALD患者AUD的一线药物。强化心理干预,如动机增强疗法和认知行为疗法也被认为是有益的。治疗保留和随访至关重要,可以积极影响结果。
    Alcohol use disorder (AUD) is a common condition that develops on the background of heavy alcohol use and is characterised by the loss of control over alcohol use and a compulsion to use alcohol, often despite negative consequences. AUD is a leading cause for the resumption of alcohol use in patients with alcoholic liver disease (ALD) after treatment. Hence it is essential to screen all patients with ALD for the presence of AUD. Screening tools such as alcohol use disorders identification test (AUDIT) and AUDIT-C are used, following which the diagnosis and severity of AUD are determined using DSM-5 criteria. The management of AUD in patients with ALD is best carried out using an integrated approach involving psychiatrists and gastroenterologists/hepatologists. The treatment most often involves a combination of pharmacotherapy and psychosocial interventions which try to achieve and maintain abstinence. Although, there is limited evidence, Baclofen is the first line pharmacological agent for long-term management of AUD in patients with ALD. Intensive psychological interventions such as motivation enhancement therapy and cognitive behavioural therapy are also seen to be beneficial. Treatment retention and follow-up are vital and can positively influence outcomes.
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  • 文章类型: Journal Article
    缺血性脑血管病的发病率近年来呈上升趋势,已成为神经功能障碍和死亡的主要原因之一。已发现人参皂苷Rg1在许多神经退行性疾病中具有防止神经元损伤的作用。然而,Rg1对脑缺血再灌注损伤(CIRI)的保护作用和机制尚不完全清楚。这里,我们报道了Rg1治疗对小鼠CIRI的神经保护作用及其可能的机制。
    双侧颈总动脉结扎用于建立小鼠慢性CIRI模型。在OGD/R后用Rg1处理HT22细胞以研究其对[Ca2]i的影响。采用开场试验和爬杆试验检测行为损伤。激光散斑血流流量计用于测量脑血流量。Nissl和H&E染色用于检查神经元损伤。Western印迹用于检查MAP2,PSD95,Tau,p-Tau,NOX2,PLC,p-PLC,CN,NFAT1和NLRP1表达。钙成像用于测试[Ca2]i的水平。
    Rg1治疗可显着改善脑血流量,运动,和肢体协调,减少ROS产生,MAP2和PSD95表达增加,减少p-Tau,NOX2,p-PLC,CN,NFAT1和NLRP1表达。钙成像结果显示,Rg1可抑制HT22细胞OGD/R后钙超载,抵抗钙稳态失衡。
    Rg1通过抑制氧化应激在减轻CIRI中发挥神经保护作用,钙超载,和神经炎症。
    UNASSIGNED: The incidence of ischemic cerebrovascular disease is increasing in recent years and has been one of the leading causes of neurological dysfunction and death. Ginsenoside Rg1 has been found to protect against neuronal damage in many neurodegenerative diseases. However, the effect and mechanism by which Rg1 protects against cerebral ischemia-reperfusion injury (CIRI) are not fully understood. Here, we report the neuroprotective effects of Rg1 treatment on CIRI and its possible mechanisms in mice.
    UNASSIGNED: A bilateral common carotid artery ligation was used to establish a chronic CIRI model in mice. HT22 cells were treated with Rg1 after OGD/R to study its effect on [Ca2+]i. The open-field test and pole-climbing experiment were used to detect behavioral injury. The laser speckle blood flowmeter was used to measure brain blood flow. The Nissl and H&E staining were used to examine the neuronal damage. The Western blotting was used to examine MAP2, PSD95, Tau, p-Tau, NOX2, PLC, p-PLC, CN, NFAT1, and NLRP1 expression. Calcium imaging was used to test the level of [Ca2+]i.
    UNASSIGNED: Rg1 treatment significantly improved cerebral blood flow, locomotion, and limb coordination, reduced ROS production, increased MAP2 and PSD95 expression, and decreased p-Tau, NOX2, p-PLC, CN, NFAT1, and NLRP1 expression. Calcium imaging results showed that Rg1 could inhibit calcium overload and resist the imbalance of calcium homeostasis after OGD/R in HT22 cells.
    UNASSIGNED: Rg1 plays a neuroprotective role in attenuating CIRI by inhibiting oxidative stress, calcium overload, and neuroinflammation.
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  • 文章类型: Case Reports
    线粒体肌病,脑病,乳酸性酸中毒,和中风样发作(MELAS)综合征表现为单纯疱疹性脑炎(HSE)的特征,这是罕见的,仅在少数病例报告中进行了描述。我们的病例描述了一名17岁的女性,没有明显的既往病史,表现为急性发烧。头痛,癫痫,类似于HSE。脑部计算机断层扫描显示双侧基底节钙化。磁共振成像显示,随着T2加权图像的延长,回旋状扩散受限。进一步的研究显示在休息时血乳酸浓度升高。因此,怀疑MELAS,并通过线粒体DNA中核苷酸3243A→G突变的存在证实了诊断。MELAS的临床表现和影像学研究是可变的,可以模仿HSE。感染也可能在该患者中沉淀MELAS表现。实验室特点,如乳酸升高,基底节钙化,和回旋型限制扩散可能有助于识别MELAS患者。
    Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome presents with the features of herpes simplex encephalitis (HSE), which is rare and has been described in only a few case reports. Our case describes a 17-year-old female with no significant previous medical history presenting with an acute onset of fever, headache, and epilepsy, similar to HSE. Computed tomography of the brain showed bilateral basal ganglia calcification. Magnetic resonance imaging demonstrated gyriform restricted diffusion with T2-weighted images prolongation. Further investigation showed elevated blood lactate concentration at rest. Hence, MELAS was suspected and the diagnosis was confirmed by the presence of a nucleotide 3243 A→G mutation in the mitochondrial DNA. The clinical presentation and imaging studies of MELAS are variable and may mimic those of HSE. Infection may have also precipitated MELAS manifestation in this patient. Laboratory features, such as elevated lactate, basal ganglia calcification, and gyriform restricted diffusion may be helpful in identifying patients with MELAS.
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  • 文章类型: Journal Article
    谷氨酸受体在阿片成瘾的神经生物学中起关键作用。使用电子显微镜免疫细胞化学方法,该项目阐明了性和慢性固定应激(CIS)如何影响羟考酮(Oxy)条件位置偏爱(CPP)后大鼠海马CA3锥体细胞中GluN1和GluA1的再分布。使用四组接受CPP的雌性和雄性Sprague-Dawley大鼠:注射盐水(Sal)和Oxy(3mg/kg,I.P.)幼稚大鼠;以及盐和氧注射CIS大鼠。GluN1:在幼稚和CIS大鼠中,与Sal雄性相比,Sal雌性的细胞质和总树突GluN1升高。遵循OxyCPP,在浆膜附近,细胞质,无应力雌性的CA3树突中的总GluN1减少,表明可用于配体结合的GluN1池减少。遵循CIS,Oxy雄性(未获得CPP)在CA3神经元的树突和棘的所有区室中都增加了GluN1。GluA1:在Sal或OxyCPP之后的初始雌性和雄性中,在CA3树突的任何细胞区室中GluA1的分布没有差异。与女性相比,CIS单独增加了男性CA3树突棘中GluA1的百分比。CISOxy男性与CISSal男性相比,细胞质和总树突GluA1增加。因此,在CISOxy-雄性增加的GluN1和GluA1库可用于CA3神经元中的配体结合。再加上我们之前的实验,男性CIS后GluN1和GluA1的这些变化可能导致CA3神经元对谷氨酸兴奋的敏感性增加和获得OxyCPP的能力降低。
    Glutamate receptors have a key role in the neurobiology of opioid addiction. Using electron microscopic immunocytochemical methods, this project elucidates how sex and chronic immobilization stress (CIS) impact the redistribution of GluN1 and GluA1 within rat hippocampal CA3 pyramidal cells following oxycodone (Oxy) conditioned place preference (CPP). Four groups of female and male Sprague-Dawley rats subjected to CPP were used: Saline- (Sal) and Oxy-injected (3 mg/kg, I.P.) naïve rats; and Sal- and Oxy-injected CIS rats. GluN1: In both naive and CIS rats, Sal-females compared to Sal-males had elevated cytoplasmic and total dendritic GluN1. Following Oxy CPP, near plasmalemmal, cytoplasmic, and total GluN1 decreased in CA3 dendrites of unstressed females suggesting reduced pools of GluN1 available for ligand binding. Following CIS, Oxy-males (which did not acquire CPP) had increased GluN1 in all compartments of dendrites and spines of CA3 neurons. GluA1: There were no differences in the distribution GluA1 in any cellular compartments of CA3 dendrites in naïve females and males following either Sal or Oxy CPP. CIS alone increased the percent of GluA1 in CA3 dendritic spines in males compared to females. CIS Oxy-males compared to CIS Sal-males had an increase in cytoplasmic and total dendritic GluA1. Thus, in CIS Oxy-males increased pools of GluN1 and GluA1 are available for ligand binding in CA3 neurons. Together with our prior experiments, these changes in GluN1 and GluA1 following CIS in males may contribute to an increased sensitivity of CA3 neurons to glutamate excitation and a reduced capacity to acquire Oxy CPP.
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  • 文章类型: Case Reports
    氯胺酮诱发的尿路病变(KIU)是一种患病率增加的泌尿系统疾病,与UTI症状相似,OAB综合征或间质性膀胱炎/膀胱疼痛综合征。我们介绍了一个18岁的男性,由于KIU导致严重的LUTS和急性肾损伤,在短短的6个月内。由于停止氯胺酮是治疗KIU的基石,正确和早期诊断至关重要。因此,医师应将KIU视为储存LUTS的鉴别诊断,尤其是在治疗耐药的LUTS年轻患者中。
    Ketamine induced uropathy (KIU) is a urological condition increasing in prevalence, with similar symptoms to UTI, OAB syndrome or interstitial cystitis/bladder pain syndrome. We present the case of an 18-year old male who established severe LUTS and acute kidney injury due to KIU, in a short time-span of 6 months. Since cessation of ketamine is the cornerstone of treating KIU, correct and early diagnosis is essential. Physicians should therefore consider KIU as a differential diagnosis in storage LUTS, especially in younger patients with therapy-resistant LUTS.
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  • 文章类型: Journal Article
    由于偏头痛的高患病率,对个人和社会造成了巨大的负担,严重残疾,和可观的经济成本。目前偏头痛的治疗方案仍然不足,对疼痛机制的不完全理解严重阻碍了新疗法的发展。颅脑膜的感觉神经支配现在被认为是偏头痛发生的关键因素。最近的研究大大提高了我们对驱动脑膜伤害感受神经元的一些过程的理解,这可以在治疗上有针对性地中止或预防偏头痛。在这篇综述中,我们将总结我们目前对一种偏头痛亚型-先兆偏头痛的头痛发生机制的理解。我们将专注于动物研究,解决皮质扩散抑制是一个关键的过程,驱动脑膜伤害感受的先兆偏头痛的概念,并讨论对一些拟议的潜在机制的最新见解。
    Migraine results in an enormous burden on individuals and societies due to its high prevalence, significant disability, and considerable economic costs. Current treatment options for migraine remain inadequate, and the development of novel therapies is severely hindered by the incomplete understanding of the mechanisms responsible for the pain. The sensory innervation of the cranial meninges is now considered a key player in migraine headache genesis. Recent studies have significantly advanced our understanding of some of the processes that drive meningeal nociceptive neurons, which may be targeted therapeutically to abort or prevent migraine pain. In this review we will summarize our current understanding of the mechanisms that contribute to the genesis of the headache in one migraine subtype - migraine with aura. We will focus on animal studies that address the notion that cortical spreading depression is a critical process that drives meningeal nociception in migraine with aura, and discuss recent insights into some of the proposed underlying mechanisms.
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  • 文章类型: Journal Article
    创伤后癫痫(PTE)是创伤性脑损伤(TBI)的严重和使人衰弱的后果。有时候,由于PTE对现有抗癫痫药物的耐药性,PTE的管理成为一项具有挑战性的任务,并且往往导致TBI后不良的功能和社会心理结局.我们研究了炎症标志物白细胞介素6(IL-6)的作用,肿瘤坏死因子α(TNF-α),干扰素γ(INF-γ)在预测PTE发生发展中的作用。
    对我们医院收治的254例头部受伤患者进行了前瞻性分析,其中35人患有创伤后癫痫(32名男性和3名女性);30名成年人(28名男性,2名具有相似人口统计学特征的妇女)被随机选择为对照个体。血液中TNF-α水平,在所有参与者中评估IL-6和INF-γ。
    PTE组的IL-6水平显着升高(121.36pg/mL;标准偏差[SD],89.23)高于非癫痫组(65.30pg/mL;SD,74.75;P=0.01),而癫痫发作组之间没有显着差异(11.42pg/mL;SD,7.84)和非癫痫发作组(10.58pg/mL;SD,7.84)在TNF-α水平方面(P=0.343)。癫痫发作组的INF-γ水平趋于更高(平均值,1.88pg/mL,SD,2.13在癫痫发作组vs.1.10pg/mL,SD,非癫痫组的1.45);然而,两组间差异无统计学意义(P=0.09)。
    创伤后癫痫与血液中IL-6水平升高密切相关。INF-γ可能与PTE相关或不相关。然而,TNF-α与PTE无关。
    UNASSIGNED: Posttraumatic epilepsy (PTE) is a serious and debilitating consequence of traumatic brain injury (TBI). Sometimes, the management of PTE becomes a challenging task on account of its resistance to existing antiepileptic drugs and often contributes to poor functional and psychosocial outcomes after TBI. We investigated the role of inflammatory markers interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), and interferon γ (INF-γ) in predicting the development of PTE.
    UNASSIGNED: A prospective analysis was performed of 254 patients who were admitted with head injury to our hospital, 35 of whom had posttraumatic epilepsy (32 males and 3 females); 30 adults (28 men, 2 women) with a similar demographic profile were selected randomly as control individuals. Blood levels of TNF-α, IL-6, and INF-γ were evaluated in all participants.
    UNASSIGNED: IL-6 levels were significantly higher in the PTE group (121.36 pg/mL; standard deviation [SD], 89.23) than in the nonseizure group (65.30 pg/mL; SD, 74.75; P = 0.01), whereas there was no significant difference between the seizure group (11.42 pg/mL; SD, 7.84) and the nonseizure groups (10.58 pg/mL; SD, 7.84) in terms of TNF-α level (P = 0.343). The level of INF-γ in the seizure group tended to be higher (mean, 1.88 pg/mL, SD, 2.13 in seizure group vs. 1.10 pg/mL, SD, 1.45 in the nonseizure group); however, no statistically significant difference was detected among the 2 groups (P = 0.09).
    UNASSIGNED: Posttraumatic epilepsy has a strong association with an increased level of IL-6 in the blood. INF-γ may or may not be associated with PTE. However, TNF-α was not associated with PTE.
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