central nervous system

中枢神经系统
  • 文章类型: Journal Article
    外结构域脱落(ES)是涉及膜结合蛋白的蛋白水解裂解的基本过程,导致具有潜在的旁分泌和自分泌信号功能的可溶性胞外片段(脱落的胞外域)的释放。在中枢神经系统(CNS),ES在大脑发育中起着关键作用,轴突调节,突触形成,和疾病的发病机理,从癌症到老年痴呆症。最近的证据还表明,它可能参与自闭症和精神分裂症等神经发育疾病。过去对中枢神经系统中ES的研究主要依赖于细胞培养上清液或脑脊液(CSF)样品,但是这些方法有局限性,对ES如何在完整的脑实质中进行调节提供了有限的见解。在这项研究中,我们介绍了一种分析啮齿动物大脑样本中全球脱落的胞外域的方法。通过生化组织亚细胞分离,质谱,和生物信息学分析,我们表明,大脑的可溶性部分脱落与体外神经元和CSF脱落具有显著的分子和功能相似性。这种方法为探索中枢神经系统中的ES动力学提供了一种有希望的方法,允许评估不同发育阶段和病理生理状态的ES。这种方法有可能帮助我们加深对ES及其在CNS功能和病理学中的作用的理解,为该领域的研究提供新的见解和机会。
    Ectodomain shedding (ES) is a fundamental process involving the proteolytic cleavage of membrane-bound proteins, leading to the release of soluble extracellular fragments (shed ectodomains) with potential paracrine and autocrine signaling functions. In the central nervous system (CNS), ES plays pivotal roles in brain development, axonal regulation, synapse formation, and disease pathogenesis, spanning from cancer to Alzheimer\'s disease. Recent evidence also suggests its potential involvement in neurodevelopmental conditions like autism and schizophrenia. Past investigations of ES in the CNS have primarily relied on cell culture supernatants or cerebrospinal fluid (CSF) samples, but these methods have limitations, offering limited insights into how ES is modulated in the intact brain parenchyma. In this study, we introduce a methodology for analyzing shed ectodomains globally within rodent brain samples. Through biochemical tissue subcellular separation, mass spectrometry, and bioinformatic analysis, we show that the brain\'s soluble fraction sheddome shares significant molecular and functional similarities with in vitro neuronal and CSF sheddomes. This approach provides a promising means of exploring ES dynamics in the CNS, allowing for the evaluation of ES at different developmental stages and pathophysiological states. This methodology has the potential to help us deepen our understanding of ES and its role in CNS function and pathology, offering new insights and opportunities for research in this field.
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  • 文章类型: Editorial
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  • 文章类型: Case Reports
    神经-Behçet病(NBD)是Behçet综合征的重要并发症,可能导致死亡率和残疾率上升。实质性NBD的标准治疗通常需要给予高剂量皮质类固醇以促进快速起效。加上免疫抑制剂,以防止随后的复发。一名患有NBD的48岁男性在9个月内表现出逐渐恶化的构音障碍。该患者在使用糖皮质激素时出现眼内压升高,恶化了他先前的青光眼.该患者先前诊断为NBD,并在9个月内出现进行性构音障碍。导致脑部磁共振成像(MRI)扫描。脑部MRI显示左额顶区域多灶性点状高信号强度,脑岛,和基底神经节.而不是标准的类固醇脉冲疗法,患者接受阿达木单抗-环磷酰胺联合治疗作为替代诱导治疗.随后的系列脑部MRI扫描显示没有出现新的病变,即使在开始诱导治疗后17个月,患者仍然没有临床复发。阿达木单抗-环磷酰胺组合可用作NBD的无皮质类固醇诱导策略。需要进一步的研究以建立最合适的联合方案。
    Neuro-Behçet\'s disease (NBD) represents a significant complication of Behçet\'s syndrome, potentially leading to elevated mortality and disability rates. The standard treatment for parenchymal NBD typically entails administering high-dose corticosteroids to prompt rapid-onset effects, coupled with immunosuppressants to prevent subsequent relapses. A 48-year-old male with NBD presented with progressively worsening dysarthria over 9 months. This patient experienced increased intraocular pressure while using glucocorticoids, which worsened his pre-existing glaucoma. The patient had a prior diagnosis of NBD and presented with progressive dysarthria over a period of nine months, leading to a brain magnetic resonance imaging (MRI) scan. The brain MRI revealed multifocal punctate high signal intensities in the left frontoparietal area, insula, and basal ganglia. Instead of the standard steroid pulse therapy, the patient received adalimumab-cyclophosphamide combination as an alternative induction therapy. Subsequent serial brain MRI scans exhibited no emergence of new lesions, and the patient remained devoid of clinical relapses even after 17 months from the commencement of induction treatment. Adalimumab-cyclophosphamide combination could be used as a corticosteroid-free induction strategy for NBD. Further investigations are warranted to establish the most suitable combination regimen.
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  • 文章类型: Journal Article
    受体蛋白酪氨酸磷酸酶γ和ζ(RPTPγ和RPTPζ)是具有细胞外碳酸酐酶样结构域的跨膜信号蛋白,在中枢神经系统(CNS)的发育和功能中起着至关重要的作用,并与肿瘤抑制有关。神经变性,和胞外[CO2]和[HCO3-]的传感。RPTPγ在全身表达,而RPTPζ优先在CNS中表达。这里,我们研究了来自C57BL/6小鼠野生型实验室品系的三种来源的RPTPγ-RPTPζ表达差异:(a)从P0-P2幼崽分离后14天的混合神经元-星形胶质细胞海马(HC)培养物;(b)P0-P2幼崽海马;(c)9至12周龄的成年海马。关于RPTPγ,我们检测到Ptprg变体1(V1)转录本,代表规范外显子1-30。此外,我们新验证了假设的程序集[XM_006517956](建议名称,Ptprg-V3),缺少第14外显子.两种转录物都在所有三个HC来源中。关于RPTPζ,我们证实了Ptprz1-V1的表达,在幼犬和成虫中检测到它,但在培养物中没有,和Ptprz1-V3至Ptprz1-V7在所有三种制剂中。我们新验证了假设的组件Ptprz1-X1(在文化和幼崽中),Ptprz1-X2(在所有三个中),和Ptprz1-X5(幼犬和成年),并建议将其分别重新指定为Ptprz1-V0,Ptprz1-V2和Ptprz1-V8。RPTPγ和RPTPζ剪接变体的多样性可能对应于不同的信号功能,在不同的细胞区室,在发展过程中与以后的生活。与以前的研究报告不同的RPTPγ和RPTPζ蛋白在神经元和有时在神经胶质中表达相反,我们观察到RPTPγ和RPTPζ在几乎所有HC神经元的躯体和过程中共表达,但在星形胶质细胞中不表达,在所有三种HC制剂中。
    Receptor protein tyrosine phosphatases γ and ζ (RPTPγ and RPTPζ) are transmembrane signaling proteins with extracellular carbonic anhydrase-like domains that play vital roles in the development and functioning of the central nervous system (CNS) and are implicated in tumor suppression, neurodegeneration, and sensing of extracellular [CO2] and [HCO3 -]. RPTPγ expresses throughout the body, whereas RPTPζ preferentially expresses in the CNS. Here, we investigate differential RPTPγ-RPTPζ expression in three sources derived from a wild-type laboratory strain of C57BL/6 mice: (a) mixed neuron-astrocyte hippocampal (HC) cultures 14 days post isolation from P0-P2 pups; (b) P0-P2 pup hippocampi; and (c) 9- to 12-week-old adult hippocampi. Regarding RPTPγ, we detect the Ptprg variant-1 (V1) transcript, representing canonical exons 1-30. Moreover, we newly validate the hypothetical assembly [XM_006517956] (propose name, Ptprg-V3), which lacks exon 14. Both transcripts are in all three HC sources. Regarding RPTPζ, we confirm the expression of Ptprz1-V1, detecting it in pups and adults but not in cultures, and Ptprz1-V3 through Ptprz1-V7 in all three preparations. We newly validate hypothetical assemblies Ptprz1-X1 (in cultures and pups), Ptprz1-X2 (in all three), and Ptprz1-X5 (in pups and adults) and propose to re-designate them as Ptprz1-V0, Ptprz1-V2, and Ptprz1-V8, respectively. The diversity of RPTPγ and RPTPζ splice variants likely corresponds to distinct signaling functions, in different cellular compartments, during development vs later life. In contrast to previous studies that report divergent RPTPγ and RPTPζ protein expressions in neurons and sometimes in the glia, we observe that RPTPγ and RPTPζ co-express in the somata and processes of almost all HC neurons but not in astrocytes, in all three HC preparations.
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  • 文章类型: Case Reports
    一名67岁的男性因发烧7天的病史出现在急诊科,萎靡不振,肌痛,头痛,和癫痫发作。体格检查显示生命体征稳定,但发烧。实验室检查显示白细胞增多,贫血,血小板增多症,和炎症标志物升高。影像学显示颅内多发病变,脑脊液分析证实存在抗酸杆菌。患者对抗结核治疗反应良好,在8周内表现出显著的临床改善。
    A 67-year-old male presented to the emergency department with a 7-day history of fever, malaise, myalgia, headache, and a seizure episode. Physical examination showed stable vital signs but a fever. Laboratory tests indicated leukocytosis, anemia, thrombocytosis, and elevated inflammatory markers. Imaging revealed multiple intracranial lesions, and cerebrospinal fluid analysis confirmed the presence of acid-fast bacilli. The patient responded well to anti-tuberculosis therapy, showing significant clinical improvement within 8 weeks.
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  • 文章类型: Case Reports
    松果体区乳头状肿瘤(PTPR)是一种罕见的神经上皮肿瘤,起源于特化的室管膜细胞。它主要影响松果体区域内的结构,包括松果体,上丘脑,四叉池,和第三脑室的后壁。这里,我们介绍了一系列四例病例,其特征是与阻塞性脑积水相关的症状,如头痛,癫痫发作,视觉障碍,步态紊乱,和Parinaud综合征.影像学检查显示松果体区有病变,提示手术干预。组织病理学检查,包括活检和术中分析,证实了PTPR的诊断。尽管取得了进步,PTPR的病因和发病机制尚不完全清楚,保证进一步研究以完善管理策略。
    The papillary tumor of the pineal region (PTPR) is a rare neuroepithelial tumor originating from specialized ependymocytes. It primarily affects structures within the pineal region, including the pineal gland, epithalamus, quadrigeminal cistern, and posterior wall of the third ventricle. Here, we present a series of four cases characterized by symptoms associated with obstructive hydrocephalus such as headaches, seizures, visual disturbances, gait disturbances, and Parinaud syndrome. Imaging studies revealed lesions in the pineal region, prompting surgical intervention. Histopathological examination, including biopsy and intraoperative analysis, confirmed the diagnosis of PTPR. Despite advancements, the etiology and pathogenesis of PTPR remain incompletely understood, warranting further research to refine management strategies.
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  • 文章类型: Journal Article
    噻虫胺(CLO),一种新烟碱,广泛用于森林和农业地区,最近有报道对哺乳动物造成毒性。尽管对化学物质的敏感性因性别和发育阶段而异,全面评估男性和女性的研究是有限的。因此,在这项研究中,我们利用小鼠模型比较了不同发育阶段CLO暴露后行为效应的性别特异性差异。我们在出生后(2周龄)将CLO作为单个高剂量溶液(80mg/kg)口服给雄性和雌性小鼠,青春期(6周龄),或成熟度(10周龄),随后评估了更高的大脑功能。行为电池测试包括开放场地,亮/暗过渡,以及在三个月和七个月大时进行的上下文/提示恐惧条件测试。在行为测试之后,解剖大脑并准备免疫组织化学染色。我们观察到焦虑中的行为异常,空间记忆,只提示雌性老鼠的记忆。此外,免疫组织化学分析显示,行为异常的雌性小鼠海马内星形胶质细胞减少。在雌性CLO处理的小鼠中观察到的行为异常与与海马星形胶质细胞功能障碍相关的典型行为异常一致。因此,CLO诱导的行为异常可能至少部分与星形胶质细胞数量的减少有关。这项研究的结果突出了性别和发育阶段之间接触CLO后行为效应的差异。
    Clothianidin (CLO), a neonicotinoid that is widely used in forests and agricultural areas, was recently reported to cause toxicity in mammals. Although sensitivity to chemicals varies between sexes and developmental stages, studies that comprehensively evaluate both males and females are limited. Therefore, in this study we utilized murine models to compare the sex-specific differences in behavioral effects following CLO exposure at different developmental stages. We orally administered CLO to male and female mice as a single high-dose solution (80 mg/kg) during the postnatal period (2-week-old), adolescence (6-week-old), or maturity (10-week-old), and subsequently evaluated higher brain function. The behavioral battery test consisted of open field, light/dark transition, and contextual/cued fear conditioning tests conducted at three and seven months of age. After the behavioral test, the brains were dissected and prepared for immunohistochemical staining. We observed behavioral abnormalities in anxiety, spatial memory, and cued memory only in female mice. Moreover, the immunohistochemical analysis showed a reduction in astrocytes within the hippocampus of female mice with behavioral abnormalities. The behavioral abnormalities observed in female CLO-treated mice were consistent with the typical behavioral abnormalities associated with hippocampal astrocyte dysfunction. It is therefore possible that the CLO-induced behavioral abnormalities are at least in part related to a reduction in astrocyte numbers. The results of this study highlight the differences in behavioral effects following CLO exposure between sexes and developmental stages.
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  • 文章类型: Journal Article
    目的:我们的目的是根据社区获得性大肠埃希菌尿路感染(UTI)患者在过去18个月内的抗生素暴露情况,量化个体对抗菌药物耐药的风险。
    方法:2015-2017年在两个中心前瞻性招募了法国患者。分离株对阿莫西林(AMX)的耐药性,阿莫西林-克拉维酸(AMC),第三代头孢菌素(3GC),甲氧苄啶-磺胺甲恶唑(TMP-SMX),氟喹诺酮类(FQ)和磷霉素(FOS)根据健康保险文件中记录的以前的类内和类间抗生素暴露进行分析.
    结果:在所分析的722例UTI病例(564例)中,有588例(81.4%)发现了以前的抗生素暴露。与远程暴露(UTI前18个月)相比,最近的暴露(UTI前3个月)对AMX的大肠杆菌耐药性具有更强的类内影响,AMC,FQ和TMP-SMX,相应的调整后赔率比[95%置信区间]为1.63[1.20-2.21],1.59[1.02-2.48],3.01[1.90-4.77],和2.60[1.75-3.87]。AMX,FQ,TMP-SMX也表现出显著的类间影响。对3GC的抗性与组内暴露没有显着相关(调整后的OR:0.88[0.41-1.90])。FOS抗性显著低(0.4%)。耐药性风险降至10%以下所需的无抗生素期持续时间,在UTI中经验使用的阈值,被建模为3GC<1个月,AMX和TMP-SMX>18个月,AMC(5.2个月[2.3至>18])和FQ(17.4个月[7.4至>18])不确定。
    结论:引起UTI的E.coli的耐药性部分可以通过以前的个人抗生素使用来预测。
    BACKGROUND: Spinal tuberculosis is often associated with poor outcomes; host-directed inflammation involving the spine contributes to this disability.
    METHODS: A retrospective review of patients with complicated spinal tuberculosis having received tumor necrosis factor-alpha (TNF-α) antagonists at a referral hospital in South Africa. A literature review was performed to identify all published cases of complicated spinal tuberculosis that received a TNF-α antagonist as part of their treatment.
    RESULTS: We describe 23 cases, of which 19 were previously reported in the literature. All patients were treated with either thalidomide (n=6) or infliximab (n=16), except for one who received both. All in all, 21 (91%) cases improved neurologically and, at the end of follow-up, 18 could walk.
    CONCLUSIONS: There is accumulating experience to confer the efficacy and safety of TNF-α antagonists in treating complicated spinal tuberculosis cases. Evidence from randomized controlled trials is urgently required to substantiate these findings.
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  • 文章类型: Journal Article
    目的:大多数视神经脊髓炎谱系障碍(NMOSD)患者的水通道蛋白4(AQP4)特异性抗体(也称为视神经脊髓炎免疫球蛋白G抗体(NMO-IgG))呈血清阳性。尽管NMO-IgG可以诱导中枢神经系统(CNS)的病理变化,中枢神经系统和外周组织的免疫学变化在很大程度上仍然未知。我们研究了NMO-IgG是否与表达AQP4的组织结合并诱导外周组织和CNS的免疫学变化。
    方法:将C57BL/6雌性小鼠分配到NMOSD或对照组中。通过免疫染色和流式细胞术测量外周组织和中枢神经系统的病理和免疫学变化,分别。运动障碍通过开放场测试进行测量。
    结果:我们发现NMO-IgG确实与表达星形细胞和AQP4的外周组织结合,但仅在中枢神经系统中诱导神经胶质原纤维酸性蛋白和AQP4丢失。NMO-IgG诱导小胶质细胞的激活并调节小胶质细胞向经典(M1)表型的极化,但不影响外周免疫系统中的先天或适应性免疫细胞,比如巨噬细胞,中性粒细胞,Th17/Th1或产生IL-10的B细胞。此外,NMOSD小鼠在开放场中表现出明显更少的总行进距离和更高的不动时间。
    结论:我们发现注射人NMO-IgG导致星形细胞病变,中枢神经系统中的小胶质细胞活化。然而,外周组织无明显病理或免疫学改变。
    OBJECTIVE: The majority of neuromyelitis optica spectrum disorders (NMOSD) patients are seropositive for aquaporin-4 (AQP4)-specific antibodies [also named neuromyelitis optica immunoglobulin G antibodies (NMO-IgG)]. Although NMO-IgG can induce pathological changes in the central nervous system (CNS), the immunological changes in the CNS and peripheral tissue remain largely unknown. We investigated whether NMO-IgG binds to tissue expressing AQP4 and induces immunological changes in the peripheral tissue and CNS.
    METHODS: C57BL/6 female mice were assigned into an NMOSD or control group. Pathological and immunological changes in peripheral tissue and CNS were measured by immunostaining and flow cytometry, respectively. Motor impairment was measured by open-field test.
    RESULTS: We found that NMO-IgG did bind to astrocyte- and AQP4-expressing peripheral tissue, but induced glial fibrillary acidic protein and AQP4 loss only in the CNS. NMO-IgG induced the activation of microglia and modulated microglia polarization toward the classical (M1) phenotype, but did not affect innate or adaptive immune cells in the peripheral immune system, such as macrophages, neutrophils, Th17/Th1, or IL-10-producing B cells. In addition, NMOSD mice showed significantly less total distance traveled and higher immobility time in the open field.
    CONCLUSIONS: We found that injection of human NMO-IgG led to astrocytopathic lesions with microglial activation in the CNS. However, there were no significant pathological or immunological changes in the peripheral tissues.
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  • 文章类型: Journal Article
    目的:中枢神经系统(CNS)癌症构成了重大负担,尽管与其他类型的癌症相比,它们的发病率相对较低。死亡率与发病率比(MIR)是长期生存和医疗保健系统性能的关键指标。计算机断层扫描(CT)在筛查中起着至关重要的作用,诊断,和监测脑肿瘤,能够进行早期干预和治疗。本研究旨在探讨CT密度,中枢神经系统癌症发病率,死亡率,和MIR来研究CT利用的区域变化及其对中枢神经系统癌症死亡率的影响。
    方法:MIR的变化,称为δMIR,是根据2012年和2018年的数据计算的。从全球卫生观察站数据储存库检索了2013年的CT密度数据。使用Spearman的等级相关系数分析变量之间的关联。
    结果:对来自107个国家的数据进行的分析显示,CT密度与中枢神经系统癌症发病率和死亡率呈正相关。然而,在CT密度和MIR之间观察到趋势。这些发现表明,在CT成像可及性较高的国家,中枢神经系统癌症病例可以更早地检测到,并且可以实现较低的死亡率。
    结论:我们的研究有助于理解CT成像对中枢神经系统癌症的治疗和结果的影响。它告知医疗保健策略和资源分配,以改善患者护理。
    OBJECTIVE: Cancers of the central nervous system (CNS) pose a significant burden, despite their relatively low incidence compared to other types of cancers. The mortality-to-incidence ratio (MIR) is a crucial indicator of long-term survival and healthcare system performance. Computed tomography (CT) plays a crucial role in the screening, diagnosis, and monitoring of brain tumors, enabling early intervention and treatment. This study aimed to explore the relationship between CT density, CNS cancer incidence, mortality, and MIR to investigate regional variations in CT utilization and their impact on CNS cancer mortality rates.
    METHODS: Changes in MIR, referred to as δMIR, were calculated based on data from 2012 and 2018. CT density data for the year 2013 were retrieved from the Global Health Observatory data repository. The association between variables was analyzed using Spearman\'s rank correlation coefficient.
    RESULTS: Analysis of data from 107 countries revealed a positive association between CT density and both CNS cancer incidence and mortality. However, a trend was observed between CT density and MIR. These findings suggest that in countries with greater accessibility to CT imaging, CNS cancer cases may be detected earlier and lower mortality rates can be achieved.
    CONCLUSIONS: Our research contributes to the understanding of the impact of CT imaging on the management and outcomes of CNS cancers. It informs healthcare strategies and resource allocation to improve patient care.
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