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New Insights Into the Pathogenesis of Bullous Pemphigoid: 2019 Update.
Genovese, G, Di Zenzo, G, Cozzani, E, Berti, E, Cugno, M, Marzano, AV
Frontiers in immunology. 2019;:1506
Abstract
There are several lines of evidence indicating that the physiopathological bases of bullous pemphigoid (BP), the most common subepidermal autoimmune bullous disease, are hallmarked by the production of autoantibodies directed against the hemidesmosomal anchoring proteins BP180 and BP230. In contrast to the robustness of the latter assumption, the multifaceted complexity of upstream and downstream mechanisms implied in the pathogenesis of BP remains an area of intense speculation. So far, an imbalance between T regulatory cells and autoreactive T helper (Th) cells has been regarded as the main pathogenic factor triggering the autoimmune response in BP patients. However, the contributory role of signaling pathways fostering the B cell stimulation, such as Toll-like receptor activation, as well as that of ancillary inflammatory mechanisms responsible for blister formation, such as Th17 axis stimulation and the activation of the coagulation cascade, are still a matter of debate. In the same way, the pathomechanisms implied in the loss of dermal-epidermal adhesion secondary to autoantibodies binding are not fully understood. Herein, we review in detail the current concepts and controversies on the complex pathogenesis of BP, shedding light on the most recent theories emerging from the literature.
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Advances in Management of Neuropsychiatric Syndromes in Neurodegenerative Diseases.
Cummings, J, Ritter, A, Rothenberg, K
Current psychiatry reports. 2019;(8):79
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Abstract
PURPOSE OF REVIEW Neuropsychiatric syndromes (NPS) are common in neurodegenerative disorders (NDD). This review describes the role of NPS in the diagnosis of NDD, criteria for the diagnosis of NPS, management of NPS, and agents in clinical trials for NPS. RECENT FINDINGS NPS play an increasingly important role in the diagnosis of NDD. Consensus diagnostic criteria have evolved for psychosis, depression, agitation, and apathy in NDD. With one exception-pimavanserin is approved for the treatment of hallucinations and delusions in Parkinson's disease-there are no drugs approved by the FDA for treatment of NPS in NDD. Trials show that atypical antipsychotics reduce psychosis in AD and in Parkinson's disease, although side effect concerns have constrained their use. Antidepressants show benefit in treatment of Parkinson's disease with depression. Several agents are in clinical trials for treatment of NPS in NDD. Neuropsychiatric syndromes play a major role in NDD diagnosis. Clinical criteria allow recognition of NPS in NDD. Psychotropic medications are often useful in the treatment of NPS in NDD; efficacious, safe, and approved agents are needed.
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Preventive and Therapeutic Effect of Ganoderma (Lingzhi) on Brain Injury.
Quan, Y, Ma, A, Yang, B
Advances in experimental medicine and biology. 2019;:159-180
Abstract
Neurological dysfunction and death are common events leading to acute and chronic neurodegenerative diseases. Neurodegenerative disorders such as Alzheimer's and Parkinson's disease account for a significant and increasing proportion of morbidity and mortality in the developed world. Ganoderma lucidum (G. lucidum, Lingzhi), one of highly nutritious and significantly effective medicinal herbs, has been used for clinical applications for thousands of years. Several researches have shown that it has a wide range of brain damage protection, such as amelioration of Alzheimer's disease, therapeutic effect on epilepsy, and the protective effect on neural cells in stroke injury. This chapter reviews the neuroprotective effects of G. lucidum and its extracts on brain injury diseases, including Alzheimer's disease, Parkinson's disease, stroke, epilepsy, and other neurodegenerative diseases, and the potential clinical applications.
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CpG and Non-CpG Methylation in the Diet-Epigenetics-Neurodegeneration Connection.
Fuso, A, Lucarelli, M
Current nutrition reports. 2019;(2):74-82
Abstract
PURPOSE OF REVIEW Unraveling the diet-epigenetics-neurodegeneration connection may disclose associated mechanisms and novel approaches to the neurodegenerative diseases. This review summarizes the basic concepts and the innovative results in this field focusing on the relevance of non-CpG methylation. RECENT FINDINGS Many multifactorial neurodegenerative diseases are associated with epigenetic changes, and the brain seems more prone to epigenetic changes than other tissues. Several environmental factors induce epigenetic modulation in the organisms: diet and nutrition retain a high capacity to modulate the epigenetic traits. Finally, unexpected, specific, and functional non-CpG methylation in the brain was identified. Non-CpG methylation modulates brain expression of genes especially in promoters characterized by low-density CpGs distribution. These genes appear more prone to the epigenetic effect of environmental factors, i.e., diet, possibly inducing neurodegenerative processes. Understanding these processes could help in setting nutritional intervention aimed at contrasting neurodegenerative diseases.
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Role of Flavonoids in Neurodegenerative Disorders with Special Emphasis on Tangeritin.
Fatima, A, Siddique, YH
CNS & neurological disorders drug targets. 2019;(8):581-597
Abstract
Flavonoids are naturally occurring plant polyphenols found universally in all fruits, vegetables and medicinal plants. They have emerged as a promising candidate in the formulation of treatment strategies for various neurodegenerative disorders. The use of flavonoid rich plant extracts and food in dietary supplementation have shown favourable outcomes. The present review describes the types, properties and metabolism of flavonoids. Neuroprotective role of various flavonoids and the possible mechanism of action in the brain against the neurodegeneration have been described in detail with special emphasis on the tangeritin.
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Vitamin D and the nervous system.
Bivona, G, Gambino, CM, Iacolino, G, Ciaccio, M
Neurological research. 2019;(9):827-835
Abstract
Objective: to summarise the activities that Vitamin D (VD) carries out in the brain and to clarify the potential role of VD in neurological diseases. Methods: a literature research has been performed in Pubmed using the following keywords: 'Vitamin D', 'nervous system', 'brain'. Results: the studies reviewed show that VD contributes to cerebral activity in both embryonic and adult brain, helping the connectivity of neural circuits responsible for locomotor, emotional and reward-dependent behavior. Low VD serum levels have been found in patients affected by Alzheimer Disease, Parkinson Disease, Multiple Sclerosis, Autism Spectrum Disorders, Sleep Disorders and Schizophrenia. Discussion: findings are controversial and should be interpreted with caution, since most of the studies performed have observational study set and few interventional studies are available, producing conflicting results. Overall, it can be stated that the potential role of Vitamin D in neurological diseases is mostly unclear and further randomised controlled trials are needed to understand better whether Vitamin D supplementation treatment can be useful in brain disorders.
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The intrinsic and extrinsic factors that contribute to proteostasis decline and pathological protein misfolding.
Kikis, EA
Advances in protein chemistry and structural biology. 2019;:145-161
Abstract
Proteostasis refers to the ability of cells to maintain the health of the proteome. Highly conserved quality control mechanisms exist to maintain proteostasis. These include the heat shock response, the unfolded protein response, and protein clearance/degradation pathways. Together, these mechanisms and others comprise the proteostasis network. This network is under constant assault and is strikingly sensitive to changes in the protein folding environment, resulting in proteostasis collapse under certain conditions. Here, the intrinsic and extrinsic stresses experienced by the proteostasis network are explored. The intrinsic stresses include genetic background as well as transcriptional and translational fidelity. These cause changes in the abundance or amino acid sequence of cellular proteins. Extrinsic stresses refer to environmental perturbation of the proteome, such as those caused by temperature stress, oxidative stress, air pollution and cigarette smoke. As the stress to the proteome exceeds the capacity of the proteostasis network, progressive neurodegenerative diseases of aging, such as Alzheimer's disease and Huntington's disease are more likely to ensue.
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Cingulate-centered large-scale networks: Normal functions, aging, and neurodegenerative disease.
Touroutoglou, A, Dickerson, BC
Handbook of clinical neurology. 2019;:113-127
Abstract
In this chapter, we review evidence from structural and functional neuroimaging in humans to consider the role of the cingulate cortex subregions (i.e., subgenual anterior cingulate cortex, pregenual anterior cingulate cortex, anterior midcingulate cortex, and dorsal posterior cingulate cortex) as major hubs anchoring multiple large-scale brain networks. We begin with a review of evidence from intrinsic functional connectivity and diffusion tensor imaging studies to show how connections within and between cingulate-centered networks contribute to processing and integrating signals related to autonomic, affective, executive, and memory functions. We then consider how variability in cingulate-centered networks could contribute to a range of aging outcomes, including typical aging and unusually successful aging (dubbed "superaging"), as well as early neurodegenerative dementias, including frontotemporal dementia and Alzheimer's disease.
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SILK studies - capturing the turnover of proteins linked to neurodegenerative diseases.
Paterson, RW, Gabelle, A, Lucey, BP, Barthélemy, NR, Leckey, CA, Hirtz, C, Lehmann, S, Sato, C, Patterson, BW, West, T, et al
Nature reviews. Neurology. 2019;(7):419-427
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Abstract
Alzheimer disease (AD) is one of several neurodegenerative diseases characterized by dysregulation, misfolding and accumulation of specific proteins in the CNS. The stable isotope labelling kinetics (SILK) technique is based on generating amino acids labelled with naturally occurring stable (that is, nonradioactive) isotopes of carbon and/or nitrogen. These labelled amino acids can then be incorporated into proteins, enabling rates of protein production and clearance to be determined in vivo and in vitro without the use of radioactive or chemical labels. Over the past decade, SILK studies have been used to determine the turnover of key pathogenic proteins amyloid-β (Aβ), tau and superoxide dismutase 1 (SOD1) in the cerebrospinal fluid of healthy individuals, patients with AD and those with other neurodegenerative diseases. These studies led to the identification of several factors that alter the production and/or clearance of these proteins, including age, sleep and disease-causing genetic mutations. SILK studies have also been used to measure Aβ turnover in blood and within brain tissue. SILK studies offer the potential to elucidate the mechanisms underlying various neurodegenerative disease mechanisms, including neuroinflammation and synaptic dysfunction, and to demonstrate target engagement of novel disease-modifying therapies.
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Plant and human aquaporins: pathogenesis from gut to brain.
Lambert, J, Mejia, S, Vojdani, A
Immunologic research. 2019;(1):12-20
Abstract
Corn, soybean, spinach leaf, and tomato aquaporins have been shown to share homology with human aquaporin-4, which is abundantly expressed by brain astrocytic endfeet. Thus, antibodies formed against the dietary aquaporins may potentially cross-react with brain aquaporin, leading to blood-brain barrier permeability and setting the stage for neuroautoimmunity and neurodegeneration. Here, we review the role of aquaporins in plants and humans in maintaining a healthy organism and mechanisms by which dietary aquaporins may contribute to neurological disorders. We include clinical data on the correlation between four real-world, dietary aquaporin and five neurological tissue antibodies. Our findings showed the percent of neurological tissue antibody production increased with the number of positive food aquaporins. Of the four food aquaporins, spinach was the most common reactive. Of the neurological tissues assessed, tubulin was the most common positive. Patients with antibody reactivity to dietary aquaporins may consider abstaining from the aquaporin-containing food in order to prevent neurological tissue damage.