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Exploring the potential of routine serological markers in predicting neurological outcomes in spinal cord injury 探索常规血清学标记物在预测脊髓损伤神经系统预后方面的潜力
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-12 DOI: 10.1016/j.expneurol.2024.114918
Jan Matthias, Louis P. Lukas, Sarah C. Brüningk, Doris Maier, O. Mach, L. Grassner, John L.K. Kramer, L. Bourguignon, C. Jutzeler
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引用次数: 0
Unraveling the molecular mechanisms of Ace2-mediated post-COVID-19 cognitive dysfunction through systems genetics approach 通过系统遗传学方法揭示Ace2-介导的COVID-19后认知功能障碍的分子机制。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-12 DOI: 10.1016/j.expneurol.2024.114921

The dysregulation of Angiotensin-converting enzyme 2 (ACE2) in central nervous system is believed associates with COVID-19 induced cognitive dysfunction. However, the detailed mechanism remains largely unknown. In this study, we performed a comprehensive system genetics analysis on hippocampal ACE2 based on BXD mice panel. Expression quantitative trait loci (eQTLs) mapping showed that Ace2 was strongly trans-regulated, and the elevation of Ace2 expression level was significantly correlated with impaired cognitive functions. Further Gene co-expression analysis showed that Ace2 may be correlated with the membrane proteins in Calcium signaling pathway. Further, qRT-PCR confirmed that SARS-CoV-2 spike S1 protein upregulated ACE2 expression together with eight membrane proteins in Calcium Signaling pathway. Moreover, such elevation can be attenuated by recombinant ACE2. Collectively, our findings revealed a potential mechanism of Ace2 in cognitive dysfunction, which could be beneficial for COVID–19–induced cognitive dysfunction prevention and potential treatment.

血管紧张素转换酶 2(ACE2)在中枢神经系统中的失调被认为与 COVID-19 诱发的认知功能障碍有关。然而,其详细机制仍不为人知。在本研究中,我们基于 BXD 小鼠面板对海马 ACE2 进行了全面的系统遗传学分析。表达量性状位点(eQTLs)图谱显示,Ace2具有很强的跨调控作用,Ace2表达水平的升高与认知功能受损显著相关。进一步的基因共表达分析表明,Ace2可能与钙信号通路中的膜蛋白相关。qRT-PCR进一步证实,SARS-CoV-2尖峰S1蛋白与钙信号通路中的8种膜蛋白一起上调了ACE2的表达。此外,重组 ACE2 可减轻这种升高。总之,我们的研究结果揭示了ACE2在认知功能障碍中的潜在机制,这可能有利于COVID-19引起的认知功能障碍的预防和潜在治疗。
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引用次数: 0
Insights into COVID-19 pathophysiology from a longitudinal multisystem report during acute infection 从急性感染期间多系统纵向报告中了解 COVID-19 的病理生理学。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-09 DOI: 10.1016/j.expneurol.2024.114917

The Coronavirus disease 2019 (COVID-19), an illness caused by a SARS-CoV-2 viral infection, has been associated with neurological and neuropsychiatric disorders, revealing its impact beyond the respiratory system. Most related research involved individuals with post-acute or persistent symptoms of COVID-19, also referred to as long COVID or Post-Acute Sequelae of COVID-19 (PASC). In this longitudinal unique report, we aimed to describe the acute supraspinal and corticospinal changes and functional alterations induced by a COVID-19 infection using neuroimaging, neurophysiological and clinical assessment of a participant during acute infection, as compared to three other visits where the participant had no COVID-19. The results favor a multisystem impairment, impacting cortical activity, functional connectivity, and corticospinal excitability, as well as motor and cardiovascular function. The report suggests pathophysiological alteration and impairment already present at the acute stage, that if resolved tend to lead to a full clinical recovery. Such results could be also insightful into PASC symptomatology.

由 SARS-CoV-2 病毒感染引起的 2019 年冠状病毒病(COVID-19)与神经和神经精神疾病有关,揭示了其对呼吸系统以外的影响。大多数相关研究都涉及 COVID-19 急性期后或持续症状的患者,也称为长期 COVID 或 COVID-19 急性期后遗症 (PASC)。在这份独特的纵向报告中,我们旨在利用神经影像学、神经生理学和临床评估,描述 COVID-19 感染引起的急性脊髓上和皮质脊髓变化及功能改变,并将急性感染期间的参与者与未感染 COVID-19 的其他三次访问进行比较。结果表明,COVID-19 会造成多系统损害,影响大脑皮层活动、功能连接、皮质脊髓兴奋性以及运动和心血管功能。报告表明,病理生理改变和损害在急性期就已经存在,如果得到解决,往往会导致临床完全康复。这些结果也有助于深入了解 PASC 症状。
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引用次数: 0
TRIM21-mediated ubiquitination of PLIN2 regulates neuronal lipid droplet accumulation after acute spinal cord injury TRIM21介导的PLIN2泛素化调节急性脊髓损伤后神经元脂滴的积聚。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-08 DOI: 10.1016/j.expneurol.2024.114916

To investigate the changes in neuronal lipid droplet (LD) accumulation and lipid metabolism after acute spinal cord injury (SCI), we established a rat model of compressive SCI. Oil Red O staining, BODIPY 493/503 staining, and 4-hydroxynonenal immunofluorescence staining were performed to determine overall LD accumulation, neuronal LD accumulation, and lipid peroxidation. Lipidomics was conducted to identify the lipid components in the local SCI microenvironment. We focused on the expression and regulation of perilipin 2 (PLIN2) and knocked down PLIN2 in vivo by intrathecal injection of adeno-associated virus 9–synapsin–short-hairpin RNA-PLIN2 (AAV9-SYN-shPlin2). Motor function was assessed using the Basso–Beattie–Bresnahan score. Proteins that interacted with PLIN2 were screened by immunoprecipitation (IP) and qualitative shotgun proteomics, and confirmed by co-IP. A ubiquitination assay was performed to validate whether ubiquitination was involved in PLIN2 degradation. Oil Red O staining indicated that LDs steadily accumulated after SCI. Fluorescent staining indicated the accumulation of LDs in neurons with increased lipid peroxidation. Lipidomics revealed significant changes in lipid components after SCI. PLIN2 expression significantly increased following SCI, and knockdown of PLIN2 using AAV9-SYN-Plin2 reduced neuronal LD accumulation. This intervention improved the neuronal survival and motor function of injured rats. IP and qualitative shotgun proteomics identified tripartite motif-containing protein 21 (TRIM21) as a direct binding protein of PLIN2, and this interaction was confirmed by co-IP in vitro and immunofluorescence staining in vivo. By manipulating TRIM21 expression, we found it was negatively correlated with PLIN2 expression. In conclusion, PLIN2 is involved in neuronal LD accumulation following SCI. TRIM21 mediated the ubiquitination and degradation of PLIN2 in neurons. Inhibition of PLIN2 enhanced the recovery of motor function after SCI.

为了研究急性脊髓损伤(SCI)后神经元脂滴(LD)积累和脂质代谢的变化,我们建立了大鼠压迫性 SCI 模型。通过油红 O 染色、BODIPY 493/503 染色和 4-羟基壬烯醛免疫荧光染色来确定总体脂滴积聚、神经元脂滴积聚和脂质过氧化。我们进行了脂质组学研究,以确定 SCI 局部微环境中的脂质成分。我们重点研究了过脂蛋白2(PLIN2)的表达和调控,并通过鞘内注射腺相关病毒9-鞘磷脂短链RNA-PLIN2(AAV9-SYN-shPlin2)在体内敲除PLIN2。运动功能采用巴索-巴蒂-布雷斯纳汉评分法进行评估。通过免疫沉淀(IP)和定性散射蛋白质组学筛选了与 PLIN2 相互作用的蛋白质,并通过共沉淀(co-IP)进行了确认。为了验证泛素化是否参与了PLIN2的降解,进行了泛素化试验。油红 O 染色表明,LDs 在 SCI 后持续积累。荧光染色表明,神经元中 LDs 的积累与脂质过氧化反应的增加有关。脂质组学显示 SCI 后脂质成分发生了显著变化。PLIN2的表达在脊髓损伤后明显增加,使用AAV9-SYN-Plin2敲除PLIN2可减少神经元LD的积累。这种干预改善了受伤大鼠神经元的存活率和运动功能。IP和定性散射蛋白质组学发现含三方基序蛋白21(TRIM21)是PLIN2的直接结合蛋白,体外共IP和体内免疫荧光染色证实了这种相互作用。通过调节 TRIM21 的表达,我们发现它与 PLIN2 的表达呈负相关。总之,PLIN2参与了脊髓损伤后神经元LD的积累。TRIM21介导了神经元中PLIN2的泛素化和降解。抑制PLIN2可促进脊髓损伤后运动功能的恢复。
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引用次数: 0
Astrocyte-derived lipocalin 2 promotes inflammation and scarring after spinal cord injury by activating SMAD in mice 星形胶质细胞源性脂褐质 2 通过激活小鼠体内的 SMAD 促进脊髓损伤后的炎症和瘢痕形成。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-07 DOI: 10.1016/j.expneurol.2024.114915

Background

The inflammatory response and scar formation after spinal cord injury (SCI) limit nerve regeneration and functional recovery. Our research group has previously shown that the expression of astrocyte-derived lipocalin 2 (Lcn2) is upregulated after SCI, which correlates with neuronal apoptosis and functional recovery. Therefore, we speculate that astrocyte-specific knockdown of Lcn2 after SCI may lead to a better prognosis.

Methods

Tissue RNA sequencing, Western blotting, PCR, and immunofluorescence assays were conducted to assess the expression of Lcn2 following SCI in mice. Adeno-associated virus 9 (AAV9) transfection was employed to specifically reduce the expression of Lcn2 in astrocytes, and subsequent evaluations of scarring and inflammation were conducted. In vitro experiments involved treating primary astrocytes with TGF-β or an A1-induced mixture (C1q, TNF-α and IL-1α) following Lcn2 knockdown. Finally, the intrathecal injection of recombinant Lcn2 (ReLcn2) protein was conducted post-injury to further confirm the role of Lcn2 and its underlying mechanism in SCI.

Results

Lcn2 expression was elevated in astrocytes after SCI at 7 dpi (days post injury). Lcn2 knockdown in astrocytes is beneficial for neuronal survival and functional recovery after SCI, and is accompanied by a reduced inflammatory response and inhibited scar formation. The inhibition of SMAD-associated signaling activation was identified as a possible mechanism, and in vitro experiments further confirmed this finding. ReLcn2 further activated SMAD-associated signaling and aggravated motor function after SCI.

Conclusion

The upregulation of Lcn2 expression in astrocytes is involved in neuroinflammation and scar formation after SCI, and the activation of SMAD-associated signaling is one of the underlying mechanisms.

背景:脊髓损伤(SCI)后的炎症反应和疤痕形成限制了神经再生和功能恢复。我们的研究小组以前曾发现,脊髓损伤后星形胶质细胞衍生脂钙蛋白 2(Lcn2)的表达上调,这与神经元凋亡和功能恢复有关。因此,我们推测损伤后星形胶质细胞特异性敲除 Lcn2 可能会导致更好的预后:方法:通过组织 RNA 测序、Western 印迹、PCR 和免疫荧光检测来评估小鼠 SCI 后 Lcn2 的表达。采用腺相关病毒9(AAV9)转染特异性地减少星形胶质细胞中Lcn2的表达,随后对瘢痕和炎症进行评估。体外实验包括在 Lcn2 被敲除后,用 TGF-β 或 A1 诱导的混合物(C1q、TNF-α 和 IL-1α)处理原代星形胶质细胞。最后,在损伤后进行了重组 Lcn2(ReLcn2)蛋白的鞘内注射,以进一步证实 Lcn2 在 SCI 中的作用及其内在机制:结果:损伤后7 dpi(损伤后数天),Lcn2在损伤后星形胶质细胞中表达升高。星形胶质细胞中 Lcn2 的敲除有利于 SCI 后神经元的存活和功能恢复,并伴随着炎症反应的减轻和瘢痕形成的抑制。体外实验进一步证实了这一发现。ReLcn2进一步激活了SMAD相关信号转导,加重了SCI后的运动功能:结论:星形胶质细胞中 Lcn2 表达的上调参与了 SCI 后的神经炎症和瘢痕形成,而 SMAD 相关信号的激活是其潜在机制之一。
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引用次数: 0
Integrated multi-omics analysis reveals molecular changes associated with chronic lipid accumulation following contusive spinal cord injury 多组学综合分析揭示了挫伤性脊髓损伤后与慢性脂质蓄积有关的分子变化。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-05 DOI: 10.1016/j.expneurol.2024.114909

Functional and pathological recovery after spinal cord injury (SCI) is often incomplete due to the limited regenerative capacity of the central nervous system (CNS), which is further impaired by several mechanisms that sustain tissue damage. Among these, the chronic activation of immune cells can cause a persistent state of local CNS inflammation and damage. However, the mechanisms that sustain this persistent maladaptive immune response in SCI have not been fully clarified yet.

In this study, we integrated histological analyses with proteomic, lipidomic, transcriptomic, and epitranscriptomic approaches to study the pathological and molecular alterations that develop in a mouse model of cervical spinal cord hemicontusion.

We found significant pathological alterations of the lesion rim with myelin damage and axonal loss that persisted throughout the late chronic phase of SCI. This was coupled by a progressive lipid accumulation in myeloid cells, including resident microglia and infiltrating monocyte-derived macrophages. At tissue level, we found significant changes of proteins indicative of glycolytic, tricarboxylic acid cycle (TCA), and fatty acid metabolic pathways with an accumulation of triacylglycerides with C16:0 fatty acyl chains in chronic SCI. Following transcriptomic, proteomic, and epitranscriptomic studies identified an increase of cholesterol and m6A methylation in lipid-droplet-accumulating myeloid cells as a core feature of chronic SCI.

By characterizing the multiple metabolic pathways altered in SCI, our work highlights a key role of lipid metabolism in the chronic response of the immune and central nervous system to damage.

由于中枢神经系统(CNS)的再生能力有限,脊髓损伤(SCI)后的功能和病理恢复往往是不完全的。其中,免疫细胞的慢性激活可导致中枢神经系统局部炎症和损伤的持续状态。然而,维持 SCI 中这种持续性不良免疫反应的机制尚未完全阐明。在本研究中,我们将组织学分析与蛋白质组、脂质组、转录物组和表观转录物组方法相结合,研究了颈脊髓半灌注小鼠模型的病理和分子改变。我们发现病变边缘有明显的病理改变,髓鞘损伤和轴突丢失一直持续到脊髓损伤的晚期慢性阶段。与此同时,髓系细胞(包括常驻小胶质细胞和浸润的单核细胞衍生巨噬细胞)中的脂质也在逐渐积累。在组织水平上,我们发现表明糖酵解、三羧酸循环(TCA)和脂肪酸代谢途径的蛋白质发生了显著变化,慢性 SCI 中带有 C16:0 脂肪酰基链的三酰甘油积累。随后进行的转录组、蛋白质组和表转录组研究发现,慢性 SCI 的一个核心特征是在脂滴聚集的髓样细胞中胆固醇和 m6A 甲基化增加。通过分析 SCI 中发生改变的多种代谢途径,我们的工作突出了脂质代谢在免疫和中枢神经系统对损伤的慢性反应中的关键作用。
{"title":"Integrated multi-omics analysis reveals molecular changes associated with chronic lipid accumulation following contusive spinal cord injury","authors":"","doi":"10.1016/j.expneurol.2024.114909","DOIUrl":"10.1016/j.expneurol.2024.114909","url":null,"abstract":"<div><p>Functional and pathological recovery after spinal cord injury (SCI) is often incomplete due to the limited regenerative capacity of the central nervous system (CNS), which is further impaired by several mechanisms that sustain tissue damage. Among these, the chronic activation of immune cells can cause a persistent state of local CNS inflammation and damage. However, the mechanisms that sustain this persistent maladaptive immune response in SCI have not been fully clarified yet.</p><p>In this study, we integrated histological analyses with proteomic, lipidomic, transcriptomic, and epitranscriptomic approaches to study the pathological and molecular alterations that develop in a mouse model of cervical spinal cord hemicontusion.</p><p>We found significant pathological alterations of the lesion rim with myelin damage and axonal loss that persisted throughout the late chronic phase of SCI. This was coupled by a progressive lipid accumulation in myeloid cells, including resident microglia and infiltrating monocyte-derived macrophages. At tissue level, we found significant changes of proteins indicative of glycolytic, tricarboxylic acid cycle (TCA), and fatty acid metabolic pathways with an accumulation of triacylglycerides with C16:0 fatty acyl chains in chronic SCI. Following transcriptomic, proteomic, and epitranscriptomic studies identified an increase of cholesterol and m<sup>6</sup>A methylation in lipid-droplet-accumulating myeloid cells as a core feature of chronic SCI.</p><p>By characterizing the multiple metabolic pathways altered in SCI, our work highlights a key role of lipid metabolism in the chronic response of the immune and central nervous system to damage.</p></div>","PeriodicalId":12246,"journal":{"name":"Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014488624002358/pdfft?md5=10302c2866f08a62bdd7ad64c744a1e5&pid=1-s2.0-S0014488624002358-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating therapeutic nonsense suppression in a neurofibromatosis mouse model 研究神经纤维瘤病小鼠模型中的治疗性无意义抑制。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-04 DOI: 10.1016/j.expneurol.2024.114914

Neurofibromatosis type 1 (NF1) is a human genetic disorder caused by variants in the NF1 gene. Plexiform neurofibromas, one of many NF1 manifestations, are benign peripheral nerve sheath tumors occurring in up to 50% of NF1 patients. A substantial fraction of NF1 pathogenetic variants are nonsense mutations, which result in the synthesis of truncated non-functional NF1 protein (neurofibromin). To date, no therapeutics have restored neurofibromin expression or addressed the consequences of this protein's absence in NF1 nonsense mutation patients, but nonsense suppression is a potential approach to the problem. Ataluren is a small molecule drug that has been shown to stimulate functional nonsense codon readthrough in several models of nonsense mutation diseases, as well as in Duchenne muscular dystrophy patients. To test ataluren's potential applicability in nonsense mutation NF1 patients, we evaluated its therapeutic effects using three treatment regimens in a previously established NF1 patient-derived (c.2041C > T; p.Arg681X) nonsense mutation mouse model. Collectively, our experiments indicate that: i) ataluren appeared to slow the growth of neurofibromas and alleviate some paralysis phenotypes, ii) female Nf1-nonsense mutation mice manifested more severe paralysis and neurofibroma phenotypes than male mice, iii) ataluren doses with apparent effectiveness were lower in female mice than in male mice, and iv) age factors also influenced ataluren's effectiveness.

1 型神经纤维瘤病(NF1)是一种由 NF1 基因变异引起的人类遗传性疾病。丛状神经纤维瘤是 NF1 的多种表现之一,是一种良性周围神经鞘瘤,在 NF1 患者中的发病率高达 50%。NF1致病变异中有很大一部分是无义突变,导致合成截短的无功能NF1蛋白(神经纤维瘤蛋白)。迄今为止,还没有治疗药物能恢复神经纤维瘤蛋白的表达或解决 NF1 无义突变患者缺乏这种蛋白的后果,但抑制无义突变是解决这一问题的潜在方法。Ataluren 是一种小分子药物,已被证明能在几种无义突变疾病模型以及杜氏肌营养不良症患者中刺激功能性无义密码子读通。为了测试阿塔卢仑在无义突变 NF1 患者中的潜在适用性,我们在先前建立的 NF1 患者来源(c.2041C > T; p.Arg681X)无义突变小鼠模型中使用三种治疗方案评估了阿塔卢仑的治疗效果。总的来说,我们的实验表明:i)阿塔尔仑似乎能减缓神经纤维瘤的生长并减轻某些瘫痪表型;ii)雌性 Nf1 无义突变小鼠比雄性小鼠表现出更严重的瘫痪和神经纤维瘤表型;iii)雌性小鼠中阿塔尔仑的明显疗效剂量低于雄性小鼠;iv)年龄因素也会影响阿塔尔仑的疗效。
{"title":"Investigating therapeutic nonsense suppression in a neurofibromatosis mouse model","authors":"","doi":"10.1016/j.expneurol.2024.114914","DOIUrl":"10.1016/j.expneurol.2024.114914","url":null,"abstract":"<div><p>Neurofibromatosis type 1 (NF1) is a human genetic disorder caused by variants in the <em>NF1</em> gene. Plexiform neurofibromas, one of many NF1 manifestations, are benign peripheral nerve sheath tumors occurring in up to 50% of NF1 patients. A substantial fraction of <em>NF1</em> pathogenetic variants are nonsense mutations, which result in the synthesis of truncated non-functional NF1 protein (neurofibromin). To date, no therapeutics have restored neurofibromin expression or addressed the consequences of this protein's absence in NF1 nonsense mutation patients, but nonsense suppression is a potential approach to the problem. Ataluren is a small molecule drug that has been shown to stimulate functional nonsense codon readthrough in several models of nonsense mutation diseases, as well as in Duchenne muscular dystrophy patients. To test ataluren's potential applicability in nonsense mutation NF1 patients, we evaluated its therapeutic effects using three treatment regimens in a previously established NF1 patient-derived (c.2041C &gt; T; p.Arg681X) nonsense mutation mouse model. Collectively, our experiments indicate that: i) ataluren appeared to slow the growth of neurofibromas and alleviate some paralysis phenotypes, ii) female <em>Nf1</em>-nonsense mutation mice manifested more severe paralysis and neurofibroma phenotypes than male mice, iii) ataluren doses with apparent effectiveness were lower in female mice than in male mice, and iv) age factors also influenced ataluren's effectiveness.</p></div>","PeriodicalId":12246,"journal":{"name":"Experimental Neurology","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0014488624002401/pdfft?md5=123a8ac0b73013ac7c3d9b34f7877191&pid=1-s2.0-S0014488624002401-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prediction of segmental motor outcomes in traumatic spinal cord injury: Advances beyond sum scores 创伤性脊髓损伤的节段运动结果预测:超越总分的进步。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-03 DOI: 10.1016/j.expneurol.2024.114905

Background and objectives

Neurological and functional recovery after traumatic spinal cord injury (SCI) is highly challenged by the level of the lesion and the high heterogeneity in severity (different degrees of in/complete SCI) and spinal cord syndromes (hemi-, ant-, central-, and posterior cord). So far outcome predictions in clinical trials are limited in targeting sum motor scores of the upper (UEMS) and lower limb (LEMS) while neglecting that the distribution of motor function is essential for functional outcomes. The development of data-driven prediction models of detailed segmental motor recovery for all spinal segments from the level of lesion towards the lowest motor segments will improve the design of rehabilitation programs and the sensitivity of clinical trials.

Methods

This study used acute-phase International Standards for Neurological Classification of SCI exams to forecast 6-month recovery of segmental motor scores as the primary evaluation endpoint. Secondary endpoints included severity grade improvement, independent walking, and self-care ability. Different similarity metrics were explored for k-nearest neighbor (kNN) matching within 1267 patients from the European Multicenter Study about Spinal Cord Injury before validation in 411 patients from the Sygen trial. The kNN performance was compared to linear and logistic regression models.

Results

We obtained a population-wide root-mean-squared error (RMSE) in motor score sequence of 0.76(0.14, 2.77) and competitive functional score predictions (AUCwalker = 0.92, AUCself-carer = 0.83) for the kNN algorithm, improving beyond the linear regression task (RMSElinear = 0.98(0.22, 2.57)). The validation cohort showed comparable results (RMSE = 0.75(0.13, 2.57), AUCwalker = 0.92). We deploy the final historic control model as a web tool for easy user interaction (https://hicsci.ethz.ch/).

Discussion

Our approach is the first to provide predictions across all motor segments independent of the level and severity of SCI. We provide a machine learning concept that is highly interpretable, i.e. the prediction formation process is transparent, that has been validated across European and American data sets, and provides reliable and validated algorithms to incorporate external control data to increase sensitivity and feasibility of multinational clinical trials.

背景和目标:外伤性脊髓损伤(SCI)后的神经和功能恢复因损伤程度、严重程度的高度异质性(不同程度的内/完全性 SCI)和脊髓综合征(半脊髓、前脊髓、中央脊髓和后脊髓)而面临巨大挑战。迄今为止,临床试验的结果预测仅限于上肢(UEMS)和下肢(LEMS)的运动总分,而忽视了运动功能的分布对功能结果的重要性。开发数据驱动的预测模型,预测从病变水平到最低运动节段的所有脊柱节段的详细节段运动恢复情况,将改善康复计划的设计和临床试验的敏感性:本研究采用国际 SCI 神经系统分类标准急性期检查来预测 6 个月的节段运动评分恢复情况,作为主要评估终点。次要终点包括严重程度等级改善、独立行走和自理能力。在对 Sygen 试验中的 411 名患者进行验证之前,对欧洲脊髓损伤多中心研究中 1267 名患者的 k 近邻(kNN)匹配进行了不同相似度指标的探索。我们将 kNN 的性能与线性回归模型和逻辑回归模型进行了比较:我们发现,kNN 算法在运动评分序列中的全人群均方根误差(RMSE)为 0.76(0.14, 2.77),在功能评分预测中的竞争力(AUCwalker = 0.92, AUCself-carer = 0.83)为 0.76(0.14, 2.77),比线性回归任务(RMSElinear = 0.98(0.22, 2.57))有所提高。验证队列显示了类似的结果(RMSE = 0.75(0.13, 2.57),AUCwalker = 0.92)。我们将最终的历史控制模型作为网络工具进行部署,以方便用户互动(https://hicsci.ethz.ch/):我们的方法是首个不受 SCI 水平和严重程度影响,对所有运动节段进行预测的方法。我们提供的机器学习概念具有很高的可解释性,即预测的形成过程是透明的,已在欧洲和美国的数据集中得到验证,并提供了可靠且经过验证的算法,可将外部控制数据纳入其中,以提高跨国临床试验的灵敏度和可行性。
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引用次数: 0
ALKBH5 deficiency attenuates oxygen-glucose deprivation-induced injury in mouse brain microvascular endothelial cells in an m6A dependent manner ALKBH5 缺乏能以 m6A 依赖性方式减轻氧-葡萄糖剥夺诱导的小鼠脑微血管内皮细胞损伤。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-03 DOI: 10.1016/j.expneurol.2024.114910

Structural and functional alterations in brain microvascular endothelial cells (BMECs) caused by oxygen-glucose deprivation (OGD) are involved in the pathogenesis of various brain disorders. AlkB homolog 5 (ALKBH5) is a primary m6A demethylase that regulates various cell processes, but its distinct roles in BMEC function remain to be clarified. In the present study, in mouse middle cerebral artery occlusion (MCAO) model, knockout of ALKBH5 reduced neurological deficits, infarct volumes and tissue apoptosis caused by ischemia/reperfusion injury. Evans blue leakage and decreased expression of the tight junction protein ZO-1 and Occludin were also attenuated by ALKBH5 knockout. During the exploration of the underlying mechanisms of the role of ALKBH5 in BMECs, we found that the expression of ALKBH5 was induced at both the mRNA and protein levels by hypoxia; however, its protein stability was impaired by OGD treatment. Knockdown of ALKBH5 expression increased total m6A levels and alleviated OGD-induced BMEC injury. At the same time, the selective ALKBH5 inhibitor Cpd 20m also exhibited a protective effect on cell injury. In contrast, overexpression of ALKBH5 increased the sensitivity of BMECs to OGD. Interestingly, the m6A sequencing data revealed that knockdown of ALKBH5altered the expression of many genes via m6A upregulation. The gene expression alterations were verified by real-time PCR. Taken together, our results suggest that ALKBH5, as well as its target genes, plays important roles in the regulation of brain microvascular endothelial cell function through its RNA demethylase activity.

氧-糖剥夺(OGD)导致的脑微血管内皮细胞(BMEC)结构和功能改变与各种脑部疾病的发病机制有关。AlkB 同源物 5(ALKBH5)是一种主要的 m6A 去甲基化酶,可调控多种细胞过程,但其在 BMEC 功能中的独特作用仍有待明确。在本研究中,在小鼠大脑中动脉闭塞(MCAO)模型中,敲除ALKBH5可减少缺血再灌注损伤引起的神经功能缺损、梗死体积和组织凋亡。ALKBH5基因敲除还可减轻埃文斯蓝渗漏以及紧密连接蛋白ZO-1和Occludin的表达减少。在探索ALKBH5在BMECs中作用的内在机制时,我们发现缺氧会诱导ALKBH5在mRNA和蛋白水平的表达,但OGD处理会影响其蛋白的稳定性。敲除 ALKBH5 的表达可增加 m6A 的总含量,减轻 OGD 诱导的 BMEC 损伤。同时,选择性 ALKBH5 抑制剂 Cpd 20 m 对细胞损伤也有保护作用。相反,过表达 ALKBH5 会增加 BMEC 对 OGD 的敏感性。有趣的是,m6A 测序数据显示,敲除 ALKBH5 会通过 m6A 上调改变许多基因的表达。基因表达的改变通过实时 PCR 得到了验证。综上所述,我们的研究结果表明,ALKBH5及其靶基因通过其RNA去甲基化酶活性在调控脑微血管内皮细胞功能方面发挥着重要作用。
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引用次数: 0
Cerebral hypoperfusion exacerbates vascular dysfunction after traumatic brain injury 脑外伤后,脑灌注不足会加剧血管功能障碍。
IF 4.6 2区 医学 Q1 NEUROSCIENCES Pub Date : 2024-08-03 DOI: 10.1016/j.expneurol.2024.114907

Traumatic brain injuries are extremely common, and although most patients recover from their injuries many TBI patients suffer prolonged symptoms and remain at a higher risk for developing cardiovascular disease and neurodegeneration. Moreover, it remains challenging to identify predictors of poor long-term outcomes. Here, we tested the hypothesis that preexisting cerebrovascular impairment exacerbates metabolic and vascular dysfunction and leads to worse outcomes after TBI. Male mice underwent a mild surgical reduction in cerebral blood flow using a model of bilateral carotid artery stenosis (BCAS) wherein steel microcoils were implanted around the carotid arteries. Then, 30 days post coil implantation, mice underwent TBI or sham surgery. Gene expression profiles, cerebral blood flow, metabolic function, oxidative damage, vascular health and angiogenesis were assessed. Single nuclei RNA sequencing of endothelial cells isolated from mice after TBI showed differential gene expression profiles after TBI and BCAS, that were further altered when mice underwent both challenges. TBI but not BCAS increased mitochondrial oxidative metabolism. Both BCAS and TBI decreased cerebrovascular responses to repeated whisker stimulation. BCAS induced oxidative damage and inflammation in the vasculature as well as loss of vascular density, and reduced the numbers of angiogenic tip cells. Finally, intravascular protein accumulation was increased among mice that experienced both BCAS and TBI. Overall, our findings reveal that a prior vascular impairment significantly alters the profile of vascular health and function of the cerebrovasculature, and when combined with TBI may result in worsened outcomes.

创伤性脑损伤极为常见,虽然大多数患者都能痊愈,但许多创伤性脑损伤患者的症状持续时间较长,患心血管疾病和神经变性的风险也较高。此外,确定不良长期预后的预测因素仍具有挑战性。在这里,我们测试了这样一个假设:预先存在的脑血管损伤会加剧代谢和血管功能障碍,并导致创伤后不良预后。雄性小鼠在双侧颈动脉狭窄(BCAS)模型中接受了轻度脑血流减少手术,在颈动脉周围植入了钢制微线圈。然后对小鼠进行轻度-中度创伤性脑损伤,或在线圈植入后 30 天进行 BCAS 和创伤性脑损伤的综合治疗。对基因表达谱、脑血流量、代谢功能、氧化损伤、血管健康和血管生成进行了评估。对小鼠进行创伤性脑损伤后分离出的内皮细胞进行单核 RNA 测序,结果显示创伤性脑损伤和 BCAS 后的基因表达谱不同,当小鼠同时接受这两种挑战时,基因表达谱会进一步改变。创伤性脑损伤增加了线粒体的氧化代谢,但 BCAS 没有增加线粒体的氧化代谢。BCAS和创伤性脑损伤都会降低脑血管对反复胡须刺激的反应。BCAS会诱发血管氧化损伤和炎症以及血管密度下降,并减少血管生成尖端细胞的数量。最后,经历过 BCAS 和创伤性脑损伤的小鼠血管内蛋白质积累增加。总之,我们的研究结果表明,先前的血管损伤会显著改变脑血管的血管健康和功能状况,当与创伤性脑损伤合并时,可能会导致预后恶化。
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Experimental Neurology
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