Folia neuropathologica最新文献

Anatomical studies of the brain and successive analyses of this organ were performed in ancient times. Indeed, notes found in the Edwin Smith Papyrus mention that the Egyptians identified the meninges and gyri millennia ago. Their successors examined the content of the skull, examined it and illustrated it in greater detail. Alexandrians (Herophilus and Erasistratus) described the cerebral ventricles and blood circulation and supply to the brain. More accurate depictions emerged during the Renaissance with Leonardo da Vinci (1452-1519), Charles Estienne (1504-1564) and Andreas Vesalius (1514-1564), followed by Thomas Bartholin (1616-1680), Franciscus Sylvius (1614-1672) and later scholars. The present study focuses on neuroanatomy and is devoted to the study of nervous system structures by the eminent pathologist Rudolph Virchow. When reorganizing the procedure and reporting of the post-mortem examination, including a meticulous autopsy of the brain, neuropathology was a discipline yet to be developed. He pioneered a new approach to the autopsy and analysis of its results, aiming to benefit not only the patients but also clinicians and pathologists.

Introduction: To determine the expression and clinical significance of maternal serum pregnancy-associated plasma protein A (PAPP-A) in pregnant women with different degrees of preeclampsia at 11-14 weeks of gestation.

Material and methods: The clinical data of 65 pregnant women with preeclampsia admitted to our hospital from January 2020 to October 2022 were retrospectively analysed. Another 45 normal pregnant women who came to our hospital for prenatal examination and delivery during the same period were selected as the healthy control group. The serum contents of PAPP-A, a-fetoprotein (AFP) and free estriol (uE3) in each group were compared. The correlation between PAPP-A and AFP as well as uE3 was analysed by Pearson analysis. The clinical value of serological indexes in diagnosing preeclampsia was analysed using ROC curve.

Results: The levels of PAPP-A and uE3 in pregnant women in the preeclampsia group were lower, while the contents of AFP were higher than these in the healthy control group ( p < 0.01). The pregnant women with severe preeclampsia had lower levels of PAPP-A and uE3 with higher levels of AFP compared to these with mild preeclampsia ( p < 0.001). Pearson correlation analysis showed that serum PAPP-A was negatively correlated with AFP (r = -0.246, p < 0.05) and positively correlated with uE3 (r = 0.398, p < 0.01) in preeclampsia patients. ROC curve analysis demonstrated that the area under the curve (AUC) of PAPP-A, AFP and uE3 to assist in the diagnosis of preeclampsia was 0.740, 0.738 and 0.806, respectively. The AUC of the combination of PAPP-A, AFP and uE3 to assist in the diagnosis was 0.912, with a sensitivity of 90.38% and a specificity of 80.33%. The clinical assisted diagnostic value of combined detection was high.

Conclusions: The serum level of PAPP-A in pregnant women with preeclampsia in the early pregnancy was significantly lower and related to the severity of the disease. The combination of routine detection for AFP and uE3 had a good predictive value for preeclampsia, which was helpful to take relevant interventions to reduce the incidence of preeclampsia as early as possible, and had a positive impact on protecting maternal and infant health.

Essential tremor (ET) is one of the most common neurological conditions and the most common movement disorder. The pathophysiological mechanisms that underlie this entity have not yet been described. However, recent post-mortem brain studies have provided useful insight into the underlying pathology of ET. Two brain areas have been consistently found to present neuropathological alterations in patients with ET: the brainstem, for presence of Lewy bodies or neuronal depletion, and the cerebellum, regarding Purkinje cells' morphology and density. In the present study we aim to review the literature on the main neuropathological findings in ET brains.

Introduction: Malignant tumours diagnosed in the central nervous system are among the leading causes of death from cancer. Central nervous system tumours are the 10th most frequent cause of mortality due to cancer. Immunohistochemistry has become an important tool in the diagnosis of brain tumours. Brain tissue and meninges tumours comprise a heterogeneous group with diverse biological behaviour, treatment management, and different prognoses. Although conventional haematoxylin-eosin staining is crucial for diagnosis, diagnostic neuropathology has benefited from the inclusion of immunohistochemistry and recent advances in the field over the past 20 years. GFAP, S100, IDH, OLIG 2, EMA, ATRX, P53 and Ki67 are the most frequently used immunohistochemical markers globally, which we also highlighted in our study.

Material and methods: Ninety-seven cases including primary-metastatic intracranial tumours, operated on in the Neurosurgery Clinic and diagnosed in the Medical Pathology Laboratory between 2018 and 2023 years, were examined retrospectively from the archive. Haematoxylin-eosin slides were re-evaluated under the light microscope by 2 double-blind pathologists and immunohistochemical features and characteristics of tumours were examined. Data were analysed using the program SPSS 22. Differences were accepted as statistically significant at p < 0.05.

Results: According to the analysis of results, 46 (47.4%) of the 97 included patients were female and 51 (52.6%) were male. The most common tumour types were meningioma with 31 (32%) and high-grade neuroglial tumours with 31 (32%). GFAP, OLIG2, ATRX, and P53 values were found to be significantly higher in high-grade neuroglial tumours. While S 100 and EMA values were especially high in meningiomas, a positive correlation was found with IDH value in low-grade neuroglial tumours. The study showed that the median Ki67 value was significantly higher in high-grade neuroglial tumours and metastatic tumours.

Conclusions: Intracranial tumours cause significant morbidity and mortality in patients. Diagnostic, prognostic and predictive biomarkers evaluated in patient biopsy specimens and/or body fluids are important in neuropathological oncology. By regularly updating our biomarkers and following new treatment approaches, we can improve survival with rapid diagnosis and appropriate treatment in central nervous system tumours after surgery.

Introduction: The nucleotide-binding domain leucine-rich repeat-containing family pyrin domain-containing 3 (NLRP3) inflammasome has been implicated in numerous neurological disorders, including epilepsy, through its role in inflammation and pyroptosis. Dihydromyricetin (DHM) has neuroprotective effects in patients with neurological disorders. However, the impact of DHM on the NLRP3 inflammasome pathway in epilepsy and related cognitive impairment is yet to be fully understood. Herein, we evaluated whether DHM can alleviate pilocarpine-induced neuronal injury and learning and memory disorders in the hippocampal body of rats by regulating the NLRP3 inflammasome.

Material and methods: An epileptic rat model was established, and spontaneous recurrent seizure (SRS) frequency and duration were recorded. The function of hippocampal pyramidal neurons was evaluated using Nissl staining. Western blotting, real-time reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assays were used to detect changes in NLRP3 inflammatory pathway-related factors in the hippocampus. Cognitive function was verified using the Morris water maze test, hippocampal late-phase long-term potentiation recording and associated synaptic protein expression assessment.

Results: Treatment with DHM after status epilepticus (SE) induction decreases the frequency and length of SRS in rats receiving pilocarpine, suggesting that DHM has the potential to improve long-term potentiation and cognitive deficits after SE induction in rats. Additionally, after inducing SE in rats, DHM raises the expression of synaptic proteins. It may prevent harm to hippocampal pyramidal neurons, and DHM-induced neuroprotection may contribute to the pyroptosis associated with NLRP3 in epileptic rats. DHM guards against harm to hippocampus pyramidal neurons.

Conclusions: We found that DHM plays a role in treating epilepsy and its comorbid cognitive impairment by inhibiting pyroptosis and inflammation.

Autoimmune diseases (AID) such as multiple sclerosis, rheumatoid arthritis, type 1 diabetes, inflammatory neuropathies, and some 100 other conditions, affect 5-10% of the global population, and their incidence is increasing, particularly in women. Among these, myasthenia gravis (MG) is a relatively rare but debilitating disease, which represents a prototype antibody-mediated autoimmune condition with well-studied pathogenesis. MG is a neuromuscular junction disorder marked clinically by fatigable muscle weakness and serologically by the presence of pathogenic autoantibodies. In MG pathological B- and T-cell subtypes are implicated, including memory B and plasma cells. In recent years there has been significant progress in the field of therapy, with several novel drugs introduced targeting major components of the pathogenetic pathway. However, there are still unmet needs in the treatment, especially the lack of a curative, upstream approach in contrast to the existing chronic downstream immunomodulatory actions. A nucleoside analog cladribine was primarily developed for the treatment of chronic leukaemias, in particular hairy cell leukaemia. For these indications, the injectable formulation of the drug was registered in 1997, and it has been manufactured in several countries since then. Later the oral formulation of cladribine (Mavenclad, Merck KGaA) was registered worldwide for use as immune reconstitution therapy (IRT) for relapsing multiple sclerosis. In this setting it has gained a strong position in the group of high-efficacy compounds, exerting long-term impact on the immune system. In a pilot clinical study, we found appreciable efficacy and safety profile of a short course of cladribine in MG. Herein, we present the design of a prospective, multicentre, randomised, controlled trial (RCT) using a parenteral preparation of cladribine in MG, currently ongoing in 6 clinical centres in Poland (EudraCT No. 2020-005762-34). In addition, we discuss the concept of immune reconstitution, which seems applicable for MG treatment.