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Resolution of inflammation and repair after ischemic brain injury 缺血性脑损伤后炎症的消退与修复
Pub Date : 2020-07-30 DOI: 10.20517/2347-8659.2020.22
A. Yoshimura, Minako Ito
After ischemic stroke, proinflammatory molecules known as danger-associated molecular patterns (DAMPs) originating from damaged brain cells recruit and activate immune cells (neutrophils, macrophages, lymphocytes) further eliciting innate and adaptive immunity. During the acute phase from day 1 to day 3 of the stroke onset, macrophages play a major role in the progression of inflammation, promoting the destruction of brain tissue. During the recovery phase, from day 3~4 to day 7 after stroke onset, infiltrating macrophages switch to repairing macrophages, which clear the DAMPs and promote tissue repair by producing neurotrophic factors. Adaptive immunity during the late or chronic phase (> day 7) of stroke has not been well investigated. Recent studies have also indicated that antigen-specific T cells, especially regulatory T cells (Tregs), play major roles in neural repair. This review focuses mainly on the resolution of inflammation and tissue repair by macrophages and Tregs.
缺血性中风后,源自受损脑细胞的被称为危险相关分子模式(DAMP)的促炎分子募集并激活免疫细胞(中性粒细胞、巨噬细胞、淋巴细胞),进一步引发先天免疫和适应性免疫。在中风发作的第1天至第3天的急性期,巨噬细胞在炎症进展中发挥主要作用,促进脑组织的破坏。在恢复期,从中风发作后的第3~4天到第7天,浸润性巨噬细胞转变为修复性巨噬细胞,通过产生神经营养因子清除DAMP并促进组织修复。中风晚期或慢性期(>第7天)的适应性免疫尚未得到很好的研究。最近的研究也表明,抗原特异性T细胞,特别是调节性T细胞(Tregs),在神经修复中发挥着重要作用。这篇综述主要集中在巨噬细胞和Tregs解决炎症和组织修复。
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引用次数: 3
The immune regulation of PD-1/PDL-1 axis, a potential biomarker in multiple sclerosis 多发性硬化症潜在生物标志物PD-1/PDL-1轴的免疫调节
Pub Date : 2020-07-30 DOI: 10.20517/2347-8659.2020.18
M. T. Cencioni
Multiple sclerosis is an autoimmune disease characterised by a chronic inflammation within the central nervous system. In the last ten years, studies on multiple sclerosis have been concentrated on the discovery of new biomarkers of disease and potential therapeutic targets. In chronic infection or in cancer, the immune system response is faulty and maintained in a condition defined as T-cell exhaustion induced by expression of co-inhibitory receptors. The PD-1/PDL-1 pathway is demonstrated to be the main one responsible for promoting T-cell exhaustion, and immunotherapies targeting PD-1 or PDL-1 have shown beneficial clinical outcomes in several tumours and chronic diseases. Contrarily, transcriptional T-cell exhaustion signature and high expression of co-inhibitor receptor PD-1 are associated with favourable prognosis in multiple sclerosis and other autoimmune diseases. Several studies have clearly demonstrated PD-1 has a dual role in immune self-tolerance: to constrain autoreactive T cells in anergic condition and to protect the tissue from the damage caused by the activation of endogenous autoreactive T cells. Consequently, immune checkpoint inhibitor therapies that target inhibitory receptors in cancer cause an exacerbation of autoimmune diseases. This review describes the roles of the PD-1/ PDL-1 pathway in cancer and autoimmune diseases, especially in multiple sclerosis, and how manipulating PD-1 can be a therapeutic approach in multiple sclerosis.
多发性硬化症是一种自身免疫性疾病,其特征是中枢神经系统内的慢性炎症。在过去的十年里,对多发性硬化症的研究集中在发现新的疾病生物标志物和潜在的治疗靶点上。在慢性感染或癌症中,免疫系统反应是错误的,并维持在由共抑制受体表达诱导的T细胞耗竭的状态。PD-1/PDL-1途径被证明是促进T细胞耗竭的主要途径,靶向PD-1或PDL-1的免疫疗法在几种肿瘤和慢性疾病中显示出有益的临床结果。相反,转录T细胞耗竭信号和共抑制剂受体PD-1的高表达与多发性硬化症和其他自身免疫性疾病的良好预后有关。几项研究清楚地表明,PD-1在免疫自我耐受中具有双重作用:在无能状态下约束自身反应性T细胞,并保护组织免受内源性自身反应性T细胞激活引起的损伤。因此,针对癌症中抑制性受体的免疫检查点抑制剂疗法导致自身免疫性疾病的恶化。这篇综述描述了PD-1/PDL-1通路在癌症和自身免疫性疾病中的作用,特别是在多发性硬化症中,以及如何操纵PD-1可以成为多发性痴呆症的治疗方法。
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引用次数: 10
Clinical efficacy and safety of single cycle rituximab as induction therapy for aggressive neuromyelitis optica spectrum disorder in a resource limited center: a preliminary study 在资源有限的中心,单周期利妥昔单抗诱导治疗侵袭性视神经脊髓炎谱系障碍的临床疗效和安全性:一项初步研究
Pub Date : 2020-07-12 DOI: 10.20517/2347-8659.2020.05
T. Ong, S. Viswanathan, S. Ong, F. Hiew
Aim: To analyse the efficacy of single dose rituximab (RTX) as induction therapy followed by conventional oral steroid-sparing agents (azathioprine, mycophenolate mofetil or methotrexate) in a cohort of patients with aggressive neuromyelitis optica spectrum disorder (NMOSD) without CD19, 20 and 27 biomarker testing. Methods: A retrospective analysis of clinical outcomes in eight patients with aggressive NMOSD treated with one course of RTX induction therapy in the Neurology Department at Kuala Lumpur Hospital from 2005 to 2018 was performed. The effectiveness of the treatment was determined by the number of relapses, expanded disability status scale, annualized relapsed rates, and modified Rankin Scale both before and after treatment. B cell enumeration testing was done instead of CD19, 20 and 27 biomarker testing. Results: There was a reduction in the mean annualized relapse rate from 4.7 to 0.5 attacks per year after treatment (P = 0.011). Mean expanded disability status scale and modified Rankin Scale values improved from 5.4 to 3.6 (P = 0.018) and 3.6 to 2.6 (P = 0.023), respectively. No patient developed any adverse effect. Conclusion: Single-course RTX induction therapy regime may be an alternative therapeutic option in resource limited hospitals to suppress NMOSD disease activity in the short term as pulse induction therapy whilst awaiting the effectiveness of conventional steroid-sparing agents. Further prospectively designed studies are required to prove efficacy. Original Article Page 312 Ong et al. Neuroimmunol Neuroinflammation 2020;7:311-8 I http://dx.doi.org/10.20517/2347-8659.2020.05
目的:在一组未进行CD19、20和27生物标志物检测的侵袭性神经脊髓炎视谱障碍(NMOSD)患者中,分析单剂量利妥昔单抗(RTX)作为诱导治疗后常规口服类固醇保留剂(硫唑嘌呤、霉酚酸酯或甲氨蝶呤)的疗效。方法:对2005年至2018年在吉隆坡医院神经内科接受一个疗程RTX诱导治疗的8名侵袭性NMOSD患者的临床结果进行回顾性分析。治疗的有效性取决于治疗前后的复发次数、扩大的残疾状况量表、年复发率和改良的兰金量表。B细胞计数测试代替CD19、20和27生物标志物测试。结果:治疗后平均年化复发率从每年4.7次降低到0.5次(P=0.011)。平均扩展残疾状态量表和改良兰金量表的值分别从5.4次提高到3.6次(P=0.018)和3.6次提高到2.6次(P=0.023)。没有患者出现任何不良反应。结论:在资源有限的医院,单疗程RTX诱导治疗方案可能是一种替代治疗方案,可以在短期内抑制NMOSD疾病活动,作为脉冲诱导治疗,同时等待传统类固醇保留药物的有效性。需要进一步前瞻性设计的研究来证明疗效。原创文章第312页Ong等人《神经免疫性神经炎2020》;7:311-8 Ihttp://dx.doi.org/10.20517/2347-8659.2020.05
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引用次数: 4
Defining activation states of microglia in human brain tissue: an unresolved issue for Alzheimer’s disease 确定人类脑组织中小胶质细胞的激活状态:阿尔茨海默病尚未解决的问题
Pub Date : 2020-07-12 DOI: 10.20517/2347-8659.2020.09
D. Walker
The development of concepts concerning the role of microglia in different brain diseases has relied on studies of animal models or human brain tissue, which primarily use antibodies and immunohistochemistry techniques to make observations. Since initial studies defined increased expression of the major histocompatibility complex II protein human leukocyte antigen-DR as a means of identifying reactive, and therefore by implication, damagecausing microglia in Alzheimer’s disease (AD) or Parkinson’s disease (PD), understanding and describing their activation states has evolved to an unexpected complexity. It is still difficult to ascertain the specific functions of individual microglia, particularly those associated with pathological structures, using a narrow range of antigenic markers. As many approaches to developing treatments for AD or PD are focused on anti-inflammatory strategies, a more refined understanding of microglial function is needed. In recent years, gene expression studies of human and rodent microglia have attempted to add clarity to the issue by sub-classification of messenger RNA expression of cell-sorted microglia to identify disease-associated profiles from homeostatic functions. Ultimately all newly identified markers will need to be studied in situ in human brain tissue. This review will consider the gaps in knowledge between using traditional immunohistochemistry approaches with small groups of markers that can be defined with antibodies, and the findings from cell-sorted and single-cell RNA sequencing transcription profiles. There have been three approaches to studying microglia in tissue samples: using antigenic markers identified from studies of peripheral macrophages, studying proteins associated with altered genetic risk factors for disease, and studying microglial proteins identified from mRNA expression analyses from cell-sorting and gene profiling. The technical aspects of studying microglia in human brain samples, inherent issues of working with antibodies, and findings of a range of different functional microglial markers will be reviewed. In particular, we will consider Review Walker. Neuroimmunol Neuroinflammation 2020;7:194-214 I http://dx.doi.org/10.20517/2347-8659.2020.09 Page 195 markers of microglia with expression profiles that do not definitively fall into the pro-inflammatory or antiinflammatory classification. These additional markers include triggering receptor expressed on myeloid cells-2, CD33 and progranulin, identified from genetic findings, colony stimulating factor-1 receptor, purinergic receptor P2RY12, CD68 and Toll-like receptors. Further directions will be considered for addressing crucial issues.
关于小胶质细胞在不同脑部疾病中的作用的概念的发展依赖于对动物模型或人类脑组织的研究,这些研究主要使用抗体和免疫组织化学技术进行观察。由于最初的研究将主要组织相容性复合体II蛋白人白细胞抗原- dr的表达增加定义为识别反应性的一种手段,因此,在阿尔茨海默病(AD)或帕金森病(PD)中,理解和描述它们的激活状态已经发展到一个意想不到的复杂性。目前仍难以确定单个小胶质细胞的具体功能,特别是那些与病理结构相关的功能,使用的抗原标记范围很窄。由于许多治疗阿尔茨海默病或帕金森病的方法都集中在抗炎策略上,因此需要对小胶质细胞的功能有更精确的了解。近年来,人类和啮齿动物小胶质细胞的基因表达研究试图通过对细胞分类小胶质细胞的信使RNA表达进行亚分类,以从稳态功能中识别疾病相关谱,从而使这一问题更加清晰。最终,所有新发现的标记都需要在人类脑组织中进行原位研究。这篇综述将考虑使用传统的免疫组织化学方法与可以用抗体定义的小组标记物之间的知识差距,以及细胞分选和单细胞RNA测序转录谱的发现。研究组织样本中的小胶质细胞有三种方法:使用从外周巨噬细胞研究中发现的抗原标记物,研究与疾病遗传风险因素改变相关的蛋白质,以及研究从细胞分选和基因谱的mRNA表达分析中发现的小胶质蛋白。本文将回顾研究人脑小胶质细胞样本的技术方面、抗体工作的固有问题以及一系列不同功能小胶质细胞标记物的发现。我们将特别考虑审查沃克。Neuroimmunol Neuroinflammation 2020;7:194-214 I http://dx.doi.org/10.20517/2347-8659.2020.09 Page 195小胶质细胞的标记物,其表达谱不能明确地归入促炎或抗炎分类。这些额外的标记包括骨髓细胞上表达的触发受体-2,CD33和前颗粒蛋白,从遗传发现,集落刺激因子-1受体,嘌呤能受体P2RY12, CD68和toll样受体。将考虑进一步的指示,以解决关键问题。
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引用次数: 23
Biomarker-based diagnosis of cognitive disorders in a case series 基于生物标志物的认知障碍病例系列诊断
Pub Date : 2020-07-12 DOI: 10.20517/2347-8659.2019.26
E. Kapaki, V. Constantinides, Efstratios-Stylianos Pyrgelis, P. Paraskevas, J. Papatriantafyllou, G. Paraskevas
The classical cerebrospinal fluid biomarkers of Alzheimer’s Disease (namely total tau, phospho-tau and amyloid beta peptide) have received much attention, since they can detect the biochemical fingerprint of Alzheimer’s disease and serve as a diagnostic aid for correct diagnosis of cognitive disorders during life. In this case series, we present 6 examples of patients with cognitive impairment of various types and severities and how biomarker data were helpful in every day diagnostic approach, combined with clinical, neuropsychological and imaging data and based on the most recent guidelines and recommendations.
阿尔茨海默病的经典脑脊液生物标志物(即总tau、磷酸化tau和淀粉样蛋白β肽)受到了广泛关注,因为它们可以检测阿尔茨海默病的生化指纹,并作为正确诊断生活中认知障碍的诊断辅助手段。在本系列病例中,我们介绍了6例不同类型和严重程度的认知障碍患者,以及生物标志物数据如何有助于日常诊断方法,结合临床、神经心理学和影像学数据,并基于最新的指南和建议。
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引用次数: 2
Microglial heterogeneity: distinct cell types or differential functional adaptation? 小胶质细胞异质性:不同的细胞类型还是不同的功能适应?
Pub Date : 2020-06-24 DOI: 10.20517/2347-8659.2020.03
S. Benusa, N. M. George, J. Dupree
Microglia were first characterized by del Rio Hortega about 100 years ago but our understanding of these cells has only gained traction in the last 20 years. We now recognize that microglia are involved in a plethora of activities including circuitry refinement, neuronal and glial trophic support, cell number modulation, angiogenesis and immune surveillance. Specific to immune surveillance, microglia detect threats which then drive their transformation from ramified to amoeboid cells. This morphological transition is accompanied by changes in cytokine and chemokine expression, which are far less conserved than morphology. To simplify discussion of these expression changes, nomenclature ascribed to states of macrophage activation, known as Macrophage 1 (“M1”; classic) and Macrophage 2 (“M2”; alternative), have been assigned to microglia. However, such a classification for microglia is an oversimplification that fails to accurately represent the array of cellular phenotypes. Additionally, multiple subclasses of microglia have now been described that do not belong to the “M1/M2” classification. Here, we provide a brief review outlining the prominent subclasses of microglia that have been described recently. Additionally, we present novel NanoString data demonstrating distinct microglial phenotypes from three commonly used central nervous system inflammation murine models to study microglial response and conclude with an introduction of recent RNA sequencing studies. In turn, this may not only facilitate a more appropriate naming scheme for these enigmatic cells, but more importantly, provide a framework for generating microglial expression “fingerprints” that may assist in the development of novel therapies by targeting disease-specific microglial subtypes.
大约100年前,del里约热内卢Hortega首次描述了小胶质细胞的特征,但我们对这些细胞的理解直到最近20年才得到关注。我们现在认识到,小胶质细胞参与了大量的活动,包括电路优化、神经元和胶质营养支持、细胞数量调节、血管生成和免疫监视。特定于免疫监视,小胶质细胞检测威胁,然后驱动它们从分支细胞转化为变形虫细胞。这种形态转变伴随着细胞因子和趋化因子表达的变化,其保守性远不如形态学。为了简化对这些表达变化的讨论,将巨噬细胞激活状态命名为巨噬细胞1(“M1”;巨噬细胞2(“M2”;可选),已被分配给小胶质细胞。然而,这种小胶质细胞的分类是一种过度简化,不能准确地代表细胞表型的阵列。此外,现在已经描述了多个不属于“M1/M2”分类的小胶质细胞亚类。在这里,我们提供了一个简短的回顾概述了突出的亚类小胶质细胞已被描述最近。此外,我们提出了新的NanoString数据,从三种常用的中枢神经系统炎症小鼠模型中展示了不同的小胶质细胞表型,以研究小胶质细胞反应,并介绍了最近的RNA测序研究。反过来,这可能不仅有助于为这些神秘细胞提供更合适的命名方案,而且更重要的是,为生成小胶质细胞表达“指纹”提供了一个框架,这可能有助于开发针对疾病特异性小胶质细胞亚型的新疗法。
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引用次数: 5
Cerebrospinal fluid biomarkers for cognitive disorders. An introductory overview 认知障碍的脑脊液生物标志物。介绍性概述
Pub Date : 2020-06-24 DOI: 10.20517/2347-8659.2019.008
G. Paraskevas
The core (established) cerebrospinal fluid biomarkers of Alzheimer’s disease (AD), namely amyloid-beta peptide, total tau protein and phospho-tau protein, have become a part of the diagnostic workup of patients with cognitive disorders in many specialized centers, especially for ambiguous cases. Combined, these biomarkers can identify the presence or absence of an AD biochemical process with sensitivities and specificities approaching or exceeding 90% in both dementia and pre-dementia stages of AD. Thus, they have been incorporated in various sets of research or clinical diagnostic criteria and recommendations. Results that are atypical, incompatible with AD, or inconclusive may occur, necessitating the use of other cerebrospinal fluid or imaging biomarkers.
核心(已建立的)阿尔茨海默病(AD)的脑脊液生物标志物,即淀粉样蛋白- β肽,总tau蛋白和磷酸化tau蛋白,已成为许多专业中心认知障碍患者诊断工作的一部分,特别是对于模棱两可的病例。综合起来,这些生物标志物可以识别AD生化过程的存在与否,在AD痴呆和痴呆前期阶段的敏感性和特异性接近或超过90%。因此,它们已被纳入各种研究或临床诊断标准和建议。可能出现非典型、与AD不相容或不确定的结果,需要使用其他脑脊液或成像生物标志物。
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引用次数: 1
Microbiome meets microglia in neuroinflammation and neurological disorders 神经炎症和神经疾病中的微生物组与小胶质细胞相遇
Pub Date : 2020-06-16 DOI: 10.20517/2347-8659.2020.13
Rachel E. Reyes, Zeyu Zhang, Lei Gao, L. Asatryan
One of the emerging hot topics in biosciences is the intriguing link between gut microbial communities and its influences outside the gastrointestinal tract, such as the central nervous system (CNS), including its cognitive activities and immune responses. Beyond its neuroprotective properties, microglia are also critical for neuronal synaptic pruning and neural remodeling during CNS development. Prolonged microglia activation and neuroinflammation are considered key contributors to neurological disorders. In this regard, it is becoming increasingly important to consider the potential influences underlying the crosstalk between the intestinal microbiota ecosystem and host when determining biomarkers of disease and treatment efficacy. The commensal microbiota is critical for immune development and continuous function through the recognition of bacteriaproduced and regulated metabolites. In cases of microbial dysbiosis and microglial dysfunction, chronic neuroinflammation may persist, leading to the propagation of neurological disorders. To address potential mechanisms, this review focuses on the microbiota-gut-brain axis as it relates to communication pathways that have been linked to aberrant CNS immune activity and pathology. We also address anti-inflammatory and neuroprotective mediators which may counteract these detrimental activities. Finally, we explore the potential benefits of current and novel microbiome-targeted approaches to treat neuroinflammation and consequential neurological disease.
生物科学中新兴的热门话题之一是肠道微生物群落与其胃肠道外影响(如中枢神经系统)之间的有趣联系,包括其认知活动和免疫反应。除了其神经保护特性外,小胶质细胞在中枢神经系统发育过程中对神经元突触修剪和神经重塑也至关重要。长期的小胶质细胞活化和神经炎症被认为是神经系统疾病的关键因素。在这方面,在确定疾病和治疗效果的生物标志物时,考虑肠道微生物群生态系统和宿主之间串扰的潜在影响变得越来越重要。共生微生物群通过识别细菌诱导和调节的代谢产物,对免疫发育和持续功能至关重要。在微生物微生态失调和小胶质细胞功能障碍的情况下,慢性神经炎症可能持续存在,导致神经系统疾病的传播。为了解决潜在的机制,这篇综述的重点是微生物群-肠-脑轴,因为它与异常中枢神经系统免疫活性和病理学相关的通讯途径。我们还讨论了可能抵消这些有害活动的抗炎和神经保护介质。最后,我们探索了当前和新的微生物组靶向方法治疗神经炎症和相应神经疾病的潜在益处。
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引用次数: 8
Anti-CASPR2 antibodies clinical significance and its main phenotypes 抗-CASPR2抗体的临床意义及其主要表型
Pub Date : 2020-06-16 DOI: 10.20517/2347-8659.2020.14
Letícia Caroline Breis, M. Schlindwein, M. Gonçalves
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引用次数: 1
COVID-19 neurotropism and implications for therapy 新冠肺炎神经依赖性及其对治疗的影响
Pub Date : 2020-06-03 DOI: 10.20517/2347-8659.2020.36
M. Das, C. Penn, T. Martinez, Karthick Mayilsamy, Andrew R. McGill, Alison Wiling, S. Mohapatra, S. Mohapatra
The mechanism underlying the pathogenesis of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in humans is poorly understood, although the cellular receptors which facilitate the virus fusion have been identified. Although the major symptoms of the infection have been identified as acute respiratory distress, pneumonia, and fever, recently, symptoms involving nervous system dysfunctions, including encephalopathy and stroke, have been detected. Herein, we comprehensively review the evidence that SARS-CoV-2 infection involves a neurotropic mechanism including a nose-brain-lung axis suggesting implications in therapy development.
尽管已经确定了促进病毒融合的细胞受体,但人类感染严重急性呼吸综合征冠状病毒-2 (SARS-CoV-2)的发病机制尚不清楚。虽然已确定感染的主要症状为急性呼吸窘迫、肺炎和发烧,但最近已发现涉及神经系统功能障碍的症状,包括脑病和中风。在此,我们全面回顾了SARS-CoV-2感染涉及包括鼻-脑-肺轴在内的嗜神经机制的证据,这提示了治疗开发的意义。
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引用次数: 4
期刊
Neuroimmunology and Neuroinflammation
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