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N-Acetylcysteine Ameliorates Loss of the Electroretinogram b-wave in a Bardet-Biedl Syndrome Type 10 Mouse Model. n -乙酰半胱氨酸改善Bardet-Biedl综合征10型小鼠视网膜电图b波丢失
Pub Date : 2025-01-01 DOI: 10.33696/Neurol.6.108
Tyler J Rankin, Sara Mayer, Joseph G Laird, Brianna Lobeck, Emily Kalmanek, Arlene V Drack

Bardet-Biedl Syndrome (BBS) is a rare autosomal recessive disorder characterized by retinal degeneration leading to blindness. This study investigates the therapeutic efficacy of N-Acetylcysteine (NAC), an oxygen free radical scavenger, in ameliorating retinal degeneration associated with BBS using a murine model of BBS10. BBS is caused by mutations in BBS genes, the protein products of which are involved in ciliary function; mutant or absent BBS10 protein disrupts the assembly of the BBSome protein complex, disturbing ciliary trafficking and leading to photoreceptor cell dysfunction and death. Photoreceptor function can be assessed using the electroretinogram (ERG), and anatomy can be assessed using optical coherence tomography (OCT) and histology to demonstrate progressive degeneration over time. This study utilizes Bbs10 -/- mice to assess the effect of NAC supplementation on retinal degeneration. Results reveal that NAC supplementation ameliorates the progressive degeneration of the retinal outer nuclear layer (ONL) on OCT and mitigates the loss-of-b-wave ERG phenotype observed in Bbs10 -/- mice. The ERG b-wave is generated by retinal bipolar cells after synapsing with photoreceptors which have been hyperpolarized by light exposure. Reducing the loss-of-b-wave phenotype may indicate improved synaptic function. Synaptic staining demonstrates a correlation between the absence of an electropositive b-wave and mislocalized presynaptic terminals, highlighting the significance of synaptic integrity for retinal function. These findings suggest NAC as a promising therapeutic intervention for managing BBS10-related retinal degeneration.

Bardet-Biedl综合征(BBS)是一种罕见的常染色体隐性遗传病,以视网膜变性导致失明为特征。本研究利用小鼠BBS10模型研究了氧自由基清除剂n -乙酰半胱氨酸(NAC)改善BBS相关视网膜变性的疗效。BBS是由BBS基因突变引起的,其蛋白质产物与纤毛功能有关;突变或缺失的BBS10蛋白会破坏BBSome蛋白复合物的组装,扰乱纤毛运输,导致光感受器细胞功能障碍和死亡。光感受器功能可以使用视网膜电图(ERG)进行评估,解剖可以使用光学相干断层扫描(OCT)和组织学来评估随时间的进行性变性。本研究利用Bbs10 -/-小鼠来评估NAC补充对视网膜变性的影响。结果表明,NAC补充改善了视网膜外核层(ONL)在OCT上的进行性变性,并减轻了Bbs10 -/-小鼠b波ERG表型的丧失。ERG b波是由视网膜双极细胞与光感受器突触后产生的,光感受器在光照射下被超极化。减少b波缺失表型可能表明突触功能得到改善。突触染色显示b波电正性缺失与突触前终末定位错误之间存在相关性,这突出了突触完整性对视网膜功能的重要性。这些发现表明NAC是一种有希望的治疗干预bbs10相关的视网膜变性。
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引用次数: 0
Molecular Cascades That Build and Connect Auditory Neurons from Hair Cells to the Auditory Cortex. 从毛细胞到听觉皮层建立和连接听觉神经元的分子级联。
Pub Date : 2025-01-01
Ebenezer N Yamoah, Gabriela Pavlinkova, Bernd Fritzsch

Understanding the development of the auditory system is crucial for uncovering the molecular origins of hearing and its related disorders. During this development, spiral ganglion neurons extend peripheral fibers to cochlear hair cells and central projections to the cochlear nuclei, setting up a tonotopic map that connects the ear to the brainstem, enabling frequency-specific sound perception. This sensory information is then integrated bilaterally through a relay involving the superior olivary complex, lateral lemniscus, inferior colliculus, medial geniculate body, and the auditory cortex. While anatomical connectivity has been well-documented, recent advancements have revealed gene regulatory networks that coordinate the specification, differentiation, and connectivity of auditory neurons. In this review, we examine the molecular cascades guiding auditory system development, emphasizing transcriptional hierarchies and lineage determinants. Insights into these mechanisms enhance our understanding of auditory circuit formation and provide a critical foundation for therapeutic strategies aimed at addressing congenital and acquired hearing loss.

理解听觉系统的发展对于揭示听力及其相关疾病的分子起源至关重要。在这一发育过程中,螺旋神经节神经元将外周纤维延伸到耳蜗毛细胞,并向中央投射到耳蜗核,建立了连接耳朵和脑干的张力分布图,实现了频率特异性声音感知。然后,这种感觉信息通过一个涉及上橄榄复合体、外侧小丘、下丘、内侧膝状体和听觉皮层的中继被双侧整合。虽然解剖学上的连通性已经得到了充分的证明,但最近的进展已经揭示了协调听觉神经元的规范、分化和连通性的基因调控网络。在这篇综述中,我们研究了引导听觉系统发育的分子级联,强调了转录层次和谱系决定因素。对这些机制的深入了解增强了我们对听觉回路形成的理解,并为先天性和获得性听力损失的治疗策略提供了重要的基础。
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引用次数: 0
Mechanical Thrombectomy for All LVO – Is It Feasible? – Recent Evidence to Expand the Current Stroke Guidelines 机械血栓切除术治疗所有 LVO - 可行吗?- 扩展现行卒中指南的最新证据
Pub Date : 2024-01-30 DOI: 10.33696/neurol.5.084
Jindong Xu, Cortney de la Torre, Devon Shafer, Margely Carrion-Carrero, Pramod Sethi
Mechanical thrombectomy (MT) has established its role as a standard care of acute ischemic stroke due to large vessel occlusion (LVO). Current early stroke management guidelines have defined certain selection criteria for LVO patients undergoing MT to achieve the most benefit. However, it is still uncertain if some other LVO patients who do not meet these criteria can also benefit from MT. In this review, we research the latest evidence on efficacy and safety of MT for LVO in various unique stroke populations, such as advanced age, pre-stroke disability, LVO with minor stroke, large infarct volume, poor mismatch profile, very late time window, posterior circulation LVO and distal medium-sized vessel occlusions. By comparing the benefits and risks of MT with best medical management only, we may develop further subgroup-specific criteria to expand our capacity to best treat these unique LVO populations.
机械取栓术(MT)已成为大血管闭塞(LVO)所致急性缺血性卒中的标准治疗方法。目前的早期卒中治疗指南已为接受机械取栓术的 LVO 患者确定了一定的选择标准,以获得最大疗效。然而,目前仍不确定其他一些不符合这些标准的 LVO 患者是否也能从 MT 中获益。在这篇综述中,我们研究了在各种特殊卒中人群中 MT 治疗 LVO 的疗效和安全性的最新证据,这些人群包括高龄、卒中前残疾、LVO 伴轻微卒中、大梗死体积、不匹配特征、极晚期时间窗、后循环 LVO 和远端中型血管闭塞。通过比较 MT 与最佳医疗管理的益处和风险,我们可以制定进一步的亚组特异性标准,以提高我们对这些独特 LVO 患者进行最佳治疗的能力。
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引用次数: 0
Could Neonatal Electroclinical Syndromes Orchestrate Diagnosis and Treatment? 新生儿临床电综合征能否协调诊断和治疗?
Pub Date : 2024-01-30 DOI: 10.33696/neurol.5.083
Rene Andrade Machado
Introduction: Neonatal seizures are associated with neurodevelopmental impairments. Implementing long-term video-EEG monitoring in the neonatal intensive care unit became the gold standard for seizure diagnosis. During the neonatal period, seizures can be associated with an acute brain insult called acute symptomatic seizures (ASS) or being part of neonatal epilepsy that may have a structural, metabolic, or genetic cause. This distinction impacts patient workup and management. Objectives: To facilitate a guide to differentiate ASS from neonatal epilepsy, and to correlate different electroclinical seizure patterns with a specific etiology. Methods: A narrative review was performed. MEDLINE, Embase, and PubMed were used to gather data for this narrative review. The following keywords were applied to focus on original research and case reports: epileptic encephalopathy, developmental Epileptic encephalopathy and neonatal seizures, neonatal genetic encephalopathies, Otahara syndrome, neonatal channelopathies, and neonatal seizure classification. Conclusions: Strict electroclinical semiology is the backbone for diagnosing neonatal seizures. The EEG and ictal semiology help with the diagnosis and the treatment. The neonatal seizure classification should be expanded to include the EEG pattern. Lumping them in a better classificatory system will prevent unnecessary and hazardous medication.
简介新生儿癫痫发作与神经发育障碍有关。在新生儿重症监护室实施长期视频脑电图监测已成为癫痫发作诊断的金标准。在新生儿期,癫痫发作可能与急性脑损伤有关,称为急性症状性癫痫发作(ASS),也可能是结构性、代谢性或遗传性原因导致的新生儿癫痫的一部分。这种区别会影响患者的治疗和管理。目标:为区分 ASS 和新生儿癫痫提供指南,并将不同的电临床发作模式与特定病因联系起来。方法进行叙述性综述。使用 MEDLINE、Embase 和 PubMed 收集数据进行叙述性综述。应用了以下关键词来关注原始研究和病例报告:癫痫性脑病、发育性癫痫性脑病和新生儿癫痫发作、新生儿遗传性脑病、小田原综合征、新生儿通道病和新生儿癫痫发作分类。结论严格的电临床半定量分析是诊断新生儿癫痫发作的基础。脑电图和发作性半身像有助于诊断和治疗。新生儿癫痫发作分类应扩展至包括脑电图模式。将它们归入一个更好的分类系统可避免不必要的危险用药。
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引用次数: 0
Definition and Characteristics of Multiple Sclerosis with Predominant Cognitive Presentation 以认知为主要表现的多发性硬化症的定义和特征
Pub Date : 2024-01-30 DOI: 10.33696/neurol.5.086
Amanda Fiori Cavassani, Álix Djone Berté, Andressa Ribeiro Pinto, Marcus Vinicius Magno Gonçalves, Gabriel de Deus Vieira
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引用次数: 0
Diagnosis and Treatment of Normal Pressure Hydrocephalus and Repeated Subdural Hematoma and Effusion after Ventriculoperitoneal Shunt in the Elderly: A Case Report 老年人脑室腹腔分流术后正常压力脑积水和反复硬膜下血肿及渗出的诊断与治疗:病例报告
Pub Date : 2024-01-30 DOI: 10.33696/neurol.5.085
Qing-Yong Wang, Qingjun Li
Idiopathic normal pressure hydrocephalus (iNPH) is a special type of hydrocephalus that is characterized by cognitive decline, gait disturbance, and urinary incontinence. It can lead to dementia and bedridden within 1-3 years. Without surgical treatment in time, the prognosis was bleak. We report an iNPH case misdiagnosed with Alzheimer’s disease, with a disease course of 3 years. The main manifestations of the patient were walking impairment, memory loss, urinary incontinence, repeated falls, and hallucinations, bedridden in the late stage, with a modified Rankin Scale (mRS):5. After undergoing the ventriculoperitoneal shunt, due to the low shunt pressure, the patient developed severe headache, repeated and severe subdural hemorrhage and effusion. After adjusting the shunt pressure in time, the patient recovered well with an mRS: 3, which was inconsistent with the previous belief that the operation was ineffective for patients with a disease course of more than 3 years. This case suggests that elderly patients with iNPH can still benefit from timely surgery even if the disease course of more than 3 years. Special attention should be paid after the operation, and the CSF shunt pressure should avoid setting too low, which may induce serious complications such as subdural hemorrhage or effusion.
特发性正常压力脑积水(iNPH)是一种特殊类型的脑积水,其特点是认知能力下降、步态障碍和尿失禁。它可导致痴呆,并在 1-3 年内卧床不起。如果不及时进行手术治疗,预后很不乐观。我们报告了一例被误诊为阿尔茨海默病的 iNPH 病例,病程 3 年。患者的主要表现为行走障碍、记忆力减退、尿失禁、反复跌倒和幻觉,晚期卧床不起,改良Rankin量表(mRS)为5。接受脑室腹腔分流术后,由于分流压力过低,患者出现剧烈头痛、反复严重硬膜下出血和渗出。在及时调整分流压力后,患者恢复良好,mRS:3,这与以往认为病程超过 3 年的患者手术无效的观点不符。本病例提示,即使病程超过 3 年,老年 iNPH 患者仍可从及时手术中获益。术后应特别注意,避免将 CSF 分流压力调得过低,以免诱发硬膜下出血或积液等严重并发症。
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引用次数: 0
A Case Report of Rheumatoid Meningitis – A Rare Condition Presenting with Neurological Deficits 类风湿性脑膜炎病例报告--一种表现为神经功能缺损的罕见疾病
Pub Date : 2024-01-10 DOI: 10.33696/neurol.4.081
Arun Swaminathan, Arvind Ramesh
Rheumatoid meningitis (RM) is a rare condition seen in patients with longstanding rheumatoid arthritis (RA). It can present with a variety of neurological symptoms and is often mistaken for other neurological conditions, especially in the setting of immune suppression in these patients. We present a rare case of RM in an elderly woman with RA that presented with focal neurological symptoms and was eventually diagnosed on brain biopsy. Our case serves to highlight the diagnostic dilemmas faced while evaluating and treating patients presenting with such an exceedingly rare condition and the importance of multidisciplinary collaboration in the management of such complex patients.
类风湿性脑膜炎(RM)是一种罕见的疾病,多见于长期患有类风湿性关节炎(RA)的患者。它可表现为多种神经系统症状,常被误诊为其他神经系统疾病,尤其是在这些患者免疫抑制的情况下。我们介绍了一例罕见的RM病例,患者是一名患有RA的老年女性,表现为局灶性神经症状,最终通过脑活检确诊。我们的病例强调了在评估和治疗这种极为罕见的疾病患者时所面临的诊断困境,以及多学科合作在治疗这类复杂患者时的重要性。
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引用次数: 0
CCR3 Expression in Relation to Delayed Microbleeds in a Rat Model of Large Vessel Occlusion. 大血管闭塞大鼠模型中 CCR3 表达与延迟性微出血的关系
Pub Date : 2024-01-01 DOI: 10.33696/neurol.5.082
Sydney M Claypoole, Jacqueline A Frank, Sarah J Messmer, Keith R Pennypacker

Thirty percent of ischemic stroke patients develop vascular cognitive impairment and dementia (VCID) within 1 year of stroke onset. The expression of C-C motif chemokine receptor 3 (CCR3) is associated with endothelial dysfunction and memory impairment. CCR3 has been reported to increase after experimental stroke and in human stroke patients. Using an in vivo model of stroke, our study aims to link CCR3 expression with endothelial dysfunction in this rodent stroke model.

Methods: 5-hour transient Middle Cerebral Artery Occlusion (5t-MCAO) or sham surgery was performed on rats and tissue collected at 3- and 30-days post-stroke. We measured the change in expression of CCR3 and its ligands in the venous blood before and after occlusion in the rat model.Immunohistochemistry was performed on consecutive coronal brain sections using Prussian blue to visualize microbleeds and DAB to visualize CCR3. Images were quantified using HALO.

Results: Using linear regression, we found that increased expression of CCR3 and its ligands after stroke were positively correlated with infarct volume. CCR3 expression was significantly increased in the ipsilateral hemisphere at 30 days post 5t-MCAO. Prussian blue staining was significantly increased in ipsilateral sections at 30 days post-stroke. Immunostaining for CCR3 was primarily detected in endothelium in areas of Prussian blue staining.

Conclusions: Our results demonstrate that CCR3 expression is associated with the presence of microbleeds at 30 days but not 3 days post-stroke in the ipsilateral hemisphere, and further supports the link between CCR3 and the endothelial dysfunction that is associated with VCID. CCR3 and its inflammatory pathway is a potential target for reducing endothelial dysfunction after ischemic stroke that may lead to VCID.

30%的缺血性中风患者会在中风发生后一年内出现血管性认知障碍和痴呆(VCID)。C-C motif趋化因子受体 3(CCR3)的表达与内皮功能障碍和记忆损伤有关。据报道,实验性中风后和人类中风患者体内的 CCR3 会增加。方法:对大鼠进行 5 小时瞬时大脑中动脉闭塞(5t-MCAO)或假手术,并在中风后 3 天和 30 天收集组织。我们测量了大鼠模型闭塞前后静脉血中 CCR3 及其配体的表达变化。在连续的冠状脑切片上进行免疫组化,用普鲁士蓝观察微出血,用 DAB 观察 CCR3。使用 HALO 对图像进行量化:结果:通过线性回归,我们发现脑卒中后 CCR3 及其配体表达的增加与梗死体积呈正相关。5t-MCAO 后 30 天,同侧半球的 CCR3 表达明显增加。卒中后30天,同侧切片的普鲁士蓝染色明显增加。CCR3的免疫染色主要在普鲁士蓝染色区域的血管内皮中检测到:我们的研究结果表明,CCR3 的表达与卒中后 30 天出现的微出血有关,但与同侧半球卒中后 3 天出现的微出血无关,这进一步证实了 CCR3 与 VCID 相关的内皮功能障碍之间的联系。CCR3 及其炎症通路是减少缺血性卒中后可能导致 VCID 的内皮功能障碍的潜在靶点。
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引用次数: 0
Cerebrovascular Dysfunction in Alzheimer's Disease and Transgenic Rodent Models. 阿尔茨海默病和转基因啮齿动物模型中的脑血管功能障碍
Pub Date : 2024-01-01 DOI: 10.33696/neurol.5.087
Xing Fang, Fan Fan, Jane J Border, Richard J Roman

Alzheimer's Disease (AD) and Alzheimer's Disease-Related Dementia (ADRD) are the primary causes of dementia that has a devastating effect on the quality of life and is a tremendous economic burden on the healthcare system. The accumulation of extracellular beta-amyloid (Aβ) plaques and intracellular hyperphosphorylated tau-containing neurofibrillary tangles (NFTs) in the brain are the hallmarks of AD. They are also thought to be the underlying cause of inflammation, neurodegeneration, brain atrophy, and cognitive impairments that accompany AD. The discovery of APP, PS1, and PS2 mutations that increase Aβ production in families with early onset familial AD led to the development of numerous transgenic rodent models of AD. These models have provided new insight into the role of Aβ in AD; however, they do not fully replicate AD pathology in patients. Familial AD patients with mutations that elevate the production of Aβ represent only a small fraction of dementia patients. In contrast, those with late-onset sporadic AD constitute the majority of cases. This observation, along with the failure of previous clinical trials targeting Aβ or Tau and the modest success of recent trials using Aβ monoclonal antibodies, has led to a reappraisal of the view that Aβ accumulation is the sole factor in the pathogenesis of AD. More recent studies have established that cerebral vascular dysfunction is one of the earliest changes seen in AD, and 67% of the candidate genes linked to AD are expressed in the cerebral vasculature. Thus, there is an increasing appreciation of the vascular contribution to AD, and the National Institute on Aging (NIA) and the Alzheimer's Disease Foundation recently prioritized it as a focused research area. This review summarizes the strengths and limitations of the most commonly used transgenic AD animal models and current views about the contribution of Aβ accumulation versus cerebrovascular dysfunction in the pathogenesis of AD.

阿尔茨海默病(AD)和阿尔茨海默病相关性痴呆(ADRD)是痴呆症的主要病因,对患者的生活质量造成毁灭性影响,也给医疗系统带来巨大的经济负担。细胞外β-淀粉样蛋白(Aβ)斑块和细胞内含神经纤维缠结(NFT)的高磷酸化tau在大脑中的积累是老年痴呆症的特征。它们也被认为是导致炎症、神经变性、脑萎缩和认知障碍的根本原因。在早发性家族性注意力缺失症家族中,APP、PS1 和 PS2 基因突变会增加 Aβ 的产生,这一发现促进了大量注意力缺失症转基因啮齿动物模型的开发。这些模型为了解 Aβ 在注意力缺失症中的作用提供了新的视角;然而,它们并不能完全复制患者的注意力缺失症病理。在痴呆症患者中,因突变导致 Aβ 生成增加的家族性 AD 患者只占一小部分。相比之下,晚发型散发性注意力缺失症患者占大多数。这一观察结果,加上以前针对 Aβ 或 Tau 的临床试验的失败,以及最近使用 Aβ 单克隆抗体的试验取得的些许成功,促使人们重新评估 Aβ 积累是 AD 发病机制中唯一因素的观点。最近的研究证实,脑血管功能障碍是注意力缺失症最早出现的变化之一,与注意力缺失症相关的候选基因中有 67% 在脑血管中表达。因此,人们越来越重视血管对阿兹海默症的影响,美国国家老龄化研究所(NIA)和阿兹海默症基金会最近将其列为重点研究领域。本综述总结了最常用的转基因AD动物模型的优势和局限性,以及目前关于Aβ积累和脑血管功能障碍在AD发病机制中的作用的观点。
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引用次数: 0
Protein Assembly Modulation: A New Approach to Amyotrophic Lateral Sclerosis (ALS) Therapeutics. 蛋白质组装调节:肌萎缩侧索硬化(ALS)治疗的新方法。
Pub Date : 2024-01-01 DOI: 10.33696/Neurol.5.103
Shao Feng Yu, Kumar Paulvannan, Dennis Solas, Anuradha F Lingappa, Ana Raquel Moreira, Shriya Sahu, Maya Michon, Amanda Macieik, Danielle Goldsmith, Nicholas DeYarman, Suguna Mallesh, M Dharma Prasad, Claudia Maios, Kai Ruan, Giulio S Tomassy, Elizabeth Jensen, Emma McGuirk, Verian Bader, Andreas Mueller-Schiffmann, Jonathan C Reed, Jaisri R Lingappa, Vinod Asundi, Shi Hong, Steve Jacobsen, Nicholas Brandon, Lyle Ostrow, Tom Lloyd, J Alex Parker, Kim A Staats, Justin Ichida, James C Dodge, Debendranath Dey, Carsten Korth, Suganya Selvarajah, Vishwanath R Lingappa, Jeffrey Rosenfeld

Amyotrophic Lateral Sclerosis (ALS) is a devastating and progressive neurodegenerative disease with a complex, multifactorial pathophysiology, culminating in death of motor neurons. We introduce a new mechanism of ALS pathogenesis via study of a novel drug-like small molecule series that targets a subset of protein disulfide isomerase (PDI) within a previously largely unappreciated transient and energy-dependent multi-protein complex enriched for proteins of the ALS interactome. This drug, found by a novel phenotypic screen, has activity in cellular models for both familial and sporadic ALS, as well as in transgenic worms, flies, and mice bearing a diversity of human genes with ALS-associated mutations. The hit compound was initially identified as a modulator of human immunodeficiency virus (HIV) capsid assembly in cell-free protein synthesis and assembly (CFPSA) systems, with demonstrated antiviral activity against infectious HIV in cell culture. Its advancement for ALS-therapeutics, subsequent separation of activity against HIV and ALS into separate chemical subseries through structure-activity-relationship (SAR) optimization, and identification of the drug target by affinity chromatography as shown here, may provide insights into the molecular mechanisms governing pathophysiology of disordered homeostasis relevant to ALS.

肌萎缩性侧索硬化症(ALS)是一种毁灭性的进行性神经退行性疾病,具有复杂的多因素病理生理,最终导致运动神经元死亡。我们通过研究一种新的药物样小分子系列,介绍了ALS发病机制的新机制,该系列靶向蛋白质二硫异构酶(PDI)的一个亚群,该亚群位于以前大部分未被认识的瞬时和能量依赖性多蛋白复合物中,该复合物富含ALS相互作用组的蛋白质。这种药物是通过一种新的表型筛选发现的,在家族性和散发性ALS的细胞模型中都有活性,在携带多种人类ALS相关突变基因的转基因蠕虫、苍蝇和小鼠中也有活性。hit化合物最初被确定为人类免疫缺陷病毒(HIV)在无细胞蛋白合成和组装(CFPSA)系统中衣壳组装的调节剂,在细胞培养中具有抗病毒活性。它在ALS治疗方面的进展,随后通过结构-活性-关系(SAR)优化将抗HIV和ALS活性分离为不同的化学亚系列,并通过亲和层析鉴定药物靶点,可能为ALS相关的紊乱体内平衡的病理生理调控分子机制提供见解。
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引用次数: 0
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Journal of experimental neurology
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