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Xiao L, Hareendran S, Loh YP. Function of exosomes in neurological disorders and brain tumors. EXTRACELLULAR VESICLES AND CIRCULATING NUCLEIC ACIDS 2021; 2:55-79. [PMID: 34368812 PMCID: PMC8341051 DOI: 10.20517/evcna.2021.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Exosomes are a subtype of extracellular vesicles released from different cell types including those in the nervous system, and are enriched in a variety of bioactive molecules such as RNAs, proteins and lipids. Numerous studies have indicated that exosomes play a critical role in many physiological and pathological activities by facilitating intercellular communication and modulating cells' responses to external environments. Particularly in the central nervous system, exosomes have been implicated to play a role in many neurological disorders such as abnormal neuronal development, neurodegenerative diseases, epilepsy, mental disorders, stroke, brain injury and brain cancer. Since exosomes recapitulate the characteristics of the parental cells and have the capacity to cross the blood-brain barrier, their cargo can serve as potential biomarkers for early diagnosis and clinical assessment of disease treatment. In this review, we describe the latest findings and current knowledge of the roles exosomes play in various neurological disorders and brain cancer, as well as their application as promising biomarkers. The potential use of exosomes to deliver therapeutic molecules to treat diseases of the central nervous system is also discussed.
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Affiliation(s)
- Lan Xiao
- Section on Cellular Neurobiology, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sangeetha Hareendran
- Section on Cellular Neurobiology, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
| | - Y Peng Loh
- Section on Cellular Neurobiology, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA
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Secreted Extracellular Vesicle Molecular Cargo as a Novel Liquid Biopsy Diagnostics of Central Nervous System Diseases. Int J Mol Sci 2021; 22:ijms22063267. [PMID: 33806874 PMCID: PMC8004928 DOI: 10.3390/ijms22063267] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/18/2021] [Accepted: 03/20/2021] [Indexed: 12/11/2022] Open
Abstract
Secreted extracellular vesicles (EVs) are heterogeneous cell-derived membranous granules which carry a large diversity of molecules and participate in intercellular communication by transferring these molecules to target cells by endocytosis. In the last decade, EVs’ role in several pathological conditions, from etiology to disease progression or therapy evasion, has been consolidated, including in central nervous system (CNS)-related disorders. For this review, we performed a systematic search of original works published, reporting the presence of molecular components expressed in the CNS via EVs, which have been purified from plasma, serum or cerebrospinal fluid. Our aim is to provide a list of molecular EV components that have been identified from both nonpathological conditions and the most common CNS-related disorders. We discuss the methods used to isolate and enrich EVs from specific CNS-cells and the relevance of its components in each disease context.
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Wu Y, Liu J. Effect of exosome -derived non -coding RNA on traumatic brain injury. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2021; 46:183-188. [PMID: 33678656 PMCID: PMC10929786 DOI: 10.11817/j.issn.1672-7347.2021.190702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Indexed: 11/03/2022]
Abstract
Traumatic brain injury (TBI) is a main cause of death and disability worldwide, posing a serious threat to public health. But currently, the diagnosis and treatments for TBI are still very limited. Exosomes are a group of extracellular vesicles and participate in multiple physiological processes including intercellular communication and substance transport. Non-coding RNAs (ncRNA) are of great abundancy as cargo of exosomes. Previous studies have shown that ncRNAs are involved in several pathophysiological processes of TBI. However, the concrete mechanisms involved in the effects induced by exosome-derived ncRNA remain largely unknown. As an important component of exosomes, ncRNA is of great significance for diagnosis, precise treatment, response evaluation, prognosis prediction, and complication management after TBI.
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Affiliation(s)
- Yun Wu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China.
| | - Jinfang Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China.
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Sun B, Tang N, Peluso MJ, Iyer NS, Torres L, Donatelli JL, Munter SE, Nixon CC, Rutishauser RL, Rodriguez-Barraquer I, Greenhouse B, Kelly JD, Martin JN, Deeks SG, Henrich TJ, Pulliam L. Characterization and Biomarker Analyses of Post-COVID-19 Complications and Neurological Manifestations. Cells 2021; 10:386. [PMID: 33668514 PMCID: PMC7918597 DOI: 10.3390/cells10020386] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/12/2022] Open
Abstract
As the SARS-CoV-2 pandemic continues, reports have demonstrated neurologic sequelae following COVID-19 recovery. Mechanisms to explain long-term neurological sequelae are unknown and need to be identified. Plasma from 24 individuals recovering from COVID-19 at 1 to 3 months after initial infection were collected for cytokine and antibody levels and neuronal-enriched extracellular vesicle (nEV) protein cargo analyses. Plasma cytokine IL-4 was increased in all COVID-19 participants. Volunteers with self-reported neurological problems (nCoV, n = 8) had a positive correlation of IL6 with age or severity of the sequalae, at least one co-morbidity and increased SARS-CoV-2 antibody compared to those COVID-19 individuals without neurological issues (CoV, n = 16). Protein markers of neuronal dysfunction including amyloid beta, neurofilament light, neurogranin, total tau, and p-T181-tau were all significantly increased in the nEVs of all participants recovering from COVID-19 compared to historic controls. This study suggests ongoing peripheral and neuroinflammation after COVID-19 infection that may influence neurological sequelae by altering nEV proteins. Individuals recovering from COVID-19 may have occult neural damage while those with demonstrative neurological symptoms additionally had more severe infection. Longitudinal studies to monitor plasma biomarkers and nEV cargo are warranted to assess persistent neurodegeneration and systemic effects.
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Affiliation(s)
- Bing Sun
- Department of Laboratory Medicine, San Francisco VA Health Care System, San Francisco, CA 94121, USA; (B.S.); (N.T.)
| | - Norina Tang
- Department of Laboratory Medicine, San Francisco VA Health Care System, San Francisco, CA 94121, USA; (B.S.); (N.T.)
| | - Michael J. Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (M.J.P.); (R.L.R.); (I.R.-B.); (B.G.); (S.G.D.)
| | - Nikita S. Iyer
- Division of Experimental Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (N.S.I.); (L.T.); (J.L.D.); (S.E.M.); (C.C.N.); (T.J.H.)
| | - Leonel Torres
- Division of Experimental Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (N.S.I.); (L.T.); (J.L.D.); (S.E.M.); (C.C.N.); (T.J.H.)
| | - Joanna L. Donatelli
- Division of Experimental Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (N.S.I.); (L.T.); (J.L.D.); (S.E.M.); (C.C.N.); (T.J.H.)
| | - Sadie E. Munter
- Division of Experimental Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (N.S.I.); (L.T.); (J.L.D.); (S.E.M.); (C.C.N.); (T.J.H.)
| | - Christopher C. Nixon
- Division of Experimental Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (N.S.I.); (L.T.); (J.L.D.); (S.E.M.); (C.C.N.); (T.J.H.)
| | - Rachel L. Rutishauser
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (M.J.P.); (R.L.R.); (I.R.-B.); (B.G.); (S.G.D.)
| | - Isabel Rodriguez-Barraquer
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (M.J.P.); (R.L.R.); (I.R.-B.); (B.G.); (S.G.D.)
| | - Bryan Greenhouse
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (M.J.P.); (R.L.R.); (I.R.-B.); (B.G.); (S.G.D.)
| | - John D. Kelly
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94158, USA; (J.D.K.); (J.N.M.)
| | - Jeffrey N. Martin
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94158, USA; (J.D.K.); (J.N.M.)
| | - Steven G. Deeks
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (M.J.P.); (R.L.R.); (I.R.-B.); (B.G.); (S.G.D.)
| | - Timothy J. Henrich
- Division of Experimental Medicine, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110, USA; (N.S.I.); (L.T.); (J.L.D.); (S.E.M.); (C.C.N.); (T.J.H.)
| | - Lynn Pulliam
- Department of Laboratory Medicine, San Francisco VA Health Care System, San Francisco, CA 94121, USA; (B.S.); (N.T.)
- Department of Laboratory Medicine and Medicine, University of California at San Francisco, San Francisco, CA 94143, USA
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Wang H, Chen FS, Zhang ZL, Zhou HX, Ma H, Li XQ. MiR-126-3p-Enriched Extracellular Vesicles from Hypoxia-Preconditioned VSC 4.1 Neurons Attenuate Ischaemia-Reperfusion-Induced Pain Hypersensitivity by Regulating the PIK3R2-Mediated Pathway. Mol Neurobiol 2021; 58:821-834. [PMID: 33029740 DOI: 10.1007/s12035-020-02159-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/02/2020] [Indexed: 02/08/2023]
Abstract
Recent evidence suggests that hypoxia preconditioning can alter the microRNA (miRNA) profile of extracellular vesicles (EVs) and has better neuroprotective effects when enriched miRs are delivered to recipients. However, the roles of exosomal miRNAs in regulating ischaemia-reperfusion (IR)-induced pain hypersensitivity are largely unknown. Thus, we isolated EVs from normoxia-conditioned neurons (Nor-VSC EVs) and Hypo-VSC EVs by ultracentrifugation. After the initial screening by a microarray analysis and quantitative RT-PCR (qRT-PCR), miR-126-3p, which was detected as the most altered miR in the Hypo-VSC EVs, was further confirmed by applying GW4869 to inhibit exosomal secretion. Moreover, transfection with a miR-126 mimic obviously increased miR-126-3p expression in Nor-VSC EVs, whereas a miR-126 inhibitor prevented the increase in miR-126-3p in Hypo-VSC EVs. A rat model of pain was established by performing 8-min occlusion of the aorta. Following IR, compared with the Nor-VSC EVs- or antagomir-126-injected rats, the Hypo-VSC EVs-injected rats displayed improved pain hypersensitivity demonstrated as higher PWT and PWL values. Mechanistically, PIK3R2 is a target of miR-126-3p and might be a modulator of the phosphoinositide 3-kinase (PI3K)/Akt pathway as the PIK3R2 and PI3K immunoreactivities in each group were changed in opposite directions. Compared with the controls, higher protein levels of PI3K and phosphorylated Akt but lower levels of phosphorylated nuclear factor-κ B (NF-κB), tumour necrosis factor (TNF)-α and interleukin (IL)-1β were detected in the spinal cords of the Hypo-VSC EVs-injected rats, and these effects were impaired by an injection of Hypo-VSC EVs combined with antagomir-126. Collectively, the miR-126-3p-enriched Hypo-VSC EVs attenuated IR-induced pain hypersensitivity by restoring miR-126-3p expression in the injured spinal cord and subsequently modulating PIK3R2-mediated PI3K/Akt and NF-κB signalling pathways.
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Affiliation(s)
- He Wang
- Department of Anesthesiology, First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Feng-Shou Chen
- Department of Anesthesiology, First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Zai-Li Zhang
- Department of Anesthesiology, First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Hong-Xu Zhou
- Department of Anesthesiology, First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Hong Ma
- Department of Anesthesiology, First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China
| | - Xiao-Qian Li
- Department of Anesthesiology, First Affiliated Hospital, China Medical University, Shenyang, 110001, Liaoning, China.
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56
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Marostica G, Gelibter S, Gironi M, Nigro A, Furlan R. Extracellular Vesicles in Neuroinflammation. Front Cell Dev Biol 2021; 8:623039. [PMID: 33553161 PMCID: PMC7858658 DOI: 10.3389/fcell.2020.623039] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/21/2020] [Indexed: 12/18/2022] Open
Abstract
Extracellular vesicles (EVs) are a heterogenous group of membrane-bound particles that play a pivotal role in cell–cell communication, not only participating in many physiological processes, but also contributing to the pathogenesis of several diseases. The term EVs defines many and different vesicles based on their biogenesis and release pathway, including exosomes, microvesicles (MVs), and apoptotic bodies. However, their classification, biological function as well as protocols for isolation and detection are still under investigation. Recent evidences suggest the existence of novel subpopulations of EVs, increasing the degree of heterogeneity between EV types and subtypes. EVs have been shown to have roles in the CNS as biomarkers and vehicles of drugs and other therapeutic molecules. They are known to cross the blood brain barrier, allowing CNS EVs to be detectable in peripheral fluids, and their cargo may give information on parental cells and the pathological process they are involved in. In this review, we summarize the knowledge on the function of EVs in the pathogenesis of multiple sclerosis (MS) and discuss recent evidences for their potential applications as diagnostic biomarkers and therapeutic targets.
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Affiliation(s)
- Giulia Marostica
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Gelibter
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Maira Gironi
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Annamaria Nigro
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Furlan
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
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57
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Yousif G, Qadri S, Haik M, Haik Y, Parray AS, Shuaib A. Circulating Exosomes of Neuronal Origin as Potential Early Biomarkers for Development of Stroke. Mol Diagn Ther 2021; 25:163-180. [DOI: 10.1007/s40291-020-00508-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 12/11/2022]
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58
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Quiroz-Baez R, Hernández-Ortega K, Martínez-Martínez E. Insights Into the Proteomic Profiling of Extracellular Vesicles for the Identification of Early Biomarkers of Neurodegeneration. Front Neurol 2020; 11:580030. [PMID: 33362690 PMCID: PMC7759525 DOI: 10.3389/fneur.2020.580030] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022] Open
Abstract
Extracellular vesicles (EVs) are involved in the development and progression of neurodegenerative diseases, including Alzheimer's and Parkinson's disease. Moreover, EVs have the capacity to modify the physiology of neuronal circuits by transferring proteins, RNA, lipids, and metabolites. The proteomic characterization of EVs (exosomes and microvesicles) from preclinical models and patient samples has the potential to reveal new proteins and molecular networks that affect the normal physiology prior to the appearance of traditional biomarkers of neurodegeneration. Noteworthy, many of the genetic risks associated to the development of Alzheimer's and Parkinson's disease affect the crosstalk between mitochondria, endosomes, and lysosomes. Recent research has focused on determining the role of endolysosomal trafficking in the onset of neurodegenerative diseases. Proteomic studies indicate an alteration of biogenesis and molecular content of EVs as a result of endolysosomal and autophagic dysfunction. In this review, we discuss the status of EV proteomic characterization and their usefulness in discovering new biomarkers for the differential diagnosis of neurodegenerative diseases. Despite the challenges related to the failure to follow a standard isolation protocol and their implementation for a clinical setting, the analysis of EV proteomes has revealed the presence of key proteins with post-translational modifications that can be measured in peripheral fluids.
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Affiliation(s)
- Ricardo Quiroz-Baez
- Departamento de Investigación Básica, Dirección de Investigación, Instituto Nacional de Geriatría, Ciudad de México, Mexico
| | - Karina Hernández-Ortega
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Mexico
| | - Eduardo Martínez-Martínez
- Laboratory of Cell Communication & Extracellular Vesicles, Division of Basic Science, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
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59
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Beard K, Meaney DF, Issadore D. Clinical Applications of Extracellular Vesicles in the Diagnosis and Treatment of Traumatic Brain Injury. J Neurotrauma 2020; 37:2045-2056. [PMID: 32312151 PMCID: PMC7502684 DOI: 10.1089/neu.2020.6990] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Extracellular vesicles (EVs) have emerged as key mediators of cell-cell communication during homeostasis and in pathology. Central nervous system (CNS)-derived EVs contain cell type-specific surface markers and intralumenal protein, RNA, DNA, and metabolite cargo that can be used to assess the biochemical and molecular state of neurons and glia during neurological injury and disease. The development of EV isolation strategies coupled with analysis of multi-plexed biomarker and clinical data have the potential to improve our ability to classify and treat traumatic brain injury (TBI) and resulting sequelae. Additionally, their ability to cross the blood-brain barrier (BBB) has implications for both EV-based diagnostic strategies and for potential EV-based therapeutics. In the present review, we discuss encouraging data for EV-based diagnostic, prognostic, and therapeutic strategies in the context of TBI monitoring and management.
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Affiliation(s)
- Kryshawna Beard
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David F. Meaney
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David Issadore
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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60
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Goetzl EJ. Advancing medicine for Alzheimer's disease: A plasma neural exosome platform. FASEB J 2020; 34:13079-13084. [PMID: 32856798 DOI: 10.1096/fj.202001655] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/27/2020] [Indexed: 12/20/2022]
Abstract
Enrichment of neurally derived extracellular vesicles of several cell-types from plasma for protein quantification longitudinally in living patients with Alzheimer's disease has permitted the development of a tentative temporal framework of initiating events, progression mechanisms, and amplification processes. Interactions of beta-amyloid peptides with an elevated level of their normal prion protein dendritic receptor and of phospho-tau species with their synaptogyrin-3 synaptic vesicle receptor replace excessive production and accumulation of neuropathic proteins as the major initiating events. Synaptic dysfunction and microvascular angiopathy are confirmed as early progression mechanisms of decreased neuronal network connectivity, hypoxia, altered blood-brain barrier, and neurocellular degeneration. Neurally derived extracellular vesicle protein abnormalities also reveal a range of later amplification processes that encompasses insulin resistance, lysosomal defects, decreased survival factors, increased reactive oxygen species, and excessive neuroinflammation. New potential therapeutic targets also are suggested as well as the likely timing of their pathogenic engagement.
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Affiliation(s)
- Edward J Goetzl
- Department of Medicine, University of California Medical Center, San Francisco, CA, USA.,Geriatric Research Center, Campus for Jewish Living, San Francisco, CA, USA
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61
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Ledreux A, Pryhoda MK, Gorgens K, Shelburne K, Gilmore A, Linseman DA, Fleming H, Koza LA, Campbell J, Wolff A, Kelly JP, Margittai M, Davidson BS, Granholm AC. Assessment of Long-Term Effects of Sports-Related Concussions: Biological Mechanisms and Exosomal Biomarkers. Front Neurosci 2020; 14:761. [PMID: 32848549 PMCID: PMC7406890 DOI: 10.3389/fnins.2020.00761] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/29/2020] [Indexed: 12/24/2022] Open
Abstract
Concussion or mild traumatic brain injury (mTBI) in athletes can cause persistent symptoms, known as post-concussion syndrome (PCS), and repeated injuries may increase the long-term risk for an athlete to develop neurodegenerative diseases such as chronic traumatic encephalopathy (CTE), and Alzheimer's disease (AD). The Center for Disease Control estimates that up to 3.8 million sport-related mTBI are reported each year in the United States. Despite the magnitude of the phenomenon, there is a current lack of comprehensive prognostic indicators and research has shown that available monitoring tools are moderately sensitive to short-term concussion effects but less sensitive to long-term consequences. The overall aim of this review is to discuss novel, quantitative, and objective measurements that can predict long-term outcomes following repeated sports-related mTBIs. The specific objectives were (1) to provide an overview of the current clinical and biomechanical tools available to health practitioners to ensure recovery after mTBIs, (2) to synthesize potential biological mechanisms in animal models underlying the long-term adverse consequences of mTBIs, (3) to discuss the possible link between repeated mTBI and neurodegenerative diseases, and (4) to discuss the current knowledge about fluid biomarkers for mTBIs with a focus on novel exosomal biomarkers. The conclusions from this review are that current post-concussion clinical tests are not sufficiently sensitive to injury and do not accurately quantify post-concussion alterations associated with repeated mTBIs. In the current review, it is proposed that current practices should be amended to include a repeated symptom inventory, a cognitive assessment of executive function and impulse control, an instrumented assessment of balance, vestibulo-ocular assessments, and an improved panel of blood or exosome biomarkers.
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Affiliation(s)
- Aurélie Ledreux
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, United States
| | - Moira K. Pryhoda
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States
| | - Kim Gorgens
- Graduate School of Professional Psychology, University of Denver, Denver, CO, United States
| | - Kevin Shelburne
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States
| | - Anah Gilmore
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, United States
| | - Daniel A. Linseman
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, United States
- Biological Sciences, University of Denver, Denver, CO, United States
| | - Holly Fleming
- Biological Sciences, University of Denver, Denver, CO, United States
| | - Lilia A. Koza
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, United States
- Biological Sciences, University of Denver, Denver, CO, United States
| | - Julie Campbell
- Pioneer Health and Performance, University of Denver, Denver, CO, United States
| | - Adam Wolff
- Denver Neurological Clinic, Denver, CO, United States
| | - James P. Kelly
- Marcus Institute for Brain Health, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Martin Margittai
- Department of Chemistry and Biochemistry, University of Denver, Denver, CO, United States
| | - Bradley S. Davidson
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States
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Guedes VA, Devoto C, Leete J, Sass D, Acott JD, Mithani S, Gill JM. Extracellular Vesicle Proteins and MicroRNAs as Biomarkers for Traumatic Brain Injury. Front Neurol 2020; 11:663. [PMID: 32765398 PMCID: PMC7378746 DOI: 10.3389/fneur.2020.00663] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/02/2020] [Indexed: 12/12/2022] Open
Abstract
Traumatic brain injury (TBI) is a heterogeneous condition, associated with diverse etiologies, clinical presentations and degrees of severity, and may result in chronic neurobehavioral sequelae. The field of TBI biomarkers is rapidly evolving to address the many facets of TBI pathology and improve its clinical management. Recent years have witnessed a marked increase in the number of publications and interest in the role of extracellular vesicles (EVs), which include exosomes, cell signaling, immune responses, and as biomarkers in a number of pathologies. Exosomes have a well-defined lipid bilayer with surface markers that reflect the cell of origin and an aqueous core that contains a variety of biological material including proteins (e.g., cytokines and growth factors) and nucleic acids (e.g., microRNAs). The presence of proteins associated with neurodegenerative changes such as amyloid-β, α-synuclein and phosphorylated tau in exosomes suggests a role in the initiation and propagation of neurological diseases. However, mechanisms of cell communication involving exosomes in the brain and their role in TBI pathology are poorly understood. Exosomes are promising TBI biomarkers as they can cross the blood-brain barrier and can be isolated from peripheral fluids, including serum, saliva, sweat, and urine. Exosomal content is protected from enzymatic degradation by exosome membranes and reflects the internal environment of their cell of origin, offering insights into tissue-specific pathological processes. Challenges in the clinical use of exosomal cargo as biomarkers include difficulty in isolating pure exosomes, variable yields of the isolation processes, quantification of vesicles, and lack of specificity of exosomal markers. Moreover, there is no consensus regarding nomenclature and characteristics of EV subtypes. In this review, we discuss current technical limitations and challenges of using exosomes and other EVs as blood-based biomarkers, highlighting their potential as diagnostic and prognostic tools in TBI.
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Affiliation(s)
- Vivian A Guedes
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
| | - Christina Devoto
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
| | - Jacqueline Leete
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
| | - Delia Sass
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
| | - Jedidiah D Acott
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
| | - Sara Mithani
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
| | - Jessica M Gill
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States
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Peltz CB, Kenney K, Gill J, Diaz-Arrastia R, Gardner RC, Yaffe K. Blood biomarkers of traumatic brain injury and cognitive impairment in older veterans. Neurology 2020; 95:e1126-e1133. [PMID: 32571850 DOI: 10.1212/wnl.0000000000010087] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/27/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To determine whether blood-based biomarkers can differentiate older veterans with and without traumatic brain injury (TBI) and cognitive impairment (CogI). METHODS We enrolled 155 veterans from 2 veterans' retirement homes: 90 without TBI and 65 with TBI history. Participants were further separated into CogI groups: controls (no TBI, no CogI), n = 60; no TBI with CogI, n = 30; TBI without CogI, n = 30; and TBI with CogI, n = 35. TBI was determined by the Ohio State University TBI Identification Method. CogI was defined as impaired cognitive testing, dementia diagnosis, or use of dementia medication. Blood specimens were enriched for CNS-derived exosomes. Proteins (neurofilament light [NfL], total tau, glial fibrillary acidic protein [GFAP], α-synuclein, β-amyloid 42 [Aβ42], and phosphorylated tau [p-tau]) and cytokines (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6], and interleukin-10) were measured using ultrasensitive immunoassays. RESULTS Veterans were, on average, 79 years old. In participants with TBI history, 65% had mild TBI; average time from most recent TBI was 37 years. In adjusted analyses, the TBI and CogI groups differed on CNS-enriched exosome concentration of p-tau, NfL, IL-6, TNF-α (all p < 0.05), and GFAP (p = 0.06), but not on Aβ42 or other markers. Adjusted area under the curve (AUC) analyses found that all significantly associated biomarkers combined separated TBI with/without CogI (AUC, 0.85; 95% confidence interval [CI], 0.74-0.95) and CogI with/without TBI (AUC, 0.88; 95% CI, 0.77-0.99). CONCLUSIONS Increased levels of blood-based, CNS-enriched exosomal biomarkers associated with TBI and CogI can be detected even decades after TBI. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that in veterans with a history of TBI, CNS-enriched exosome concentration of p-tau, NfL, IL-6, and TNF-α are associated with CogI.
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Affiliation(s)
- Carrie B Peltz
- From San Francisco Veterans Affairs Health Care System (C.B.P., R.C.G., K.Y.), CA; Northern California Institute for Research and Education (C.B.P.), San Francisco; Uniformed Services University of the Health Sciences (K.K.), Rockville; NIH (J.G.), Bethesda, MD; Department of Neurology (R.D.-A.), University of Pennsylvania, Philadelphia; and Departments of Neurology (R.C.G., K.Y.), Psychiatry (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco.
| | - Kimbra Kenney
- From San Francisco Veterans Affairs Health Care System (C.B.P., R.C.G., K.Y.), CA; Northern California Institute for Research and Education (C.B.P.), San Francisco; Uniformed Services University of the Health Sciences (K.K.), Rockville; NIH (J.G.), Bethesda, MD; Department of Neurology (R.D.-A.), University of Pennsylvania, Philadelphia; and Departments of Neurology (R.C.G., K.Y.), Psychiatry (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Jessica Gill
- From San Francisco Veterans Affairs Health Care System (C.B.P., R.C.G., K.Y.), CA; Northern California Institute for Research and Education (C.B.P.), San Francisco; Uniformed Services University of the Health Sciences (K.K.), Rockville; NIH (J.G.), Bethesda, MD; Department of Neurology (R.D.-A.), University of Pennsylvania, Philadelphia; and Departments of Neurology (R.C.G., K.Y.), Psychiatry (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Ramon Diaz-Arrastia
- From San Francisco Veterans Affairs Health Care System (C.B.P., R.C.G., K.Y.), CA; Northern California Institute for Research and Education (C.B.P.), San Francisco; Uniformed Services University of the Health Sciences (K.K.), Rockville; NIH (J.G.), Bethesda, MD; Department of Neurology (R.D.-A.), University of Pennsylvania, Philadelphia; and Departments of Neurology (R.C.G., K.Y.), Psychiatry (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Raquel C Gardner
- From San Francisco Veterans Affairs Health Care System (C.B.P., R.C.G., K.Y.), CA; Northern California Institute for Research and Education (C.B.P.), San Francisco; Uniformed Services University of the Health Sciences (K.K.), Rockville; NIH (J.G.), Bethesda, MD; Department of Neurology (R.D.-A.), University of Pennsylvania, Philadelphia; and Departments of Neurology (R.C.G., K.Y.), Psychiatry (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
| | - Kristine Yaffe
- From San Francisco Veterans Affairs Health Care System (C.B.P., R.C.G., K.Y.), CA; Northern California Institute for Research and Education (C.B.P.), San Francisco; Uniformed Services University of the Health Sciences (K.K.), Rockville; NIH (J.G.), Bethesda, MD; Department of Neurology (R.D.-A.), University of Pennsylvania, Philadelphia; and Departments of Neurology (R.C.G., K.Y.), Psychiatry (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California, San Francisco
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Bhargava P, Nogueras-Ortiz C, Kim S, Delgado-Peraza F, Calabresi PA, Kapogiannis D. Synaptic and complement markers in extracellular vesicles in multiple sclerosis. Mult Scler 2020; 27:509-518. [PMID: 32669030 DOI: 10.1177/1352458520924590] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Synaptic loss is a feature of multiple sclerosis pathology that can be seen even in normal-appearing gray matter. Opsonization of synapses with complement components may underlie pathologic synapse loss. OBJECTIVE We sought to determine whether circulating neuronal-enriched and astrocytic-enriched extracellular vesicles (NEVs and AEVs) provide biomarkers reflecting complement-mediated synaptic loss in multiple sclerosis. METHODS From plasma of 61 people with multiple sclerosis (46 relapsing-remitting multiple sclerosis (RRMS) and 15 progressive MS) and 31 healthy controls, we immunocaptured L1CAM + NEVs and GLAST + AEVs. We measured pre- and post-synaptic proteins synaptopodin and synaptophysin in NEVs and complement components (C1q, C3, C3b/iC3b, C4, C5, C5a, C9, Factor B, and Factor H) in AEVs, total circulating EVs, and neat plasma. RESULTS We found lower levels of NEV synaptopodin and synaptophysin in MS compared to controls (p < 0.0001 for both). In AEVs, we found higher levels of multiple complement cascade components in people with MS compared to controls; these differences were not noted in total EVs or neat plasma. Strikingly, there were strong inverse correlations between NEV synaptic proteins and multiple AEV complement components in MS, but not in controls. CONCLUSION Circulating EVs could identify synaptic loss in MS and suggest a link between astrocytic complement production and synaptic loss.
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Affiliation(s)
- Pavan Bhargava
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Carlos Nogueras-Ortiz
- Laboratory of Clinical Investigation, National Institutes of Aging, Baltimore, MD, USA
| | - Sol Kim
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Peter A Calabresi
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dimitrios Kapogiannis
- Laboratory of Clinical Investigation, National Institutes of Aging, Baltimore, MD, USA/Biomedical Research Center, National Institute on Aging, National Institute of Health, Baltimore, MD, USA/ Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Abner EL, Elahi FM, Jicha GA, Mustapic M, Al-Janabi O, Kramer JH, Kapogiannis D, Goetzl EJ. Endothelial-derived plasma exosome proteins in Alzheimer's disease angiopathy. FASEB J 2020; 34:5967-5974. [PMID: 32157747 PMCID: PMC7233139 DOI: 10.1096/fj.202000034r] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/30/2022]
Abstract
Small cerebral vascular disease (SCeVD) demonstrated by white matter hyperintensity (WMH) on MRI contributes to the development of dementia in Alzheimer's disease (AD), but it has not been possible to correlate onset, severity, or protein components of SCeVD with characteristics of WMH in living patients. Plasma endothelial-derived exosomes (EDEs) were enriched by two-step immunoabsorption from four groups of participants with no clinical evidence of cerebrovascular disease: cognitively normal (CN) without WMH (CN without SCeVD, n = 20), CN with SCeVD (n = 22), preclinical AD (pAD) + mild cognitive impairment (MCI) without SCeVD (pAD/MCI without SCeVD, n = 22), and pAD/MCI with SCeVD (n = 16) for ELISA quantification of cargo proteins. Exosome marker CD81-normalized EDE levels of the cerebrovascular-selective biomarkers large neutral amino acid transporter 1 (LAT-1), glucose transporter type 1 (Glut-1), and permeability-glycoprotein (p-GP, ABCB1) were similarly significantly higher in the CN with SCeVD and pAD/MCI with SCeVD groups than their corresponding control groups without SCeVD. CD81-normalized EDE levels of Aβ40 and Aβ42 were significantly higher in the pAD/MCI with SCeVD group but not in the CN with SCeVD group relative to controls without SCeVD. Levels of normal cellular prion protein (PrPc), a receptor for amyloid peptides, and phospho-181T-tau were higher in both CN and pAD/MCI with SCeVD groups than in the corresponding controls. High EDE levels of Aβ40, Aβ42, and phospho-181T-tau in patients with WMH suggesting SCeVD appear at the pre-clinical or MCI stage of AD and therapeutic lowering of neurotoxic peptide levels may delay progression of AD angiopathy.
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Affiliation(s)
- Erin L. Abner
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Epidemiology, University of Kentucky, Lexington, KY, USA
| | - Fanny M. Elahi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Gregory A. Jicha
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - Maja Mustapic
- Cellular and Molecular Neurosciences Section, Laboratory of Neurosciences, National Institute on Aging, Baltimore, MD, USA
| | - Omar Al-Janabi
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Dimitrios Kapogiannis
- Cellular and Molecular Neurosciences Section, Laboratory of Neurosciences, National Institute on Aging, Baltimore, MD, USA
| | - Edward J. Goetzl
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Campus for Jewish Living, San Francisco, CA, USA
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Acute Insulin Resistance and Rapid Alterations in Neuronal Derived Blood Exosome Concentration After Branched Endovascular Aortic Aneurysm Repair. Eur J Vasc Endovasc Surg 2020; 59:457-463. [DOI: 10.1016/j.ejvs.2019.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 09/26/2019] [Accepted: 10/11/2019] [Indexed: 12/23/2022]
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Visual working memory deficits in undergraduates with a history of mild traumatic brain injury. Atten Percept Psychophys 2020; 81:2597-2603. [PMID: 31218600 DOI: 10.3758/s13414-019-01774-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We investigated whether a history of mild traumatic brain injury (mTBI), or concussion, has any effect on visual working memory (WM) performance. In most cases, cognitive performance is thought to return to premorbid levels soon after injury, without further medical intervention. We tested this assumption in undergraduates, among whom a history of mTBI is prevalent. Notably, participants with a history of mTBI performed worse than their colleagues with no such history. Experiment 1 was based on a change detection paradigm in which we manipulated visual WM set size from one to three items, which revealed a significant deficit at set size 3. In Experiment 2 we investigated whether feedback could rescue WM performance in the mTBI group, and found that it failed. In Experiment 3 we manipulated WM maintenance duration (set size 3, 500-1,500 ms) to investigate a maintenance-related deficit. Across all durations, the mTBI group was impaired. In Experiment 4 we tested whether retrieval demands contributed to WM deficits and showed a consistent deficit across recognition and recall probes. In short, even years after an mTBI, undergraduates perform differently on visual WM tasks than their peers with no such history. Given the prevalence of mTBI, these data may benefit other researchers who see high variability in their data. Clearly, further studies will be needed to determine the breadth of the cognitive deficits in those with a history of mTBI and to identify relevant factors that contribute to positive cognitive outcomes.
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Goetzl EJ, Yaffe K, Peltz CB, Ledreux A, Gorgens K, Davidson B, Granholm AC, Mustapic M, Kapogiannis D, Tweedie D, Greig NH. Traumatic brain injury increases plasma astrocyte-derived exosome levels of neurotoxic complement proteins. FASEB J 2020; 34:3359-3366. [PMID: 31916313 PMCID: PMC7459190 DOI: 10.1096/fj.201902842r] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/26/2019] [Accepted: 12/26/2019] [Indexed: 01/16/2023]
Abstract
Possible involvement of complement (C) systems in the pathogenesis of traumatic brain injury (TBI) was investigated by quantifying Cproteins in plasma astrocyte-derived exosomes (ADEs) of subjects with sports-related TBI (sTBI) and TBI in military veterans (mtTBI) without cognitive impairment. All sTBI subjects (n = 24) had mild injuries, whereas eight of the mtTBI subjects had moderate, and 17 had mild injuries. Plasma levels of ADEs were decreased after acute sTBI and returned to normal within months. Cprotein levels in ADEs were from 12- to 35-fold higher than the corresponding levels in neuron-derived exosomes. CD81 exosome marker-normalized ADE levels of classical pathway C4b, alternative pathway factor D and Bb, lectin pathway mannose-binding lectin (MBL), and shared neurotoxic effectors C3b and C5b-9 terminal C complex were significantly higher and those of C regulatory proteins CR1 and CD59 were lower in the first week of acute sTBI (n = 12) than in controls (n = 12). Most C abnormalities were no longer detected in chronic sTBI at 3-12 months after acute sTBI, except for elevated levels of factor D, Bb, and MBL. In contrast, significant elevations of ADE levels of C4b, factor D, Bb, MBL, C3b and C5b-9 terminal C complex, and depressions of CR1 and CD59 relative to those of controls were observed after 1-4 years in early chronic mtTBI (n = 10) and persisted for decades except for normalization of Bb, MBL, and CD59 in late chronic mtTBI (n = 15). Complement inhibitors may be useful therapeutically in acute TBI and post-concussion syndrome.
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Affiliation(s)
- Edward J. Goetzl
- Department of Medicine, University of California Medical Center, San Francisco, CA, USA
| | - Kristine Yaffe
- Neurology-Psychiatry, University of California Medical Center, San Francisco, CA, USA
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, USA
| | - Carrie B. Peltz
- Department of Psychiatry, San Francisco VA Medical Center, San Francisco, CA, USA
- Northern California Institute for Research and Education, San Francisco, CA, USA
| | - Aurélie Ledreux
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
| | - Kim Gorgens
- Graduate School of Professional Psychology, University of Denver, Denver, CO, USA
| | - Bradley Davidson
- Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, USA
| | | | - Maja Mustapic
- Laboratory for Clinical Investigation, National Institute on Aging, Baltimore, MD, USA
| | - Dimitrios Kapogiannis
- Laboratory for Clinical Investigation, National Institute on Aging, Baltimore, MD, USA
| | - David Tweedie
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Nigel H. Greig
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
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Integrated Bioinformatics Analysis for the Identification of Key Molecules and Pathways in the Hippocampus of Rats After Traumatic Brain Injury. Neurochem Res 2020; 45:928-939. [PMID: 31997105 DOI: 10.1007/s11064-020-02973-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/02/2020] [Accepted: 01/22/2020] [Indexed: 12/29/2022]
Abstract
High-throughput and bioinformatics technology have been broadly applied to demonstrate the key molecules involved in traumatic brain injury (TBI), while no study has integrated the available TBI-related datasets for analysis. In this study, four available expression datasets of fluid percussion injury (FPI) and sham samples from the hippocampus of rats were analysed. A total of 248 differentially expressed genes (DEGs) and 10 differentially expressed microRNAs (DEMIs) were identified. Then, functional annotation was performed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Most of the DEGs were enriched for the term inflammatory immune response. The MCODE plug-in in the Cytoscape software was applied to build a protein-protein interaction (PPI) network, and 18 hub genes were demonstrated to be enriched in the cell cycle pathway. Besides, time sequence (3 h, 6 h, 12 h, 24 h, and 48 h) profile analysis was performed using short time-series expression miner (STEM). The significantly expressed genes were assigned into 24 pattern clusters with four significant uptrend clusters. Four DEGs, Fcgr2a, Bcl2a1, Cxcl16, and Gbp2, were found to be differentially expressed at all time-points. Fifty-three DEGs and eight DEMIs were identified to form a miRNA-mRNA negative regulatory network using miRWalk3.0 and Cytoscape. Moreover, the mRNA levels of eight hub genes were validated by qRT-PCR. These DEGs, DEMIs, and time-dependent expression patterns facilitate our knowledge of the molecular mechanisms underlying the process of TBI in the hippocampus of rats and have the potential to improve the diagnosis and treatment of TBI.
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Greig NH, Lecca D, Hsueh SC, Nogueras-Ortiz C, Kapogiannis D, Tweedie D, Glotfelty EJ, Becker RE, Chiang YH, Hoffer BJ. (-)-Phenserine tartrate (PhenT) as a treatment for traumatic brain injury. CNS Neurosci Ther 2019; 26:636-649. [PMID: 31828969 PMCID: PMC7248544 DOI: 10.1111/cns.13274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/14/2019] [Accepted: 11/16/2019] [Indexed: 12/21/2022] Open
Abstract
Aim Traumatic brain injury (TBI) is one of the most common causes of morbidity and mortality of both young adults and the elderly, and is a key contributing factor in about 30% of all injury‐associated deaths occurring within the United States of America. Albeit substantial impact has been made to improve our comprehension of the mechanisms that underpin the primary and secondary injury stages initiated by a TBI incident, this knowledge has yet to successfully translate into the development of an effective TBI pharmacological treatment. Developing consent suggests that a TBI can concomitantly trigger multiple TBI‐linked cascades that then progress in parallel and, if correct, the multifactorial nature of TBI would make the discovery of a single effective mechanism‐targeted drug unlikely. Discussion We review recent data indicating that the small molecular weight drug (−)‐phenserine tartrate (PhenT), originally developed for Alzheimer's disease (AD), effectively inhibits a broad range of mechanisms pertinent to mild (m) and moderate (mod)TBI, which in combination underpin the ensuing cognitive and motor impairments. In cellular and animal models at clinically translatable doses, PhenT mitigated mTBI‐ and modTBI‐induced programmed neuronal cell death (PNCD), oxidative stress, glutamate excitotoxicity, neuroinflammation, and effectively reversed injury‐induced gene pathways leading to chronic neurodegeneration. In addition to proving efficacious in well‐characterized animal TBI models, significantly mitigating cognitive and motor impairments, the drug also has demonstrated neuroprotective actions against ischemic stroke and the organophosphorus nerve agent and chemical weapon, soman. Conclusion In the light of its tolerability in AD clinical trials, PhenT is an agent that can be fast‐tracked for evaluation in not only civilian TBI, but also as a potentially protective agent in battlefield conditions where TBI and chemical weapon exposure are increasingly jointly occurring.
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Affiliation(s)
- Nigel H Greig
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Daniela Lecca
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Shih-Chang Hsueh
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.,The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Carlos Nogueras-Ortiz
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Dimitrios Kapogiannis
- Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - David Tweedie
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Elliot J Glotfelty
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.,Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Robert E Becker
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.,Aristea Translational Medicine Corporation, Park City, UT, USA
| | - Yung-Hsiao Chiang
- The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Center for Neurotrauma and Neuroregeneration, Taipei Medical University, Taipei, Taiwan.,Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Barry J Hoffer
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Goetzl EJ, Peltz CB, Mustapic M, Kapogiannis D, Yaffe K. Neuron-Derived Plasma Exosome Proteins after Remote Traumatic Brain Injury. J Neurotrauma 2019; 37:382-388. [PMID: 31441374 DOI: 10.1089/neu.2019.6711] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
To identify long-term effects of traumatic brain injury (TBI) on levels of plasma neuron-derived exosome (NDE) protein biomarkers of cognitive impairment (CI), plasmas were obtained from four groups of older veterans, who were matched for age and sex: no TBI or CI (n = 42), no TBI with CI (n = 19), TBI without CI (n = 21), and TBI with CI (n = 26). The TBI was sustained 12 to 74 years before the study in 75%. The NDEs were enriched by sequential precipitation and anti-L1CAM antibody immunoabsorption, and extracted protein biomarkers were quantified by enzyme-linked immunosorbent assays. Chronic NDE biomarkers known to increase for three to 12 months after TBI, including cellular prion protein (PrPc), synaptogyrin-3, P-T181-tau, P-S396-tau, Aβ42, and interleukin (IL)-6, were elevated significantly in subjects who had TBI and CI compared with controls with TBI but no CI. Chronic NDE biomarker levels in subjects without TBI showed significantly higher levels of PrPc, synaptogyrin-3, P-T181-tau, and Aβ42, but not P-S396-tau and IL-6, in those with CI compared with controls without CI. The acute NDE biomarkers claudin-5, annexin VII, and aquaporin-4 were not increased in either group with CI. The NDE biomarkers P-S396-tau and IL-6, which are increased distinctively with CI after TBI, may prove useful in evaluating CI in older patients. Aβ42 and P-tau species, as well as their respective putative receptors, PrPc and synaptogyrin-3, remain elevated for decades after TBI and may mediate TBI-associated CI and be useful targets for development of drugs.
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Affiliation(s)
- Edward J Goetzl
- Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Carrie B Peltz
- San Francisco VA Medical Center, San Francisco, California.,Northern California Institute for Research and Education, San Francisco, California
| | - Maja Mustapic
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | | | - Kristine Yaffe
- Department of Neurology-Psychiatry, University of California, San Francisco, San Francisco, California.,San Francisco VA Medical Center, San Francisco, California
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Winston CN, Romero HK, Ellisman M, Nauss S, Julovich DA, Conger T, Hall JR, Campana W, O’Bryant SE, Nievergelt CM, Baker DG, Risbrough VB, Rissman RA. Assessing Neuronal and Astrocyte Derived Exosomes From Individuals With Mild Traumatic Brain Injury for Markers of Neurodegeneration and Cytotoxic Activity. Front Neurosci 2019; 13:1005. [PMID: 31680797 PMCID: PMC6797846 DOI: 10.3389/fnins.2019.01005] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/04/2019] [Indexed: 12/14/2022] Open
Abstract
Mild traumatic brain injury (mTBI) disproportionately affects military service members and is very difficult to diagnose. To-date, there is currently no blood-based, diagnostic biomarker for mTBI cases with persistent post concussive symptoms. To examine the potential of neuronally-derived (NDE) and astrocytic-derived (ADE) exosome cargo proteins as biomarkers of chronic mTBI in younger adults, we examined plasma exosomes from a prospective longitudinal study of combat-related risk and resilience, marine resiliency study II (MRSII). After return from a combat-deployment participants were interviewed to assess TBI exposure while on deployment. Plasma exosomes from military service members with mTBI (mean age, 21.7 years, n = 19, avg. days since injury 151), and age-matched, controls (deployed service members who did not endorse a deployment-related TBI or a pre-deployment history of TBI; mean age, 21.95 years, n = 20) were precipitated and enriched against a neuronal adhesion protein, L1-CAM, and an astrocyte marker, glutamine aspartate transporter (GLAST) using magnetic beads to immunocapture the proteins and subsequently selected by fluorescent activated cell sorting (FACS). Extracted protein cargo from NDE and ADE preparations were quantified for protein levels implicated in TBI neuropathology by standard ELISAs and on the ultra-sensitive single molecule assay (Simoa) platform. Plasma NDE and ADE levels of Aβ42 were significantly higher while plasma NDE and ADE levels of the postsynaptic protein, neurogranin (NRGN) were significantly lower in participants endorsing mTBI exposure compared to controls with no TBI history. Plasma NDE and ADE levels of Aβ40, total tau, and neurofilament light (NFL), P-T181-tau, P-S396-tau were either undetectable or not significantly different between the two groups. In an effort to understand the pathogenetic potential of NDE and ADE cargo proteins, neuron-like cultures were treated with NDE and ADE preparations from TBI and non-TBI groups. Lastly, we determined that plasma NDE but not ADE cargo proteins from mTBI samples were found to be toxic to neuron-like recipient cells in vitro. These data support the presence of markers of neurodegeneration in NDEs of mTBI and suggest that these NDEs can be used as tools to identify pathogenic mechanisms of TBI.
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Affiliation(s)
- Charisse N. Winston
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Haylie K. Romero
- Department of Anesthesiology, University of California, San Diego, La Jolla, CA, United States
| | - Maya Ellisman
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Sophie Nauss
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - David A. Julovich
- Department of Pharmacology and Neuroscience, Institute for Translational Research, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Tori Conger
- Department of Pharmacology and Neuroscience, Institute for Translational Research, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - James R. Hall
- Department of Pharmacology and Neuroscience, Institute for Translational Research, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Wendy Campana
- Department of Anesthesiology, University of California, San Diego, La Jolla, CA, United States
- VA San Diego Healthcare System, La Jolla, CA, United States
| | - Sid E. O’Bryant
- Department of Pharmacology and Neuroscience, Institute for Translational Research, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Caroline M. Nievergelt
- Center of Excellence for Stress and Mental Health, La Jolla, CA, United States
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Dewleen G. Baker
- Center of Excellence for Stress and Mental Health, La Jolla, CA, United States
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Victoria B. Risbrough
- Center of Excellence for Stress and Mental Health, La Jolla, CA, United States
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Robert A. Rissman
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
- VA San Diego Healthcare System, La Jolla, CA, United States
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73
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Hamlett ED, LaRosa A, Mufson EJ, Fortea J, Ledreux A, Granholm AC. Exosome release and cargo in Down syndrome. Dev Neurobiol 2019; 79:639-655. [PMID: 31347291 DOI: 10.1002/dneu.22712] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/11/2022]
Abstract
Down syndrome (DS) is a multisystem disorder affecting 1 in 800 births worldwide. Advancing technology, medical treatment, and social intervention have dramatically increased life expectancy, yet there are many etiologies of this disorder that are in need of further research. The advent of the ability to capture extracellular vesicles (EVs) in blood from specific cell types allows for the investigation of novel intracellular processes. Exosomes are one type of EVs that have demonstrated great potential in uncovering new biomarkers of neurodegeneration and disease, and also that appear to be intricately involved in the transsynaptic spread of pathogenic factors underlying Alzheimer's disease and other neurological diseases. Exosomes are nanosized vesicles, generated in endosomal multivesicular bodies (MVBs) and secreted by most cells in the body. Since exosomes are important mediators of intercellular communication and genetic exchange, they have emerged as a major research focus and have revealed novel biological sequelae involved in conditions afflicting the DS population. This review summarizes current knowledge on exosome biology in individuals with DS, both early in life and in aging individuals. Collectively these studies have demonstrated that complex multicellular processes underlying DS etiologies may include abnormal formation and secretion of extracellular vesicles such as exosomes.
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Affiliation(s)
- Eric D Hamlett
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Angela LaRosa
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Elliott J Mufson
- Department of Neurobiology and Neurology, Barrow Neurological Institute, Phoenix, Arizona
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, CIBERNED, Universitat Autònoma de Barcelona, Barcelona, Spain.,Alzheimer's Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d'Investigació Biomèdica August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Aurélie Ledreux
- Department of Biological Sciences and the Knoebel Institute for Healthy Aging, University of Denver, Denver, Colorado
| | - Ann-Charlotte Granholm
- Department of Biological Sciences and the Knoebel Institute for Healthy Aging, University of Denver, Denver, Colorado
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74
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Goetzl EJ, Ledreux A, Granholm AC, Elahi FM, Goetzl L, Hiramoto J, Kapogiannis D. Neuron-Derived Exosome Proteins May Contribute to Progression From Repetitive Mild Traumatic Brain Injuries to Chronic Traumatic Encephalopathy. Front Neurosci 2019; 13:452. [PMID: 31133789 PMCID: PMC6517542 DOI: 10.3389/fnins.2019.00452] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/23/2019] [Indexed: 12/22/2022] Open
Abstract
The recent recognition that Alzheimer disease-like pathology may be found in chronic traumatic encephalopathy (CTE) even after acute mild traumatic brain injury (mTBI) has increased the urgency of elucidating mechanisms, identifying biomarkers predictive of high risk of development of CTE, and establishing biomarker profiles indicative of impactful effects of treatments. Of the many proteins that are loaded into neuron-derived exosomes (NDEs) from damaged neurons after acute TBI, the levels of prion cellular protein (PRPc), coagulation factor XIII (XIIIa), synaptogyrin-3, IL-6, and aquaporins remain elevated for months. Prolonged heightened expression of aquaporins and IL-6 may account for the persistent central nervous system edema and inflammation of CTE. PRPc, XIIIa and synaptogyrin-3 bind and concentrate neurotoxic forms of oligomeric amyloid β peptides or P-tau for delivery into neurons at or distant from the site of trauma. Our progression factor hypothesis of CTE asserts that physiological neuronal proteins, such as PRPc, XIIIa, synaptogyrin-3, IL-6 and aquaporins, that increase in concentration in neurons and NDEs for months after acute TBI, are etiological contributors to CTE by either direct actions or by recruiting neurotoxic forms of Aβ peptides or P-tau. Such progression factors also may be useful new targets for development of drugs to prevent CTE.
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Affiliation(s)
- Edward J Goetzl
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Aurélie Ledreux
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, United States
| | | | - Fanny M Elahi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Laura Goetzl
- Department of Obstetrics, Gynecology and Reproductive Sciences, Health Sciences Center at Houston, University of Texas, Houston, TX, United States
| | - Jade Hiramoto
- Division of Vascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Dimitrios Kapogiannis
- Laboratory of Neurosciences, Intramural Research Program, National Institute on Aging, Baltimore, MD, United States
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Fernandes N, Pulliam L. Inflammatory Mechanisms and Cascades Contributing to Neurocognitive Impairment in HIV/AIDS. Curr Top Behav Neurosci 2019; 50:77-103. [PMID: 31385260 DOI: 10.1007/7854_2019_100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Neurocognitive impairment caused by chronic human immunodeficiency virus (HIV) infection is a growing concern. In this chapter we discuss the inflammatory mechanisms underlying the pathology of asymptomatic and mild neurocognitive impairment in the context of antiretroviral therapy. We discuss the role of HIV, viral proteins, and virally infected cells on the development of neuroinflammation and the effect of viral proteins on the cells of the central nervous system.We examine how these collective factors result in an inflammatory context that triggers the development of neurocognitive impairment in HIV. We assess the contribution of antiretrovirals and drugs of abuse, including methamphetamine, cannabis, and opioids, to the neurotoxic and neuroinflammatory milieu that leads to the development of neurocognitive impairment in HIV-infected individuals. We also examined circulating biomarkers, NF-L, sCD163, and sCD14, pertinent to identifying changes in the CNS that could indicate real-time changes in patient physiology. Lastly, we discuss future studies, such as exosomes and the microbiome, which could play a role in the HIV-induced neuroinflammation that eventually manifests as cognitive impairment.
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Affiliation(s)
- Nicole Fernandes
- Department of Laboratory Medicine, San Francisco VA Health Care System, San Francisco, CA, USA.,University of California, San Francisco, San Francisco, CA, USA
| | - Lynn Pulliam
- Department of Laboratory Medicine, San Francisco VA Health Care System, San Francisco, CA, USA. .,University of California, San Francisco, San Francisco, CA, USA.
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