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Serafino A, Giovannini D, Rossi S, Cozzolino M. Targeting the Wnt/β-catenin pathway in neurodegenerative diseases: recent approaches and current challenges. Expert Opin Drug Discov 2020; 15:803-822. [PMID: 32281421 DOI: 10.1080/17460441.2020.1746266] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Wnt/β-catenin signaling is an evolutionarily conserved pathway having a crucial role in embryonic and adult life. Specifically, the Wnt/β-catenin axis is pivotal to the development and homeostasis of the nervous system, and its dysregulation has been associated with various neurological disorders, including neurodegenerative diseases. Therefore, this signaling pathway has been proposed as a potential therapeutic target against neurodegeneration. AREAS COVERED This review focuses on the role of Wnt/β-catenin pathway in the pathogenesis of neurodegenerative diseases, including Parkinson's, Alzheimer's Diseases and Amyotrophic Lateral Sclerosis. The evidence showing that defects in the signaling might be involved in the development of these diseases, and the pharmacological approaches tested so far, are discussed. The possibilities that this pathway offers in terms of new therapeutic opportunities are also considered. EXPERT OPINION The increasing interest paid to the role of Wnt/β-catenin pathway in the onset of neurodegenerative diseases demonstrates how targeting this signaling for therapeutic purposes could be a great opportunity for both neuroprotection and neurorepair. Without overlooking some licit concerns about drug safety and delivery to the brain, there is growing and more convincing evidence that restoring this signaling in neurodegenerative diseases may strongly increase the chance to develop disease-modifying treatments for these brain pathologies.
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Affiliation(s)
- Annalucia Serafino
- Institute of Translational Pharmacology, National Research Council (CNR) , Rome, Italy
| | - Daniela Giovannini
- Institute of Translational Pharmacology, National Research Council (CNR) , Rome, Italy
| | - Simona Rossi
- Institute of Translational Pharmacology, National Research Council (CNR) , Rome, Italy
| | - Mauro Cozzolino
- Institute of Translational Pharmacology, National Research Council (CNR) , Rome, Italy
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Li M, Reisman J, Morris-Eppolito B, Qian SX, Kazis LE, Wolozin B, Goldstein LE, Xia W. Beneficial association of angiotensin-converting enzyme inhibitors and statins on the occurrence of possible Alzheimer's disease after traumatic brain injury. ALZHEIMERS RESEARCH & THERAPY 2020; 12:33. [PMID: 32220235 PMCID: PMC7102441 DOI: 10.1186/s13195-020-00589-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/25/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Pathological analysis of brain tissue from animals and humans with a history of traumatic brain injury (TBI) suggests that TBI could be one of the risk factors facilitating onset of dementia with possible Alzheimer's disease (AD), but medications to prevent or delay AD onset are not yet available. METHODS This study explores four medication classes (angiotensin-converting enzyme inhibitors (ACEI), beta blockers, metformin, and statins) approved by the Food and Drug Administration (FDA) for other indications and evaluates their influence when used in combination on the risk of possible AD development for patients with a history of TBI. We identified patients with history of TBI from an existing Department of Veterans Affairs (VA) national database. Among 1,660,151 veterans who used VA services between the ages of 50 to 89 years old, we analyzed 733,920 patients, including 15,450 patients with a history of TBI and 718,470 non-TBI patients. The TBI patients were followed for up to 18.5 years, with an average of 7.7 ± 4.7 years, and onset of dementia with possible AD was recorded based on International Statistical Classification of Diseases (ICD) 9 or 10 codes. The effect of TBI on possible AD development was evaluated by multivariable logistic regression models adjusted by age, gender, race, and other comorbidities. The association of ACEI, beta blockers, metformin, statins, and combinations of these agents over time from the first occurrence of TBI to possible AD onset was assessed using Cox proportional hazard models adjusted for demographics and comorbidities. RESULTS Veterans with at least two TBI occurrences by claims data were 25% (odds ratio (OR) = 1.25, 95% confidence intervals (CI) (1.13, 1.37)) more likely to develop dementia with possible AD, compared to those with no record of TBI. In multivariable logistic regression models (propensity score weighted or adjusted), veterans taking a combination of ACEI and statins had reduced risk in developing possible AD after suffering TBI, and use of this medication class combination was associated with a longer period between TBI occurring and dementia with possible AD onset, compared to patients who took statins alone or did not take any of the four target drugs after TBI. CONCLUSIONS The combination of ACEI and statins significantly lowered the risk of development of dementia with possible AD in a national cohort of people with a history of TBI, thus supporting a clinical approach to lowering the risk of dementia with possible AD.
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Affiliation(s)
- Mingfei Li
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Hospital, Bedford, MA, USA.,Department of Mathematical Sciences, Bentley University, Waltham, MA, USA
| | - Joel Reisman
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Hospital, Bedford, MA, USA
| | - Benjamin Morris-Eppolito
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, 01730, USA
| | - Shirley X Qian
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Hospital, Bedford, MA, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Lewis E Kazis
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Hospital, Bedford, MA, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Benjamin Wolozin
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Lee E Goldstein
- Departments of Radiology, Psychiatry, Neurology, and Pathology, Boston University School of Medicine, Boston, MA, USA.,Departments of Biomedical, Electrical, and Computer Engineering, Boston University College of Engineering & Photonics Center, Boston, MA, USA.,Boston University Alzheimer's Disease Center, Boston, MA, USA
| | - Weiming Xia
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, 01730, USA. .,Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA.
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Barthold D, Joyce G, Diaz Brinton R, Wharton W, Kehoe PG, Zissimopoulos J. Association of combination statin and antihypertensive therapy with reduced Alzheimer's disease and related dementia risk. PLoS One 2020; 15:e0229541. [PMID: 32130251 PMCID: PMC7055882 DOI: 10.1371/journal.pone.0229541] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 02/08/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hyperlipidemia and hypertension are modifiable risk factors for Alzheimer's disease and related dementias (ADRD). Approximately 25% of adults over age 65 use both antihypertensives (AHTs) and statins for these conditions. While a growing body of evidence found statins and AHTs are independently associated with lower ADRD risk, no evidence exists on simultaneous use for different drug class combinations and ADRD risk. Our primary objective was to compare ADRD risk associated with concurrent use of different combinations of statins and antihypertensives. METHODS In a retrospective cohort study (2007-2014), we analyzed 694,672 Medicare beneficiaries in the United States (2,017,786 person-years) who concurrently used both statins and AHTs. Using logistic regression adjusting for age, socioeconomic status and comorbidities, we quantified incident ADRD diagnosis associated with concurrent use of different statin molecules (atorvastatin, pravastatin, rosuvastatin, and simvastatin) and AHT drug classes (two renin-angiotensin system (RAS)-acting AHTs, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin-II receptor blockers (ARBs), vs non-RAS-acting AHTs). FINDINGS Pravastatin or rosuvastatin combined with RAS-acting AHTs reduce risk of ADRD relative to any statin combined with non-RAS-acting AHTs: ACEI+pravastatin odds ratio (OR) = 0.942 (CI: 0.899-0.986, p = 0.011), ACEI+rosuvastatin OR = 0.841 (CI: 0.794-0.892, p<0.001), ARB+pravastatin OR = 0.794 (CI: 0.748-0.843, p<0.001), ARB+rosuvastatin OR = 0.818 (CI: 0.765-0.874, p<0.001). ARBs combined with atorvastatin and simvastatin are associated with smaller reductions in risk, and ACEI with no risk reduction, compared to when combined with pravastatin or rosuvastatin. Among Hispanics, no combination of statins and RAS-acting AHTs reduces risk relative to combinations of statins and non-RAS-acting AHTs. Among blacks using ACEI+rosuvastatin, ADRD odds were 33% lower compared to blacks using other statins combined with non-RAS-acting AHTs (OR = 0.672 (CI: 0.548-0.825, p<0.001)). CONCLUSION Among older Americans, use of pravastatin and rosuvastatin to treat hyperlipidemia is less common than use of simvastatin and atorvastatin, however, in combination with RAS-acting AHTs, particularly ARBs, they may be more effective at reducing risk of ADRD. The number of Americans with ADRD may be reduced with drug treatments for vascular health that also confer effects on ADRD.
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Affiliation(s)
- Douglas Barthold
- Department of Pharmacy, The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington, Seattle, WA, United States of America
- * E-mail:
| | - Geoffrey Joyce
- School of Pharmacy, Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States of America
| | - Roberta Diaz Brinton
- Center for Innovation in Brain Science, University of Arizona Health Sciences, Tuscon, AZ, United States of America
| | - Whitney Wharton
- School of Nursing, Emory University, Atlanta, GA, United States of America
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Patrick Gavin Kehoe
- Bristol Medical School, Translational Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Julie Zissimopoulos
- Price School of Public Policy, Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, United States of America
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Impact of Statin Use on Dementia Incidence in Elderly Men and Women with Ischemic Heart Disease. Biomedicines 2020; 8:biomedicines8020030. [PMID: 32050497 PMCID: PMC7168191 DOI: 10.3390/biomedicines8020030] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/26/2022] Open
Abstract
This study aimed to determine the association between statins and the prevention of dementia according to sex differences in elderly patients with ischemic heart disease (IHD). We performed a nationwide retrospective cohort study using the Korean Health Insurance Review and Assessment Service database (2007–2015). Among the 264,036 eligible patients aged ≥65 years with IHD, statin users were compared with non–users by propensity score matching at a 1:1 ratio (71,587 in each group). The primary outcome was dementia risk by estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Differential risks of dementia were assessed by sex in the subgroups of statin types, exposure duration, and patient age, implying that sex is an influential factor for the link between statin use and dementia incidence. Among seven commonly prescribed statins, rosuvastatin was associated with the greatest preventive effect on dementia incidence, with an adjusted HR of 0.82 (95% CI = 0.78–0.87). In a subgroup analysis organized by sex, the differential risk of dementia incidence was assessed in each statin group, implying that sex is an influential factor for the link between statin and dementia. This study suggests that appropriate statin use considering sex differences may have beneficial effects on the development of dementia.
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Kuzyk CL, Anderson CC, Roede JR. Simvastatin Induces Delayed Apoptosis Through Disruption of Glycolysis and Mitochondrial Impairment in Neuroblastoma Cells. Clin Transl Sci 2020; 13:563-572. [PMID: 31917509 PMCID: PMC7214657 DOI: 10.1111/cts.12740] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/25/2019] [Indexed: 12/11/2022] Open
Abstract
Simvastatin, a commonly used cholesterol-lowering drug, inhibits the mevalonate pathway involved in the synthesis of the mitochondrial electron carrier coenzyme Q10 (CoQ10), as well as other bioenergetics substrates. The purpose of this study was to investigate simvastatin exposure on mitochondrial respiration, metabolic fuel preferences, and glucose utilization. We hypothesized that simvastatin at a noncytotoxic dose will impair energy metabolism in human neuroblastoma cells. SK-N-AS cells were exposed at acute and chronic time points and evaluated in a Seahorse XF analyzer, revealing decreased mitochondrial and glycolytic parameters. Flow cytometry showed a significant induction of apoptosis in simvastatin-treated cells at 48 hours. Finally, multiple techniques were used to show that simvastatin-mediated impairment of bioenergetics is more complex than CoQ10 depletion or hampered glucose uptake. Therefore, the data reported here represent a biphasic hit to mitochondria followed by reduction in glucose and glutamine metabolism in neuroblastoma; adding mechanism to potential pleotropic effects of statins.
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Affiliation(s)
- Crystal L Kuzyk
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado, USA
| | - Colin C Anderson
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado, USA
| | - James R Roede
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado, USA
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Synergy between plasminogen activator inhibitor-1, α-synuclein, and neuroinflammation in Parkinson's disease. Med Hypotheses 2020; 138:109602. [PMID: 32035284 DOI: 10.1016/j.mehy.2020.109602] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 02/06/2023]
Abstract
Parkinson's disease (PD) is a progressive degenerative nervous system disorder and is the second most common neurodegenerative disorder in the elderly population. The disease originates from the loss of dopamine-producing neurons in the substantia nigra in the brain, resulting in unregulated activity of the basal ganglia. Αlpha-synuclein (α-syn) is a protein found to aggregate in the substantia nigra region of patients with PD, forming Lewy Body inclusions; its aggregation may contribute to neuronal cell death in PD. This work hypothesizes about the synergistic relationship between α-syn aggregation and neuroinflammation to up-regulate expression of the serine protease inhibitor (serpin) plasminogen activator inhibitor-1 (PAI-1). The protease, plasmin, has been shown to cleave extracellular α-syn (including its monomeric, oligomeric, and fibrillary forms), resulting in less aggregation and Lewy Body formation. The zymogen plasminogen is converted to its active serine protease form, plasmin, either by tissue plasminogen activator (tPA) or by urokinase plasminogen activator (uPA) bound to urokinase receptor (uPAR). Both tPA and uPA/uPAR are inhibited by PAI-1. Thus, when PAI-1 levels increase, less plasmin is generated, which would lead to reduced proteolysis of α-syn. Expression of PAI-1 is increased both in inflammatory environments and in the presence of extracellular α-syn aggregates. This scenario suggests a pathological amplification loop: increased extracellular α-syn aggregation activates an inflammatory response from microglia and astrocytes, increasing PAI-1 levels, and decreasing the generation of plasmin. With reduced plasmin, less α-syn can be cleaved, and aggregation continues, sustaining the pathological process. Understanding this putative pathogenic loop could provide insight into the means by which neurodegeneration progresses in PD, and it may offer possible novel therapeutic strategies.
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Srithumsuk W, Kabayama M, Gondo Y, Masui Y, Akagi Y, Klinpudtan N, Kiyoshige E, Godai K, Sugimoto K, Akasaka H, Takami Y, Takeya Y, Yamamoto K, Ikebe K, Ogawa M, Inagaki H, Ishizaki T, Arai Y, Rakugi H, Kamide K. The importance of stroke as a risk factor of cognitive decline in community dwelling older and oldest peoples: the SONIC study. BMC Geriatr 2020; 20:24. [PMID: 31969126 PMCID: PMC6977260 DOI: 10.1186/s12877-020-1423-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/10/2020] [Indexed: 12/31/2022] Open
Abstract
Background Cognitive impairment is a major health concern among older and oldest people. Moreover, stroke is a relevant contributor for cognitive decline and development of dementia. The study of cognitive decline focused on stroke as the important risk factor by recruiting older and oldest is still lagging behind. Therefore, the aim of this study was to investigate the importance of stroke as a risk factor of cognitive decline during 3 years in community dwelling older and oldest people. Methods This study was longitudinal study with a 3-year follow-up in Japan. The participants were 1333 community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, long-term care (LTC) service used, and residential area). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was decline of ≥2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up. Results The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up. Conclusions The cognitive decline after the 3-year follow-up was influenced by the history of stroke and advanced age, while greater MoCA-J score at the baseline was positively associated with subsequent 3 years cognitive decline. The protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.
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Affiliation(s)
- Werayuth Srithumsuk
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mai Kabayama
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yuya Akagi
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Nonglak Klinpudtan
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Eri Kiyoshige
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kayo Godai
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ken Sugimoto
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoichi Takami
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasushi Takeya
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Madoka Ogawa
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kei Kamide
- Department of Health Promotion System Sciences, Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan.
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Xuan K, Zhao T, Qu G, Liu H, Chen X, Sun Y. The efficacy of statins in the treatment of Alzheimer's disease: a meta-analysis of randomized controlled trial. Neurol Sci 2020; 41:1391-1404. [PMID: 31930449 DOI: 10.1007/s10072-020-04243-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a common type of dementia, which has caused heavy global economic and health burden, and the using of statins to treat AD has caused widely debated. The purpose of this meta-analysis is to explore the effect of statins in the treatment of Alzheimer's disease. METHODS Studies were retrieved by searching PubMed, Embase, Cochrane library, OvisdSP, Web of Science, Chinese Nation Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases before March 31, 2019. We extracted the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog), Neuropsychiatric Inventory (NPI), Activities of Daily Living (ADL) scale score, and other information. The pooled Weighted Mean Difference (WMD) and their 95% confidence intervals (95% CI) were calculated with random effect model or fixed random effect model. RESULTS A total of nine randomized controlled trials were included that contained 1489 patients; of them, 742 patients in the statins group, 747 patients in the control group. There were nine studies used the MMSE scale, five studies used the ADAS-Cog scale, four studies used the NPI scale, and six studies used the ADL scale. Meta-analysis of the nine studies that reported the MMSE scale scores indicated that there is no significant effect of statins as compared with control group (the pooled WMD = 1.09, 95% CI, - 0.00, 2.18, p = 0.05, I2 = 87.9%). Meta-analysis of the five studies that reported the ADAS-Cog scale scores also indicated that there is no significant effect of statins as compared with control group (the pooled WMD = - 0.16, 95% CI, - 2.67, 2.36, p = 0.90, I2 = 80.1%). Meta-analysis of the four studies that reported the NPI scale scores indicated that treatment with statins could slow the rise in the NPI scale scores (the pooled WMD = - 1.16, 95% CI, - 1.88, - 0.44, p = 0.002, I2 = 45.4%). Meta-analysis of the six studies that reported the ADL scale scores indicated that treatment with statins could improve patients' daily living ability (the pooled WMD = - 4.06, 95% CI, - 6.88, - 1.24, p = 0.005, I2 = 86.7%). Results of subgroup analysis indicated that the use of statins in the short term (≤ 12 months) associated with the change of the MMSE scale scores (the pooled WMD = 1.78, 95% CI, 0.53, 3.04, p = 0.005, I2 = 79.6%). Sensitivity analysis and publication bias test were both negative, and the results were relatively reliable and stable. CONCLUSION Statins used in AD patients had beneficial effects on the scores of MMSE scale in the short term (≤ 12 months), and statins could slow the deterioration of neuropsychiatric status and significantly improve activities of daily living ability in AD patients, but statins did not show an advantage in the change of the ADAS-Cog scale scores.
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Affiliation(s)
- Kun Xuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xin Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China. .,Center for Evidence-Based Practice, Anhui Medical University, Hefei, Anhui, China.
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McFarlane O, Kędziora-Kornatowska K. Cholesterol and Dementia: A Long and Complicated Relationship. Curr Aging Sci 2020; 13:42-51. [PMID: 31530269 PMCID: PMC7403650 DOI: 10.2174/1874609812666190917155400] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/09/2019] [Accepted: 08/16/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND There is a huge demand for efficient strategies for maintaining cognitive wellbeing with age, especially in the context of population aging. Dementia constitutes the main reason for disability and dependency in the elderly. Identification of potential risk and protective factors, as well as determinants of conversion from MCI to dementia, is therefore crucial. In case of Alzheimer's disease, the most prevalent dementia syndrome amongst the members of modern societies, neurodegenerative processes in the brain can begin many years before first clinical symptoms appear. First functional changes typically mean advanced neuron loss, therefore, the earliest possible diagnosis is critical for implementation of promising early pharmaceutical interventions. OBJECTIVE The study aimed to discuss the relationships between both circulating and brain cholesterol with cognition, and explore its potential role in early diagnosis of cognitive disorders. METHODS Literature review. RESULTS The causal role of high cholesterol levels in AD or MCI has not been confirmed. It has been postulated that plasma levels of 24(S)-OHC can potentially be used as an early biochemical marker of altered cholesterol homeostasis in the CNS. Some studies brought conflicting results, finding normal or lowered levels of 24(S)-OHC in dementia patients compared to controls. In spite of decades of research on the relationship between cholesterol and dementia, so far, no single trusted indicator of an early cognitive deterioration has been identified. CONCLUSION The current state of knowledge makes the use of cholesterol markers of cognitive decline in clinical practice impossible.
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Affiliation(s)
- Oliwia McFarlane
- Address correspondence to this author at the Department of Public Health, Faculty of Health Sciences, Nicolaus Copernicus University, Ludwik Rydygier Collegium Medicum in Bydgoszcz, P.O. Box: 85-830, Bydgoszcz, Poland; Tel/Fax: ++48-52-585-5408; E-mail:
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Kern DM, Cepeda MS, Lovestone S, Seabrook GR. Aiding the discovery of new treatments for dementia by uncovering unknown benefits of existing medications. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2019; 5:862-870. [PMID: 31872043 PMCID: PMC6909196 DOI: 10.1016/j.trci.2019.07.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction There is a significant need for disease-modifying therapies to treat and prevent dementia, including Alzheimer's disease. Availability of real-world observational information and new analytic techniques to analyze large volumes of data can provide a path to aid drug discovery. Methods Using a self-controlled study design, we examined the association between 2181 medications and incidence of dementia across four US insurance claims databases. Medications associated with ≥50% reduction in risk of dementia in ≥2 databases were examined. Results A total of 117,015,066 individuals were included in the analysis. Seventeen medications met our threshold criteria for a potential protective effect on dementia and fell into five classes: catecholamine modulators, anticonvulsants, antibiotics/antivirals, anticoagulants, and a miscellaneous group. Discussion The biological pathways of the medications identified in this analysis may be targets for further research and may aid in discovering novel therapeutic approaches to treat dementia. These data show association not causality.
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Affiliation(s)
- David M Kern
- Janssen Research & Development, Epidemiology, Titusville, NJ, USA
| | - M Soledad Cepeda
- Janssen Research & Development, Epidemiology, Titusville, NJ, USA
| | - Simon Lovestone
- Janssen Research & Development, Neuroscience, Beerse, Belgium
| | - Guy R Seabrook
- Johnson & Johnson, Scientific Innovation, South San Francisco, CA, USA
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Apostu D, Lucaciu O, Mester A, Oltean-Dan D, Baciut M, Baciut G, Bran S, Onisor F, Piciu A, Pasca RD, Maxim A, Benea H. Systemic drugs with impact on osteoarthritis. Drug Metab Rev 2019; 51:498-523. [DOI: 10.1080/03602532.2019.1687511] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Dragos Apostu
- Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ondine Lucaciu
- Department of Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Mester
- Department of Oral Rehabilitation, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel Oltean-Dan
- Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Baciut
- Department of Maxillofacial Surgery and Oral Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Baciut
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Oral Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Florin Onisor
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andra Piciu
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana D. Pasca
- Department of Biomolecular Physics, Faculty of Physics, Cluj-Napoca, Romania
- Department of Molecular and Biomolecular Physics, National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania
| | - Andrei Maxim
- Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Horea Benea
- Department of Orthopaedics and Traumatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Modifiable risk and protective factors in disease development, progression and clinical subtypes of Parkinson's disease: What do prospective studies suggest? Neurobiol Dis 2019; 134:104671. [PMID: 31706021 DOI: 10.1016/j.nbd.2019.104671] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/23/2019] [Accepted: 11/05/2019] [Indexed: 12/20/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder whose pathogenesis depends on a combination of genetic and environmental factors. The aim of the present review was to provide an updated description of the findings emerging from prospective longitudinal cohort studies on the possible risk/protective factors underlying the development, progression and clinical subtypes of PD. We reviewed all the environmental, lifestyle, dietary, comorbid and pharmacological factors that have been investigated as possible modifiable protective/risk factors for PD by longitudinal studies. Only a few factors have the epidemiological evidence and the biological plausibility to be considered risk (pesticides, dairy products, β2-adrenoreceptor antagonists) or protective (smoking, caffeine and tea intake, physical activity, gout, vitamin E intake, non-steroidal anti-inflammatory drugs and β2-adrenoreceptor agonists) factors for PD. Caffeine intake and physical activity also seem to slow down the progression of the disease, thus representing good candidates for primary prevention and disease modifying strategies in PD. Possible modifiable risk factors of PD subtypes is almost unknown and this might depend on the uncertain biological and neuropathological reliability of clinical subtypes. The results of the present review suggest that only eleven risk/protective factors may be associated with the risk of PD. It may be possible to target some of these factors for preventive interventions aimed at reducing the risk of developing and the rate of progression of PD.
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Dhakal S, Kushairi N, Phan CW, Adhikari B, Sabaratnam V, Macreadie I. Dietary Polyphenols: A Multifactorial Strategy to Target Alzheimer's Disease. Int J Mol Sci 2019; 20:E5090. [PMID: 31615073 PMCID: PMC6834216 DOI: 10.3390/ijms20205090] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/11/2019] [Accepted: 10/11/2019] [Indexed: 02/06/2023] Open
Abstract
Ageing is an inevitable fundamental process for people and is their greatest risk factor for neurodegenerative disease. The ageing processes bring changes in cells that can drive the organisms to experience loss of nutrient sensing, disrupted cellular functions, increased oxidative stress, loss of cellular homeostasis, genomic instability, accumulation of misfolded protein, impaired cellular defenses and telomere shortening. Perturbation of these vital cellular processes in neuronal cells can lead to life threatening neurological disorders like Alzheimer's Disease, Parkinson's Disease, Huntington's Disease, Lewy body dementia, etc. Alzheimer's Disease is the most frequent cause of deaths in the elderly population. Various therapeutic molecules have been designed to overcome the social, economic and health care burden caused by Alzheimer's Disease. Almost all the chemical compounds in clinical practice have been found to treat symptoms only limiting them to palliative care. The reason behind such imperfect drugs may result from the inefficiencies of the current drugs to target the cause of the disease. Here, we review the potential role of antioxidant polyphenolic compounds that could possibly be the most effective preventative strategy against Alzheimer's Disease.
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Affiliation(s)
- Sudip Dhakal
- School of Science, RMIT University, Bundoora, Victoria 3083, Australia.
| | - Naufal Kushairi
- Mushroom Research Centre, University of Malaya, 50603 Kuala Lumpur, Malaysia.
- Department of Anatomy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Chia Wei Phan
- Mushroom Research Centre, University of Malaya, 50603 Kuala Lumpur, Malaysia.
- Department of Pharmaceutical Life Sciences, Faculty of Pharmacy, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Benu Adhikari
- School of Science, RMIT University, Bundoora, Victoria 3083, Australia.
| | - Vikineswary Sabaratnam
- Mushroom Research Centre, University of Malaya, 50603 Kuala Lumpur, Malaysia.
- Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Ian Macreadie
- School of Science, RMIT University, Bundoora, Victoria 3083, Australia.
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Picard C, Poirier A, Bélanger S, Labonté A, Auld D, Poirier J. Proprotein convertase subtilisin/kexin type 9 (PCSK9) in Alzheimer's disease: A genetic and proteomic multi-cohort study. PLoS One 2019; 14:e0220254. [PMID: 31437157 PMCID: PMC6705826 DOI: 10.1371/journal.pone.0220254] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/11/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a hepatic enzyme that regulates circulating low-density lipoprotein (LDL) cholesterol levels by binding to LDL receptors (LDLR) and promoting their degradation. Although PCSK9 inhibitors were shown to reduce the risk of cardiovascular disease, a warning was issued concerning their possible impact on cognitive functions. In Alzheimer's disease (AD), it is believed that cognitive impairment is associated with cholesterol metabolism alterations, which could involve PCSK9. The main objective of this study is to determine if PCSK9 plays a significant role in the pre-symptomatic phase of the disease when the pathophysiological markers of AD unfolds and, later, when cognitive symptoms emerge. METHODS AND FINDINGS To test if PCSK9 is associated with AD pathology, we measured its expression levels in 65 autopsy confirmed AD brains and 45 age and gender matched controls. Messenger ribonucleic acid (mRNA) were quantified using real-time polymerase chain reaction (RT-PCR) and protein levels were quantified using enzyme-linked immunosorbent assay (ELISA). PCSK9 was elevated in frontal cortices of AD subjects compared to controls, both at the mRNA and protein levels. LDLR protein levels were unchanged in AD frontal cortices, despite and upregulation at the mRNA level. To verify if PCSK9 dysregulation was observable before the onset of AD, we measured its expression in the cerebrospinal fluid (CSF) of 104 "at-risk" subjects and contrasted it with known apolipoproteins levels and specific AD biomarkers using ELISAs. Positive correlations were found between CSF PCSK9 and apolipoprotein E (APOE), apolipoprotein J (APOJ or CLU), apolipoprotein B (APOB), phospho Tau (pTau) and total Tau. To investigate if PCSK9 levels were driven by genetic variants, we conducted an expression quantitative trait loci (eQTL) study using bioinformatic tools and found two polymorphisms in strong association. Further investigation of these variants in two independent cohorts showed a female specific association with AD risk and with CSF Tau levels in cognitively impaired individuals. CONCLUSIONS PCSK9 levels differ between control and AD brains and its protein levels correlate with those of other lipoproteins and AD biomarkers even before the onset of the disease. PCSK9 regulation seems to be under tight genetic control in females only, with specific variants that could predispose to increased AD risk.
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Affiliation(s)
- Cynthia Picard
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Centre for the Studies in the Prevention of Alzheimer’s Disease, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Alexandre Poirier
- Douglas Mental Health University Institute, Montréal, Québec, Canada
| | | | - Anne Labonté
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Centre for the Studies in the Prevention of Alzheimer’s Disease, Montréal, Québec, Canada
| | - Daniel Auld
- Génome Québec Innovation Centre, Montréal, Québec, Canada
| | - Judes Poirier
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Centre for the Studies in the Prevention of Alzheimer’s Disease, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - on behalf of the PREVENT-AD Research Group
- Douglas Mental Health University Institute, Montréal, Québec, Canada
- Centre for the Studies in the Prevention of Alzheimer’s Disease, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
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65
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Zissimopoulos JM, Tysinger BC, St Clair PA, Crimmins EM. The Impact of Changes in Population Health and Mortality on Future Prevalence of Alzheimer's Disease and Other Dementias in the United States. J Gerontol B Psychol Sci Soc Sci 2019; 73:S38-S47. [PMID: 29669100 DOI: 10.1093/geronb/gbx147] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Indexed: 12/14/2022] Open
Abstract
Objectives We assessed potential benefits for older Americans of reducing risk factors associated with dementia. Methods A dynamic simulation model tracked a national cohort of persons 51 and 52 years of age to project dementia onset and mortality in risk reduction scenarios for diabetes, hypertension, and dementia. Results We found reducing incidence of diabetes by 50% did not reduce number of years a person ages 51 or 52 lived with dementia and increased the population ages 65 and older in 2040 with dementia by about 115,000. Eliminating hypertension at middle and older ages increased life expectancy conditional on survival to age 65 by almost 1 year, however, it increased years living with dementia. Innovation in treatments that delay onset of dementia by 2 years increased longevity, reduced years with dementia, and decreased the population ages 65 and older in 2040 with dementia by 2.2 million. Conclusions Prevention of chronic disease may generate health and longevity benefits but does not reduce burden of dementia. A focus on treatments that provide even short delays in onset of dementia can have immediate impacts on longevity and quality of life and reduce the number of Americans with dementia over the next decades.
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Affiliation(s)
- Julie M Zissimopoulos
- Price School of Public Policy & Schaeffer Center, University of Southern California, Los Angeles
| | - Bryan C Tysinger
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles
| | - Patricia A St Clair
- Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles
| | - Eileen M Crimmins
- Davis School of Gerontology, University of Southern California, Los Angeles
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Meade RM, Fairlie DP, Mason JM. Alpha-synuclein structure and Parkinson's disease - lessons and emerging principles. Mol Neurodegener 2019; 14:29. [PMID: 31331359 PMCID: PMC6647174 DOI: 10.1186/s13024-019-0329-1] [Citation(s) in RCA: 234] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/01/2019] [Indexed: 12/22/2022] Open
Abstract
Alpha-synuclein (αS) is the major constituent of Lewy bodies and a pathogenic hallmark of all synucleinopathathies, including Parkinson's disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). All diseases are determined by αS aggregate deposition but can be separated into distinct pathological phenotypes and diagnostic criteria. Here we attempt to reinterpret the literature, particularly in terms of how αS structure may relate to pathology. We do so in the context of a rapidly evolving field, taking into account newly revealed structural information on both native and pathogenic forms of the αS protein, including recent solid state NMR and cryoEM fibril structures. We discuss how these new findings impact on current understanding of αS and PD, and where this information may direct the field.
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Affiliation(s)
- Richard M. Meade
- Department of Biology & Biochemistry, University of Bath, Claverton Down, Bath, BA2 7AY UK
| | - David P. Fairlie
- Division of Chemistry and Structural Biology, Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4072 Australia
| | - Jody M. Mason
- Department of Biology & Biochemistry, University of Bath, Claverton Down, Bath, BA2 7AY UK
- Division of Chemistry and Structural Biology, Australian Research Council Centre of Excellence in Advanced Molecular Imaging, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4072 Australia
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Simvastatin Efficiently Reduces Levels of Alzheimer's Amyloid Beta in Yeast. Int J Mol Sci 2019; 20:ijms20143531. [PMID: 31330953 PMCID: PMC6678968 DOI: 10.3390/ijms20143531] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/12/2019] [Accepted: 07/17/2019] [Indexed: 11/17/2022] Open
Abstract
A large-scale epidemiology study on statins previously showed that simvastatin was unique among statins in reducing the incidence of dementia. Since amyloid beta (Aβ42) is the protein that is most associated with Alzheimer's disease, this study has focused on how simvastatin influences the turnover of native Aβ42 and Aβ42 fused with green fluorescent protein (GFP), in the simplest eukaryotic model organism, Saccharomyces cerevisiae. Previous studies have established that yeast constitutively producing Aβ42 fused to GFP offer a convenient means of analyzing yeast cellular responses to Aβ42. Young cells clear the GFP fusion protein and do not have green fluorescence while the older population of cells retains the fusion protein and exhibits green fluorescence, offering a fast and convenient means of studying factors that affect Aβ42 turnover. In this study the proportion of cells having GFP fused to Aβ after exposure to simvastatin, atorvastatin and lovastatin was analyzed by flow cytometry. Simvastatin effectively reduced levels of the cellular Aβ42 protein in a dose-dependent manner. Simvastatin promoted the greatest reduction as compared to the other two statins. A comparison with fluconazole, which targets that same pathway of ergosterol synthesis, suggests that effects on ergosterol synthesis do not account for the reduced amounts of Aβ42 fused to GFP. The levels of native Aβ42 following treated with simvastatin were also examined using a more laborious approach, quantitative MALDI TOF mass spectrometry. Simvastatin efficiently reduced levels of native Aβ42 from the population. This work indicates a novel action of simvastatin in reducing levels of Aβ42 providing new insights into how simvastatin exerts its neuroprotective role. We hypothesize that this reduction may be due to protein clearance.
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68
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Larsson SC, Markus HS. Does Treating Vascular Risk Factors Prevent Dementia and Alzheimer's Disease? A Systematic Review and Meta-Analysis. J Alzheimers Dis 2019; 64:657-668. [PMID: 29914039 DOI: 10.3233/jad-180288] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Epidemiological evidence has associated Alzheimer's disease (AD) with vascular risk factors (VRFs), but whether treatment of VRFs reduces the incidence of dementia and AD is uncertain. OBJECTIVE To conduct a systematic review and meta-analysis to summarize available data on the impact of treatment of VRFs on dementia and AD incidence. METHODS Pertinent studies published until 1 January 2018 were identified from PubMed. Both randomized controlled trials (RCT) and prospective studies that investigated the impact of treatment of VRFs on dementia or AD incidence were included. RESULTS Eight RCTs and 52 prospective studies were identified. Antihypertensive treatment was associated with a non-significant reduced risk of dementia in RCTs (n = 5; relative risk [RR], 0.84; 95% confidence interval [CI], 0.69-1.02) and prospective studies (n = 3; RR, 0.77; 95% CI, 0.58-1.01) and with reduced AD risk in prospective studies (n = 5; RR = 0.78; 95% CI, 0.66-0.91). In prospective studies, treatment of hyperlipidemia with statins, but not nonstatin lipid-lowering agents, was associated with reduced risk of dementia (n = 17; RR, 0.77; 95% CI, 0.63-0.95) and AD (n = 13; RR, 0.86; 95% CI, 0.80-0.92). The single RCT on statins and dementia incidence showed no association. Data from one RCT and six prospective studies did not support a beneficial impact of antidiabetic drugs or insulin therapy on dementia risk. CONCLUSION Current evidence indicates that antihypertensives and statins might reduce the incidence of dementia and AD. Further trials to determine the effect of VRF on AD are needed.
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Affiliation(s)
- Susanna C Larsson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Stroke Research Group, Neurology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Hugh S Markus
- Stroke Research Group, Neurology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Petrov AM, Pikuleva IA. Cholesterol 24-Hydroxylation by CYP46A1: Benefits of Modulation for Brain Diseases. Neurotherapeutics 2019; 16:635-648. [PMID: 31001737 PMCID: PMC6694357 DOI: 10.1007/s13311-019-00731-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Cholesterol 24-hydroxylation is the major mechanism for cholesterol removal from the brain and the reaction catalyzed by cytochrome P450 46A1 (CYP46A1), a CNS-specific enzyme. This review describes CYP46A1 in the context of cholesterol homeostasis in the brain and summarizes available experimental data on CYP46A1 association with different neurologic diseases, including the mechanisms by which changes in the CYP46A1 activity in the brain could be beneficial for these diseases. The modulation of CYP46A1 activity by genetic and pharmacologic means is also presented along with a brief synopsis of the two clinical trials that evaluate CYP46A1 as a therapeutic target for Alzheimer's disease as well as Dravet and Lennox-Gastaut syndromes.
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Affiliation(s)
- Alexey M Petrov
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, 2085 Adelbert Rd., Room 303, Cleveland, OH, 44106, USA
| | - Irina A Pikuleva
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, 2085 Adelbert Rd., Room 303, Cleveland, OH, 44106, USA.
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Zou T, Duan Y, Zhou X, Chen W, Ying X, Liu G, Zhao Y, Zhu M, Pari A, Alimu K, Miao H, Kabinur K, Zhang L, Wang Q, Duan S. Significant association of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) rs3846662 and sirtuin 1 (SIRT1) rs7895833 and apolipoprotein E (APOE) hypermethylation with mild cognitive impairment (MCI). Medicine (Baltimore) 2019; 98:e16405. [PMID: 31305452 PMCID: PMC6641831 DOI: 10.1097/md.0000000000016405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Our study investigated the association of five genes with MCI in the Xinjiang Uygur population in China. In addition, we also analyzed the association between APOE methylation and MCI.Forty-three MCI and 125 controls were included in the present study. Genotyping was done by Sanger sequencing. DNA methylation assay was done using quantitative methylation-specific polymerase chain reaction (qMSP).The distribution of HMGCR rs3846662 allele frequencies was significantly different between the MCI group and the control group (P = .04), especially in women (P = .032). Subgroup analysis showed that there was a statistically significant association of HMGCR rs3846662 with MCI in the non-APOE ε4 group (P = .024), especially in the females with non-APOE ε4. Similarly, HMGCR rs3846662 genotype and allele frequency in the ApoE E2 protein group were significantly different in the MCI group and the control group (genotype P = .021; allele P = .007). In addition, SIRT1 rs7895833 genotype frequency in the APOE ε4 group was found to be significantly different between the MCI and the control group (P = .005). We also observed a significant association of SIRT1 rs7895833 with MCI in the ApoE E4 protein subgroup (P = .005). In addition, APOE methylation levels were significantly different between the MCI group and the control group (P = .021), especially in men (P = .006). Subgroup analysis showed that APOE methylation levels were significantly associated with MCI in the non-APOE ε4 group (P = .009), especially in men (P = .015).This study found a significant association of HMGCR rs3846662 with MCI in females independent of APOE ε4. In contrast, we revealed that the association of SIRT1 rs7895833 with MCI was dependent on with APOE ε4. We also showed that hypermethylation of APOE in MCI was independent of APOE ε4.
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Affiliation(s)
- Ting Zou
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Yali Duan
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Xiaohui Zhou
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Wei Chen
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Xiuru Ying
- Ningbo Key Lab of Behavior Neuroscience, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang Province, China
| | - Guili Liu
- Ningbo Key Lab of Behavior Neuroscience, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang Province, China
| | - Yongjie Zhao
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Meisheng Zhu
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Abuliz Pari
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Kader Alimu
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Haijun Miao
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Keyim Kabinur
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Lei Zhang
- Department of Geriatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Province
| | - Qinwen Wang
- Ningbo Key Lab of Behavior Neuroscience, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang Province, China
| | - Shiwei Duan
- Ningbo Key Lab of Behavior Neuroscience, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang Province, China
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Litvinenko IV, Krasakov IV, Bisaga GN, Skulyabin DI, Poltavsky ID. [Modern conception of the pathogenesis of neurodegenerative diseases and therapeutic strategy]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 117:3-10. [PMID: 28980606 DOI: 10.17116/jnevro2017117623-10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Here we discuss the pathogenesis of the inflammatory and degenerative nervous system disorders on the example of Parkinson's disease, Alzheimer's disease, multiple sclerosis. Common mechanisms of neurodegeneration in these diseases are reviewed. The role of neurodegeneration as the main process leading to the resistant disability of patients with multiple sclerosis is discussed. The authors consider a contribution of inflammatory process and chronic infection to the manifestation and progressing of a neurodegenerative disease and discuss the use of treatment not usually indicated including interferon, anti-inflammatory drugs, statin, vitamin D, monoclonal antibodies, correction of the intestinal microbiota in Parkinson's disease and Alzheimer's disease.
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Affiliation(s)
| | - I V Krasakov
- Kirov Military Medical Academy, St. Petersburg, Russia
| | - G N Bisaga
- Kirov Military Medical Academy, St. Petersburg, Russia
| | - D I Skulyabin
- Kirov Military Medical Academy, St. Petersburg, Russia
| | - I D Poltavsky
- Kirov Military Medical Academy, St. Petersburg, Russia
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Garrud TAC, Giussani DA. Combined Antioxidant and Glucocorticoid Therapy for Safer Treatment of Preterm Birth. Trends Endocrinol Metab 2019; 30:258-269. [PMID: 30850263 DOI: 10.1016/j.tem.2019.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 12/31/2022]
Abstract
Ante- and postnatal glucocorticoid therapy reduces morbidity and mortality in the preterm infant, and it is therefore one of the best examples of the successful translation of basic experimental science into human clinical practice. However, accruing evidence derived from human clinical studies and from experimental studies in animal models raise serious concerns about potential long-term adverse effects of treatment on growth and neurological and cardiovascular function in the offspring. This review explores whether combined antioxidant and glucocorticoid therapy may be safer than glucocorticoid therapy alone for the treatment of preterm birth.
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Affiliation(s)
- Tessa A C Garrud
- Department of Physiology Development & Neuroscience, University of Cambridge, Cambridge, UK; Cambridge Cardiovascular Strategic Research Initiative, University of Cambridge, Cambridge, UK; Cambridge Strategic Research Initiative on Reproduction, University of Cambridge, Cambridge, UK
| | - Dino A Giussani
- Department of Physiology Development & Neuroscience, University of Cambridge, Cambridge, UK; Cambridge Cardiovascular Strategic Research Initiative, University of Cambridge, Cambridge, UK; Cambridge Strategic Research Initiative on Reproduction, University of Cambridge, Cambridge, UK.
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73
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Yan J, Qiao L, Tian J, Liu A, Wu J, Huang J, Shen M, Lai X. Effect of statins on Parkinson's disease: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e14852. [PMID: 30896628 PMCID: PMC6709163 DOI: 10.1097/md.0000000000014852] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Statins have key lipid-lowering, anti-inflammatory, and anti-oxidative effects. However, it remains unclear whether statins are beneficial to patients with Parkinson's disease (PD). This study aimed to evaluate the relationship between statins and PD through a systematic review. METHODS This study adhered to the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Potentially relevant case-control or cohort studies published before March 2018 were identified by searching the MEDLINE (PubMed), EMBASE (OVID), CENTRAL (Cochrane Library), CNKI, WANGANG, VIP, CBM, CMCC, Clinicaltrials.gov, ProQuest, Opengray, and ISI Proceedings databases and conducting a manual search. Summarized relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a fixed effect model. Sensitivity and subgroup analyses were also performed. RESULTS The meta-analysis included 17 studies (3,845,303 patients; 8 case-control and 9 cohort studies), including 5 articles not cited by other studies. We searched the Chinese database, but unfortunately, no Chinese literature can be included in the study. Briefly, statins could decrease the risk of PD, with a summary OR of 0.92 (95% CI: 0.86-0.99). A sensitivity analysis demonstrated the robustness of the results. Subgroup analyses revealed heterogeneity across the studies in terms of subject race, study type, reporting style, quality, statins type, and time for taking statins. CONCLUSION Our study provides evidence that statins, especially atorvastatin, can reduce the risk of PD. Different time of statins using has different effects on PD. However, additional randomized controlled trials and observational studies are needed to confirm this conclusion. REGISTRATION ID PROSPERO CRD: 42018095580.
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Affiliation(s)
- Junqiang Yan
- Laboratory of Molecular Neurobiology
- Department of Neurology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, PR China
| | - Liang Qiao
- Department of Neurology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, PR China
| | - Jing Tian
- Department of Neurology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, PR China
| | - Anran Liu
- Department of Neurology, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, PR China
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Huang X, Sterling NW, Du G, Sun D, Stetter C, Kong L, Zhu Y, Neighbors J, Lewis MM, Chen H, Hohl RJ, Mailman RB. Brain cholesterol metabolism and Parkinson's disease. Mov Disord 2019; 34:386-395. [PMID: 30681742 PMCID: PMC6420391 DOI: 10.1002/mds.27609] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/12/2018] [Accepted: 12/06/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Circulating cholesterol levels have been linked to PD, but not directly to brain physiology. OBJECTIVE To assess whether brain cholesterol metabolism is related to PD. METHODS Sixty PD patients and 64 controls were recruited from an academic movement disorder clinic (2009-2012). Thirty-five PD patients and 33 controls returned approximately 36 months later. Fasting plasma (S)24-OH-cholesterol (brain-derived cholesterol metabolite) and 27-OH-cholesterol (peripheral cholesterol metabolite) were quantified. Odds ratios for PD were derived from logistic regression models, adjusting for potential confounders. Relationships between the oxysterols and clinical measurements were explored using Spearman correlation coefficients. RESULTS Mean age of PD subjects was 63.8 ± 8.3 years and disease duration was 5.0 ± 5.4 years. Plasma (S)24-OH-cholesterol levels were inversely associated with the odds of having PD, with an odds ratio of 0.92 (95% confidence interval: 0.87-0.97) for each 1-ng/mL increase (P = 0.004). Compared to the lowest tertile, the odds ratio was 0.34 (0.12-0.98) for the second tertile (P = 0.045) and 0.08 (0.02-0.31) for the highest tertile (P < 0.001). Higher (S)24-OH-cholesterol levels also were correlated with better sense of smell (r = 0.35; P = 0.01). No significant associations were found between clinical measures and 27-OH-cholesterol, a peripheral cholesterol metabolite. Furthermore, (S)24-OH-cholesterol levels were stable over time, whereas 27-OH-cholesterol decreased with time in both cases and controls. CONCLUSIONS Results indicate that plasma (S)24-OH-cholesterol (possibly reflecting brain cholesterol metabolism) is inversely linked to PD, is relatively stable over time, and may serve as a new biomarker for PD. Further investigation is necessary to determine the mechanistic and clinical implications. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Xuemei Huang
- Departments of Neurology, Pennsylvania State University, Hershey PA 17033 USA
- Neurosurgery, Pennsylvania State University, Hershey PA 17033 USA
- Radiology, Pennsylvania State University, Hershey PA 17033 USA
- Pharmacology, Pennsylvania State University, Hershey PA 17033 USA
- Kinesiology, Pennsylvania State University, Hershey PA 17033 USA
| | | | - Guangwei Du
- Departments of Neurology, Pennsylvania State University, Hershey PA 17033 USA
| | - Dongxiao Sun
- Pharmacology, Pennsylvania State University, Hershey PA 17033 USA
- Mass Spectrometry Core Facility, Pennsylvania State University, Hershey PA 17033 USA
| | - Christina Stetter
- Public Health Sciences, Pennsylvania State University, Hershey PA 17033 USA
| | - Lan Kong
- Public Health Sciences, Pennsylvania State University, Hershey PA 17033 USA
| | - Yusheng Zhu
- Pathology and Laboratory Medicine, Pennsylvania State University, Hershey PA 17033 USA
| | - Jeffery Neighbors
- Pharmacology, Pennsylvania State University, Hershey PA 17033 USA
- Penn State Cancer Institute, Pennsylvania State University, Hershey PA 17033 USA
| | - Mechelle M. Lewis
- Departments of Neurology, Pennsylvania State University, Hershey PA 17033 USA
- Pharmacology, Pennsylvania State University, Hershey PA 17033 USA
| | - Honglei Chen
- Department of Epidemiology, Michigan State University, East Lansing MI 48824
| | - Raymond J. Hohl
- Pharmacology, Pennsylvania State University, Hershey PA 17033 USA
- Penn State Cancer Institute, Pennsylvania State University, Hershey PA 17033 USA
- Medicine, Pennsylvania State University, Hershey PA 17033 USA
| | - Richard B. Mailman
- Departments of Neurology, Pennsylvania State University, Hershey PA 17033 USA
- Pharmacology, Pennsylvania State University, Hershey PA 17033 USA
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Tang Y, Yang K, Zhao J, Liang X, Wang J. Evidence of Repurposing Drugs and Identifying Contraindications from Real World Study in Parkinson's Disease. ACS Chem Neurosci 2019; 10:954-963. [PMID: 30702853 DOI: 10.1021/acschemneuro.8b00456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
There is great unmet need in discovering novel treatment for Parkinson's disease (PD) and identifying the new agents potentially causing drug-induced parkinsonism. New indications and contraindications of drugs are typically approved following rigorous randomized controlled trial (RCT) evaluation. However, RCTs have their inherent limitations, since they are usually conducted in ideal conditions, with high cost and limited follow-up periods. In the past decade, large cohort studies with long follow-up outcome data was derived from a PD database in a real-world setting. Studies based on real world data (RWD) can help to augment and extrapolate data obtained in RCTs and provide information about the safety and effectiveness of a medication in heterogeneous, large populations. In the present review, we focus on the published real world studies designed to develop new treatment strategies for repurposing drugs and identifying contraindications for PD. We also outline the challenges and limitations in these studies. Subsequently we introduce PaWei app platform, which hopefully can facilitate PD management and address real-world problems associated with PD. Better understanding of RWD collection and analysis is needed if RWD is to achieve its full potential.
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Affiliation(s)
- Yilin Tang
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ke Yang
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jue Zhao
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xiaoniu Liang
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Jian Wang
- Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
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76
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Jo DS, Cho DH. Peroxisomal dysfunction in neurodegenerative diseases. Arch Pharm Res 2019; 42:393-406. [PMID: 30739266 DOI: 10.1007/s12272-019-01131-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/03/2019] [Indexed: 01/06/2023]
Abstract
Peroxisomes and their (patho-)physiological importance in heath and disease have attracted increasing interest during last few decades. Together with mitochondria, peroxisomes comprise key metabolic platforms for oxidation of various fatty acids and redox regulation. In addition, peroxisomes contribute to bile acid, cholesterol, and plasmalogen biosynthesis. The importance of functional peroxisomes for cellular metabolism is demonstrated by the marked brain and systemic organ abnormalities occuring in peroxisome biogenesis disorders and peroxisomal enzyme deficiencies. Current evidences indicate that peroxisomal function is declined with aging, with peroxisomal dysfunction being linked to early onset of multiple age-related diseases including neurodegenerative diseases. Herein, we review recent progress toward understanding the physiological roles and pathological implications of peroxisomal dysfunctions, focusing on neurodegenerative disease.
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Affiliation(s)
- Doo Sin Jo
- School of Life Sciences, Kyungpook National University, 80 Daehakro Bukgu, Daegu, 41566, Republic of Korea
| | - Dong-Hyung Cho
- School of Life Sciences, Kyungpook National University, 80 Daehakro Bukgu, Daegu, 41566, Republic of Korea.
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Novel Approaches for the Treatment of Alzheimer's and Parkinson's Disease. Int J Mol Sci 2019; 20:ijms20030719. [PMID: 30743990 PMCID: PMC6386829 DOI: 10.3390/ijms20030719] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/18/2019] [Accepted: 02/03/2019] [Indexed: 12/19/2022] Open
Abstract
Neurodegenerative disorders affect around one billion people worldwide. They can arise from a combination of genomic, epigenomic, metabolic, and environmental factors. Aging is the leading risk factor for most chronic illnesses of old age, including Alzheimer’s and Parkinson’s diseases. A progressive neurodegenerative process and neuroinflammation occur, and no current therapies can prevent, slow, or halt disease progression. To date, no novel disease-modifying therapies have been shown to provide significant benefit for patients who suffer from these devastating disorders. Therefore, early diagnosis and the discovery of new targets and novel therapies are of upmost importance. Neurodegenerative diseases, like in other age-related disorders, the progression of pathology begins many years before the onset of symptoms. Many efforts in this field have led to the conclusion that exits some similar events among these diseases that can explain why the aging brain is so vulnerable to suffer neurodegenerative diseases. This article reviews the current knowledge about these diseases by summarizing the most common features of major neurodegenerative disorders, their causes and consequences, and the proposed novel therapeutic approaches.
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78
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Abstract
Parkinson’s disease (PD) is a neurodegenerative disease characterized by a progressive loss of dopaminergic neurons from the nigrostriatal pathway, formation of Lewy bodies, and microgliosis. During the past decades multiple cellular pathways have been associated with PD pathology (i.e., oxidative stress, endosomal-lysosomal dysfunction, endoplasmic reticulum stress, and immune response), yet disease-modifying treatments are not available. We have recently used genetic data from familial and sporadic cases in an unbiased approach to build a molecular landscape for PD, revealing lipids as central players in this disease. Here we extensively review the current knowledge concerning the involvement of various subclasses of fatty acyls, glycerolipids, glycerophospholipids, sphingolipids, sterols, and lipoproteins in PD pathogenesis. Our review corroborates a central role for most lipid classes, but the available information is fragmented, not always reproducible, and sometimes differs by sex, age or PD etiology of the patients. This hinders drawing firm conclusions about causal or associative effects of dietary lipids or defects in specific steps of lipid metabolism in PD. Future technological advances in lipidomics and additional systematic studies on lipid species from PD patient material may improve this situation and lead to a better appreciation of the significance of lipids for this devastating disease.
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79
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Fracassi A, Marangoni M, Rosso P, Pallottini V, Fioramonti M, Siteni S, Segatto M. Statins and the Brain: More than Lipid Lowering Agents? Curr Neuropharmacol 2019; 17:59-83. [PMID: 28676012 PMCID: PMC6341496 DOI: 10.2174/1570159x15666170703101816] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 05/24/2017] [Accepted: 06/26/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Statins represent a class of medications widely prescribed to efficiently treat dyslipidemia. These drugs inhibit 3-βhydroxy 3β-methylglutaryl Coenzyme A reductase (HMGR), the rate-limiting enzyme of mevalonate (MVA) pathway. Besides cholesterol, MVA pathway leads to the production of several other compounds, which are essential in the regulation of a plethora of biological activities, including in the central nervous system. For these reasons, statins are able to induce pleiotropic actions, and acquire increased interest as potential and novel modulators in brain processes, especially during pathological conditions. OBJECTIVE The purpose of this review is to summarize and examine the current knowledge about pharmacokinetic and pharmacodynamic properties of statins in the brain. In addition, effects of statin on brain diseases are discussed providing the most up-to-date information. METHODS Relevant scientific information was identified from PubMed database using the following keywords: statins and brain, central nervous system, neurological diseases, neurodegeneration, brain tumors, mood, stroke. RESULTS 315 scientific articles were selected and analyzed for the writing of this review article. Several papers highlighted that statin treatment is effective in preventing or ameliorating the symptomatology of a number of brain pathologies. However, other studies failed to demonstrate a neuroprotective effect. CONCLUSION Even though considerable research studies suggest pivotal functional outcomes induced by statin therapy, additional investigation is required to better determine the pharmacological effectiveness of statins in the brain, and support their clinical use in the management of different neuropathologies.
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Affiliation(s)
| | | | | | | | | | | | - Marco Segatto
- Address correspondence to this author at the Department of Sense Organs, Sapienza University, viale del Policlinico 155, 00186 Rome, Italy; E-mail:
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80
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Albeely AM, Ryan SD, Perreault ML. Pathogenic Feed-Forward Mechanisms in Alzheimer's and Parkinson's Disease Converge on GSK-3. Brain Plast 2018; 4:151-167. [PMID: 30598867 PMCID: PMC6311352 DOI: 10.3233/bpl-180078] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 12/23/2022] Open
Abstract
Alzheimer's disease (AD) and Parkinson's disease (PD) share many commonalities ranging from signaling deficits such as altered cholinergic activity, neurotrophin and insulin signaling to cell stress cascades that result in proteinopathy, mitochondrial dysfunction and neuronal cell death. These pathological processes are not unidirectional, but are intertwined, resulting in a series of feed-forward loops that worsen symptoms and advance disease progression. At the center of these loops is glycogen synthase kinase-3 (GSK-3), a keystone protein involved in many of the multidirectional biological processes that contribute to AD and PD neuropathology. Here, a unified overview of the involvement of GSK-3 in the major processes involved in these diseases will be presented. The mechanisms by which these processes are linked will be discussed and the feed-forward pathways identified. In this regard, this review will put forth the notion that combination therapy, targeting these multiple facets of AD or PD neuropathology is a necessary next step in the search for effective therapies.
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Affiliation(s)
- Abdalla M. Albeely
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Scott D. Ryan
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Melissa L. Perreault
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
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Petek B, Villa-Lopez M, Loera-Valencia R, Gerenu G, Winblad B, Kramberger MG, Ismail MAM, Eriksdotter M, Garcia-Ptacek S. Connecting the brain cholesterol and renin-angiotensin systems: potential role of statins and RAS-modifying medications in dementia. J Intern Med 2018; 284:620-642. [PMID: 30264910 DOI: 10.1111/joim.12838] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Millions of people worldwide receive agents targeting the renin-angiotensin system (RAS) to treat hypertension or statins to lower cholesterol. The RAS and cholesterol metabolic pathways in the brain are autonomous from their systemic counterparts and are interrelated through the cholesterol metabolite 27-hydroxycholesterol (27-OHC). These systems contribute to memory and dementia pathogenesis through interference in the amyloid-beta cascade, vascular mechanisms, glucose metabolism, apoptosis, neuroinflammation and oxidative stress. Previous studies examining the relationship between these treatments and cognition and dementia risk have produced inconsistent results. Defining the blood-brain barrier penetration of these medications has been challenging, and the mechanisms of action on cognition are not clearly established. Potential biases are apparent in epidemiological and clinical studies, such as reverse epidemiology, indication bias, problems defining medication exposure, uncertain and changing doses, and inappropriate grouping of outcomes and medications. This review summarizes current knowledge of the brain cholesterol and RAS metabolism and the mechanisms by which these pathways affect neurodegeneration. The putative mechanisms of action of statins and medications inhibiting the RAS will be examined, together with prior clinical and animal studies on their effects on cognition. We review prior epidemiological studies, analysing their strengths and biases, and identify areas for future research. Understanding the pathophysiology of the brain cholesterol system and RAS and their links to neurodegeneration has enormous potential. In future, well-designed epidemiological studies could identify potential treatments for Alzheimer's disease (AD) amongst medications that are already in use for other indications.
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Affiliation(s)
- B Petek
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, University Medical Centre, Ljubljana, Slovenia.,University of Ljubljana, Ljubljana, Slovenia
| | - M Villa-Lopez
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - R Loera-Valencia
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - G Gerenu
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurosciences, Biodonostia Health Research Institute, San Sebastian, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases, CIBERNED, Health Institute Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain
| | - B Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - M G Kramberger
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, University Medical Centre, Ljubljana, Slovenia.,University of Ljubljana, Ljubljana, Slovenia
| | - M-A-M Ismail
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Theme Neuro, Diseases of the Nervous System patient flow, Karolinska University Hospital, Huddinge, Sweden
| | - M Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - S Garcia-Ptacek
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Internal Medicine, Neurology Section, Södersjukhuset, Stockholm, Sweden
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Zhu XC, Dai WZ, Ma T. Overview the effect of statin therapy on dementia risk, cognitive changes and its pathologic change: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:435. [PMID: 30596065 DOI: 10.21037/atm.2018.06.43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Many studies have reported on the role of statin therapy in dementia, but its efficacy remains controversial. We aimed to search for reliable and meaningful articles to assess the efficacy of statin therapy for dementia risk, cognitive items, and pathologic markers. Methods Related literature for this study was published in the period from January 1, 1987 to January 1, 2018. Odds ratio (OR) and 95% confidence interval (95% CI) estimates were pooled in either fixed or random effects models. Results A total of 23 relevant studies were included after the application of the search strategy. The pooled results showed that statin therapy would downregulate dementia risk according to an analysis of 1,314,431 dementia patients and 1,836,539 healthy controls (OR: 0.64, 95% CI: 0.50, 0.81). In addition, specific changes in mini-mental state examination (MMSE) score were observed in individuals with dementia with statin therapy (OR: 0.46, 95% CI: 0.17, 0.74). However, the results of this meta-analysis showed that statin therapy did not significantly modify the Alzheimer's Disease Assessment Scale (ADAS-cog) score (OR: -0.26, 95% CI: -1.13, 0.62). No significant association was found between statin therapy and activities of daily living performance (OR: -0.69, 95% CI: -4.12, 2.74). When investigating pathological markers, our results indicated a significant influence of statin therapy on plasma amyloid β40 (Aβ40) (OR: 9.27, 95% CI: 0.71, 17.84), plasma Aβ42 (OR: 2.60, 95% CI: 1.07, 4.13), plasma low-density lipoprotein (LDL) cholesterol (OR: -16.95, 95% CI: -25.54, -8.37), plasma lathosterol (OR: -0.11, 95% CI: -0.14, -0.07), plasma 24s-hydroxycholesterol (OR: -10.41, 95% CI: -15.57, -5.25), and cerebrospinal fluid (CSF) lathosterol (OR: -0.07, 95% CI: -0.12, -0.01). Conclusions The available data indicate that statin therapy may reduce dementia risk, altering cognitive items and pathologic markers.
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Affiliation(s)
- Xi-Chen Zhu
- Department of Neurology, the Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi 214002, China
| | - Wen-Zhuo Dai
- Department of Neurology, the Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi 214002, China
| | - Tao Ma
- Department of Neurology, the Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi 214002, China
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83
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Peng Z, Dong S, Tao Y, Huo Y, Zhou Z, Huang W, Qu H, Liu J, Chen Y, Xu Z, Wang Y, Zhou H. Metabolic syndrome contributes to cognitive impairment in patients with Parkinson's disease. Parkinsonism Relat Disord 2018; 55:68-74. [DOI: 10.1016/j.parkreldis.2018.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 01/13/2023]
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Whyte J, Ketchum JM, Bogner J, Brunner RC, Hammond FM, Zafonte R, Whiteneck GG, Weintraub A. Effects of Statin Treatment on Outcomes after Traumatic Brain Injury. J Neurotrauma 2018; 36:118-125. [PMID: 29954258 DOI: 10.1089/neu.2017.5545] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Neuroprotective treatments that have shown promise in reducing secondary injury and improving recovery in animal models of traumatic brain injury (TBI) have not been found effective to date in humans. One reason may be the delay after injury in initiating treatment. Statin medications are among the promising neuroprotective agents in animal models, and their presence in the bloodstream of many individuals at the time of injury might optimize their clinical impact. This observational study conducted by a subset of centers participating in the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)-funded TBI Model System program sought to examine the effects of taking statin medication at the time injury on functional outcomes. Participants >50 years of age were prospectively enrolled during patient rehabilitation. Demographic data, cardiovascular history, and brain injury history were obtained through chart abstraction and interview. Prescription medication use in the year prior to enrollment was determined from a national pharmacy search service. Propensity scoring was used to create 49 pairs of participants who were well matched on demographic and clinical attributes but discordant for statin use. The treated and untreated participants did not differ on initial Glasgow Coma Score, time until commands were followed, duration of post-traumatic amnesia, or Functional Independence Measure (FIM) scores at rehabilitation admission, discharge, or 1 year post-injury, or on acute or rehabilitation hospital lengths of stay. Evidence of greater and lesser statin compliance was not associated with outcome. This study did not provide support for a clinically important benefit of statin use at the time of moderate to severe TBI.
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Affiliation(s)
- John Whyte
- 1 Moss Rehabilitation Research Institute , Einstein Healthcare Network, Elkins Park, Pennsylvania
| | - Jessica M Ketchum
- 2 Research Department, Craig Hospital , Englewood, Colorado
- 3 Traumatic Brain Injury Model Systems National Data and Statistical Center , Englewood, Colorado
| | - Jenny Bogner
- 4 Ohio State University at Wexner Medical Center , Columbus, Ohio
| | - Robert C Brunner
- 5 University of Alabama at Birmingham , Spain Rehabilitation Center, Birmingham, Alabama
| | - Flora M Hammond
- 6 Indiana University School of Medicine , Rehabilitation Hospital of Indiana, Indianapolis, Indiana
| | - Ross Zafonte
- 7 Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital, and Home Base , Boston, Massachusetts
| | | | - Alan Weintraub
- 8 Craig Hospital , Rocky Mountain Regional Brain Injury System, Englewood, Colorado
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85
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Han BS, Minh NV, Choi HY, Byun JS, Kim WG. Daphnane and Phorbol Diterpenes, Anti-neuroinflammatory Compounds with Nurr1 Activation from the Roots and Stems of Daphne genkwa. Biol Pharm Bull 2018; 40:2205-2211. [PMID: 29199243 DOI: 10.1248/bpb.b17-00641] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The methanol extract of the roots and stems of Daphne genkwa and its constituents yuanhuacin (1) and genkwanine N were previously reported to have Nurr1 activating effects and neuroprotective effects in an animal model of Parkinson's disease (PD). In this study, four more daphnane-type diterpenes (acutilonine F (2), wikstroemia factor M1 (3), yuanhuadine (5), and yuanhuatine (6)) and two phorbol-type diterpenes (prostratin Q (4) and 12-O-n-deca-2,4,6-trienoyl-phorbol-(13)-acetate (7)) were isolated as Nurr1 activating compounds from the D. genkwa extract. Consistent with their higher Nurr1 activating activity, compounds 1, 4, 5, and 7 exhibited higher inhibitory activity on lipopolysaccharide (LPS)-induced nitric oxide (NO) production in murine microglial BV-2 cells with an IC50 (µM) of 1-2, which was 15-30 times more potent than that of minocycline (29.9 µM), a well-known anti-neuroinflammatory agent. Additionally, these diterpenes reduced expression and transcription of LPS-induced pro-inflammatory cytokines in BV-2 cells. Thus, the daphnane-type and phorbol-type diterpenes had anti-neuroinflammatory activity with Nurr1 activation and could be responsible for the anti-PD effect of the roots and stems of D. genkwa.
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Affiliation(s)
- Baek-Soo Han
- Metabolic Regulation Research Center, Korea Research Institute of Bioscience and Biotechnology
| | - Nguyen Van Minh
- Superbacteria Research Center, Korea Research Institute of Bioscience and Biotechnology
| | - Ha-Young Choi
- Superbacteria Research Center, Korea Research Institute of Bioscience and Biotechnology
| | - Jung-Su Byun
- Metabolic Regulation Research Center, Korea Research Institute of Bioscience and Biotechnology
| | - Won-Gon Kim
- Superbacteria Research Center, Korea Research Institute of Bioscience and Biotechnology
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86
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Abstract
Previous studies have indicated that statins use is associated with risk of dementia, but presented controversial results. Medline, Embase, Web of Science, and the Cochrane Database were searched update to November 2017 to identify the potential relationship between statins use and dementia. Thirty-one eligible studies involving a total of 3332,706 participants with 184,666 incident cases were included in this meta-analysis. Statins use was associated with dementia risk decrement (relevant risk [RR]: 0.85; 95% confidence interval [CI], 0.80-0.89). Subgroup analysis showed statins use was associated with Alzheimer disease (AD) (RR: 0.81; 95% CI, 0.73-0.89) and non-AD dementia (RR: 0.81; 95% CI, 0.73-0.89) risk decrement. Furthermore, statins use was associated with dementia risk decrement in female (RR: 0.89; 95% CI, 0.80-0.98) and male (RR: 0.88; 95% CI, 0.83-0.93). In addition, a dose-response showed per 1 year of duration of statins use incremental increase was associated with 20% dementia risk decrement (RR: 0.80; 95% CI, 0.73-0.87), and per 5-mg mean daily dose incremental increase in statins use was associated with 11% dementia risk decrement (RR: 0.89; 95% CI, 0.83-0.96). Statins use was associated with dementia risk decrement. The potency and the cumulative duration of statin utilized played critical roles.
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Affiliation(s)
- Xiaoyu Zhang
- Department of General Rehabilitation, Capital Medical University School of Rehabilitation Medicine, China Rehabilitation Research Center, Beijing Boai Hospital, Beijing
| | - Jianzhong Wen
- Department of Anesthesiology, Second Affiliated Hospital of Shanxi Medical University, Taiyuan, Shanxi
| | - Zhiqiang Zhang
- Department of Community Chronic Disease Research Center, Institute of Chinese Basic Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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87
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Carroll CB, Wyse RKH. Simvastatin as a Potential Disease-Modifying Therapy for Patients with Parkinson's Disease: Rationale for Clinical Trial, and Current Progress. JOURNAL OF PARKINSONS DISEASE 2018; 7:545-568. [PMID: 29036837 PMCID: PMC5676977 DOI: 10.3233/jpd-171203] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many now believe the holy grail for the next stage of therapeutic advance surrounds the development of disease-modifying approaches aimed at intercepting the year-on-year neurodegenerative decline experienced by most patients with Parkinson’s disease (PD). Based on recommendations of an international committee of experts who are currently bringing multiple, potentially disease-modifying, PD therapeutics into long-term neuroprotective PD trials, a clinical trial involving 198 patients is underway to determine whether Simvastatin provides protection against chronic neurodegeneration. Statins are widely used to reduce cardiovascular risk, and act as competitive inhibitors of HMG-CoA reductase. It is also known that statins serve as ligands for PPARα, a known arbiter for mitochondrial size and number. Statins possess multiple cholesterol-independent biochemical mechanisms of action, many of which offer neuroprotective potential (suppression of proinflammatory molecules & microglial activation, stimulation of endothelial nitric oxide synthase, inhibition of oxidative stress, attenuation of α-synuclein aggregation, modulation of adaptive immunity, and increased expression of neurotrophic factors). We describe the biochemical, physiological and pharmaceutical credentials that continue to underpin the rationale for taking Simvastatin into a disease-modifying trial in PD patients. While unrelated to the Simvastatin trial (because this conducted in patients who already have PD), we discuss conflicting epidemiological studies which variously suggest that statin use for cardiovascular prophylaxis may increase or decrease risk of developing PD. Finally, since so few disease-modifying PD trials have ever been launched (compared to those of symptomatic therapies), we discuss the rationale of the trial structure we have adopted, decisions made, and lessons learnt so far.
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Affiliation(s)
- Camille B Carroll
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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88
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Tong H, Zhang X, Meng X, Lu L, Mai D, Qu S. Simvastatin Inhibits Activation of NADPH Oxidase/p38 MAPK Pathway and Enhances Expression of Antioxidant Protein in Parkinson Disease Models. Front Mol Neurosci 2018; 11:165. [PMID: 29872377 PMCID: PMC5972184 DOI: 10.3389/fnmol.2018.00165] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/01/2018] [Indexed: 11/13/2022] Open
Abstract
Evidence suggests that oxidative stress is involved in the pathogenesis of Parkinson disease (PD). Simvastatin has been suggested to protect against oxidative stress in several diseases. However, the molecular mechanisms by which simvastatin protects against neuropathology and oxidative damage in PD are poorly elucidated. In this study, we aimed to investigate the potential neuroprotective effects of simvastatin owing to its anti-oxidative properties in 6-hydroxydopamine (6-OHDA)-treated SH-SY5Y cells and mice. The results of 2′,7′-dichlorodihydrofluorescein diacetate (DCFH-DA) fluorescence and CCK-8 assay demonstrated that simvastatin reduced intracellular reactive oxygen species (ROS) levels and reversed apoptosis in 6-OHDA-treated SH-SY5Y cells. Mechanistic studies revealed that 6-OHDA-induced activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase/p38 mitogen-activated protein kinase (MAPK) pathway was inhibited and nuclear factor-κB (NF-κB) nuclear transcription decreased in SH-SY5Y cells after simvastatin treatment. Enhanced expression levels of superoxide dismutase (SOD), heme oxygenase-1 (HO-1), peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) and glutamate-cysteine ligase modifier subunit (GCLM) were observed after simvastatin treatment in 6-OHDA-treated SH-SY5Y cells. In vivo studies revealed that administration of simvastatin by gavage decreased limb-use asymmetry and apomorphine-induced rotations in 6-OHDA-lesioned mice. Simvastatin increased dopaminergic neurons and reduced protein tyrosine nitration and gliosis in the midbrain of PD mice. An inhibitory effect on activation of the NADPH oxidase/p38 MAPK was observed, and increased antioxidant protein expression in the midbrain were seen in the simvastatin plus 6-OHDA group compared with the 6-OHDA-lesioned group. Taken together, these results demonstrate that simvastatin might inhibit the activation of NADPH oxidase/p38 MAPK pathway, enhance antioxidant protein expression and protect against oxidative stress, thereby providing a novel antioxidant mechanism that has therapeutic validity.
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Affiliation(s)
- Huichun Tong
- Clinical Medicine Research Center, Shunde Hospital, Southern Medical University, Foshan, China
| | - Xiuping Zhang
- Teaching Center of Experimental Medicine, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Xingjun Meng
- Clinical Medicine Research Center, Shunde Hospital, Southern Medical University, Foshan, China
| | - Lingli Lu
- Clinical Medicine Research Center, Shunde Hospital, Southern Medical University, Foshan, China
| | - Dongmei Mai
- Clinical Medicine Research Center, Shunde Hospital, Southern Medical University, Foshan, China
| | - Shaogang Qu
- Clinical Medicine Research Center, Shunde Hospital, Southern Medical University, Foshan, China
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89
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Wang ZT, Zhong XL, Tan MS, Wang HF, Tan CC, Zhang W, Zheng ZJ, Kong LL, Tan L, Sun L. Association of lectin-like oxidized low density lipoprotein receptor 1 ( OLR1) polymorphisms with late-onset Alzheimer disease in Han Chinese. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:172. [PMID: 29951494 DOI: 10.21037/atm.2018.04.31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Lectin-like oxidized low density lipoprotein receptor 1 (OLR1) locates within the area of chromosome 12p, which has been identified as the AD-susceptible region, and plays a role in lipid metabolism. Therefore, it has been suggested to be a good candidate gene for Alzheimer's disease (AD). Several SNPs within OLR1 have been reported to have association with AD among Caucasians. Methods We selected and genotyped three SNPs (rs1050283, rs1050286, rs17808009) in OLR1 to investigate its possible relationship with the onset of late-onset Alzheimer disease(LOAD) in 984 LOAD cases and 1,354 healthy controls among northern Han Chinese. Results No significant association was found between the OLR1 (rs1050283, rs1050286, rs17808009) polymorphisms and LOAD, even after adjustment for gender and age and stratification for apolipoprotein E (APOE) status. Conclusions Our study showed that the SNPs (rs1050283, rs1050286, rs17808009) located in the 3'UTR of OLR1 may not involve in the mechanism of LOAD in Han Chinese population.
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Affiliation(s)
- Zuo-Teng Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Xiao-Ling Zhong
- Department of Neurology, Qingdao Central Hospital, Qingdao University, Qingdao 266042, China
| | - Meng-Shan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Hui-Fu Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Wei Zhang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Zhan-Jie Zheng
- Department of Geriatric, Qingdao Mental Health Center, Qingdao 266034, China
| | - Ling-Li Kong
- Department of Geriatric, Qingdao Mental Health Center, Qingdao 266034, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China
| | - Li Sun
- Department of Neurology, Qingdao Central Hospital, Qingdao University, Qingdao 266042, China
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90
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Use of statins and the risk of dementia and mild cognitive impairment: A systematic review and meta-analysis. Sci Rep 2018; 8:5804. [PMID: 29643479 PMCID: PMC5895617 DOI: 10.1038/s41598-018-24248-8] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 03/29/2018] [Indexed: 12/16/2022] Open
Abstract
We conducted a systematic review and meta-analysis to investigate whether the use of statins could be associated with the risk of all-caused dementia, Alzheimer’s disease (AD), vascular dementia (VaD), and mild cognitive impairment (MCI). Major electronic databases were searched until December 27th, 2017 for studies investigating use of statins and incident cognitive decline in adults. Random-effects meta-analyses calculating relative risks (RRs) were conducted to synthesize effect sizes of individual studies. Twenty-five studies met eligibility criteria. Use of statins was significantly associated with a reduced risk of all-caused dementia (k = 16 studies, adjusted RR (aRR) = 0.849, 95% CI = 0.787–0.916, p = 0.000), AD (k = 14, aRR = 0.719, 95% CI = 0.576–0.899, p = 0.004), and MCI (k = 6, aRR = 0.737, 95% CI = 0.556–0.976, p = 0.033), but no meaningful effects on incident VaD (k = 3, aRR = 1.012, 95% CI = 0.620–1.652, p = 0.961). Subgroup analysis suggested that hydrophilic statins were associated with reduced risk of all-caused dementia (aRR = 0.877; CI = 0.818–0.940; p = 0.000) and possibly lower AD risk (aRR = 0.619; CI = 0.383–1.000; p = 0.050). Lipophilic statins were associated with reduced risk of AD (aRR = 0.639; CI = 0.449–0.908; p = 0.013) but not all-caused dementia (aRR = 0.738; CI = 0.475–1.146; p = 0.176). In conclusion, our meta-analysis suggests that the use of statins may reduce the risk of all-type dementia, AD, and MCI, but not of incident VaD.
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91
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Differences in statin associated neuroprotection corresponds with either decreased production of IL-1β or TNF-α in an in vitro model of neuroinflammation-induced neurodegeneration. Toxicol Appl Pharmacol 2018. [DOI: 10.1016/j.taap.2018.03.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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92
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Pelleieux S, Picard C, Lamarre-Théroux L, Dea D, Leduc V, Tsantrizos YS, Poirier J. Isoprenoids and tau pathology in sporadic Alzheimer's disease. Neurobiol Aging 2018; 65:132-139. [PMID: 29476987 DOI: 10.1016/j.neurobiolaging.2018.01.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/07/2017] [Accepted: 01/21/2018] [Indexed: 12/12/2022]
Abstract
The mevalonate pathway has been described to play a key role in Alzheimer's disease (AD) physiopathology. Farnesyl pyrophosphate (FPP) and geranylgeranyl pyrophosphate (GGPP) are nonsterol isoprenoids derived from mevalonate, which serve as precursors to numerous human metabolites. They facilitate protein prenylation; hFPP and hGGPP synthases act as gateway enzymes to the prenylation of the small guanosine triphosphate (GTP)ase proteins such as RhoA and cdc42 that have been shown to facilitate phospho-tau (p-Tau, i.e., protein tau phosphorylated) production in the brain. In this study, a significant positive correlation was observed between the synthases mRNA prevalence and disease status (FPPS, p < 0.001, n = 123; GGPPS, p < 0.001, n = 122). The levels of mRNA for hFPPS and hGGPPS were found to significantly correlate with the amount of p-Tau protein levels (p < 0.05, n = 34) and neurofibrillary tangle density (p < 0.05, n = 39) in the frontal cortex. Interestingly, high levels of hFPPS and hGGPPS mRNA prevalence are associated with earlier age of onset in AD (p < 0.05, n = 58). Together, these results suggest that accumulation of p-Tau in the AD brain is related, at least in part, to increased levels of neuronal isoprenoids.
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Affiliation(s)
- Sandra Pelleieux
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Cynthia Picard
- Douglas Mental Health University Institute, McGill University, Montreal, Canada; Center for Studies on the Prevention of Alzheimer's Disease, McGill University, Montreal, Canada
| | | | - Doris Dea
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Valérie Leduc
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Youla S Tsantrizos
- Department of Chemistry, McGill University, Montreal, Canada; Department of Biochemistry, McGill University, Montreal, Quebec, Canada
| | - Judes Poirier
- Douglas Mental Health University Institute, McGill University, Montreal, Canada; Center for Studies on the Prevention of Alzheimer's Disease, McGill University, Montreal, Canada.
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93
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Colini Baldeschi A, Pittaluga E, Andreola F, Rossi S, Cozzolino M, Nicotera G, Sferrazza G, Pierimarchi P, Serafino A. Atrial Natriuretic Peptide Acts as a Neuroprotective Agent in in Vitro Models of Parkinson's Disease via Up-regulation of the Wnt/β-Catenin Pathway. Front Aging Neurosci 2018; 10:20. [PMID: 29449807 PMCID: PMC5799264 DOI: 10.3389/fnagi.2018.00020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 01/17/2018] [Indexed: 12/14/2022] Open
Abstract
In the last decades increasing evidence indicated a crucial role of the Wnt/β-catenin signaling in development of midbrain dopaminergic (mDA) neurons. Recently dysregulation of this pathway has been proposed as a novel pathomechanism leading to Parkinson's disease (PD) and some of the molecules participating to the signaling have been evaluated as potential therapeutic targets for PD. Atrial natriuretic peptide (ANP) is a cardiac-derived hormone having a critical role in cardiovascular homeostasis. ANP and its receptors (NPRs) are widely expressed in mammalian central nervous system (CNS) where they could be implicated in the regulation of neural development, synaptic transmission and information processing, as well as in neuroprotection. Until now, the effects of ANP in the CNS have been mainly ascribed to the binding and activation of NPRs. We have previously demonstrated that ANP affects the Wnt/β-catenin signaling in colorectal cancer cells through a Frizzled receptor-mediated mechanism. The purpose of this study was to investigate if ANP is able to exert neuroprotective effect on two in vitro models of PD, and if this effect could be related to activation of the Wnt/β-catenin signaling. As cellular models of DA neurons, we used the proliferating or RA-differentiated human neuroblastoma cell line SH-SY5Y. In both DA neuron-like cultures, ANP is able to positively affect the Wnt/β-catenin signaling, by inducing β-catenin stabilization and nuclear translocation. Importantly, activation of the Wnt pathway by ANP exerts neuroprotective effect when these two cellular systems were subjected to neurotoxic insult (6-OHDA) for mimicking the neurodegeneration of PD. Our data support the relevance of exogenous ANP as an innovative therapeutic molecule for midbrain, and more in general for brain diseases for which aberrant Wnt signaling seems to be involved.
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Affiliation(s)
| | - Eugenia Pittaluga
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Federica Andreola
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Simona Rossi
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Mauro Cozzolino
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Giuseppe Nicotera
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Gianluca Sferrazza
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Pasquale Pierimarchi
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
| | - Annalucia Serafino
- Institute of Translational Pharmacology, National Research Council of Italy, Rome, Italy
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94
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Morissette M, Morin N, Rouillard C, Di Paolo T. Membrane cholesterol removal and replenishment affect rat and monkey brain monoamine transporters. Neuropharmacology 2018; 133:289-306. [PMID: 29407218 DOI: 10.1016/j.neuropharm.2018.01.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/10/2018] [Accepted: 01/25/2018] [Indexed: 12/16/2022]
Abstract
The dopamine transporter (DAT) is abundantly expressed in the striatum where it removes extracellular dopamine into the cytosol of presynaptic nerve terminals. It is the target of drugs of abuse and antidepressants. There is a loss of the DAT in Parkinson's disease affecting release of levodopa implicated in levodopa-induced dyskinesias. This study investigated the effect of cholesterol on DAT, serotonin transporter (SERT) and vesicular monoamine transporter 2 (VMAT2) in monkey and rat brains in vitro. DAT protein levels measured by Western blot remained unchanged with in vitro methyl-β-cyclodextrin (MCD) incubations to remove membrane cholesterol or with incubations to increase membrane cholesterol content. By contrast, striatal DAT specific binding labelled with [125I]RTI-121 or with [125I]RTI-55 decreased with increasing concentrations of MCD and increased with cholesterol loading. Moreover, [125I]RTI-121 specific binding of striatal membranes depleted of cholesterol with MCD was restored to initial DAT content with addition of cholesterol showing its rapid and reversible effect. By contrast, striatal VMAT2 and SERT specific binding showed no or limited changes by cholesterol manipulations. Similar results were obtained for monkey caudate nucleus, putamen and nucleus accumbens. Membrane microviscosity was assessed by fluorescence polarization spectroscopy, using the probe 1,6-diphenyl-1,3,5-hexatriene. DAT changes positively correlated with changes of membrane microviscosity in rat and monkey brain regions investigated and with membrane cholesterol contents. Similar findings were observed with desmosterol but to a lower extent than with cholesterol. These results show an important effect of cholesterol on the DAT associated with microviscosity changes that should be considered in drug therapies.
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Affiliation(s)
- Marc Morissette
- Neuroscience Research Unit, Centre Hospitalier Universitaire de Québec, CHUL, Quebec City G1V 4G2, Canada
| | - Nicolas Morin
- Neuroscience Research Unit, Centre Hospitalier Universitaire de Québec, CHUL, Quebec City G1V 4G2, Canada; Faculty of Pharmacy, Université Laval, Quebec City G1K 7P4, Canada
| | - Claude Rouillard
- Neuroscience Research Unit, Centre Hospitalier Universitaire de Québec, CHUL, Quebec City G1V 4G2, Canada; Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Quebec City G1K 7P4, Canada
| | - Thérèse Di Paolo
- Neuroscience Research Unit, Centre Hospitalier Universitaire de Québec, CHUL, Quebec City G1V 4G2, Canada; Faculty of Pharmacy, Université Laval, Quebec City G1K 7P4, Canada.
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95
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Bioconversion of mevastatin to pravastatin by various microorganisms and its applications – A review. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2018. [DOI: 10.1016/j.bcab.2017.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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96
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Sinyavskaya L, Gauthier S, Renoux C, Dell'Aniello S, Suissa S, Brassard P. Comparative effect of statins on the risk of incident Alzheimer disease. Neurology 2017; 90:e179-e187. [DOI: 10.1212/wnl.0000000000004818] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 09/19/2017] [Indexed: 01/06/2023] Open
Abstract
ObjectiveTo investigate whether fungus-derived statins are associated with a lower risk of incident Alzheimer disease (AD) compared with synthetic statins using real-world clinical practice data.MethodsWe identified a population-based retrospective cohort of patients aged ≥60 years newly prescribed a statin between January 1, 1994, and December 31, 2012, and followed until March 31, 2015, using the UK Clinical Practice Research Datalink. Statins were consecutively classified according to their type, lipophilicity, and potency. For each group, we calculated the crude AD incidence rates per 1,000 person-years. Time-dependent Cox proportional hazards models adjusted for propensity score deciles were used to estimate hazard ratios (HRs) with 95% confidence interval (CIs) of incident AD associated with different statin categories.ResultsOver the 18-year study period, we identified 465,085 statin users, including 7,669 patients who developed AD during 2,891,268 person-years of follow-up (incidence rate 2.65 [95% CI 2.59–2.71] per 1,000 person-years). Compared to synthetic, fungus-derived statins were associated with an increased risk of AD (HR 1.09, 95% CI 1.03–1.15). Lipophilic statins also were associated with higher AD risk (HR 1.18, 95% CI 1.09–1.27) compared to hydrophilic statins, while statin potency did not modify the risk of AD (adjusted HR 1.03, 95% CI 0.98–1.08). The risk was further reduced in sensitivity analyses.ConclusionFungus-derived and lipophilic statins were not associated with decreased incidence of AD compared to synthetic and hydrophilic statins. The modest variations in the risk of incident AD observed between statin characteristics needs to be evaluated in future studies on their possible heterogeneous neuroprotective effect.
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97
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Manickavasagam D, Novak K, Oyewumi MO. Therapeutic Delivery of Simvastatin Loaded in PLA-PEG Polymersomes Resulted in Amplification of Anti-inflammatory Effects in Activated Microglia. AAPS JOURNAL 2017; 20:18. [DOI: 10.1208/s12248-017-0176-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/21/2017] [Indexed: 01/18/2023]
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98
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Liu W, Zhao Y, Zhang X, Ji J. Simvastatin ameliorates cognitive impairments via inhibition of oxidative stress‑induced apoptosis of hippocampal cells through the ERK/AKT signaling pathway in a rat model of senile dementia. Mol Med Rep 2017; 17:1885-1892. [PMID: 29257256 DOI: 10.3892/mmr.2017.8098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 10/06/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Wenting Liu
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Yan Zhao
- Department of Neurology, The Affiliated Qingdao Hiser Hospital of Qingdao University, Qingdao, Shandong 266033, P.R. China
| | - Xinyu Zhang
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Jiangang Ji
- Department of Encephalopathy, Traditional Chinese Medicine Hospital of Weifang, Weifang, Shandong 261041, P.R. China
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99
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Poly T, Islam M, Walther B, Yang HC, Nguyen PA, Huang CW, Shabbir SA, Li YC. Exploring the Association between Statin Use and the Risk of Parkinson’s Disease: A Meta-Analysis of Observational Studies. Neuroepidemiology 2017; 49:142-151. [DOI: 10.1159/000480401] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/17/2017] [Indexed: 11/19/2022] Open
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100
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Rong X, Yin J, Wang H, Zhang X, Peng Y. Statin treatment may lower the risk of postradiation epilepsy in patients with nasopharyngeal carcinoma. Epilepsia 2017; 58:2172-2177. [PMID: 29034463 DOI: 10.1111/epi.13924] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Xiaoming Rong
- Department of Neurology; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation; Medical Research Center; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
| | - Jing Yin
- Department of Neurology; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation; Medical Research Center; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
| | - Hongxuan Wang
- Department of Neurology; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation; Medical Research Center; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
| | - Xiaoni Zhang
- Department of Neurology; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation; Medical Research Center; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
| | - Ying Peng
- Department of Neurology; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation; Medical Research Center; Sun Yat-Sen Memorial Hospital; Sun Yat-Sen University; Guangzhou China
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