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Lu W, Huang J, Flores J, Li P, Wang W, Liu S, Zhang JH, Tang J. GW0742 reduces mast cells degranulation and attenuates neurological impairments via PPAR β/δ/CD300a/SHP1 pathway after GMH in neonatal rats. Exp Neurol 2024; 372:114615. [PMID: 37995951 PMCID: PMC10842885 DOI: 10.1016/j.expneurol.2023.114615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/03/2023] [Accepted: 11/19/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Activation of mast cells plays an important role in brain inflammation. CD300a, an inhibitory receptor located on mast cell surfaces, has been reported to reduce the production of pro-inflammatory cytokines and exert protective effects in inflammation-related diseases. Peroxisome proliferator-activated receptor β/δ (PPARβ/δ), a ligand-activated nuclear receptor, activation upregulates the transcription of CD300a. In this study, we aim to investigate the role of PPARβ/δ in the attenuation of germinal matrix hemorrhage (GMH)-induced mast cell activation via CD300a/SHP1 pathway. METHODS GMH model was induced by intraparenchymal injection of bacterial collagenase into the right hemispheric ganglionic eminence in P7 Sprague Dawley rats. GW0742, a PPARβ/δ agonist, was administered intranasally at 1 h post-ictus. CD300a small interfering RNA (siRNA) and PPARβ/δ siRNA were injected intracerebroventricularly 5 days and 2 days before GMH induction. Behavioral tests, Western blot, immunofluorescence, Toluidine Blue staining, and Nissl staining were applied to assess post-GMH evaluation. RESULTS Results demonstrated that endogenous protein levels of PPARβ/δ and CD300a were decreased, whereas chymase, tryptase, IL-17A and transforming growth factor β1 (TGF-β1) were elevated after GMH. GMH induced significant short- and long-term neurobehavioral deficits in rat pups. GW0742 decreased mast cell degranulation, improved neurological outcomes, and attenuated ventriculomegaly after GMH. Additionally, GW0742 increased expression of PPARβ/δ, CD300a and phosphorylation of SHP1, decreased phosphorylation of Syk, chymase, tryptase, IL-17A and TGF-β1 levels. PPARβ/δ siRNA and CD300a siRNA abolished the beneficial effects of GW0742. CONCLUSIONS GW0742 inhibited mast cell-induced inflammation and improved neurobehavior after GMH, which is mediated by PPARβ/δ/CD300a/SHP1 pathway. GW0742 may serve as a potential treatment to reduce brain injury for GMH patients.
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Affiliation(s)
- Weitian Lu
- Institute of Neuroscience, Basic Medical College, Chongqing Medical University, Chongqing 400016, China; Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Juan Huang
- Institute of Neuroscience, Basic Medical College, Chongqing Medical University, Chongqing 400016, China; Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Jerry Flores
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Peng Li
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Wenna Wang
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Shengpeng Liu
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - John H Zhang
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA; Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA; Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Jiping Tang
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
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Zhang X, Yuan J, Zhang S, Li W, Xu Y, Li H, Zhang L, Chen X, Ding W, Zhu J, Song J, Wang X, Zhu C. Germinal matrix hemorrhage induces immune responses, brain injury, and motor impairment in neonatal rats. J Cereb Blood Flow Metab 2023; 43:49-65. [PMID: 36545808 PMCID: PMC10638988 DOI: 10.1177/0271678x221147091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/17/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022]
Abstract
Germinal matrix hemorrhage (GMH) is a major complication of prematurity that causes secondary brain injury and is associated with long-term neurological disabilities. This study used a postnatal day 5 rat model of GMH to explore immune response, brain injury, and neurobehavioral changes after hemorrhagic injury. The results showed that CD45high/CD11b+ immune cells increased in the brain after GMH and were accompanied by increased macrophage-related chemokine/cytokines and inflammatory mediators. Hematoma formed as early as 2 h after injection of collagenase VII and white matter injury appeared not only in the external capsule and hippocampus, but also in the thalamus. In addition, GMH caused abnormal motor function as revealed by gait analysis, and locomotor hyperactivity in the elevated plus maze, though no other obvious anxiety or recognition/memory function changes were noted when examined by the open field test and novel object recognition test. The animal model used here partially reproduces the GMH-induced brain injury and motor dysfunction seen in human neonates and therefore can be used as a valid tool in experimental studies for the development of effective therapeutic strategies for GMH-induced brain injury.
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Affiliation(s)
- Xiaoli Zhang
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Jing Yuan
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Shan Zhang
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Wendong Li
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Yiran Xu
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
- NHC Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, China
| | - Hongwei Li
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Lingling Zhang
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Xi Chen
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Wenjun Ding
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Jinjin Zhu
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Juan Song
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
| | - Xiaoyang Wang
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
- Center for Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Changlian Zhu
- Henan Key Laboratory of Child Brain Injury and Henan Pediatric Clinical Research Center, Third Affiliated Hospital and Institute of Neuroscience of Zhengzhou University, Zhengzhou, China
- Center for Bran Repair and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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3
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Jiang L, Yu Q, Wang F, Wu M, Liu F, Fu M, Gao J, Feng X, Zhang L, Xu Z. The role of blood pressure variability indicators combined with cerebral blood flow parameters in predicting intraventricular hemorrhage in very low birth weight preterm infants. Front Pediatr 2023; 11:1241809. [PMID: 37876522 PMCID: PMC10590921 DOI: 10.3389/fped.2023.1241809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/22/2023] [Indexed: 10/26/2023] Open
Abstract
Background Hemodynamic instability is the main factor responsible for the development of intraventricular hemorrhage (IVH) in premature newborns. Herein, we evaluated the predictive ability of blood pressure variability (BPV) and anterior cerebral artery (ACA) blood flow parameters in IVH in premature infants with gestational age (GA) ≤32 weeks and birth weight (BW) ≤ 1,500 g. Methods Preterm infants with GA ≤32 weeks and BW ≤ 1,500 g admitted to the neonatal intensive care unit (NICU) of the hospital affiliated to Yangzhou University from January 2020 to January 2023 were selected as the research subjects. All preterm infants were admitted within 1 h after birth, and systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MABP) were monitored at 1-h intervals. The difference between maximum and minimum values (max-min), standard deviation (SD), coefficient of variation (CV), and successive variation (SV) were used as BPV indicators. On the 1st, 3rd, and 7th day after birth, transcranial ultrasound examination was performed to screen for the occurrence of IVH. On the 24 ± 1 h after birth, systolic velocity (Vs), diastolic velocity (Vd), and resistance index (RI) of the ACA were measured simultaneously. Preterm infants were divided into the IVH group and non-IVH group based on the results of transcranial ultrasound examination, and the correlation between BPV indicators, ACA blood flow parameters, and development of IVH was analyzed. Results A total of 92 premature infants were enrolled, including 49 in the IVH group and 43 in the non-IVH group. There was no statistically significant difference in baseline characteristics such as BW, GA, sex, and perinatal medical history between the two groups of preterm infants (P > 0.05). The SBP SD (OR: 1.480, 95%CI: 1.020-2.147) and ACA-RI (OR: 3.027, 95%CI: 2.769-3.591) were independent risk factors for IVH in premature newborns. The sensitivity and specificity of combined detection of SBP SD and ACA-RI in predicting IVH were 61.2% and 79.1%, respectively. Conclusion High BPV and ACA-RI are related to IVH in premature infants with GA ≤32 w and BW ≤1,500 g. Combined detection of SBP SD and ACA-RI has a certain predictive effect on early identification of IVH.
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Affiliation(s)
- Lijun Jiang
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Qian Yu
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Fudong Wang
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Mingfu Wu
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Feng Liu
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Mingfeng Fu
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Junyan Gao
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Xing Feng
- Department of Neonatology, Affiliated Children's Hospital of Soochow University, Suzhou, China
| | - Longfeng Zhang
- Department of Clinical Laboratory, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Zhenxing Xu
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, China
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Vafaeipour Z, Ghasemzadeh Rahbardar M, Hosseinzadeh H. Effect of saffron, black seed, and their main constituents on inflammatory cytokine response (mainly TNF-α) and oxidative stress status: an aspect on pharmacological insights. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:2241-2259. [PMID: 37103518 DOI: 10.1007/s00210-023-02501-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/15/2023] [Indexed: 04/28/2023]
Abstract
Tumor necrosis factor-α (TNF-α), an inflammatory cytokine, is produced by monocytes and macrophages. It is known as a 'double-edged sword' because it is responsible for advantageous and disadvantageous events in the body system. The unfavorable incident includes inflammation, which induces some diseases such as rheumatoid arthritis, obesity, cancer, and diabetes. Many medicinal plants have been found to prevent inflammation, such as saffron (Crocus sativus L.) and black seed (Nigella sativa). Therefore, the purpose of this review was to assess the pharmacological effects of saffron and black seed on TNF-α and diseases related to its imbalance. Different databases without time limitations were investigated up to 2022, including PubMed, Scopus, Medline, and Web of Science. All the original articles (in vitro, in vivo, and clinical studies) were collected on the effects of black seed and saffron on TNF-α. Black seed and saffron have therapeutic effects against many disorders, such as hepatotoxicity, cancer, ischemia, and non-alcoholic fatty liver, by decreasing TNF-α levels based on their anti-inflammatory, anticancer, and antioxidant properties. Saffron and black seed can treat a variety of diseases by suppressing TNF-α and exhibiting a variety of activities such as neuroprotective, gastroprotective, immunomodulatory, antimicrobial, analgesic, antitussive, bronchodilator, antidiabetic activity, anticancer, and antioxidant effects. To uncover the beneficial underlying mechanisms of black seed and saffron, more clinical trials and phytochemical research are required. Also, these two plants affect other inflammatory cytokines, hormones, and enzymes, implying that they could be used to treat a variety of diseases.
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Affiliation(s)
- Zeinab Vafaeipour
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hossein Hosseinzadeh
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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Paez-Gonzalez P, Lopez-de-San-Sebastian J, Ceron-Funez R, Jimenez AJ, Rodríguez-Perez LM. Therapeutic strategies to recover ependymal barrier after inflammatory damage: relevance for recovering neurogenesis during development. Front Neurosci 2023; 17:1204197. [PMID: 37397456 PMCID: PMC10308384 DOI: 10.3389/fnins.2023.1204197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
The epithelium covering the surfaces of the cerebral ventricular system is known as the ependyma, and is essential for maintaining the physical and functional integrity of the central nervous system. Additionally, the ependyma plays an essential role in neurogenesis, neuroinflammatory modulation and neurodegenerative diseases. Ependyma barrier is severely affected by perinatal hemorrhages and infections that cross the blood brain barrier. The recovery and regeneration of ependyma after damage are key to stabilizing neuroinflammatory and neurodegenerative processes that are critical during early postnatal ages. Unfortunately, there are no effective therapies to regenerate this tissue in human patients. Here, the roles of the ependymal barrier in the context of neurogenesis and homeostasis are reviewed, and future research lines for development of actual therapeutic strategies are discussed.
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Affiliation(s)
- Patricia Paez-Gonzalez
- Department of Cell Biology, Genetics and Physiology, University of Malaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
| | | | - Raquel Ceron-Funez
- Department of Cell Biology, Genetics and Physiology, University of Malaga, Málaga, Spain
| | - Antonio J. Jimenez
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
| | - Luis Manuel Rodríguez-Perez
- Department of Cell Biology, Genetics and Physiology, University of Malaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
- Department of Human Physiology, Human Histology, Pathological Anatomy and Sports, University of Malaga, Málaga, Spain
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6
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Alshareef M, Hatchell D, Vasas T, Mallah K, Shingala A, Cutrone J, Alawieh A, Guo C, Tomlinson S, Eskandari R. Complement Drives Chronic Inflammation and Progressive Hydrocephalus in Murine Neonatal Germinal Matrix Hemorrhage. Int J Mol Sci 2023; 24:10171. [PMID: 37373319 PMCID: PMC10299267 DOI: 10.3390/ijms241210171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Germinal matrix hemorrhage (GMH) is a pathology that occurs in infancy, with often devastating long-term consequences. Posthemorrhagic hydrocephalus (PHH) can develop acutely, while periventricular leukomalacia (PVL) is a chronic sequala. There are no pharmacological therapies to treat PHH and PVL. We investigated different aspects of the complement pathway in acute and chronic outcomes after murine neonatal GMH induced at postnatal day 4 (P4). Following GMH-induction, the cytolytic complement membrane attack complex (MAC) colocalized with infiltrating red blood cells (RBCs) acutely but not in animals treated with the complement inhibitor CR2-Crry. Acute MAC deposition on RBCs was associated with heme oxygenase-1 expression and heme and iron deposition, which was reduced with CR2-Crry treatment. Complement inhibition also reduced hydrocephalus and improved survival. Following GMH, there were structural alterations in specific brain regions linked to motor and cognitive functions, and these changes were ameliorated by CR2-Crry, as measured at various timepoints through P90. Astrocytosis was reduced in CR2-Crry-treated animals at chronic, but not acute, timepoints. At P90, myelin basic protein and LAMP-1 colocalized, indicating chronic ongoing phagocytosis of white matter, which was reduced by CR2-Crry treatment. Data indicate acute MAC-mediated iron-related toxicity and inflammation exacerbated the chronic effects of GMH.
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Affiliation(s)
- Mohammed Alshareef
- Department of Neurological Surgery, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO 80045, USA;
| | - Devin Hatchell
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA; (D.H.); (K.M.); (C.G.)
| | - Tyler Vasas
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; (T.V.); (A.S.)
| | - Khalil Mallah
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA; (D.H.); (K.M.); (C.G.)
| | - Aakash Shingala
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; (T.V.); (A.S.)
| | - Jonathan Cutrone
- Department of Family Medicine, AnMed Health Medical Center, Anderson, SC 29621, USA;
| | - Ali Alawieh
- Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Chunfang Guo
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA; (D.H.); (K.M.); (C.G.)
| | - Stephen Tomlinson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29425, USA; (D.H.); (K.M.); (C.G.)
- Ralph Johnson VA Medical Center, Charleston, SC 29401, USA
| | - Ramin Eskandari
- Department of Neurological Surgery, Medical University of South Carolina, Charleston, SC 29425, USA
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Kebaya LMN, Stubbs K, Lo M, Al-Saoud S, Karat B, St Lawrence K, de Ribaupierre S, Duerden EG. Three-dimensional cranial ultrasound and functional near-infrared spectroscopy for bedside monitoring of intraventricular hemorrhage in preterm neonates. Sci Rep 2023; 13:3730. [PMID: 36878952 PMCID: PMC9988970 DOI: 10.1038/s41598-023-30743-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Germinal Matrix-Intraventricular Hemorrhage (GMH-IVH) remains a significant cause of adverse neurodevelopment in preterm infants. Current management relies on 2-dimensional cranial ultrasound (2D cUS) ventricular measurements. Reliable biomarkers are needed to aid in the early detection of posthemorrhagic ventricular dilatation (PHVD) and subsequent neurodevelopment. In a prospective cohort study, we incorporated 3-dimensional (3D) cUS and functional near-infrared spectroscopy (fNIRS) to monitor neonates with GMH-IVH. Preterm neonates (≤ 32 weeks' gestation) were enrolled following a GMH-IVH diagnosis. Neonates underwent sequential measurements: 3D cUS images were manually segmented using in-house software, and the ventricle volumes (VV) were extracted. Multichannel fNIRS data were acquired using a high-density system, and spontaneous functional connectivity (sFC) was calculated. Of the 30 neonates enrolled in the study, 19 (63.3%) had grade I-II and 11 (36.7%) grade III-IV GMH-IVH; of these, 7 neonates (23%) underwent surgical interventions to divert cerebrospinal fluid (CSF). In infants with severe GMH-IVH, larger VV were significantly associated with decreased |sFC|. Our findings of increased VV and reduced sFC suggest that regional disruptions of ventricular size may impact the development of the underlying white matter. Hence, 3D cUS and fNIRS are promising bedside tools for monitoring the progression of GMH-IVH in preterm neonates.
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Affiliation(s)
- Lilian M N Kebaya
- Neuroscience Program, Western University, London, ON, Canada.
- Department of Paediatrics, Division of Neonatal-Perinatal Medicine, London Health Sciences Centre, 800 Commissioner's Road East, London, ON, N6A5W9, Canada.
| | - Kevin Stubbs
- Western Institute for Neuroscience, Western University, London, ON, Canada
- BrainsCAN, Western University, London, ON, Canada
| | - Marcus Lo
- School of Medicine, Queen's University, Kingston, ON, Canada
| | - Sarah Al-Saoud
- Western Institute for Neuroscience, Western University, London, ON, Canada
| | - Bradley Karat
- Neuroscience Program, Western University, London, ON, Canada
| | - Keith St Lawrence
- Department of Medical Biophysics, Western University, London, ON, Canada
- Imaging Program, Lawson Health Research Institute, London, ON, Canada
| | - Sandrine de Ribaupierre
- Neuroscience Program, Western University, London, ON, Canada
- Western Institute for Neuroscience, Western University, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
- Children's Health Research Institute, London, ON, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Emma G Duerden
- Neuroscience Program, Western University, London, ON, Canada
- Western Institute for Neuroscience, Western University, London, ON, Canada
- Children's Health Research Institute, London, ON, Canada
- Applied Psychology, Faculty of Education, Western University, London, ON, Canada
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Zhang Q, Zhou X. Review on the application of imaging examination for brain injury in premature infants. Front Neurol 2023; 14:1100623. [PMID: 36846145 PMCID: PMC9946993 DOI: 10.3389/fneur.2023.1100623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/10/2023] [Indexed: 02/11/2023] Open
Abstract
Brain injury is the main factor leading to the decline of the quality of life in premature infants. The clinical manifestations of such diseases are often diverse and complex, lacking obvious neurological symptoms and signs, and the disease progresses rapidly. Due to missed diagnosis, it is easy to miss the best treatment opportunity. Brain ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and other imaging methods can help clinicians diagnose and assess the type and extent of brain injury in premature infants to some extent, but the three methods have their own characteristics. This article briefly reviews the diagnostic value of these three methods for brain injury in premature infants.
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Affiliation(s)
- Qing Zhang
- First Affiliated Hospital of Xi'an Jiaotong University, Xi'an Jiaotong University Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China,Northwest Women's and Children's Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China,*Correspondence: Qing Zhang ✉
| | - Xihui Zhou
- First Affiliated Hospital of Xi'an Jiaotong University, Xi'an Jiaotong University Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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9
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De Vito A, Ben Zvi I, D'Arco F. MR Protocols for Paediatric Neurosurgical Common Conditions: An Update Guide for Neurosurgeons. Adv Tech Stand Neurosurg 2023; 48:57-72. [PMID: 37770681 DOI: 10.1007/978-3-031-36785-4_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
The biggest challenge for clinicians and surgeons when it comes to radiological examinations is the ability to request the right modalities and to understand the strengths and limitations of each modality. This is particularly important in paediatric neurosciences where despite magnetic resonance imaging (MRI) being the main imaging modality, there are several protocols, technical limitations of specific scanners and issues related to sedation that need to be taken into account. In this chapter, we describe a simple approach for six common neurosurgical conditions to guide the paediatric neurosurgeons in requesting the right MR protocol and understanding the rationale of it.Paediatric neuro-oncology, epilepsy and neck/skull base protocols are discussed elsewhere in this book and therefore will not be a focus in this chapter (Bernasconi et al., Epilepsia 60:1054-68, 2019; D'Arco et al., Neuroradiology 64:1081-100; 2022; Avula et al., Childs Nerv Syst 37:2497-508; 2021).
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Affiliation(s)
- Andrea De Vito
- Department of Neuroradiology, H. S. Gerardo Monza, Monza, Italy.
| | - Ido Ben Zvi
- Paediatric Neurosurgery Department, Great Ormond Street Hospital, London, UK
| | - Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital, London, UK
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10
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Collados-Gómez L, Esteban-Gonzalo L, López-López C, Jiménez-Fernández L, Piris-Borregas S, García-García E, Fernández-Gonzalo JC, Martínez-Miguel E. Lateral Kangaroo Care in Hemodynamic Stability of Extremely Preterm Infants: Protocol Study for a Non-Inferiority Randomized Controlled Trial CANGULAT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:293. [PMID: 35010554 PMCID: PMC8750690 DOI: 10.3390/ijerph19010293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/15/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This study aims to assess the efficacy of the modified kangaroo care lateral position on the thermal stability of preterm neonates versus conventional kangaroo care prone position. MATERIAL AND METHODS A non-inferiority randomized parallel clinical trial. Kangaroo care will be performed in a lateral position for the experimental group and in a prone position for the control group preterm. The study will take place at the neonatal intensive care unit (NICU) of a University Hospital. The participants will be extremely premature infants (under 28 weeks of gestational age) along the first five days of life, hemodynamically stable, with mother or father willing to do kangaroo care and give their written consent to participate in the study. The sample size calculated was 35 participants in each group. When the premature infant is hemodynamically stable and one of the parents stays in the NICU, the patient will be randomized into two groups: an experimental group or a control group. The primary outcome is premature infant axillary temperature. Neonatal pain level and intraventricular hemorrhage are secondary outcomes. DISCUSSION There is no scientific evidence on modified kangaroo care lateral position. Furthermore, there is little evidence of increased intraventricular hemorrhage association with the lateral head position necessary in conventional or prone kangaroo care in extremely premature newborns. Kangaroo care is a priority intervention in neonatal units increasing the time of use more and more, making postural changes necessary to optimize comfort and minimize risks with kangaroo care lateral position as an alternative to conventional prone position kangaroo care. Meanwhile, it is essential to ensure that the conventional kangaroo care prone position, which requires the head to lay sideways, is a safe position in terms of preventing intraventricular hemorrhage in the first five days of life of children under 28 weeks of gestational age. Trial registration at clinicaltrials.gov: NCT03990116.
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Affiliation(s)
- Laura Collados-Gómez
- Faculty of Biomedicine, Nursing and Nutrition Department, Universidad Europea de Madrid, 28670 Madrid, Spain; (L.C.-G.); (E.G.-G.); (J.C.F.-G.); (E.M.-M.)
- Department of Neonatal Intensive Care, Hospital Universitario 12 de Octubre, (H12O), 28041 Madrid, Spain; (C.L.-L.); (L.J.-F.); (S.P.-B.)
- Care Research Group (Invecuid), Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain
| | - Laura Esteban-Gonzalo
- Faculty of Biomedicine, Nursing and Nutrition Department, Universidad Europea de Madrid, 28670 Madrid, Spain; (L.C.-G.); (E.G.-G.); (J.C.F.-G.); (E.M.-M.)
- Faculty of Nursing, Physiotherapy and Podiatry, Nursing Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Candelas López-López
- Department of Neonatal Intensive Care, Hospital Universitario 12 de Octubre, (H12O), 28041 Madrid, Spain; (C.L.-L.); (L.J.-F.); (S.P.-B.)
- Care Research Group (Invecuid), Instituto de Investigación Sanitaria 12 de Octubre (imas12), 28041 Madrid, Spain
- Faculty of Nursing, Physiotherapy and Podiatry, Nursing Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Lucía Jiménez-Fernández
- Department of Neonatal Intensive Care, Hospital Universitario 12 de Octubre, (H12O), 28041 Madrid, Spain; (C.L.-L.); (L.J.-F.); (S.P.-B.)
| | - Salvador Piris-Borregas
- Department of Neonatal Intensive Care, Hospital Universitario 12 de Octubre, (H12O), 28041 Madrid, Spain; (C.L.-L.); (L.J.-F.); (S.P.-B.)
- Researcher at the Maternity and Childhood Health Research Group (Area 4), 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Esther García-García
- Faculty of Biomedicine, Nursing and Nutrition Department, Universidad Europea de Madrid, 28670 Madrid, Spain; (L.C.-G.); (E.G.-G.); (J.C.F.-G.); (E.M.-M.)
| | - Juan Carlos Fernández-Gonzalo
- Faculty of Biomedicine, Nursing and Nutrition Department, Universidad Europea de Madrid, 28670 Madrid, Spain; (L.C.-G.); (E.G.-G.); (J.C.F.-G.); (E.M.-M.)
| | - Esther Martínez-Miguel
- Faculty of Biomedicine, Nursing and Nutrition Department, Universidad Europea de Madrid, 28670 Madrid, Spain; (L.C.-G.); (E.G.-G.); (J.C.F.-G.); (E.M.-M.)
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Humberg A, Dzietko M, Schulz S, Felderhoff-Müser U, Hüning B, Stein A, Fortmann MI, Marissen J, Rausch TK, Herting E, Härtel C, Göpel W. Association of ApoE Genotypes and Recovery From Intracerebral Hemorrhage in Very Low Birth Weight Infants. Stroke 2021; 53:514-522. [PMID: 34619984 DOI: 10.1161/strokeaha.120.033432] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Associations of APOE genotypes with intracerebral hemorrhage (ICH) in preterm infants were previously described. In adults, APOE-ε4 genotype has been proposed as susceptibility factor for impaired recovery after cerebral insult. We here aim to determine APOE genotype-specific neurological consequences of neonatal ICH at school age. METHODS In this multicenter observational cohort study, very low birth weight (<1500 g, <32 weeks gestational age) children were studied for cerebral palsy (CP) after ultrasound diagnosed ICH stratified by APOE genotype. Follow-up examination was done at the age of 5 to 6 years. Study personnel were blinded for perinatal information and complications. Participants were born between January 1, 2009 and December 31, 2013 and enrolled in the German Neonatal Network. Of 8022 infants primarily enrolled, 2467 children were invited for follow-up between January 1, 2014 and December 31, 2019. Univariate analyses and multivariate logistic regression models were used to assess the impact of APOE genotype (APOE-ε2, APOE-ε3, APOE-ε4) on CP after ICH. RESULTS Two thousand two hundred fifteen children participated at follow-up, including 363 children with ultrasound diagnosed neonatal ICH. In univariate analyses of children with a history of ICH, APOE-ε3 carriers had lower frequencies of CP (n=33/250; 13.2 [95% CI, 9.4%-17.8%]), as compared to APOE-ε2 (n=15/63; 23.8 [14.6%-35.3%], P=0.037) and -ε4 carriers (n=31/107; 29.0 [21.0%-38.0%], P<0.001), respectively. Regression models revealed an association of APOE-ε4 genotype and CP development (odds ratio, 2.77 [1.44-5.32], P=0.002) after ICH. Notably, at low-grade ICH (grade I) APOE-ε4 expression resulted in an increased rate of CP (n=6/39; 15.4 [6.7-29.0]) in comparison to APOE-ε3 (n=2/105; 1.9 [0.4%-6.0%], P=0.002). CONCLUSIONS APOE-ε4 carriers have an increased risk for long-term motor deficits after ICH. We assume an effect even after low-grade neonatal ICH, but more data are needed to clarify this issue.
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Affiliation(s)
- Alexander Humberg
- Department of Pediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany. (A.H., S.S., M.I.F., T.K.R., E.H., W.G.)
| | - Mark Dzietko
- Department of Pediatrics I, University Duisburg-Essen, Germany (M.D., U.F-.M. B.H., A.S.)
| | - Sören Schulz
- Department of Pediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany. (A.H., S.S., M.I.F., T.K.R., E.H., W.G.)
| | | | - Britta Hüning
- Department of Pediatrics I, University Duisburg-Essen, Germany (M.D., U.F-.M. B.H., A.S.)
| | - Anja Stein
- Department of Pediatrics I, University Duisburg-Essen, Germany (M.D., U.F-.M. B.H., A.S.)
| | - Mats I Fortmann
- Department of Pediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany. (A.H., S.S., M.I.F., T.K.R., E.H., W.G.)
| | - Janina Marissen
- Department of Pediatrics, University Hospital of Würzburg, Germany (J.M., C.H.)
| | - Tanja K Rausch
- Department of Pediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany. (A.H., S.S., M.I.F., T.K.R., E.H., W.G.).,Institute of Medical Biometry and Statistics, University of Lübeck, University Hospital of Schleswig-Holstein, Lübeck, Germany. (T.K.R.)
| | - Egbert Herting
- Department of Pediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany. (A.H., S.S., M.I.F., T.K.R., E.H., W.G.)
| | - Christoph Härtel
- Department of Pediatrics, University Hospital of Würzburg, Germany (J.M., C.H.)
| | - Wolfgang Göpel
- Department of Pediatrics, University Hospital of Schleswig-Holstein, Lübeck, Germany. (A.H., S.S., M.I.F., T.K.R., E.H., W.G.)
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12
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McLean G, Malhotra A, Lombardo P, Schneider M. Cranial Ultrasound Screening Protocols for Very Preterm Infants. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1645-1656. [PMID: 33895036 DOI: 10.1016/j.ultrasmedbio.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
Cranial ultrasound examinations are routinely performed in very preterm neonates. There is no widespread agreement on the optimal timing of these examinations. This review examines screening protocols and recommendations available for the timing of cranial ultrasound examinations in preterm neonates born before 32 wk of gestation. A systematic search was performed to find published screening protocols, and 18 articles were included in the final review. The protocols varied in their recommendations on timing, although at least one examination in the first week of life was universally recommended. The recommended timing for a "late" or final ultrasound examination was variable, and included at 6 wks of postnatal age, term-equivalent age or hospital discharge. There was no agreement as to whether weekly or fortnightly sequential ultrasound imaging should be performed after the first week of life. Further studies are required to establish an optimal protocol for these very preterm neonates to improve detection and monitoring of brain injuries.
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Affiliation(s)
- Glenda McLean
- Diagnostic Imaging Department, Monash Health, Melbourne, Australia; Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Australia.
| | - Atul Malhotra
- Monash Newborn, Monash Children's Hospital, Clayton, Australia; Department of Paediatrics, Monash University, Melbourne, Australia
| | - Paul Lombardo
- Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Australia
| | - Michal Schneider
- Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Australia
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13
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Liu Y, Qu M, Wang N, Wang L. Effects of an evidence-based nursing intervention on neurological function and serum inflammatory cytokines in patients with acute cerebral infarction: A randomized controlled trial. Restor Neurol Neurosci 2021; 39:129-137. [PMID: 33935121 DOI: 10.3233/rnn-201080] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Acute cerebral infarction is a clinically common and critical disease which seriously endangers the life and safety of elderly patients. Evidence-based nursing is an effective way of nursing and has great significance in improving the neurological function and quality of life of patients. In China, evidence-based nursing has been highlighted and highly developed in recent decades. OBJECTIVES This research aimed to investigate the effect of evidence-based nursing on the recovery of neurological function and serum inflammatory cytokines in patients with acute cerebral infarction. METHODS A total of 116 patients with acute cerebral infarction were randomly divided into two groups: the control group patients (n = 58) received conventional nursing, while the intervention group patients (n = 58) received evidence-based nursing intervention. National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer assessment (FMA) and activities of daily living (ADL) scores, as well as serum TNF-α and IL-6 levels were evaluated and compared between the two groups. RESULTS NIHSS scores in the intervention group were significantly lower than the control group. FMA and ADL scores in the intervention group were significantly higher than the control group. TNF-α and IL-6 levels in the serum of the intervention group were significantly lower than the control group. CONCLUSIONS In conclusion, evidence-based nursing has a positive effect on the treatment of patients with acute cerebral infarction, which decreases the level of serum inflammatory cytokines and contributes to the recovery of neurological function, motor function and activities of daily living.
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Affiliation(s)
- Yaping Liu
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Mingwei Qu
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Nan Wang
- Party Office, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Limin Wang
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
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14
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Genestine M, Ambriz D, Crabtree GW, Dummer P, Molotkova A, Quintero M, Mela A, Biswas S, Feng H, Zhang C, Canoll P, Hargus G, Agalliu D, Gogos JA, Au E. Vascular-derived SPARC and SerpinE1 regulate interneuron tangential migration and accelerate functional maturation of human stem cell-derived interneurons. eLife 2021; 10:e56063. [PMID: 33904394 PMCID: PMC8099424 DOI: 10.7554/elife.56063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 04/26/2021] [Indexed: 12/18/2022] Open
Abstract
Cortical interneurons establish inhibitory microcircuits throughout the neocortex and their dysfunction has been implicated in epilepsy and neuropsychiatric diseases. Developmentally, interneurons migrate from a distal progenitor domain in order to populate the neocortex - a process that occurs at a slower rate in humans than in mice. In this study, we sought to identify factors that regulate the rate of interneuron maturation across the two species. Using embryonic mouse development as a model system, we found that the process of initiating interneuron migration is regulated by blood vessels of the medial ganglionic eminence (MGE), an interneuron progenitor domain. We identified two endothelial cell-derived paracrine factors, SPARC and SerpinE1, that enhance interneuron migration in mouse MGE explants and organotypic cultures. Moreover, pre-treatment of human stem cell-derived interneurons (hSC-interneurons) with SPARC and SerpinE1 prior to transplantation into neonatal mouse cortex enhanced their migration and morphological elaboration in the host cortex. Further, SPARC and SerpinE1-treated hSC-interneurons also exhibited more mature electrophysiological characteristics compared to controls. Overall, our studies suggest a critical role for CNS vasculature in regulating interneuron developmental maturation in both mice and humans.
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Affiliation(s)
- Matthieu Genestine
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
| | - Daisy Ambriz
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
| | - Gregg W Crabtree
- Department of Neurology, Columbia University Irving Medical CenterNew YorkUnited States
| | - Patrick Dummer
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
| | - Anna Molotkova
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
| | - Michael Quintero
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
| | - Angeliki Mela
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
| | - Saptarshi Biswas
- Department of Neurology, Columbia University Irving Medical CenterNew YorkUnited States
| | - Huijuan Feng
- Department of Department of Systems Biology, Columbia University Irving Medical CenterNew YorkUnited States
| | - Chaolin Zhang
- Department of Department of Systems Biology, Columbia University Irving Medical CenterNew YorkUnited States
| | - Peter Canoll
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
| | - Gunnar Hargus
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
| | - Dritan Agalliu
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
- Department of Neurology, Columbia University Irving Medical CenterNew YorkUnited States
| | - Joseph A Gogos
- Department of Cellular Physiology and Biophysics, Columbia UniversityNew YorkUnited States
- Department of Neuroscience, Zuckerman Mind Brain and Behavior Institute, Columbia UniversityNew YorkUnited States
| | - Edmund Au
- Department of Pathology and Cell Biology, Columbia UniversityNew YorkUnited States
- Columbia Translational Neuroscience Initiative ScholarNew YorkUnited States
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15
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Birnbaum R, Winsteen A, Brusilov M, Wolman I, Ben-Sira L, Malinger G, Krajden Haratz K. A unique brain germinal matrix involvement in cytomegalovirus infected fetuses: A retrospective neurosonographic analysis with outcome correlation. Prenat Diagn 2021; 41:877-883. [PMID: 33440022 DOI: 10.1002/pd.5888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/07/2020] [Accepted: 12/20/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To study the clinical significance of brain germinal matrix (GM) changes in cytomegalovirus (CMV) infected fetuses. METHOD This is a retrospective analysis. Group A; isolated GM finding, with or without lenticulostriatal vasculopathy (LSV). Group B; non-isolated lesion. Amniocentesis, urinalysis, postnatal US and developmental assessment, were obtained. RESULTS Group A and B included 18 and four fetuses, respectively. In group A, mean fetal age at diagnosis was 34.3 weeks (31-38 weeks). In 15/18 (83.3%), the lesion was bilateral and LSV was present in 8/18 (44.4%). Small cysts appeared inside the lesion in 5/18 (27.7%). MRI was normal in 8/18 (44.4%). Subtle or inconclusive findings were reported in the remaining fetuses. Brain ultrasound was normal in 10/18 (55.5%) of newborns. In the remaining, caudothalamic cyst with or without LSV, or isolated LSV were found. All newborns are developing normally at a mean follow-up age of 33.3 months (+/- 19.6 moths). In group B, all four patients requested for termination of pregnancy. CONCLUSION Fetal CMV infection may cause focal GM changes, frequently accompanied by LSV, late in pregnancy. These changes may be isolated, or as part of a more generalized brain damage. When isolated, favorable prognosis is expected.
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Affiliation(s)
- Roee Birnbaum
- OB-GYN Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Adi Winsteen
- OB-GYN Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Michael Brusilov
- OB-GYN Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Igal Wolman
- OB-GYN Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Liat Ben-Sira
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.,Tel Aviv Sourasky Medical Center, Pediatric Radiology Unit, Tel Aviv, Israel
| | - Gustavo Malinger
- OB-GYN Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Karina Krajden Haratz
- OB-GYN Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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16
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Kalailingam P, Wang KQ, Toh XR, Nguyen TQ, Chandrakanthan M, Hasan Z, Habib C, Schif A, Radio FC, Dallapiccola B, Weiss K, Nguyen LN. Deficiency of MFSD7c results in microcephaly-associated vasculopathy in Fowler syndrome. J Clin Invest 2021; 130:4081-4093. [PMID: 32369449 DOI: 10.1172/jci136727] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/22/2020] [Indexed: 02/06/2023] Open
Abstract
Several missense mutations in the orphan transporter FLVCR2 have been reported in Fowler syndrome. Affected subjects exhibit signs of severe neurological defects. We identified the mouse ortholog Mfsd7c as a gene expressed in the blood-brain barrier. Here, we report the characterizations of Mfsd7c-KO mice and compare these characterizations to phenotypic findings in humans with biallelic FLVCR2 mutations. Global KO of Mfsd7c in mice resulted in late-gestation lethality, likely due to CNS phenotypes. We found that the angiogenic growth of CNS blood vessels in the brain of Mfsd7c-KO embryos was inhibited in cortical ventricular zones and ganglionic eminences. Vascular tips were dilated and fused, resulting in glomeruloid vessels. Nonetheless, CNS blood vessels were intact, without hemorrhage. Both embryos and humans with biallelic FLVCR2 mutations exhibited reduced cerebral cortical layers, enlargement of the cerebral ventricles, and microcephaly. Transcriptomic analysis of Mfsd7cK-KO embryonic brains revealed upregulation of genes involved in glycolysis and angiogenesis. The Mfsd7c-KO brain exhibited hypoxia and neuronal cell death. Our results indicate that MFSD7c is required for the normal growth of CNS blood vessels and that ablation of this gene results in microcephaly-associated vasculopathy in mice and humans.
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Affiliation(s)
- Pazhanichamy Kalailingam
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kai Qi Wang
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xiu Ru Toh
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Toan Q Nguyen
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Madhuvanthi Chandrakanthan
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Zafrul Hasan
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Clair Habib
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Aharon Schif
- Pediatric Neurology Unit, Rambam Health Care Center, Ruth Children's Hospital, Haifa, Israel
| | - Francesca Clementina Radio
- Genetics and Rare Diseases Research Area, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Bruno Dallapiccola
- Genetics and Rare Diseases Research Area, Bambino Gesù Children's Hospital, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy
| | - Karin Weiss
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel.,Genetics Institute, Rambam Health Care Center, Haifa, Israel
| | - Long N Nguyen
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,SLING and Immunology Program, Life Sciences Institute, Centre for Life Sciences, National University of Singapore, Singapore.,Cardiovascular Disease Research (CVD) Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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17
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Whitehead K, Jones L, Laudiano-Dray MP, Meek J, Fabrizi L. Altered cortical processing of somatosensory input in pre-term infants who had high-grade germinal matrix-intraventricular haemorrhage. NEUROIMAGE-CLINICAL 2019; 25:102095. [PMID: 31835239 PMCID: PMC6920135 DOI: 10.1016/j.nicl.2019.102095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 11/06/2019] [Accepted: 11/15/2019] [Indexed: 12/27/2022]
Abstract
Infants who had GM-IVH recruit different cortical sources following foot stimulation. Results indicate restructuring of somatosensory processing during the weeks after GM-IVH. GM-IVH is more detrimental for lower than upper limb somatosensory processing.
High-grade (large) germinal matrix-intraventricular haemorrhage (GM-IVH) is one of the most common causes of somatomotor neurodisability in pre-term infants. GM-IVH presents during the first postnatal week and can impinge on somatosensory circuits resulting in aberrant somatosensory cortical events straight after injury. Subsequently, somatosensory circuits undergo significant plastic changes, sometimes allowing the reinstatement of a somatosensory cortical response. However, it is not known whether this restructuring results in a full recovery of somatosensory functions. To investigate this, we compared somatosensory responses to mechanical stimulation measured with 18-channels EEG between infants who had high-grade GM-IVH (with ventricular dilatation and/or intraparenchymal lesion; n = 7 studies from 6 infants; mean corrected gestational age = 33 weeks; mean postnatal age = 56 days) and age-matched controls (n = 9 studies from 8 infants; mean corrected gestational age = 32 weeks; mean postnatal age = 36 days). We showed that infants who had high-grade GM-IVH did not recruit the same cortical source configuration following stimulation of the foot, but their response to stimulation of the hand resembled that of controls. These results show that somatosensory cortical circuits are reinstated in infants who had GM-IVH, during the several weeks after injury, but remain different from those of infants without brain injury. An important next step will be to investigate whether these evidences of neural reorganisation predict neurodevelopmental outcome.
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Affiliation(s)
- Kimberley Whitehead
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom.
| | - Laura Jones
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom.
| | - Maria Pureza Laudiano-Dray
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom.
| | - Judith Meek
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom; Elizabeth Garrett Anderson Wing, University College London Hospitals, London WC1E 6BD, United Kingdom.
| | - Lorenzo Fabrizi
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom.
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