Targeting cellular batteries for the therapy of neurological diseases

Targeting calcium homeostasis and impaired inter-organelle crosstalk as a potential therapeutic approach in Parkinson's disease

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta, leading to motor symptoms such as tremors, rigidity, and bradykinesia. Current therapeutic strategies for PD are limited and mainly involve symptomatic relief, with no available treatment for the underlying causes of the disease. Therefore, there is a need for new therapeutic approaches that target the underlying pathophysiological mechanisms of PD. Calcium homeostasis is an essential process for maintaining proper cellular function and survival, including neuronal cells. Calcium dysregulation is also observed in various organelles, including the endoplasmic reticulum (ER), mitochondria, and lysosomes, resulting in organelle dysfunction and impaired inter-organelle communication. The ER, as the primary calcium reservoir, is responsible for folding proteins and maintaining calcium homeostasis, and its dysregulation can lead to protein misfolding and neurodegeneration. The crosstalk between ER and mitochondrial calcium signaling is disrupted in PD, leading to neuronal dysfunction and death. In addition, a lethal network of calcium cytotoxicity utilizes mitochondria, ER and lysosome to destroy neurons. This review article focused on the complex role of calcium dysregulation and its role in aggravating functioning of organelles in PD so as to provide new insight into therapeutic strategies for treating this disease. Targeting dysfunctional organelles, such as the ER and mitochondria and lysosomes and whole network of calcium dyshomeostasis can restore proper calcium homeostasis and improve neuronal function. Additionally targeting calcium dyshomeostasis that arises from miscommunication between several organelles can be targeted so that therapeutic effects of calcium are realised in whole cellular territory.

Free radical biology in neurological manifestations: mechanisms to therapeutics interventions

Recent advancements and growing attention about free radicals (ROS) and redox signaling enable the scientific fraternity to consider their involvement in the pathophysiology of inflammatory diseases, metabolic disorders, and neurological defects. Free radicals increase the concentration of reactive oxygen and nitrogen species in the biological system through different endogenous sources and thus increased the overall oxidative stress. An increase in oxidative stress causes cell death through different signaling mechanisms such as mitochondrial impairment, cell-cycle arrest, DNA damage response, inflammation, negative regulation of protein, and lipid peroxidation. Thus, an appropriate balance between free radicals and antioxidants becomes crucial to maintain physiological function. Since the 1brain requires high oxygen for its functioning, it is highly vulnerable to free radical generation and enhanced ROS in the brain adversely affects axonal regeneration and synaptic plasticity, which results in neuronal cell death. In addition, increased ROS in the brain alters various signaling pathways such as apoptosis, autophagy, inflammation and microglial activation, DNA damage response, and cell-cycle arrest, leading to memory and learning defects. Mounting evidence suggests the potential involvement of micro-RNAs, circular-RNAs, natural and dietary compounds, synthetic inhibitors, and heat-shock proteins as therapeutic agents to combat neurological diseases. Herein, we explain the mechanism of free radical generation and its role in mitochondrial, protein, and lipid peroxidation biology. Further, we discuss the negative role of free radicals in synaptic plasticity and axonal regeneration through the modulation of various signaling molecules and also in the involvement of free radicals in various neurological diseases and their potential therapeutic approaches. The primary cause of free radical generation is drug overdosing, industrial air pollution, toxic heavy metals, ionizing radiation, smoking, alcohol, pesticides, and ultraviolet radiation. Excessive generation of free radicals inside the cell R1Q1 increases reactive oxygen and nitrogen species, which causes oxidative damage. An increase in oxidative damage alters different cellular pathways and processes such as mitochondrial impairment, DNA damage response, cell cycle arrest, and inflammatory response, leading to pathogenesis and progression of neurodegenerative disease other neurological defects.

The recovery management of patients with operated extrame-dullary spinal arteriovenous fistula, evolution and socio-professional reintegration: case report and review of the litera-ture

Adequate therapeutic intervention performed in the case of extradural spinal AVM and an inten-sive recovery program allow the amelioration of neurological manifestations in a very high percentage. With the ultimate goal of practicing a trade, a good biological recovery is needed for social recovery. The effectiveness of strategies for professional integration and reintegration de-pends largely on the patient’s experiences before the onset of the disease. The paper aims to re-view the treatment, the evolution of patients with extradural spinal AV and the possibilities of socio-professional reintegration. Methods and analysis. A case presentation of a patient diag-nosed with extradural spinal AV fistula is proposed, along with a review of the current literature on the treatment of this pathology, the evolution and the possibilities of vocational recovery. The studies will be analysed and selected in two stages, in the first stage the titles and abstracts, in the second stage, the articles with full text will be analysed, selected and a narrative synthesis of the included studies will be made. Summary case. The 51-year-old urban patient, a profes-sional driving instructor who underwent endovascular and surgical treatment for extradural spinal AV fistula, is hospitalized for a moderate motor deficit, such as paraparesis, back pain, mechanical pain in the knees and gait disorders. The objectives of recovery are represented by neuromotor recovery and socio-professional reintegration. Conclusions. Spinal EAVFs are rare lesions with a low risk of bleeding; the clinical manifestations are determined by the compres-sion of the bone marrow; these being significantly improved after the endovascular and surgical treatment. Studies show a good long-term prognosis, which is determined by the absence of re-currences. An essential role in the integration of patients with disabilities in the socio-professional life is the identification of their deficiencies and their reorientation according to the outstanding abilities, the stimulation of the preserved skills. Keywords: rehabilitation, disc hernia, low back pain, paraplegia