Protective effects of activated protein C on neurovascular unit in a rat model of intrauterine infection-induced neonatal white matter injury

Neurovascular unit dysregulation, white matter disease, and executive dysfunction: the shared triad of vascular cognitive impairment and Alzheimer disease

Executive dysfunction is the most important predictor for loss of independence in dementia. As executive function involves the coordination of distributed cerebral functions, executive function requires healthy white matter. However, white matter is highly vulnerable to cerebrovascular insults, with executive dysfunction being a core feature of vascular cognitive impairment (VCI). At the same time, cerebrovascular pathology, white matter disease, and executive dysfunction are all increasingly recognized as features of Alzheimer disease (AD). Recent studies have characterized the crucial role of glial cells in the pathological changes observed in both VCI and AD. In comorbid VCI and AD, the glial cells of the neurovascular unit (NVU) emerge as important therapeutic targets for the preservation of white matter integrity and executive function. Our synthesis from current research identifies dysregulation of the NVU, white matter disease, and executive dysfunction as a fundamental triad that is common to both VCI and AD. Further study of this triad will be critical for advancing the prevention and management of dementia.

Inhibitory Effect of LPS on the Proliferation of Oligodendrocyte Precursor Cells through the Notch Signaling Pathway in Intrauterine Infection-induced Rats

Periventricular white matter injury (PWMI) is very common in survivors of premature birth, and the final outcomes are a reduction in myelinated neurons leading to white matter hypomyelination. How and (or) why the oligodendrocyte lineage develops abnormally and myelination is reduced is a hot topic in the field. This study focuses on the effect of intrauterine inflammation on the proliferation of oligodendrocyte lineage cells and the underlying mechanisms. Lipopolysaccharide (LPS) (300 μg/kg) was intraperitoneally injected into pregnant Sprague-Dawley rats at embryonic days 19 and 20 to establish a rat model of intrauterine infection-induced white matter injury. Corpus callosum tissues were collected at postnatal day 14 (P14) to quantify the number of oligodendrocytes, the number and proliferation of oligodendrocyte precursor cells (OPCs), and the expression of myelin proteins (MBP and PLP). Furthermore, the expression of Wnt and Notch signaling-related proteins was analyzed. The results showed that the number of oligodendrocytes in the corpus callosum tissues of LPS-treated rats was reduced, and the expression levels of myelinating proteins were down-regulated. Further analysis showed that the Notch signaling pathway was down-regulated in the LPStreated group. These results indicate that intrauterine LPS may inhibit the proliferation of OPCs by down-regulating the Notch rather than the Wnt signaling pathway, leading to hypomyelination of white matter.

Predictive value of procalcitonin or c-reactive protein for subclinical intrauterine infection in patients with premature rupture of membranes (PROM)

INTRODUCTION

to evaluate the diagnostic value of procalcitonin (PCT) and C-reactive protein (CRP) for the prediction of subclinical intrauterine infection in patients with premature rupture of membranes (PROM).

METHODS

a retrospective analysis was performed based on patients with PROM admitted into our hospital between January 2011 and January 2016. Using the pathological diagnosis of placenta as the gold standard, the sensitivities, specificities, positive predictive values, and negative predictive values of PCT and CRP for the diagnosis of subclinical intrauterine infection at different gestational weeks were analyzed. Further, the diagnostic accuracies were compared according to their receiver operating characteristic (ROC) curves.

RESULTS

276 cases were included. The area under the ROC curve of CRP is 0.632, and it is significantly better than PCT. The sensitivity, specificity, positive predictive value, and negative predictive value of CRP are 0.686, 0.958, 0.501, and 0.765, which are all better than those of PCT. The group analysis according to different gestational weeks demonstrated that for the group of 28-33+6 weeks pregnant women, the area under the ROC curve of CRP and PCT is 0.869, and 0.787. The both test have satisfactory accuracy. But the sensitivity and specificity of PCT is 0.830, and 0.950, respectively. That are significantly better than CRP.

CONCLUSION

both PCT and CRP have good application potential for the diagnostic prediction of subclinical intrauterine infection in <34 gestational weeks pregnant women with PROM, and PCT is more applicable to 28-33+6 gestational weeks pregnant women with PROM.