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Banerjee G, Collinge J, Fox NC, Lashley T, Mead S, Schott JM, Werring DJ, Ryan NS. Clinical considerations in early-onset cerebral amyloid angiopathy. Brain 2023; 146:3991-4014. [PMID: 37280119 PMCID: PMC10545523 DOI: 10.1093/brain/awad193] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 06/08/2023] Open
Abstract
Cerebral amyloid angiopathy (CAA) is an important cerebral small vessel disease associated with brain haemorrhage and cognitive change. The commonest form, sporadic amyloid-β CAA, usually affects people in mid- to later life. However, early-onset forms, though uncommon, are increasingly recognized and may result from genetic or iatrogenic causes that warrant specific and focused investigation and management. In this review, we firstly describe the causes of early-onset CAA, including monogenic causes of amyloid-β CAA (APP missense mutations and copy number variants; mutations of PSEN1 and PSEN2) and non-amyloid-β CAA (associated with ITM2B, CST3, GSN, PRNP and TTR mutations), and other unusual sporadic and acquired causes including the newly-recognized iatrogenic subtype. We then provide a structured approach for investigating early-onset CAA, and highlight important management considerations. Improving awareness of these unusual forms of CAA amongst healthcare professionals is essential for facilitating their prompt diagnosis, and an understanding of their underlying pathophysiology may have implications for more common, late-onset, forms of the disease.
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Affiliation(s)
- Gargi Banerjee
- MRC Prion Unit at University College London (UCL), Institute of Prion Diseases, UCL, London, W1W 7FF, UK
| | - John Collinge
- MRC Prion Unit at University College London (UCL), Institute of Prion Diseases, UCL, London, W1W 7FF, UK
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UK Dementia Research Institute at UCL, London, WC1E 6BT, UK
| | - Tammaryn Lashley
- The Queen Square Brain Bank for Neurological Disorders, Department of Clinical and Movement Disorders, UCL Queen Square Institute of Neurology, London, W1 1PJ, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Simon Mead
- MRC Prion Unit at University College London (UCL), Institute of Prion Diseases, UCL, London, W1W 7FF, UK
| | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UK Dementia Research Institute at UCL, London, WC1E 6BT, UK
| | - David J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Natalie S Ryan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
- UK Dementia Research Institute at UCL, London, WC1E 6BT, UK
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Lu A, Duan P, Xie J, Gao H, Chen M, Gong Y, Li J, Xu H. Recent progress and research trend of anti-cataract pharmacology therapy: A bibliometric analysis and literature review. Eur J Pharmacol 2022; 934:175299. [PMID: 36181780 DOI: 10.1016/j.ejphar.2022.175299] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022]
Abstract
Cataract is the leading cause of blindness worldwide. Cataract phacoemulsification combined with intraocular lens implantation causes great burden to global healthcare, especially for low- and middle-income countries. Such burden would be significantly relieved if cataracts can effectively be treated or delayed by non-surgical means. Excitingly, novel drugs have been developed to treat cataracts in recent decades. For example, oxysterols are found to be able to innovatively reverse lens clouding, novel nanotechnology-loaded drugs improve anti-cataract pharmacological effect, and traditional Chinese medicine demonstrates promising therapeutic effects against cataracts. In the present review, we performed bibliometric analysis to provide an overview perspective regarding the research status, hot topics, and academic trends in the field of anti-cataract pharmacology therapy. We further reviewed the curative effects and molecular mechanisms of anti-cataract drugs such as lanosterol, metformin, resveratrol and curcumin, and prospected the possibility of their clinical application in future.
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Affiliation(s)
- Ao Lu
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China; Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China; The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing, China
| | - Ping Duan
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China; Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Jing Xie
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China; Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Hui Gao
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China; Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Mengmeng Chen
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China; Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Yu Gong
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China; Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Jiawen Li
- Department of Ophthalmology, University-Town Hospital of Chongqing Medical University, China.
| | - Haiwei Xu
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China; Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China.
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Yao D, Li S, Jing J, Cai X, Jin A, Yang Y, Wang S, Meng X, Lin J, Mei L, Li H, Wei T, Wang Y, Pan Y, Wang Y. Association of Serum Cystatin C With Cerebral Small Vessel Disease in Community-Based Population. Stroke 2022; 53:3123-3132. [PMID: 35862202 DOI: 10.1161/strokeaha.122.039277] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND:
The aim of this study was to investigate the relationship between serum cystatin C levels and the presence and severity of cerebral small vessel disease (CSVD).
METHODS:
Community-dwelling residents in the Lishui city in China from the cross-sectional survey of the PRECISE (Poly-Vascular Evaluation for Cognitive Impairment and Vascular Events) cohort study were included in present study from 2017 to 2019. Total CSVD burden and modified total CSVD burden score, as well as the markers of CSVD on magnetic resonance imaging, including white matter hyperintensity, lacunes, cerebral microbleeds, and perivascular spaces, were assessed at baseline survey. Participants were divided into 4 groups according to the quartiles of cystatin C. The association of serum cystatin C with total CSVD burden and imaging markers was analyzed using ordinal or binary logistic regression models. Furthermore, 2-sample Mendelian randomization analysis was performed to investigate the genetically predicted effect of cystatin C on CSVD.
RESULTS:
A total of 3061 participants were included in this study. The mean age of the participants was 61.2±6.7 years, and 1637 (53.5%) were women. Higher level of cystatin C was associated with an increased total CSVD burden and modified total CSVD burden (Q4 versus Q1: common odds ratio [OR], 1.30 [95% CI, 1.03–1.64] and 1.32 [95% CI, 1.01–1.73]) after adjustment for covariates. Further, compared with the first quartile of cystatin C, subjects in the last quartile had higher risk of lacunes (OR, 1.99 [95% CI, 1.05–3.76]), modified white matter hyperintensity burden (common OR, 1.42 [95% CI, 1.07–1.90]), and moderate-to-severe perivascular spaces (OR, 2.15 [95% CI, 1.29–3.59]) but not cerebral microbleeds. The Mendelian randomization analysis showed that a genetically predicted higher cystatin C level was associated with increased risk of lacunar stroke (OR, 1.16 [95% CI, 1.06–1.27]).
CONCLUSIONS:
In this community-based study, we found a possible association between cystatin C and CSVD, especially for lacunes, that was independent of estimated glomerular filtration rate.
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Affiliation(s)
- Dongxiao Yao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Shan Li
- Cerebrovascular Research Lab, Lishui Hospital, Zhejiang University School of Medicine, China. (S.L., S.W., L.M.)
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Xueli Cai
- Department of Neurology, Lishui Hospital, Zhejiang University School of Medicine, China. (X.C.)
| | - Aoming Jin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Yingying Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Suying Wang
- Cerebrovascular Research Lab, Lishui Hospital, Zhejiang University School of Medicine, China. (S.L., S.W., L.M.)
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Jinxi Lin
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Lerong Mei
- Cerebrovascular Research Lab, Lishui Hospital, Zhejiang University School of Medicine, China. (S.L., S.W., L.M.)
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Tiemin Wei
- Department of Cardiology, Lishui Hospital, Zhejiang University School of Medicine, China. (T.W.)
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
- China National Clinical Research Center for Neurological Diseases, Beijing (D.Y., J.J., A.J., Y.Y., X.M., J.L., H.L., Yongjun Wang, Y.P., Yilong Wang)
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