A hypothesis accounting for the inconsistent benefit of glucocorticoid therapy in closed head trauma

Pharmacological Neuroprotection During Cardiac Surgery

Despite more than 30 years of aggressive neuroprotective research by many investigators, neuropsychological deficit after cardiac surgery remains an important cause of postoperative morbidity. Although the neurological outcome is a result of a multifactorial etiology, many physicians world-wide have recognized the importance of this problem, and extensive efforts have been made in attempting to minimize the incidence of neurological and neurocognitive dysfunction. Pharmacological intervention is one of the important potential methods of neuroprotection during cardiac surgery. In vitro studies have identified drugs that are effective protectants against focal cerebral ischemia, hemorrhage, and global ischemia. However, at present there is no solid agreement on the need for prophylactic neuroprotectants in cardiac surgery. Researchers and clinicians must become more cognizant of the pitfalls and paradoxes that have arisen in attempting to translate the results of animal studies into clinical trial, with regard to neuroprotective therapy during cardiac surgery. There is an extensive need for new pharmacological approaches directed at reducing neurologic and neurocognitive injury during cardiac surgery. This article reviews past and present neuroprotective efforts and interventions during cardiac surgery.

Glutamate signaling through the kainate receptor enhances human immunoglobulin production

CD23 is implicated as a regulator of IgE synthesis. A soluble form of CD23 (sCD23) is released following cleavage by ADAM10 and enhanced sCD23 is correlated with increased IgE. In the CNS, signaling through the kainate receptor (KAR) increases ADAM10. In B cells, activation of KARs produced a significant increase in ADAM10 and sCD23 release as well as an increase in B cell proliferation and immunoglobulin production. In addition, ADAM10 inhibitors reduce IgE synthesis from in vitro cultures of human B cells. Thus, we report for the first time the unique presence of the kainate receptor in B cells and that activation of KARs could serve as a novel mechanism for enhancing B cell activation.