Smoking and Cerebral Oxidative Stress and Air Pollution: A Dreadful Equation with Particulate Matter Involved and One More Powerful Reason Not to Smoke Anything!

Autoencoder to Identify Sex-Specific Sub-phenotypes in Alzheimer's Disease Progression Using Longitudinal Electronic Health Records

Alzheimer's Disease (AD) is a complex neurodegenerative disorder significantly influenced by sex differences, with approximately two-thirds of AD patients being women. Characterizing the sex-specific AD progression and identifying its progression trajectory is a crucial step to developing effective risk stratification and prevention strategies. In this study, we developed an autoencoder to uncover sex-specific sub-phenotypes in AD progression leveraging longitudinal electronic health record (EHR) data from OneFlorida+ Clinical Research Consortium. Specifically, we first constructed temporal patient representation using longitudinal EHRs from a sex-stratified AD cohort. We used a long short-term memory (LSTM)-based autoencoder to extract and generate latent representation embeddings from sequential clinical records of patients. We then applied hierarchical agglomerative clustering to the learned representations, grouping patients based on their progression sub-phenotypes. The experimental results show we successfully identified five primary sex-based AD sub-phenotypes with corresponding progression pathways with high confidence. These sex-specific sub-phenotypes not only illustrated distinct AD progression patterns but also revealed differences in clinical characteristics and comorbidities between females and males in AD development. These findings could provide valuable insights for advancing personalized AD intervention and treatment strategies.

Impaired antioxidant KEAP1-NRF2 system in amyotrophic lateral sclerosis: NRF2 activation as a potential therapeutic strategy

BACKGROUND

Oxidative stress (OS) is an imbalance between oxidant and antioxidant species and, together with other numerous pathological mechanisms, leads to the degeneration and death of motor neurons (MNs) in amyotrophic lateral sclerosis (ALS).

MAIN BODY

Two of the main players in the molecular and cellular response to OS are NRF2, the transcription nuclear factor erythroid 2-related factor 2, and its principal negative regulator, KEAP1, Kelch-like ECH (erythroid cell-derived protein with CNC homology)-associated protein 1. Here we first provide an overview of the structural organization, regulation, and critical role of the KEAP1-NRF2 system in counteracting OS, with a focus on its alteration in ALS. We then examine several compounds capable of promoting NRF2 activity thereby inducing cytoprotective effects, and which are currently in different stages of clinical development for many pathologies, including neurodegenerative diseases.

CONCLUSIONS

Although challenges associated with some of these compounds remain, important advances have been made in the development of safer and more effective drugs that could actually represent a breakthrough for fatal degenerative diseases such as ALS.

“Vaping”- a Trojan Horse Against Fight Toward Tobacco Use and Cancer: A Systematic Review of the Existing Evidence

The purpose of this systematic review is to understand many aspects of vaping, like what is vaping, why it is more enticing to adolescents and young adults, what makes it more harmful than regular smoked tobacco products, subsequent health consequences, and what measures are currently being taken against this activity. A literature search was conducted in online database PubMed using search string “(((((Lung injury*[Title/Abstract]) AND Vaping[Title/Abstract]) OR electronic nicotine delivery device[Title/Abstract]) OR electronic cigarette*[Title/Abstract]) AND e-cigarettes liquid) AND electronic cigars and search filter used were “published in the last 5 years” and “Human Studies.” Similar search terms were used to search EMBASE, Web of Science, Google Scholar, and the CENTRAL database of the Cochrane Library with the help of Boolean terms. Thirty-six articles were included for a final systematic review. Many of the known brands use additives such as flavoring and thickening agents that, when used even for the short term, can cause toxicity to human lung tissues. This toxicity depends not only on the extent of the habit, but also on the variable susceptibility to lung damage, dual use with cigarettes, variability in the product design of different brands, and the liquid content used in them. Vaping may be linked with significant health issues, including respiratory diseases such as asthma, very severe forms of bronchitis such as popcorn lung, or E-cigarette, or vaping, product use-associated lung injury, and cardiovascular illnesses such as atherosclerotic plaque and myocardial ischemia. From the current systematic review, we would like to emphasize that no long-term toxicological and health studies have been carried out in humans using these vaping products and their constituents to date. Although cessation should be strongly encouraged in smokers for better quality of life, it is uncertain whether it is a universally safer option to replace cigarettes with these vaping devices.

Associations between metabolic syndrome and type of dementia: analysis based on the National Health Insurance Service database of Gangwon province in South Korea

BACKGROUND

Metabolic syndrome is a cluster of conditions that occur together, increasing the risk of cardiovascular disease. However, the relationship between metabolic syndrome and dementia has remained controversial. Using nationwide population cohort data, we investigated the association between metabolic syndrome and dementia, according to the dementia type.

METHODS

We analyzed data of 84,144 individuals, in the aged group of more than 60 years, between January 1, 2009, to December 31, 2009, at Gangwon province by using the information of the (Korean) National Health Insurance Service. After eight years of gap, in 2017, we investigated the relationship between metabolic syndrome and dementia. We classified Dementia either as dementia of the Alzheimer type (AD) or vascular dementia (VD). AD and VD were defined as per the criteria of International Classification of Disease, Tenth Revision, Clinical Modification codes. Multiple logistic regression analyses examined the associations between metabolic syndrome or five metabolic syndrome components and dementia. Analyses included factors like age, sex, smoking, alcohol, physical inactivity, previous stroke, and previous cardiac disease.

RESULTS

Metabolic syndrome was associated with AD (OR = 11.48, 95% CI 9.03-14.59), not with VD. Each of five components of metabolic syndrome were also associated with AD. (high serum triglycerides: OR = 1.87, 95% CI 1.60-2.19; high blood pressure: OR = 1.85, 95% CI 1.55-2.21; high glucose: OR = 1.77, 95% CI 1.52-2.06; abdominal obesity: OR = 1.88, 95% CI 1.57-2.25; low serum high-density lipoprotein cholesterol: OR = 1.91, 95% CI 1.63-2.24) However, among components of metabolic syndrome, only the high glucose level was associated with VD. (OR = 1.26, 95% CI 1.01-1.56) body mass index (BMI), fasting glucose, and smoking were also associated with AD. (BMI: OR = 0.951, 95% CI 0.927-0.975; fasting glucose: OR = 1.003, 95% CI 1.001-1.005; smoking: OR = 1.020, 95% CI 1.003-1.039) A history of the previous stroke was associated with both AD and VD. (AD: OR = 1.827, 95% CI 1.263-2.644; VD: OR 2.775, 95% CI 1.747-4.406) CONCLUSIONS: Metabolic syndrome was associated with AD but not with VD. Patients with metabolic syndrome had an 11.48 times more likeliness to develop AD compared to those without metabolic syndrome. VD was associated only with several risk factors that could affect the vascular state rather than a metabolic syndrome. We suggested that the associations between metabolic syndrome and dementia would vary depending on the type of dementia.

On the Etiopathogenesis and Pathophysiology of Alzheimer's Disease: A Comprehensive Theoretical Review

Alzheimers' disease (AD) is the most common cause of dementia, with an estimated 5 million new cases occurring annually. Among the elderly, AD shortens life expectancy, results in disability, decreases quality of life, and ultimately, leads to institutionalization. Despite extensive research in the last few decades, its heterogeneous pathophysiology and etiopathogenesis have made it difficult to develop an effective treatment and prevention strategy. Aging is the biggest risk factor for AD and evidence suggest that the total number of older people in the population is going to increase astronomically in the next decades. Also, there is evidence that air pollution and increasing income inequality may result in higher incidence and prevalence of AD. This makes the need for a comprehensive understanding of the etiopathogenesis and pathophysiology of the disease extremely critical. In this paper, a quintuple framework of thyroid dysfunction, vitamin D deficiency, sex hormones, and mitochondria dysfunction and oxidative stress are used to provide a comprehensive description of AD etiopathogenesis and pathophysiology. The individual role of each factor, their synergistic and genetic interactions, as well as the limitations of the framework are discussed.

Effects of prenatal exposure to NO2 on children's neurodevelopment: a systematic review and meta-analysis

The neurotoxicity of NO₂ exposure is well-known and potentially causes impaired of neural functions. This review aimed to estimate associations between prenatal NO₂ exposure and neurodevelopment for children. Articles published until May 2019 reported prenatal NO₂ exposure and children's cognition, psychomotor, language, attention, IQ, and behavior function were searched according to all related terms. The main databases we retrieved included PubMed, Web of Science, Embase, and Cochrane Library. Coefficient was extracted, conversed, and synthesized by random effects meta-analysis. Meanwhile, qualitatively describe would be used for some studies which cannot be synthesized quantitatively for lack of quantity or methods inconsistency. Finally, a total of 3848 citations were searched, and only 10 studies were included. We estimated that per 10 μg/m³ increase of NO₂ during pregnancy was associated with a - 0.76 point decrease in global psychomotor (95% CI, - 1.34, - 0.18) and a - 0.62 point decrease in fine psychomotor for children (95% CI, - 1.09, - 0.16). But no significant association found in general cognitive and language. In addition, through the literature review, it seemed that prenatal exposure to NO₂ might cause adverse impacts on children's attention, IQ, and different behaviors, but this requires confirmation from further researches. Our study indicated that prenatal exposure to NO₂ seems to be associated with impaired neural development for children, especially for fine psychomotor. However, further studies are needed for determining the effects of prenatal air pollution exposure on attention, IQ, and behavior.

On the central role of mitochondria dysfunction and oxidative stress in Alzheimer's disease

BACKGROUND

Alzheimer's disease (AD) is the commonest cause of dementia, with approximately 5 million new cases occurring annually. Despite decades of research, its complex pathophysiology and etiopathogenesis presents a major hindrance to the development of an effective treatment and prevention strategy. Aging is the biggest risk factor for the development of AD, and the total number of older people in the population is going to significantly increase in the next decades, suggesting that AD incidence and prevalence is likely to increase in the future. This makes the need for a better understanding of the disease to be extremely urgent.

METHODS

A search was done by accessing PubMed/Medline, EBSCO, and PsycINFO databases. The search string used was "(dementia* OR Alzheimer's) AND (pathophysiology* OR pathogenesis)". New key terms were identified (new term included "vitamin D, thyroid hormone, mitochondria dysfunction, oxidative stress, testosterone, estrogen, melatonin, progesterone, luteinizing hormone, amyloid-β (Aβ), and hyperphosphorylated tau"). The electronic databases were searched for titles or abstracts containing these terms in all published articles between January 1, 1965, and January 31, 2019. The search was limited to studies published in English and other languages involving both animal and human subjects.

RESULTS

Mitochondria dysfunction and oxidative stress play a critical role in AD etiopathogenesis and pathophysiology.

CONCLUSION

AD treatment and prevention strategies must be geared towards improving mitochondrial function and attenuating oxidative stress.

In utero exposure to fine particulate matter results in an altered neuroimmune phenotype in adult mice

Environmental exposure to air pollution has been linked to a number of health problems including organ rejection, lung damage and inflammation. While the deleterious effects of air pollution in adult animals are well documented, the long-term consequences of particulate matter (PM) exposure during animal development are uncertain. In this study we tested the hypothesis that environmental exposure to PM 2.5 μm in diameter in utero promotes long term inflammation and neurodegeneration. We evaluated the behavior of PM exposed animals using several tests and observed deficits in spatial memory without robust changes in anxiety-like behavior. We then examined how this affects the brains of adult animals by examining proteins implicated in neurodegeneration, synapse formation and inflammation by western blot, ELISA and immunohistochemistry. These tests revealed significantly increased levels of COX2 protein in PM2.5 exposed animal brains in addition to changes in synaptophysin and Arg1 proteins. Exposure to PM2.5 also increased the immunoreactivity for GFAP, a marker of activated astrocytes. Cytokine concentrations in the brain and spleen were also altered by PM2.5 exposure. These findings indicate that in utero exposure to particulate matter has long term consequences which may affect the development of both the brain and the immune system in addition to promoting inflammatory change in adult animals.