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Salken I, Provencio JJ, Coulibaly AP. A potential therapeutic target: The role of neutrophils in the central nervous system. Brain Behav Immun Health 2023; 33:100688. [PMID: 37767236 PMCID: PMC10520304 DOI: 10.1016/j.bbih.2023.100688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
Neutrophils play a critical role in immune defense as the first recruited and most abundant leukocytes in the innate immune system. As such, regulation of neutrophil effector functions have strong implications on immunity. These cells display a wide heterogeneity of function, including both inflammatory and immunomodulatory roles. Neutrophils commonly infiltrate the central nervous system (CNS) in response to varied pathological conditions. There is still little understanding of the role these cells play in the CNS in such conditions. In the present review, we will summarize what is known of neutrophil's role in cancer and Alzheimer's disease (AD), with a focus on highlighting the gaps in our understanding.
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Affiliation(s)
- Isabel Salken
- College of Arts and Science, University of Virginia, USA
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Jiao Y, Peng W, Yang J, Li C. Effect of Repetitive Transcranial Magnetic Stimulation on the Nutritional Status and Neurological Function of Patients With Postischemic Stroke Dysphagia. Neurologist 2023; 28:69-72. [PMID: 35593910 DOI: 10.1097/nrl.0000000000000442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND This project aimed to explore the effects of repetitive transcranial magnetic stimulation (rTMS) on the nutritional status and neurological function of patients with postischemic stroke dysphagia. MATERIALS AND METHODS After recruiting 70 inpatients with cerebral infarction combined with dysphagia hospitalized in the Cerebrovascular Center of Guangdong Second Provincial General Hospital from June 2017 to June 2020, we assigned them randomly into a control group and an rTMS group. Patients in the control group received swallowing training, while patients of the rTMS group received swallowing training and rTMS. RESULTS Fifteen days after treatment, serum nutrition indexes and neurotrophic indexes of both groups were higher than before treatment, and their serum nerve injury indexes were lower than before treatment. After 15 days of treatment, the body nutrition indexes and neuronutrition indexes of the rTMS group were higher than those of the control group, while the nerve injury indexes of the rTMS group were lower than those of the control group. CONCLUSION rTMS in the treatment of dysphagia after stroke can better improve nutritional status and nerve function, reducing nerve damage.
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Affiliation(s)
- Yonggang Jiao
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province
| | - Wei Peng
- Department of Neurology, People's Hospital of Wuwei of Gansu Province, Wuwei, Gansu Province, China
| | - Jingping Yang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province
| | - Cheng Li
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province
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Coulibaly AP. Neutrophil modulation of behavior and cognition in health and disease: The unexplored role of an innate immune cell. Immunol Rev 2022; 311:177-186. [PMID: 35924463 PMCID: PMC9804154 DOI: 10.1111/imr.13123] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Behavior and cognition are multifaceted processes influenced by genetics, synaptic plasticity, and neuronal connectivity. Recent reports have demonstrated that peripheral inflammation and peripheral immune cells play important roles in the preservation and deterioration of behavior/cognition under various conditions. Indeed, several studies show that the activity of peripheral immune cells can be critical for normal cognitive function. Neutrophils are the most abundant immune cells in the mammalian system. Their activation is critical to the initiation of the inflammatory process and critical for wound healing. Neutrophils are the first cells to be activated and recruited to the central nervous system in both injury and disease. However, our understanding of the role these cells play in behavior and cognition is limited. The present review will summarize what is currently known about the effect the activation of these cells has on various behaviors and cognitive processes.
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Affiliation(s)
- Aminata P. Coulibaly
- Department of NeuroscienceRockefeller Neuroscience InstituteWest Virginia UniversityMorgantownWest VirginiaUSA
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An Exploratory Assessment of Serum Biomarkers of Post-Cardiac Arrest Syndrome in Children. Resuscitation 2021; 167:307-316. [PMID: 34271122 DOI: 10.1016/j.resuscitation.2021.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/08/2021] [Accepted: 07/01/2021] [Indexed: 11/23/2022]
Abstract
AIM We hypothesized that serum biomarkers of inflammation including chemokine, cytokine, pituitary hormones, and growth factors following cardiac arrest in children would independently associate with 6-month neurologic outcome. METHODS In this prospective observational single center study of children with in-hospital and out-of-hospital cardiac arrest surviving to intensive care unit admission, serum was obtained twice per 24h period between 0h and 96h and once at approximately 196h post-cardiac arrest. Inflammatory mediators, hormones, and growth factors were analyzed by Luminex Multiplex Bead Immunoassay. We recorded demographics, resuscitation characteristics, and Pediatric Cerebral Performance Category (PCPC) at 6 months. We analyzed the association and area under the curve (AUC) of biomarker levels with favorable (PCPC 1-3) or unfavorable (PCPC 4-6, or >1 increase from baseline) outcome. RESULTS Forty-two children (50% female; median age of 2.5 [IQR: 0.4-10.2]) were enrolled and 18 (42%) died prior to 6-month follow up. Receiver operator curves for initial levels of ciliary neurotrophic factor (CNTF, AUC 0.84, 95% CI 0.73-0.96, p<0.001) and interleukin (IL-17, AUC 0.84, 95% CI 0.73-0.97, p<0.001) best classified favorable versus unfavorable 6-month outcome. In multivariable analysis, initial levels of CNTF and IL-17 remained associated with 6-month PCPC. Peak levels of interferon-γ-inducible protein 10 (IP-10), CNTF, and hepatocyte growth factor (HGF) were also independently associated with outcome. CONCLUSION Increased serum concentrations of CNTF and IL-17 associated with unfavorable 6-month neurologic outcome of children surviving cardiac arrest. Further investigation of the prognostic utility and roles of CNTF and IL-17 in the pathophysiology of post-cardiac arrest syndrome are warranted.
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Bae HW, Choi W, Hwang AR, Lee SY, Seong GJ, Kim CY. Effects of Hypoxic Preconditioning and Vascular Endothelial Growth Factor on the Survival of Isolated Primary Retinal Ganglion Cells. Biomolecules 2021; 11:biom11030391. [PMID: 33800918 PMCID: PMC8002095 DOI: 10.3390/biom11030391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effect of hypoxic preconditioning (HPC) on primary retinal ganglion cell (RGC) survival and the associated mechanism, including the role of vascular endothelial growth factor (VEGF). Retinas were separated from the enucleated eyeballs of Sprague-Dawley rats on postnatal days 1-4. RGCs were harvested using an immunopanning-magnetic separation system and maintained for 24 h in a defined medium. Hypoxic damage (0.3% O2) was inflicted on the cells using a CO₂ chamber. Anti-VEGF antibody (bevacizumab) was administered to RGCs exposed to hypoxic conditions, and RGC survival rate was compared to that of non-anti-VEGF antibody-treated RGCs. HPC lasting 4 h significantly increased RGC survival rate. In the RGCs exposed to hypoxic conditions for 4 h, VEGF mRNA and protein levels were significantly increased. Treatment with high dose bevacizumab (>1 mg/mL) countered HPC-mediated RGC survival. Protein kinase B and focal adhesion kinase levels were significantly increased in 4-h hypoxia-treated RGCs. HPC showed beneficial effects on primary RGC survival. However, only specifically controlled exposure to hypoxic conditions rendered neuroprotective effects. Strong inhibition of VEGF inhibited HPC-mediated RGC survival. These results indicate that VEGF may play an essential role in promoting cell survival under hypoxic conditions.
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Affiliation(s)
| | | | | | | | | | - Chan Yun Kim
- Correspondence: ; Tel.: +82-2-2228-3570; Fax: +82-2-312-0541
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Li Y, Lv Q, Li B, Luo D, Sun X, Xu J. The role of trauma experiences, personality traits, and genotype in maintaining posttraumatic stress disorder symptoms among child survivors of the Wenchuan earthquake. BMC Psychiatry 2020; 20:439. [PMID: 32894097 PMCID: PMC7487586 DOI: 10.1186/s12888-020-02844-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/30/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is the most prevalent type of psychiatric disorder among children after an earthquake. This study investigated the role of trauma experiences, personality traits, and genotype in the maintenance of PTSD symptoms. METHODS In a previous large-scale epidemiological investigation 1 year after the Wenchuan earthquake, 215 children with PTSD symptoms were selected at random with their blood samples collected. All of them were followed up, and their PTSD symptoms were assessed 3 years later. The adolescent version of the UCLA PTSD Reaction Index, the earthquake exposure scale, and the Junior Eysenck Personality Questionnaire were used to determine PTSD symptoms, trauma experiences, and personality traits, respectively. We sequenced candidate genes involved in the regulation of long-term potentiation via NMDA-type receptors to identify the related SNP variations. RESULTS Being trapped for a longer period of time, feeling one's own or a family member's life to be in danger, losing a close family member or friend, extraversion, neuroticism, TrkB, G72 and CNTF were found to be associated with the maintenance of PTSD symptoms. CONCLUSIONS Experiences, personality traits, and genotype influenced the maintenance of PTSD in child survivors who were considered to be followed up without medicine. This result could help to identify potential targets for treatment and promote the rational allocation of medical resources.
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Affiliation(s)
- Yuwei Li
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuyue Lv
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Li
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Dan Luo
- grid.13291.380000 0001 0807 1581Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xueli Sun
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Jiajun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
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Cui W, Liu CX, Wang J, Zhang YC, Shen Q, Feng ZH, Wu J, Li JX. An oleanolic acid derivative reduces denervation-induced muscle atrophy via activation of CNTF-mediated JAK2/STAT3 signaling pathway. Eur J Pharmacol 2019; 861:172612. [PMID: 31421088 DOI: 10.1016/j.ejphar.2019.172612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/10/2019] [Accepted: 08/14/2019] [Indexed: 02/07/2023]
Abstract
Denervation caused by sciatic nerve injury has brought great harm to the patients, especially denervation-induced muscle atrophy. The body stress produces a large number of Schwann cells when the sciatic nerve is injured, and the cells secrete some cytokines including ciliary neurotrophic factor (CNTF) that not only play a role in promoting the repair of sciatic nerve, but also maintain the normal physiological function of the muscles surrounding the damaged nerves. CNTF upregulates janus kinase 2 (JAK2) and signal transducers and activators of transcription 3 (STAT3) signals in myoblasts, and consequently accelerates the proliferation and differentiation of myoblasts. This effect on myoblasts is the most effective way to relieve muscle atrophy. Therefore, increasing CNTF is a promising direction to improve muscle atrophy. In the present study, an oleanolic acid derivative, HA-19, increased the proliferation of Schwann cells, and elevated CNTF production of the cells. HA-19 up-regulated the phosphorylation of JAK2 and STAT3 not only by directly acting on myoblasts, but also by increasing the secretion of CNTF of Schwann cells; and consequently, promoted the proliferation and differentiation of myoblasts. In denervation-induced muscle atrophy mice model, treatment with HA-19 significantly increased the weights of tibialis anterior (TA), gastrocnemius (Gastroc.), extensor digitorum longus (EDL), soleus and quadriceps (Quad.) under atrophied state. And, very interestingly, these muscles under normal condition were also strengthened by HA-19. Our finding demonstrated that HA-19 has a great potential as a lead compound for the drug discovery of anti-denervation-induced muscle atrophy.
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Affiliation(s)
- Wei Cui
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences, Jiangsu Key Laboratory of Advanced Organic Materials, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, 210023, China
| | - Chen-Xi Liu
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences, Jiangsu Key Laboratory of Advanced Organic Materials, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, 210023, China
| | - Jie Wang
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences, Jiangsu Key Laboratory of Advanced Organic Materials, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, 210023, China
| | - Yu-Chao Zhang
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences, Jiangsu Key Laboratory of Advanced Organic Materials, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, 210023, China
| | - Qi Shen
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences, Jiangsu Key Laboratory of Advanced Organic Materials, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, 210023, China
| | - Zhen-Hua Feng
- The Center of Diagnosis and Treatment for Joint Disease, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, 210008, China
| | - Jing Wu
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences, Jiangsu Key Laboratory of Advanced Organic Materials, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, 210023, China.
| | - Jian-Xin Li
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences, Jiangsu Key Laboratory of Advanced Organic Materials, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, 210023, China.
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Ma KH, Duong P, Moran JJ, Junaidi N, Svaren J. Polycomb repression regulates Schwann cell proliferation and axon regeneration after nerve injury. Glia 2018; 66:2487-2502. [PMID: 30306639 PMCID: PMC6289291 DOI: 10.1002/glia.23500] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 01/01/2023]
Abstract
The transition of differentiated Schwann cells to support of nerve repair after injury is accompanied by remodeling of the Schwann cell epigenome. The EED-containing polycomb repressive complex 2 (PRC2) catalyzes histone H3K27 methylation and represses key nerve repair genes such as Shh, Gdnf, and Bdnf, and their activation is accompanied by loss of H3K27 methylation. Analysis of nerve injury in mice with a Schwann cell-specific loss of EED showed the reversal of polycomb repression is required and a rate limiting step in the increased transcription of Neuregulin 1 (type I), which is required for efficient remyelination. However, mouse nerves with EED-deficient Schwann cells display slow axonal regeneration with significantly low expression of axon guidance genes, including Sema4f and Cntf. Finally, EED loss causes impaired Schwann cell proliferation after injury with significant induction of the Cdkn2a cell cycle inhibitor gene. Interestingly, PRC2 subunits and CDKN2A are commonly co-mutated in the transition from benign neurofibromas to malignant peripheral nerve sheath tumors (MPNST's). RNA-seq analysis of EED-deficient mice identified PRC2-regulated molecular pathways that may contribute to the transition to malignancy in neurofibromatosis.
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Affiliation(s)
- Ki H. Ma
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Phu Duong
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Cellular and Molecular Pathology Graduate Program, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - John J. Moran
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Nabil Junaidi
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - John Svaren
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, WI 53705, USA
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Zhao F, Ding XY, Wu F, Li XH, Li YH, Huang SL. Effects of passage and cryopreservation on neurotrophic factor secretion from choroid plexus epithelial cells. Biomed Rep 2018; 8:535-539. [PMID: 29774144 DOI: 10.3892/br.2018.1087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/04/2018] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to evaluate the effects of passage and cryopreservation of choroid plexus epithelial cells on their secretion of neurotrophic factors. Choroid plexus epithelial cells were cryopreserved and thawed following primary culture or passage cultured for up to two passages. The supernatant of primary, first/second passage and cryopreserved-thawed choroid plexus epithelial cells was collected when cells reached 80-90% confluence. ELISA was used to quantify brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor (GDNF), nerve growth factor (NGF) and ciliary neurotrophic factor (CNTF) levels in the cell supernatant. First passage and cryopreserved-thawed cells secreted less BDNF and CNTF compared with primary cultured cells and increased levels of these two factors compared with second passage cells, and increased levels of GDNF and NGF compared with primary cultured and second passage cells (all P<0.05). Therefore, first passage culture decreased BDNF and CNTF secretion but increased NGF and GDNF compared with primary culture; second passage culture diminished neurotrophic factor secretion compared with first passage culture; and cryopreservation did not weaken the function of choroid plexus epithelial cells in secreting BDNF, GDNF, NGF and CNTF. The current study demonstrates that first passage and cryopreserved-thawed choroid plexus epithelial cells have an enhanced function to secrete neurotrophic factors including BDNF, GDNF, NGF and CNTF.
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Affiliation(s)
- Feng Zhao
- Department of Thoracic Surgery, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Xiao-Yan Ding
- Department of Ophthalmology, Xi'an No. 3 Hospital, Xi'an, Shaanxi 710018, P.R. China
| | - Feng Wu
- Department of Pathogenic Biology and Immunology, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Xiao-Hui Li
- Department of Radiology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Yu-Huan Li
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
| | - Sheng-Li Huang
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
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Wen SY, Li AM, Mi KQ, Wang RZ, Li H, Liu HX, Xing Y. In vitro neuroprotective effects of ciliary neurotrophic factor on dorsal root ganglion neurons with glutamate-induced neurotoxicity. Neural Regen Res 2017; 12:1716-1723. [PMID: 29171438 PMCID: PMC5696854 DOI: 10.4103/1673-5374.217352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Ciliary neurotrophic factor has neuroprotective effects mediated through signal transducer and Janus kinase (JAK) 2/activator of transcription 3 (STAT3) and phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathways. Whether ciliary neurotrophic factor is neuroprotective for glutamate-induced excitotoxicity of dorsal root ganglion neurons is poorly understood. In the present study, the in vitro neuroprotective effects of ciliary neurotrophic factor against glutamate-induced excitotoxicity were determined in a primary culture of dorsal root ganglion neurons from Wistar rat embryos at embryonic day 15. Whether the JAK2/STAT3 and PI3K/Akt signaling pathways were related to the protective effects of ciliary neurotrophic factor was also determined. Glutamate exposure inhibited neurite outgrowth, cell viability, and growth-associated protein 43 expression and promoted apoptotic neuronal cell death, all of which were reversed by the administration of exogenous ciliary neurotrophic factor. Additionally, preincubation with either JAK2 inhibitor AG490 or PI3K inhibitor LY294002 blocked the neuroprotective effect of ciliary neurotrophic factor. These data indicate that the two pathways JAK2/STAT3 and PI3K/Akt play major roles in mediating the in vitro neuroprotective effects of ciliary neurotrophic factor on dorsal root ganglion neurons with glutamate-induced neurotoxicity.
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Affiliation(s)
- Shu-Yun Wen
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province; Department of Rheumatology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Ai-Min Li
- Department of Rheumatology, Qingdao Fifth People's Hospital, Qingdao, Shandong Province, China
| | - Kuan-Qing Mi
- Department of Neurosurgery, Jinan Fifth People's Hospital, Jinan, Shandong Province, China
| | - Rui-Zheng Wang
- Department of Neurosurgery, Jinan Fifth People's Hospital, Jinan, Shandong Province, China
| | - Hao Li
- Department of Orthopedics, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Hua-Xiang Liu
- Department of Rheumatology, Qilu Hospital, Shandong University, Jinan, Shandong Province, China
| | - Yi Xing
- Department of Neurosurgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
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