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Agnello L, Gambino CM, Ciaccio AM, Masucci A, Vassallo R, Tamburello M, Scazzone C, Lo Sasso B, Ciaccio M. Molecular Biomarkers of Neurodegenerative Disorders: A Practical Guide to Their Appropriate Use and Interpretation in Clinical Practice. Int J Mol Sci 2024; 25:4323. [PMID: 38673907 PMCID: PMC11049959 DOI: 10.3390/ijms25084323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Neurodegenerative disorders (NDs) represent a group of different diseases characterized by the progressive degeneration and death of the nervous system's cells. The diagnosis is challenging, especially in the early stages, due to no specific clinical signs and symptoms. In this context, laboratory medicine could support clinicians in detecting and differentiating NDs. Indeed, biomarkers could indicate the pathological mechanisms underpinning NDs. The ideal biofluid for detecting the biomarkers of NDs is cerebrospinal fluid (CSF), which has limitations, hampering its widespread use in clinical practice. However, intensive efforts are underway to introduce high-sensitivity analytical methods to detect ND biomarkers in alternative nonivasive biofluid, such as blood or saliva. This study presents an overview of the ND molecular biomarkers currently used in clinical practice. For some diseases, such as Alzheimer's disease or multiple sclerosis, biomarkers are well established and recommended by guidelines. However, for most NDs, intensive research is ongoing to identify reliable and specific biomarkers, and no consensus has yet been achieved.
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Affiliation(s)
- Luisa Agnello
- Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (L.A.); (C.M.G.); (A.M.); (R.V.); (M.T.); (C.S.); (B.L.S.)
| | - Caterina Maria Gambino
- Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (L.A.); (C.M.G.); (A.M.); (R.V.); (M.T.); (C.S.); (B.L.S.)
- Department of Laboratory Medicine, University Hospital “P. Giaccone”, 90127 Palermo, Italy
| | - Anna Maria Ciaccio
- Internal Medicine and Medical Specialties “G. D’Alessandro”, Department of Health Promotion, Maternal and Infant Care, University of Palermo, 90127 Palermo, Italy;
| | - Anna Masucci
- Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (L.A.); (C.M.G.); (A.M.); (R.V.); (M.T.); (C.S.); (B.L.S.)
| | - Roberta Vassallo
- Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (L.A.); (C.M.G.); (A.M.); (R.V.); (M.T.); (C.S.); (B.L.S.)
| | - Martina Tamburello
- Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (L.A.); (C.M.G.); (A.M.); (R.V.); (M.T.); (C.S.); (B.L.S.)
| | - Concetta Scazzone
- Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (L.A.); (C.M.G.); (A.M.); (R.V.); (M.T.); (C.S.); (B.L.S.)
| | - Bruna Lo Sasso
- Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (L.A.); (C.M.G.); (A.M.); (R.V.); (M.T.); (C.S.); (B.L.S.)
- Department of Laboratory Medicine, University Hospital “P. Giaccone”, 90127 Palermo, Italy
| | - Marcello Ciaccio
- Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (L.A.); (C.M.G.); (A.M.); (R.V.); (M.T.); (C.S.); (B.L.S.)
- Department of Laboratory Medicine, University Hospital “P. Giaccone”, 90127 Palermo, Italy
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Klíčová K, Mareš J, Menšíková K, Kaiserová M, Friedecký D, Kaňovský P, Strnad M, Matěj R. Utilizing neurodegenerative markers for the diagnostic evaluation of amyotrophic lateral sclerosis. Eur J Med Res 2024; 29:31. [PMID: 38184629 PMCID: PMC10771003 DOI: 10.1186/s40001-023-01596-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/14/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by progressive deterioration of upper and lower motor neurons. A definitive diagnostic test or biomarker for ALS is currently unavailable, leading to a diagnostic delay following the onset of initial symptoms. Our study focused on cerebrospinal fluid (CSF) concentrations of clusterin, tau protein, phosphorylated tau protein, and beta-amyloid1-42 in ALS patients and a control group. METHODS Our study involved 54 ALS patients and 58 control subjects. Among the ALS patients, 14 presented with bulbar-onset ALS, and 40 with limb-onset ALS. We quantified biomarker levels using enzyme-linked immunosorbent assay (ELISA) and compared the results using the Mann-Whitney U-test. RESULTS Significant elevations in neurodegenerative markers, including tau protein (p < 0.0001), phosphorylated tau protein (p < 0.0001), and clusterin (p = 0.038), were observed in ALS patients compared to controls. Elevated levels of tau protein and phosphorylated tau protein were also noted in both bulbar and limb-onset ALS patients. However, no significant difference was observed for beta-amyloid1-42. ROC analysis identified tau protein (AUC = 0.767) and p-tau protein (AUC = 0.719) as statistically significant predictors for ALS. CONCLUSION Our study demonstrates that neurodegenerative marker levels indicate an ongoing neurodegenerative process in ALS. Nonetheless, the progression of ALS cannot be predicted solely based on these markers. The discovery of a specific biomarker could potentially complement existing diagnostic criteria for ALS.
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Affiliation(s)
- Kateřina Klíčová
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic.
| | - Jan Mareš
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Kateřina Menšíková
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Michaela Kaiserová
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - David Friedecký
- Laboratory of Inherited Metabolic Disorders, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic Olomouc, Czech Republic
| | - Petr Kaňovský
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Miroslav Strnad
- Department of Neurology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
- Laboratory of Growth Regulators, Faculty of Science and Institute of Experimental Botany of the Czech Academy of Sciences, Palacky University Olomouc, Olomouc, Czech Republic
| | - Radoslav Matěj
- Department of Pathology and Molecular Medicine, Third Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic
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Kioutchoukova IP, Foster D, Thakkar RN, Kurz HN, Lucke-Wold B. Amyotrophic Lateral Sclerosis: From Mechanisms to Current, Emerging, and Alternative Therapeutics. MED DISCOVERIES 2023; 2:1059. [PMID: 37799543 PMCID: PMC10552707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a severe neurodegenerative disease affecting the motor neurons. Although the etiology remains unknown, mutations in superoxide dismutase 1 have been observed in patients with familial ALS, resulting in increased calcium in the cells and leading to cell death. Additionally, studies in patients with the C9orf72 repeat expansion have shown lower age of onset, cognitive and behavioral impairments, and reduced survival. Accumulation of TDP-43 in the cytoplasm of neurons and glial cells caused by the loss of UBQLN2 has been shown to lead to mitotoxicity and proteasomal overload. Early diagnosis of ALS is necessary for the optimization of care between a patient's neurologist and interdisciplinary team members to ensure the best outcomes possible. Proper management between physical therapy, occupation therapy, and pharmaceutical medications can improve ALS symptoms, achieving the highest quality of life possible for the patient. The current therapeutic medication recommended for ALS is Riluzole, but new therapies are emerging. This paper analyzes mechanisms of injury and progression of ALS along while analyzing current, emerging, and alternative therapeutics targeting ALS.
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Affiliation(s)
| | - Devon Foster
- University of Florida, College of Medicine, Gainesville, FL 32611, USA
| | - Rajvi N Thakkar
- University of Florida, College of Medicine, Gainesville, FL 32611, USA
| | - Hayley N Kurz
- University of Florida, College of Medicine, Gainesville, FL 32611, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32611, USA
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Ketabforoush AHME, Chegini R, Barati S, Tahmasebi F, Moghisseh B, Joghataei MT, Faghihi F, Azedi F. Masitinib: The promising actor in the next season of the Amyotrophic Lateral Sclerosis treatment series. Biomed Pharmacother 2023; 160:114378. [PMID: 36774721 DOI: 10.1016/j.biopha.2023.114378] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/25/2023] [Accepted: 02/05/2023] [Indexed: 02/12/2023] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease with high mortality and morbidity rate affecting both upper and lower motor neurons (MN). Muscle force reduction, behavioral change, pseudobulbar affect, and cognitive impairments are the most common clinical manifestations of ALS. The main physiopathology of ALS is still unclear, though several studies have identified that oxidative stress, proteinopathies, glutamate-related excitotoxicity, microglial activation, and neuroinflammation may be involved in the pathogenesis of ALS. From 1995 until October 2022, only Riluzole, Dextromethorphan Hydrobromide (DH) with Quinidine sulfate (Q), Edaravone, and Sodium phenylbutyrate with Taurursodiol (PB/TUDCO) have achieved FDA approval for ALS treatment. Despite the use of these four approved agents, the survival rate and quality of life of ALS patients are still low. Thus, finding novel treatments for ALS patients is an urgent requirement. Masitinib, a tyrosine kinase inhibitor, emphasizes the neuro-inflammatory activity of ALS by targeting macrophages, mast cells, and microglia cells. Masitinib downregulates the proinflammatory cytokines, indirectly reduces inflammation, and induces neuroprotection. Also, it was effective in phase 2/3 and 3 clinical trials (CTs) by increasing overall survival and delaying motor, bulbar, and respiratory function deterioration. This review describes the pathophysiology of ALS, focusing on Masitinib's mechanism of action and explaining why Masitinib could be a promising actor in the treatment of ALS patients. In addition, Masitinib CTs and other competitor drugs in phase 3 CTs have been discussed.
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Affiliation(s)
| | - Rojin Chegini
- Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Barati
- Department of Anatomy, Saveh University of Medical Sciences, Saveh, Iran
| | - Fatemeh Tahmasebi
- Department of Anatomy, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bardia Moghisseh
- Student Research Committee, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Taghi Joghataei
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Faezeh Faghihi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Fereshteh Azedi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Interplay between activation of endogenous retroviruses and inflammation as common pathogenic mechanism in neurological and psychiatric disorders. Brain Behav Immun 2023; 107:242-252. [PMID: 36270439 DOI: 10.1016/j.bbi.2022.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/21/2022] [Accepted: 10/13/2022] [Indexed: 12/05/2022] Open
Abstract
Human endogenous retroviruses (ERVs) are ancestorial retroviral elements that were integrated into our genome through germline infections and insertions during evolution. They have repeatedly been implicated in the aetiology and pathophysiology of numerous human disorders, particularly in those that affect the central nervous system. In addition to the known association of ERVs with multiple sclerosis and amyotrophic lateral sclerosis, a growing number of studies links the induction and expression of these retroviral elements with the onset and severity of neurodevelopmental and psychiatric disorders. Although these disorders differ in terms of overall disease pathology and causalities, a certain degree of (subclinical) chronic inflammation can be identified in all of them. Based on these commonalities, we discuss the bidirectional relationship between ERV expression and inflammation and highlight that numerous entry points to this reciprocal sequence of events exist, including initial infections with ERV-activating pathogens, exposure to non-infectious inflammatory stimuli, and conditions in which epigenetic silencing of ERV elements is disrupted.
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Wang S, Yuan T, Yang H, Zhou X, Cao J. Effect of complete high-caloric nutrition on the nutritional status and survival rate of amyotrophic lateral sclerosis patients after gastrostomy. Am J Transl Res 2022; 14:7842-7851. [PMID: 36505314 PMCID: PMC9730112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/17/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Malnutrition is an independent risk factor for the prognosis of patients with amyotrophic lateral sclerosis (ALS). Complete high-caloric nutrition is emerging as an instrument for dietary intervention in disease prevention. Our aim was to evaluate the beneficial effects of complete high-caloric nutrition on nutritional status and prognosis in ALS patients undergoing percutaneous gastrostomy. METHODS Forty patients with ALS following percutaneous gastrostomy were randomized to receive either routine diet alone (the control group) or complete high-caloric nutrition combined with routine diet (the Ensure group) for six months. Body weight, body mass index (BMI), nutritional indicator proteins, lipid levels and total lymphocyte count were measured before intervention and after six months of intervention. At 12 months of follow-up, Kaplan-Meier survival was generated to evaluate the beneficial effects of complete high-caloric nutrition on prognosis. RESULTS After adjustment for baseline, compared with routine diet, body weight, total lymphocyte count and nutritional indicator proteins including transferrin, albumin, hemoglobin, and prealbumin were significantly increased at six months of intervention (all P<0.05). However, we found no significant changes in total cholesterol, triglycerides, low- or high-density lipoprotein cholesterol or BMI during the intervention in either group (all P>0.05). Interestingly, the cumulative survival rate of ALS patients in the Ensure group was significantly better than that of ALS patients in the control group (P<0.05). CONCLUSIONS The findings of our study suggest that high-caloric nutrition offers potential for improvement of nutritional status and prolonged life. However, no evidence was found for a blood lipid-improving effect of complete high-caloric nutrition.
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Novel Drugs in a Pipeline for Progressive Multiple Sclerosis. J Clin Med 2022; 11:jcm11123342. [PMID: 35743410 PMCID: PMC9225445 DOI: 10.3390/jcm11123342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/27/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Multiple sclerosis (MS) is a widely known inflammatory, demyelinating disease of the central nervous system. The pathogenesis of progressive multiple sclerosis (PMS) is a complex, multi-level process that causes therapeutic difficulties. Along with variables such as age and duration of the disease, pathogenetic mechanisms change from inflammatory to neurodegenerative processes. Therefore, the efficacy of available anti-inflammatory drugs approved for the treatment of PMS, such as ocrelizumab or siponimod, is limited in time. In search of innovative solutions, several research studies have been conducted to evaluate the effectiveness of drugs with neuroprotective or remyelinating effects in PMS, including biotin, ibudilast, simvastatin, alpha-lipoic acid, clemastine, amiloride, fluoxetine, riluzole, masitinib, opicinumab, and lamotrigine. The current review includes those compounds, which have entered the clinical phase of assessment, and the authors discuss future prospects for successful PMS treatment.
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Bordoni M, Pansarasa O, Scarian E, Cristofani R, Leone R, Fantini V, Garofalo M, Diamanti L, Bernuzzi S, Gagliardi S, Carelli S, Poletti A, Cereda C. Lysosomes Dysfunction Causes Mitophagy Impairment in PBMCs of Sporadic ALS Patients. Cells 2022; 11:cells11081272. [PMID: 35455952 PMCID: PMC9030813 DOI: 10.3390/cells11081272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 02/06/2023] Open
Abstract
Mitochondria alterations are present in tissues derived from patients and animal models, but no data are available for peripheral blood mononuclear cells (PBMCs) of ALS patients. This work aims to investigate mitophagy in PBMCs of sporadic (sALS) patients and how this pathway can be tuned by using small molecules. We found the presence of morphologically atypical mitochondria by TEM and morphological abnormalities by MitoTracker™. We found a decreased number of healthy mitochondria in sALS PBMCs and an impairment of mitophagy with western blot and immunofluorescence. After rapamycin treatment, we found a higher increase in the LC3 marker in sALS PBMCs, while after NH4Cl treatment, we found a lower increase in the LC3 marker. Finally, mTOR-independent autophagy induction with trehalose resulted in a significant decrease in the lysosomes level sALS PBMCs. Our data suggest that the presence of morphologically altered mitochondria and an inefficient turnover of damaged mitochondria in PBMCs of sALS patients rely on the impairment of the mitophagy pathway. We also found that the induction of the mTOR-independent autophagy pathway leads to a decrease in lysosomes level, suggesting a more sensitivity of sALS PBMCs to trehalose. Such evidence suggests that trehalose could represent an effective treatment for ALS patients.
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Affiliation(s)
- Matteo Bordoni
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.B.); (E.S.); (M.G.); (S.G.); (C.C.)
| | - Orietta Pansarasa
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.B.); (E.S.); (M.G.); (S.G.); (C.C.)
- Correspondence: ; Tel.: +0382-380-248
| | - Eveljn Scarian
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.B.); (E.S.); (M.G.); (S.G.); (C.C.)
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Riccardo Cristofani
- Dipartimento di Scienze Farmacologiche e Biomolecolari (DiSFeB), Dipartimento di Eccellenza 2018-2022, Università Degli Studi di Milano, 20133 Milano, Italy; (R.C.); (A.P.)
| | | | - Valentina Fantini
- Laboratory of Neurobiology and Neurogenetic, Golgi-Cenci Foundation, 20081 Abbiategrasso, Italy;
| | - Maria Garofalo
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.B.); (E.S.); (M.G.); (S.G.); (C.C.)
| | - Luca Diamanti
- Neuroncology Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy;
| | - Stefano Bernuzzi
- Immunohematological and Transfusional Service and Centre of Transplantation Immunology, IRCCS “San Matteo Foundation”, 27100 Pavia, Italy;
| | - Stella Gagliardi
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.B.); (E.S.); (M.G.); (S.G.); (C.C.)
| | - Stephana Carelli
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, 20157 Milan, Italy;
- Pediatric Clinical Research Centre Fondazione “Romeo ed Enrica Invernizzi”, University of Milano, 20157 Milan, Italy
| | - Angelo Poletti
- Dipartimento di Scienze Farmacologiche e Biomolecolari (DiSFeB), Dipartimento di Eccellenza 2018-2022, Università Degli Studi di Milano, 20133 Milano, Italy; (R.C.); (A.P.)
| | - Cristina Cereda
- Genomic and Post-Genomic Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy; (M.B.); (E.S.); (M.G.); (S.G.); (C.C.)
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Post J, Schaffrath A, Gering I, Hartwig S, Lehr S, Shah NJ, Langen KJ, Willbold D, Kutzsche J, Willuweit A. Oral Treatment with RD2RD2 Impedes Development of Motoric Phenotype and Delays Symptom Onset in SOD1 G93A Transgenic Mice. Int J Mol Sci 2021; 22:ijms22137066. [PMID: 34209129 PMCID: PMC8269060 DOI: 10.3390/ijms22137066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 11/16/2022] Open
Abstract
Neuroinflammation is a pathological hallmark of several neurodegenerative disorders and plays a key role in the pathogenesis of amyotrophic lateral sclerosis (ALS). It has been implicated as driver of disease progression and is observed in ALS patients, as well as in the transgenic SOD1G93A mouse model. Here, we explore and validate the therapeutic potential of the d-enantiomeric peptide RD2RD2 upon oral administration in SOD1G93A mice. Transgenic mice were treated daily with RD2RD2 or placebo for 10 weeks and phenotype progression was followed with several behavioural tests. At the end of the study, plasma cytokine levels and glia cell markers in brain and spinal cord were analysed. Treatment resulted in a significantly increased performance in behavioural and motor coordination tests and a decelerated neurodegenerative phenotype in RD2RD2-treated SOD1G93A mice. Additionally, we observed retardation of the average disease onset. Treatment of SOD1G93A mice led to significant reduction in glial cell activation and a rescue of neurons. Analysis of plasma revealed normalisation of several cytokines in samples of RD2RD2-treated SOD1G93A mice towards the levels of non-transgenic mice. In conclusion, these findings qualify RD2RD2 to be considered for further development and testing towards a disease modifying ALS treatment.
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Affiliation(s)
- Julia Post
- Institute of Biological Information Processing, Structural Biochemistry (IBI-7), Forschungszentrum Jülich, 52425 Jülich, Germany; (J.P.); (A.S.); (I.G.)
| | - Anja Schaffrath
- Institute of Biological Information Processing, Structural Biochemistry (IBI-7), Forschungszentrum Jülich, 52425 Jülich, Germany; (J.P.); (A.S.); (I.G.)
| | - Ian Gering
- Institute of Biological Information Processing, Structural Biochemistry (IBI-7), Forschungszentrum Jülich, 52425 Jülich, Germany; (J.P.); (A.S.); (I.G.)
| | - Sonja Hartwig
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (S.H.); (S.L.)
- German Center for Diabetes Research, Partner Düsseldorf, 85764 München-Neuherberg, Germany
| | - Stefan Lehr
- Institute for Clinical Biochemistry and Pathobiochemistry, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany; (S.H.); (S.L.)
- German Center for Diabetes Research, Partner Düsseldorf, 85764 München-Neuherberg, Germany
| | - N. Jon Shah
- Institute of Neuroscience and Medicine, Medical Imaging Physics (INM-4), Forschungszentrum Jülich, 52425 Jülich, Germany; (N.J.S.); (K.-J.L.)
- Institute of Neuroscience and Medicine 11, INM-11, JARA, Forschungszentrum Jülich, 52425 Jülich, Germany
- JARA-Brain-Translational Medicine, 52062 Aachen, Germany
- Department of Neurology, RWTH Aachen University, 52062 Aachen, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine, Medical Imaging Physics (INM-4), Forschungszentrum Jülich, 52425 Jülich, Germany; (N.J.S.); (K.-J.L.)
- Department of Nuclear Medicine, RWTH Aachen University, 52062 Aachen, Germany
| | - Dieter Willbold
- Institute of Biological Information Processing, Structural Biochemistry (IBI-7), Forschungszentrum Jülich, 52425 Jülich, Germany; (J.P.); (A.S.); (I.G.)
- Institut für Physikalische Biologie, Heinrich-Heine-Universität, 40225 Düsseldorf, Germany
- Correspondence: (D.W.); (J.K.); (A.W.); Tel.: +49-2461-612100 (D.W.); +49-2461-619496 (J.K.); +49-2461-6196358 (A.W.); Fax: +49-2461-612023 (D.W.); +49-2461-619497 (J.K.); +49-2461-612302 (A.W.)
| | - Janine Kutzsche
- Institute of Biological Information Processing, Structural Biochemistry (IBI-7), Forschungszentrum Jülich, 52425 Jülich, Germany; (J.P.); (A.S.); (I.G.)
- Correspondence: (D.W.); (J.K.); (A.W.); Tel.: +49-2461-612100 (D.W.); +49-2461-619496 (J.K.); +49-2461-6196358 (A.W.); Fax: +49-2461-612023 (D.W.); +49-2461-619497 (J.K.); +49-2461-612302 (A.W.)
| | - Antje Willuweit
- Institute of Neuroscience and Medicine, Medical Imaging Physics (INM-4), Forschungszentrum Jülich, 52425 Jülich, Germany; (N.J.S.); (K.-J.L.)
- Correspondence: (D.W.); (J.K.); (A.W.); Tel.: +49-2461-612100 (D.W.); +49-2461-619496 (J.K.); +49-2461-6196358 (A.W.); Fax: +49-2461-612023 (D.W.); +49-2461-619497 (J.K.); +49-2461-612302 (A.W.)
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Štětkářová I, Ehler E. Diagnostics of Amyotrophic Lateral Sclerosis: Up to Date. Diagnostics (Basel) 2021; 11:diagnostics11020231. [PMID: 33546386 PMCID: PMC7913557 DOI: 10.3390/diagnostics11020231] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by gradual loss of upper and lower motor neurons and their pathways, usually without affecting the extraocular and sphincter muscles. The cause of the disease is not yet known. It is a chain of subsequent events, ending in programmed cell death in selective neuronal subpopulations. The prognosis for survival is rather short with a median of 2 to 4 years. Survival may be prolonged based on prompt diagnosis, ALS subtype and proper management with supportive treatment (tracheostomy, gastrostomy, etc.). According to the clinical picture, the typical form of ALS with upper and lower motoneuron involvement and progressive bulbar paralysis with bulbar muscle involvement is observed. The ALS form with progressive muscle atrophy, where only the lower motoneuron is affected, and primary lateral sclerosis with only upper motoneuron damage are rare. Familiar forms of ALS (FALS) associated with specific genes (the most common is C9orf72) have been discovered. FALS is usually associated with dementia (frontotemporal lobar dementia, FTLD), behavioral disorders, cognitive dysfunction and impairment of executive functions. The diagnosis of ALS is determined by excluding other conditions and utilizing clinical examinations, laboratory and genetic tests and nerve conduction/needle electromyography studies (EMG). Needle EMG records abnormal activities at rest and looks for neurogenic patterns during muscle contraction. Motor evoked potentials after transcranial magnetic stimulation remain the test of choice to identify impairment of upper motor neurons. New biochemical, neurophysiological and morphological biomarkers are extensively studied as early diagnostic and prognostic factors and have implications for clinical trials, research and drug development.
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Affiliation(s)
- Ivana Štětkářová
- Department of Neurology, Third Faculty of Medicine, Charles University and Faculty Hospital Královské Vinohrady, 100 34 Prague, Czech Republic
- Correspondence: ; Tel.: +420-267162814
| | - Edvard Ehler
- Neurological Department, Faculty of Health Studies, Pardubice University and Pardubice Regional Hospital, 530 03 Pardubice, Czech Republic;
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11
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Li B, Xia M, Zorec R, Parpura V, Verkhratsky A. Astrocytes in heavy metal neurotoxicity and neurodegeneration. Brain Res 2021; 1752:147234. [PMID: 33412145 DOI: 10.1016/j.brainres.2020.147234] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/15/2020] [Accepted: 12/07/2020] [Indexed: 12/14/2022]
Abstract
With the industrial development and progressive increase in environmental pollution, the mankind overexposure to heavy metals emerges as a pressing public health issue. Excessive intake of heavy metals, such as arsenic (As), manganese (Mn), mercury (Hg), aluminium (Al), lead (Pb), nickel (Ni), bismuth (Bi), cadmium (Cd), copper (Cu), zinc (Zn), and iron (Fe), is neurotoxic and it promotes neurodegeneration. Astrocytes are primary homeostatic cells in the central nervous system. They protect neurons against all types of insults, in particular by accumulating heavy metals. However, this makes astrocytes the main target for heavy metals neurotoxicity. Intake of heavy metals affects astroglial homeostatic and neuroprotective cascades including glutamate/GABA-glutamine shuttle, antioxidative machinery and energy metabolism. Deficits in these astroglial pathways facilitate or even instigate neurodegeneration. In this review, we provide a concise outlook on heavy metal-induced astrogliopathies and their association with major neurodegenerative disorders. In particular, we focus on astroglial mechanisms of iron-induced neurotoxicity. Iron deposits in the brain are detected in main neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis. Accumulation of iron in the brain is associated with motor and cognitive impairments and iron-induced histopathological manifestations may be considered as the potential diagnostic biomarker of neurodegenerative diseases. Effective management of heavy metal neurotoxicity can be regarded as a potential strategy to prevent or retard neurodegenerative pathologies.
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Affiliation(s)
- Baoman Li
- Practical Teaching Centre, School of Forensic Medicine, China Medical University, Shenyang, People's Republic of China.
| | - Maosheng Xia
- Department of Orthopaedics, The First Hospital, China Medical University, Shenyang, People's Republic of China
| | - Robert Zorec
- Celica BIOMEDICAL, Tehnološki Park 24, 1000 Ljubljana, Slovenia; Laboratory of Neuroendocrinology-Molecular Cell Physiology, Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Vladimir Parpura
- Department of Neurobiology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Alexei Verkhratsky
- Practical Teaching Centre, School of Forensic Medicine, China Medical University, Shenyang, People's Republic of China; Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK; Achucarro Center for Neuroscience, IKERBASQUE, Basque Foundation for Science, 48011 Bilbao, Spain.
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12
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Minimizing the Diagnostic Delay in Amyotrophic Lateral Sclerosis: The Role of Nonneurologist Practitioners. Neurol Res Int 2020; 2020:1473981. [PMID: 32455015 PMCID: PMC7238340 DOI: 10.1155/2020/1473981] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 04/16/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction Amyotrophic lateral sclerosis (ALS), usually fatal in a few years, is a neurodegenerative disorder where the diagnostic delay, although variable according to the studies, remains too long. The main objective of this study was to determine the average time to diagnose ALS and the role of each physician, general practitioner (GP), or specialist (neurologist or not) involved in the management of these patients. The secondary objective was to propose some simple schemes to quickly identify an ALS suspicion with the aim to reduce this delay. Patients and Methods. This retrospective study evaluated the diagnostic delay (and other intermediate delays) of 90 ALS patients registered in the ALS Center of Bordeaux (France) in 2013. The main clinical signs encountered (and their order of appearance) were studied. Results The average diagnostic delay was 17 months, with a median diagnostic delay of 12 months. The average diagnostic delay was 2.7 months between the first symptoms and the first complaint to GP, followed by an additional 6.5 month delay before the patient's first visit to a neurologist. This period could be shortened, especially if GP performed additional tests quickly (p=0.01), as the time spent consulting various specialists often extends this crucial step. Overall, diagnostic delay accounted for 40% of the total duration of the disease progression. Conclusion In relation to total survival time, the diagnostic delay of ALS appears to be proportionately very long, sometimes longer than that observed in previous studies (because it also included the total delay to diagnostic or treatment initiation). The rapid execution of useful additional tests by the first medical doctor, often GP (with the help of a neurologist), considerably reduces the diagnostic delay. The central role of GP seems to be crucial in the management of patients with ALS. The main objective is, of course, to initiate appropriate treatment and care as soon as possible. Finally, based on our results, we also provide a short practical diagram to help nonneurologist practitioners to quickly discuss the diagnosis of ALS in case of some specific symptoms (“red flags”).
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13
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Schepici G, Silvestro S, Trubiani O, Bramanti P, Mazzon E. Salivary Biomarkers: Future Approaches for Early Diagnosis of Neurodegenerative Diseases. Brain Sci 2020; 10:brainsci10040245. [PMID: 32326227 PMCID: PMC7226627 DOI: 10.3390/brainsci10040245] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/14/2020] [Accepted: 04/19/2020] [Indexed: 12/13/2022] Open
Abstract
Many neurological diseases are characterized by progressive neuronal degeneration. Early diagnosis and new markers are necessary for prompt therapeutic intervention. Several studies have aimed to identify biomarkers in different biological liquids. Furthermore, it is being considered whether saliva could be a potential biological sample for the investigation of neurodegenerative diseases. This work aims to provide an overview of the literature concerning biomarkers identified in saliva for the diagnosis of neurodegenerative diseases such as Alzheimer’s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS). Specifically, the studies have revealed that is possible to quantify beta-amyloid1–42 and TAU protein from the saliva of AD patients. Instead, alpha-synuclein and protein deglycase (DJ-1) have been identified as new potential salivary biomarkers for the diagnosis of PD. Nevertheless, future studies will be needed to validate these salivary biomarkers in the diagnosis of neurological diseases.
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Affiliation(s)
- Giovanni Schepici
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (G.S.); (S.S.); (P.B.)
| | - Serena Silvestro
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (G.S.); (S.S.); (P.B.)
| | - Oriana Trubiani
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy;
| | - Placido Bramanti
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (G.S.); (S.S.); (P.B.)
| | - Emanuela Mazzon
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (G.S.); (S.S.); (P.B.)
- Correspondence: ; Tel.: +39-090-6012-8172
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14
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van Eijk RPA, Genge A. The rise of innovative clinical trial designs: what's in it for amyotrophic lateral sclerosis? Amyotroph Lateral Scler Frontotemporal Degener 2019; 21:3-4. [PMID: 31661983 DOI: 10.1080/21678421.2019.1681455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ruben P A van Eijk
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.,Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Angela Genge
- Department of Neurology, Clinical Research Unit, Montreal Neurological Institute, McGill University, Montreal, Canada
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15
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Babu S, Macklin EA, Jackson KE, Simpson E, Mahoney K, Yu H, Walker J, Simmons Z, David WS, Barkhaus PE, Simionescu L, Dimachkie MM, Pestronk A, Salameh JS, Weiss MD, Brooks BR, Schoenfeld D, Shefner J, Aggarwal S, Cudkowicz ME, Atassi N. Selection design phase II trial of high dosages of tamoxifen and creatine in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2019; 21:15-23. [DOI: 10.1080/21678421.2019.1672750] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Suma Babu
- Department of Neurology, Sean M Healey & AMG Center for ALS at Massachusetts General Hospital, Neurological Clinical Research Institute, Boston, MA, USA,
| | - Eric A. Macklin
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,
| | - Katherine E. Jackson
- Office of the Prescription Drug Monitoring Program, Maryland Department of Health, Baltimore, MD, USA,
| | - Elizabeth Simpson
- McCance Center for Brain Health at Massachusetts General Hospital, Boston, MA, USA,
| | - Katy Mahoney
- Department of Neurology, Sean M Healey & AMG Center for ALS at Massachusetts General Hospital, Neurological Clinical Research Institute, Boston, MA, USA,
| | - Hong Yu
- Department of Neurology, Sean M Healey & AMG Center for ALS at Massachusetts General Hospital, Neurological Clinical Research Institute, Boston, MA, USA,
| | - Jason Walker
- Department of Neurology, Sean M Healey & AMG Center for ALS at Massachusetts General Hospital, Neurological Clinical Research Institute, Boston, MA, USA,
| | | | - William S. David
- Department of Neurology, Sean M Healey & AMG Center for ALS at Massachusetts General Hospital, Neurological Clinical Research Institute, Boston, MA, USA,
| | | | | | | | - Alan Pestronk
- Washington University School of Medicine, St. Louis, MO, USA,
| | | | | | - Benjamin Rix Brooks
- Atrium Health Neurosciences Institute, Carolinas Medical Center, University of North Carolina School of Medicine, Charlotte, NC, USA, and
| | - David Schoenfeld
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,
| | - Jeremy Shefner
- Barrow Neurological Institute and University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Swati Aggarwal
- Department of Neurology, Sean M Healey & AMG Center for ALS at Massachusetts General Hospital, Neurological Clinical Research Institute, Boston, MA, USA,
| | - Merit E. Cudkowicz
- Department of Neurology, Sean M Healey & AMG Center for ALS at Massachusetts General Hospital, Neurological Clinical Research Institute, Boston, MA, USA,
| | - Nazem Atassi
- Department of Neurology, Sean M Healey & AMG Center for ALS at Massachusetts General Hospital, Neurological Clinical Research Institute, Boston, MA, USA,
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16
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Strayer AL, Dennys-Rivers CN, Ricart KC, Bae N, Beckman JS, Franco MC, Estevez AG. Ligand-independent activation of the P2X7 receptor by Hsp90 inhibition stimulates motor neuron apoptosis. Exp Biol Med (Maywood) 2019; 244:901-914. [PMID: 31142143 PMCID: PMC6690143 DOI: 10.1177/1535370219853798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/08/2019] [Indexed: 01/15/2023] Open
Abstract
Activation of the extracellular ATP ionotropic receptor P2X7 stimulates motor neuron apoptosis, whereas its inhibition in cell and animal models of amyotrophic lateral sclerosis can be protective. These observations suggest that P2X7 receptor activation is relevant to motor neuron disease and that it could be targeted for therapeutic development. Heat shock protein 90 (Hsp90) is an integral regulatory component of the P2X7 receptor complex, antagonizing ligand-induced receptor activation. Here, we show that the repressive activity of Hsp90 on P2X7 receptor activation in primary motor neurons is highly sensitive to inhibition. Primary motor neurons in culture are 100-fold more sensitive to Hsp90 inhibition by geldanamycin than other neuronal populations. Pharmacological inhibition and down-regulation of the P2X7 receptor prevented motor neuron apoptosis triggered by Hsp90 inhibition, which occurred in the absence of extracellular ATP. These observations suggest that inhibition of a seemingly motor neuron specific pool of Hsp90 leads to ligand independent activation of P2X7 receptor and motor neuron death. Downstream of Hsp90 inhibition, P2X7 receptor activated the phosphatase and tensin homolog (TPEN), which in turn suppressed the pro-survival phosphatidyl inositol 3 kinase (PI3K)/Akt pathway, leading to Fas-dependent motor neuron apoptosis. Conditions altering the interaction between P2X7 receptor and Hsp90, such as recruitment of Hsp90 to other subcellular compartments under stress conditions, or nitration following oxidative stress can induce motor neuron death. These findings may have broad implications in neurodegenerative disorders, including amyotrophic lateral sclerosis, in which activation of P2X7 receptor may be involved in both autonomous and non-autonomous motor neurons death.
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Affiliation(s)
- Amy L Strayer
- Department of Neuroscience Weill Cornell Medical College, New
York, NY10021, USA
| | - Cassandra N Dennys-Rivers
- Burnett School of Biomedical Sciences, College of Medicine,
University of Central Florida, Orlando, FL 32826, USA
| | - Karina C Ricart
- Department of Pathology, University of Alabama at Birmingham,
Birmingham, AL 35294, USA
| | - Narae Bae
- Department of Pharmacology, Weill Cornell Medical College, New
York, NY10021, USA
| | - Joseph S Beckman
- Department of Biochemistry and Biophysics, College of Science,
Oregon State University, Corvallis, OR 97331, USA
| | - Maria Clara Franco
- Department of Biochemistry and Biophysics, College of Science,
Oregon State University, Corvallis, OR 97331, USA
| | - Alvaro G Estevez
- Department of Biochemistry and Biophysics, College of Science,
Oregon State University, Corvallis, OR 97331, USA
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17
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Roushandeh AM, Kuwahara Y, Roudkenar MH. Mitochondrial transplantation as a potential and novel master key for treatment of various incurable diseases. Cytotechnology 2019; 71:647-663. [PMID: 30706303 PMCID: PMC6465382 DOI: 10.1007/s10616-019-00302-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 01/22/2019] [Indexed: 01/01/2023] Open
Abstract
Mitochondria are attractive cellular organelles which are so interesting in both basic and clinical research, especially after it was found that they were arisen as a bacterial intruder in ancient cells. Interestingly, even now, they are the focus of many investigations and their function and relevance to health and disease have remained open questions. More recently, research on mitochondria have turned out their potential application in medicine as a novel therapeutic intervention. The importance of this issue is highlighted when we know that mitochondrial dysfunction can be observed in a variety of diseases such as cardiovascular diseases, neurodegenerative diseases, ischemia, diabetes, renal failure, skeletal muscles disorders, liver diseases, burns, aging, and cancer progression. In other words, transplantation of viable mitochondria into the injured tissues would replace or augment damaged mitochondria, allowing the rescue of cells and restoration of the normal function. Therefore, mitochondrial transplantation would be revolutionary for the treatment of a variety of diseases in which conventional therapies have proved unsuccessful. Here, we describe pieces of evidence of mitochondrial transplantation, discuss and highlight the current and future directions to show why mitochondrial transplantation could be a master key for treatment of a variety of diseases or injuries.
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Affiliation(s)
| | - Yoshikazu Kuwahara
- Divisions of Radiation Biology and Medicine, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Mehryar Habibi Roudkenar
- Department of Cardiology, Cardiovascular Disease Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
- Stem Cell and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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18
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Mesenchymal Stem Cells: A Potential Therapeutic Approach for Amyotrophic Lateral Sclerosis? Stem Cells Int 2019; 2019:3675627. [PMID: 30956667 PMCID: PMC6431432 DOI: 10.1155/2019/3675627] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/24/2018] [Accepted: 02/01/2019] [Indexed: 02/07/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the degeneration of both upper and lower motor neurons. Patients show both motor and extra-motor symptoms. A cure is not available at this time, and the disease leads to death within 3-5 years, mainly due to respiratory failure. Stem cell therapy is arising as a new promising approach for the treatment of neurodegenerative disorders. In particular, mesenchymal stem cells (MSCs) seem the most suitable type of stem cells, thanks to their demonstrated beneficial effects in different experimental models, to the easy availability, and to the lack of ethical problems. In this review, we focused on the studies involving ALS rodent models and clinical trials in order to understand the potential beneficial effects of MSC transplantation. In different ALS rodent models, the administration of MSCs induced a delay in disease progression and at least a partial recovery of the motor function. In addition, clinical trials evidenced the feasibility and safety of MSC transplantation in ALS patients, given that no major adverse events were recorded. However, only partial improvements were shown. For this reason, more studies and trials are needed to clarify the real effectiveness of MSC-based therapy in ALS.
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19
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Festoff BW, Citron BA. Thrombin and the Coag-Inflammatory Nexus in Neurotrauma, ALS, and Other Neurodegenerative Disorders. Front Neurol 2019; 10:59. [PMID: 30804878 PMCID: PMC6371052 DOI: 10.3389/fneur.2019.00059] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/17/2019] [Indexed: 12/15/2022] Open
Abstract
This review details our current understanding of thrombin signaling in neurodegeneration, with a focus on amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease) as well as future directions to be pursued. The key factors are multifunctional and involved in regulatory pathways, namely innate immune and the coagulation cascade activation, that are essential for normal nervous system function and health. These two major host defense systems have a long history in evolution and include elements and regulators of the coagulation pathway that have significant impacts on both the peripheral and central nervous system in health and disease. The clotting cascade responds to a variety of insults to the CNS including injury and infection. The blood brain barrier is affected by these responses and its compromise also contributes to these detrimental effects. Important molecules in signaling that contribute to or protect against neurodegeneration include thrombin, thrombomodulin (TM), protease activated receptor 1 (PAR1), damage associated molecular patterns (DAMPs), such as high mobility group box protein 1 (HMGB1) and those released from mitochondria (mtDAMPs). Each of these molecules are entangled in choices dependent upon specific signaling pathways in play. For example, the particular cleavage of PAR1 by thrombin vs. activated protein C (APC) will have downstream effects through coupled factors to result in toxicity or neuroprotection. Furthermore, numerous interactions influence these choices such as the interplay between HMGB1, thrombin, and TM. Our hope is that improved understanding of the ways that components of the coagulation cascade affect innate immune inflammatory responses and influence the course of neurodegeneration, especially after injury, will lead to effective therapeutic approaches for ALS, traumatic brain injury, and other neurodegenerative disorders.
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Affiliation(s)
- Barry W Festoff
- pHLOGISTIX LLC, Fairway, KS, United States.,Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Bruce A Citron
- Laboratory of Molecular Biology Research & Development, VA New Jersey Health Care System, East Orange, NJ, United States.,Department of Pharmacology, Physiology & Neuroscience, Rutgers New Jersey Medical School, Newark, NJ, United States
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20
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Fungal Neurotoxins and Sporadic Amyotrophic Lateral Sclerosis. Neurotox Res 2018; 35:969-980. [PMID: 30515715 DOI: 10.1007/s12640-018-9980-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/07/2018] [Accepted: 11/07/2018] [Indexed: 12/11/2022]
Abstract
We review several lines of evidence that point to a potential fungal origin of sporadic amyotrophic lateral sclerosis (ALS). ALS is the most common form of motor neuron disease (MND) in adults. It is a progressive and fatal disease. Approximately 90% cases of ALS are sporadic, and 5-10% are due to genetic mutations (familial). About 25 genes implicated in familial ALS have been identified so far, including SOD1 and TARDBP, the gene encoding 43 kDa transactive response (TAR) DNA-binding protein (TDP-43). Despite intensive research over many decades, the aetiology of sporadic ALS is still unknown. An environmental cause, including grass or soil-associated fungal infections, is suggested from a range of widely diverse lines of evidence. Clusters of ALS have been reported in soccer players, natives of Guam and farmers. Grass-associated fungi are known to produce a range of neurotoxins and, in symbiotic associations, high levels of fungal SOD1. Exposure of neurons to fungal neurotoxins elicits a significant increase in glutamate production. High levels of glutamate stimulate TDP-43 translocation and modification, providing a link between fungal infection and one of the molecular and histologic hallmarks of sporadic ALS. A recent study provided evidence of a variety of fungi in the cerebrospinal fluid and brain tissue of ALS patients. This review provides a rational explanation for this observation. If a fungal infection could be confirmed as a potential cause of ALS, this could provide a straightforward treatment strategy for this fatal and incurable disease.
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21
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Yamashita T, Kwak S. Cell death cascade and molecular therapy in ADAR2-deficient motor neurons of ALS. Neurosci Res 2018; 144:4-13. [PMID: 29944911 DOI: 10.1016/j.neures.2018.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/19/2018] [Accepted: 06/14/2018] [Indexed: 02/06/2023]
Abstract
TAR DNA-binding protein (TDP-43) pathology in the motor neurons is the most reliable pathological hallmark of amyotrophic lateral sclerosis (ALS), and motor neurons bearing TDP-43 pathology invariably exhibit failure in RNA editing at the GluA2 glutamine/arginine (Q/R) site due to down-regulation of adenosine deaminase acting on RNA 2 (ADAR2). Conditional ADAR2 knockout (AR2) mice display ALS-like phenotype, including progressive motor dysfunction due to loss of motor neurons. Motor neurons devoid of ADAR2 express Q/R site-unedited GluA2, and AMPA receptors with unedited GluA2 in their subunit assembly are abnormally permeable to Ca2+, which results in progressive neuronal death. Moreover, analysis of AR2 mice has demonstrated that exaggerated Ca2+ influx through the abnormal AMPA receptors overactivates calpain, a Ca2+-dependent protease, that cleaves TDP-43 into aggregation-prone fragments, which serve as seeds for TDP-43 pathology. Activated calpain also disrupts nucleo-cytoplasmic transport and gene expression by cleaving molecules involved in nucleocytoplasmic transport, including nucleoporins. These lines of evidence prompted us to develop molecular targeting therapy for ALS by normalization of disrupted intracellular environment due to ADAR2 down-regulation. In this review, we have summarized the work from our group on the cell death cascade in sporadic ALS and discussed a potential therapeutic strategy for ALS.
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Affiliation(s)
- Takenari Yamashita
- Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shin Kwak
- Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan; Department of Neurology, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
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22
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D’hulst L, Van Weehaeghe D, Chiò A, Calvo A, Moglia C, Canosa A, Cistaro A, Willekens SM, De Vocht J, Van Damme P, Pagani M, Van Laere K. Multicenter validation of [18F]-FDG PET and support-vector machine discriminant analysis in automatically classifying patients with amyotrophic lateral sclerosis versus controls. Amyotroph Lateral Scler Frontotemporal Degener 2018; 19:570-577. [DOI: 10.1080/21678421.2018.1476548] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Ludovic D’hulst
- Division of Nuclear Medicine and Department of Imaging and pathology, University Hospitals Leuven and KU Leuven, Leuven, Belgium,
| | - Donatienne Van Weehaeghe
- Division of Nuclear Medicine and Department of Imaging and pathology, University Hospitals Leuven and KU Leuven, Leuven, Belgium,
| | - Adriano Chiò
- ALS Center, ‘Rita Levi Montalcini’ Department of Neuroscience, University of Torino, Torino, Italy,
- Neuroscience Institute of Torino, Torino, Italy,
| | - Andrea Calvo
- ALS Center, ‘Rita Levi Montalcini’ Department of Neuroscience, University of Torino, Torino, Italy,
- Neuroscience Institute of Torino, Torino, Italy,
| | - Cristina Moglia
- ALS Center, ‘Rita Levi Montalcini’ Department of Neuroscience, University of Torino, Torino, Italy,
| | - Antonio Canosa
- ALS Center, ‘Rita Levi Montalcini’ Department of Neuroscience, University of Torino, Torino, Italy,
| | | | - Stefanie Ma Willekens
- Division of Nuclear Medicine and Department of Imaging and pathology, University Hospitals Leuven and KU Leuven, Leuven, Belgium,
| | - Joke De Vocht
- Department of Neurology, University Hospitals Leuven and Laboratory of Neurobiology, Center for Brain & Disease Research KU Leuven and VIB, Leuven, Belgium,
| | - Philip Van Damme
- Department of Neurology, University Hospitals Leuven and Laboratory of Neurobiology, Center for Brain & Disease Research KU Leuven and VIB, Leuven, Belgium,
| | - Marco Pagani
- Department of Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden, and
- Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
| | - Koen Van Laere
- Division of Nuclear Medicine and Department of Imaging and pathology, University Hospitals Leuven and KU Leuven, Leuven, Belgium,
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Olloquequi J, Cornejo-Córdova E, Verdaguer E, Soriano FX, Binvignat O, Auladell C, Camins A. Excitotoxicity in the pathogenesis of neurological and psychiatric disorders: Therapeutic implications. J Psychopharmacol 2018; 32:265-275. [PMID: 29444621 DOI: 10.1177/0269881118754680] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurological and psychiatric disorders are leading contributors to the global disease burden, having a serious impact on the quality of life of both patients and their relatives. Although the molecular events underlying these heterogeneous diseases remain poorly understood, some studies have raised the idea of common mechanisms involved. In excitotoxicity, there is an excessive activation of glutamate receptors by excitatory amino acids, leading to neuronal damage. Thus, the excessive release of glutamate can lead to a dysregulation of Ca2+ homeostasis, triggering the production of free radicals and oxidative stress, mitochondrial dysfunction and eventually cell death. Although there is a consensus in considering excitotoxicity as a hallmark in most neurodegenerative diseases, increasing evidence points to the relevant role of this pathological mechanism in other illnesses affecting the central nervous system. Consequently, antagonists of glutamate receptors are used in current treatments or in clinical trials in both neurological and psychiatric disorders. However, drugs modulating other aspects of the excitotoxic mechanism could be more beneficial. This review discusses how excitotoxicity is involved in the pathogenesis of different neurological and psychiatric disorders and the promising strategies targeting the excitotoxic insult.
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Affiliation(s)
- Jordi Olloquequi
- 1 Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Talca, Chile
| | | | - Ester Verdaguer
- 3 Departament de Biologia Cellular, Fisiologia i Immunologia, Universitat de Barcelona, Spain.,4 Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,5 Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Francesc X Soriano
- 3 Departament de Biologia Cellular, Fisiologia i Immunologia, Universitat de Barcelona, Spain.,5 Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Octavio Binvignat
- 6 Laboratorio de Ciencias Morfológicas, Pontificia Universidad Católica de Valparaíso, Chile
| | - Carme Auladell
- 3 Departament de Biologia Cellular, Fisiologia i Immunologia, Universitat de Barcelona, Spain.,4 Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,5 Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Camins
- 4 Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,5 Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,7 Departament de Farmacologia, Toxicologia i Química Terapèutica, Universitat de Barcelona, Spain
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RNA-Targeted Therapies and Amyotrophic Lateral Sclerosis. Biomedicines 2018; 6:biomedicines6010009. [PMID: 29342921 PMCID: PMC5874666 DOI: 10.3390/biomedicines6010009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/07/2018] [Accepted: 01/09/2018] [Indexed: 12/11/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal motor disease in adults. Its pathophysiology remains mysterious, but tremendous advances have been made with the discovery of the most frequent mutations of its more common familial form linked to the C9ORF72 gene. Although most cases are still considered sporadic, these genetic mutations have revealed the role of RNA production, processing and transport in ALS, and may be important players in all ALS forms. There are no disease-modifying treatments for adult human neurodegenerative diseases, including ALS. As in spinal muscular atrophy, RNA-targeted therapies have been proposed as potential strategies for treating this neurodegenerative disorder. Successes achieved in various animal models of ALS have proven that RNA therapies are both safe and effective. With careful consideration of the applicability of such therapies in humans, it is possible to anticipate ongoing in vivo research and clinical trial development of RNA therapies for treating ALS.
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Paróla A, de Palhares Falcão FDSM, Farinha H, Caetano A, Santos L, Medeiros E, Viana-Baptista M. Analysis of riluzole's profile of use in a Central Hospital in Lisbon. Patient Prefer Adherence 2018; 12:2357-2361. [PMID: 30464422 PMCID: PMC6229141 DOI: 10.2147/ppa.s167861] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Riluzole is indicated to prolong life or delay the institution of mechanical ventilation in patients with amyotrophic lateral sclerosis (ALS). Clinical studies have shown that this drug prolongs survival, defined as living patients who are not intubated for mechanical ventilation and without tracheotomy. The purpose of this study is to characterize riluzole's use as well as the user population in order to contribute to a rational and safe use. PATIENTS AND METHODS Descriptive, observational, retrospective study describing and characterizing the use of riluzole in ALS patients between July 2006 and December 2016 conducted in a Lisbon's Central Hospital. RESULTS Over the course of the study period, 77 patients with different phenotypes of ALS received riluzole. The majority of patients (63%, n=49) were male. The median survival was 10.1 months, but 12 patients (16%) remained on therapy for more than 3 years; 65% of patients were lost to follow-up. The mean adherence rate was 91.2%, and the median adherence rate was 99.3%. One patient discontinued therapy due to gastrointestinal intolerance. Dyspnea and cough were the most common side effects, with roughly one third of patients experiencing each, followed by asthenia and hepatic effects. CONCLUSION Despite the extended enrollment period, only 77 patients met the criteria for study inclusion. Nonetheless, statistical data regarding our population is in accordance with reported international data. High adherence rates were observed, but 14% of patients discontinued riluzole. In such cases, assessment by a multidisciplinary team is warranted.
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Affiliation(s)
- Ana Paróla
- Pharmacy Department, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal,
| | | | - Helena Farinha
- Pharmacy Department, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal,
| | - André Caetano
- Neurology Department, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Luís Santos
- Neurology Department, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Elmira Medeiros
- Neurology Department, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Miguel Viana-Baptista
- Neurology Department, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
- Faculty of Medical Sciences, Nova University of Lisbon, Lisbon, Portugal
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Sluyter R, Bartlett R, Ly D, Yerbury JJ. P2X7 receptor antagonism in amyotrophic lateral sclerosis. Neural Regen Res 2017; 12:749-750. [PMID: 28616029 PMCID: PMC5461610 DOI: 10.4103/1673-5374.206643] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Ronald Sluyter
- School of Biological Sciences and Center for Medical and Molecular Bioscience, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Wollongong, Australia
| | - Rachael Bartlett
- School of Biological Sciences and Center for Medical and Molecular Bioscience, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Wollongong, Australia
| | - Diane Ly
- School of Biological Sciences and Center for Medical and Molecular Bioscience, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Wollongong, Australia
| | - Justin J Yerbury
- School of Biological Sciences and Center for Medical and Molecular Bioscience, University of Wollongong, Wollongong, NSW, Australia; Illawarra Health and Medical Research Institute, NSW, Wollongong, Australia
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