[Development of early diagnosis of Parkinson's disease and comprehensive economic analysis of the effect of its implementation]. / Razrabotka rannei diagnostiki bolezni Parkinsona i kompleksnyi ekonomicheskii analiz effekta ot ee vnedreniya.

The paper summarizes the literature and author's data on the development of early (preclinical) diagnosis of Parkinson's disease (PD). Implementation of this diagnosis will promote the use of preventive therapy and change investments in diagnosis and treatment of patients. The paper declares that at present the only approach to early diagnosis of PD is positron-emission tomography of the nigrostriatal dopaminergic system, but it cannot be used for preventive examination due to its high cost. The authors consider that a less specific, but more promising approach to the development of early diagnosis of PD is the search for markers in body fluids, mainly in the blood, in patients at the prodromal stage of PD. Indeed, a number of markers as changes in the level of metabolites of monoamines, sphingolipids, urates, and indicators of oxidative stress were found in patients selected for the risk group of the prodromal stage of PD, according to characteristic premotor symptoms. In addition, it is assumed that the search for blood markers at an earlier - pre-prodromal stage is possible only in animal models of PD at the early preclinical stage. This approach can also be used to verify blood markers identified in patients at the clinical stage of PD. It is also evident that the complex socio-economic factors influencing the incidence of PD is different in developed versus developing countries. The societal and medical costs of Parkinson's are huge and efforts to improve early preclinical diagnosis of PD will lead to considerable economical and societal benefits. For instance this will allow efficient selection of patients for preclinical diagnostic tests. To assess the effectiveness of this strategy considering the uncertainty of socio-economic issues, a modification of the «cost-utility¼ analysis is proposed. For the first time, a Markov model of PD including preclinical diagnostic tests and possible neuroprotective therapy was developed and studied. Analytical outcomes of this process suggest that the idea of developing a new multimodal strategy is promising from a socio-economic point of view.

Expression analysis of genes involved in mitochondrial biogenesis in mice with MPTP-induced model of Parkinson's disease.

The mitochondrion is an extremely important organelle that performs various functions in the cell: e.g. energy production, regulation of respiration processes and maintenance of calcium homeostasis. Disruption of the biogenesis and functioning of this organelle can lead to cell damage and cell death. Mitochondrial dysfunction has been shown to possibly be involved in the pathogenesis of Parkinson's disease. However, the role of genes associated with mitochondrial biogenesis in the early stages of disease remains poorly understood. The objective of the present study was to analyze changes in the expression of activator (Nrf1, Ppargc1a, Prkn, and Kif1b) and repressor (Zfp746 and Mybbp1a) genes of mitochondrial biogenesis in the early stages of the development of neurodegeneration in an MPTP-induced model of presymptomatic and early symptomatic stages of PD. Statistically significant changes in expression at the mRNA level were detected for all studied genes. There was mainly a decrease in the expression of activator genes (Nrf1, Ppargc1a, Prkn, and Kif1b) at all stages of neurodegeneration, which seemed to be associated with impaired mitochondrial biogenesis and the development of neurodegeneration processes. A predominant decrease in the expression was detected for the Zfp746 and Mybbp1a repressor genes of mitochondrial biogenesis. However, in this case, it was associated with the emergence of compensatory mechanisms during the development of Parkinson's disease. The largest number of statistically significant changes was detected for the Nrf1 activator gene and the Mybbp1a repressor gene. Apparently, these two genes play the most important role in this disease.

[Possible Involvement of Genes Related to Lysosomal Storage Disorders in the Pathogenesis of Parkinson's Disease].

Parkinson's disease (PD) characterized with slow continuous degeneration of dopaminergic neurons in the substantia nigra is one of the most common neurodegenerative diseases, but its etiology and pathogenesis are not fully understood. The pathogenesis of PD involves the impairment of lysosomal autophagy, which also contributes to lysosomal storage disorders (LSDs). In this work, the expression of genes related to lysosomal autophagy: Hspa8, Lamp2, Tfam, Slc18a2, and Vps35, was analyzed in the brain tissues of mice with the earliest stage of MPTP-induced PD. The detected decrease in Hspa8 and Lamp2 mRNA levels suggests that dysfunction of lysosomal autophagy maybe involved in the earliest stages of PD pathogenesis. A decrease in the rate of lysosomal autophagy may affect the accumulation of damaged proteins and the formation of protein inclusions in PD. Genes related to the lysosome function may be involved in development of both LSD and PD at the earliest stages of these pathophysiological processes.

Whole-Transcriptome Analysis of Mouse Models with MPTP-Induced Early Stages of Parkinson's Disease Reveals Stage-Specific Response of Transcriptome and a Possible Role of Myelin-Linked Genes in Neurodegeneration.

Parkinson's disease (PD) is characterized by degeneration of dopaminergic neurons. A whole-transcriptome analysis of the substantia nigra and striatum of an MPTP-induced mouse models of the earliest stages of PD was performed. Functional clustering of differentially represented transcripts revealed processes associated with the functioning of synapses, dendrites, axons, and myelination of neuronal projections. All of these processes occur in both the substantia nigra and striatum, but they are aimed at the functioning of neuron terminals in the striatum. One cluster was identified at the earliest stage modeled, i.e., "neuron projection" in the substantia nigra and "transport" in the striatum, and their number increased at subsequent stages. The number of clusters in the striatum predominates over those in the substantia nigra and there is a pronounced increase in the number of clusters from the modeled early stages to the late stages. These findings indicate that the substantia nigra and striatum have unique patterns of changes at each stage. Considering the clustering of individual processes, it was seen that there is a set of hierarchical clusters that overlap only partially at different stages and in different tissues. The data indicate a consistent involvement of the transcriptome in the pathogenesis of PD and highlight the independent role of various brain structures and individual parts of nerve cells in the formation of a response to the development of neurodegeneration. Decreased myelination of neuronal projections may be associated with the development of PD in the models considered.

[Reciprocal Humoral Regulation of Endocrine Noradrenaline Sources in Perinatal Development of Rats].

The goal of the present study was to verify our hypothesis of humoral interaction between the norepinephrine secreting organs in the perinatal period of ontogenesis that is aimed at the sustaining of physiologically active concentration of norepinephrine in blood. The objects of the study were the transitory organs, such as brain, organ of Zuckerkandl, and adrenals, the permanent endocrine organ of rats that releases norepinephrine into the bloodstream. To reach this goal, we assessed the adrenal secretory activity (norepinephrine level) and activity of the Zuckerkandl's organ under the conditions of destructed noradrenergic neurons of brain caused by (1) their selective death induced by introduction of a hybrid molecular complex, which consisted of antibodies against dopamine-ß-hydroxylase (DBH) conjugated with saporin cytotoxin (anti-DBH-saporin) into the lateral brain ventricles of neonatal rats; and (2) microsurgical in utero destruction of embryo's brain (in utero encephalectomy). It was observed that 72 h after either pharmacological or microsurgical norepinephrine synthesis deprivation in the newborn rat's brain, the level of norepinephrine was increased in adrenals and, conversely, decreased in the Zuckerkandl's organ. Therefore, the experiments with models of chronical inhibition of norepinephrine synthesis in prenatal and early postnatal rat's brain revealed changes in the secretory activity of peripheral norepinephrine sources. This, apparently, favors the sustaining of physiologically active norepinephrine level in the bloodstream.

Changes in plasma catecholamines levels as preclinical biomarkers in experimental models of Parkinson's disease.

The goal of this study was to investigate the changes in the concentrations of blood plasma catecholamines as possible biomarkers of Parkinson's disease (PD) in the mouse experimental model of PD induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). A significant decrease was detected in the levels of dopamine and L-DOPA in the PD preclinical stage model as a result of the catecholamines systemic metabolism disfunction. In the PD early clinical stage models, the level of L-DOPA and dihydroxyphenylacetic acid decreased, which is consistent with the results of blood tests in untreated patients.

Activity of Monoamine Oxidase in the Nigrostriatal System at Presymptomatic and Early Symptomatic Stages of Parkinsonism in Mice.

Activities of monoamine oxidases A and B were examined on the models of presymptomatic and early symptomatic stages of Parkinson's disease developed in mice treated with MPTP, a specific neurotoxin affecting dopaminergic neurons. Activity of monoamine oxidases A, the key enzyme of dopamine degradation, is increased in neuronal somas during the symptomatic stage, and it is augmented in the axons during both stages. Neuronal activity of monoamine oxidases A is higher during the symptomatic stage than that during the presymptomatic stage, which can explain depletion of intercellular dopamine and appearance of motor disturbances. Activity of monoamine oxidase B in the striatum is reduced during the presymptomatic stage, but returns to the control level during the symptomatic stage. Variation in monoamine oxidase activity seems to reflect the compensatory mechanisms triggered in degrading nigrostriatal dopaminergic system.

Vasopressinergic neurons in rats in ontogenesis: responses to salt loading and their modulation by noradrenergic afferents.

Salt loading in adult mammals leads to increased vasopressin secretion by vasopressinergic neurons in the supraoptic nucleus, which is mediated by the actions of a number of hormones and neurotransmitters, including noradrenaline. The present study addressed identification of the stage of ontogenesis at which vasopressinergic neurons start to respond to salt loading and when the noradrenalinergic regulation of this process begins. Studies were performed on rats at embryonic day 21 (E21), postnatal day 3 (P3), and postnatal day 13 (P13) using immunocytochemical and in situ hybridization. Animals were subjected to salt loading, in some cases on the background of the alpha1-adrenoceptor inhibitor prazosin. Salt loading in rats of all age groups induced increases in the synthesis of vasopressin mRNA, probably accompanied by increased synthesis of vasopressin peptide. At E21 and P3, intraneuronal vasopressin levels were increased; there was no change at P13. In salt loading on the background of prazosin administration, vasopressin mRNA and vasopressin contents at E21 showed no change, while at P3 they were increased, which is evidence of the inhibitory effect of noradrenaline on vasopressin expression in the early postnatal period. Thus, vasopressinergic neurons start to respond to salt loading at the end of the prenatal period with increases in vasopressin expression; noradrenergic afferents have inhibitory influences on vasopressin expression in the early postnatal period.

The brain is one of the most important sources of dopamine in the systemic circulation in the perinatal period of ontogenesis in rats.

This study was designed to test the authors' hypothesis that dopamine passes from dopamine-synthesizing cells in the brain to the systemic circulation prior to the formation of the blood-brain barrier during ontogenesis. High-performance liquid chromatography studies demonstrated that peripheral blood dopamine levels before formation of the blood-brain barrier-in rat fetuses and neonates-are significantly higher than after formation of the barrier in adult rats, providing indirect evidence in support of the hypothesis. Furthermore, formation of the blood-brain barrier is accompanied by a significant increase in dopamine levels in the rat brain. Direct evidence for the hypothesis was obtained in the form of a sharp decrease in blood dopamine levels in fetuses after lesioning of dopamine-synthesizing neurons in the brain by encephalectomy.

Dopamine synthesis by non-dopaminergic neurons in the arcuate nucleus of rat fetuses.

The aim of the present work was to verify the hypothesis that non-dopaminergic neurons expressing individual complementary dopamine synthesis enzymes can perform the co-located synthesis of dopamine. According to this hypothesis, neurons expressing tyrosine hydroxylase use L-tyrosine for the synthesis of L-dihydroxyphenylalanine (L-DOPA), which then enters neurons expressing aromatic amino acid decarboxylase, which converts L-DOPA to dopamine. Experiments were performed using the mediobasal hypothalamus of rat fetuses, which mostly contains single-enzyme neurons (>99%) and occasional double-enzyme neurons (<1%). Controls were obtained from the fetal substantia nigra, which is enriched with dopaminergic neurons. High-performance liquid chromatography was used to measure levels of dopamine and L-DOPA in cell extracts and the incubation medium after incubation in the presence and absence of exogenous L-tyrosine. Addition of L-tyrosine to the medium led to increases in the level of synthesis and release of L-DOPA in the mediobasal hypothalamus and substantia nigra. In addition, L-tyrosine increased dopamine synthesis in the substantia nigra and decreased dopamine synthesis in the mediobasal hypothalamus. This regional difference in levels of dopamine synthesis is probably due to inhibition of the uptake of L-DOPA from the intercellular medium by neurons in the mediobasal hypothalamus containing aromatic amino acid decarboxylase, due to the competitive binding of the L-DOPA transporter by L-tyrosine. Thus, these results provide the first evidence for the co-located synthesis of dopamine by non-dopaminergic neurons expressing single complementary enzymes involved in the synthesis of this neurotransmitter.

The effects of serotonin on the differentiation of neurons producing vasoactive intestinal polypeptide in the suprachiasmatic nucleus of the rat.

The morphogenetic influences of serotonin on the differentiation of neurons synthesizing vasoactive intestinal polypeptide (VIP) in the suprachiasmatic nucleus were studied in rats. This was addressed by comparative morphofunctional analysis of VIP neurons in adult rats whose brains developed prenatally in conditions of normal and deficient serotonin metabolism. Serotonin deficiency was created in fetuses by treatment of their mothers with p-chlorophenylalanine (PCPA). Pregnant females in controls were treated with 0.9% NaCl. VIP neurons in experimental and control animals were found to show no differences in VIP mRNA concentrations and, probably, in the level of VIP synthesis. However, inhibition of serotonin synthesis led to an increase in the number of VIP-immunoreactive neurons and an increase in the VIP concentration within these cells. This was not associated with any change in neuron size, which was an indicator of the absence of functional hypertrophy accompanying activation of specific synthesis. Comparison of the data obtained here showed that during prenatal ontogenesis, serotonin has an imprinting influence on the differentiation of VIP neurons and is probably involved in the formation of the mechanism of VIP secretion.

Non-dopaminergic neurons expressing dopamine synthesis enzymes: differentiation and functional significance.

The development and functional significance of neurons in the arcuate nucleus expressing tyrosine hydroxylase and/or aromatic L-amino acid decarboxylase were studied in rat fetuses, neonates, and adults using immunocytochemical (single and double immunolabeling of tyrosine hydroxylase and aromatic L-amino acid decarboxylase) methods with a confocal microscope and computerized image analysis, HPLC with electrochemical detection, and radioimmunological analysis. Single-enzyme neurons containing tyrosine hydroxylase were first seen on day 18 of embryonic development in the ventrolateral part of the arcuate nucleus. Neurons expressing only aromatic L-amino acid decarboxylase or both enzymes of the dopamine synthesis pathway were first seen on day 20 of embryonic development, in the dorsomedial part of the nucleus. On days 20-21 of embryonic development, dopaminergic (containing both enzymes) neurons amounted to less than 1% of all neurons expressing tyrosine hydroxylase and/or aromatic L-amino acid decarboxylase. Nonetheless, in the ex vivo arcuate nucleus and in primary neuron cultures from this structure, there were relatively high leveLs of dopamine and L-dihydroxyphenylalanine (L-DOPA), and these substances were secreted spontaneously and in response to stimulation. In addition. dopamine levels in the arcuate nucleus in fetuses were sufficient to support the inhibitory regulation of prolactin secretion by the hypophysis, which is typical of adult animals. During development, the proportion of dopaminergic neurons increased, reaching 38% in adult rats. Specialized contacts between single-enzyme tyrosine hydroxylase-containing and aromatic L-amino acid decarboxylase-containing neurons were present by day 21 of embryonic development; these were probably involved in transporting L-DOPA from the former neurons to the latter. It was also demonstrated that the axons of single-enzyme decarboxylase-containing neurons projected into the median eminence, supporting the secretion of dopamine into the hypophyseal portal circulation. Thus, dopamine is probably synthesized in the arcuate nucleus not only by dopaminergic neurons, but also by neurons expressing only tyrosine hydroxylase or aromatic L-amino acid decarboxylase.

The responses of vasopressin- and tyrosine hydroxylase-expressing neurons of the supraoptic nucleus in rats to chronic osmotic stimulation.

The dynamics of intracellular contents of vasopressin and tyrosine hydroxylase in neuron bodies were studied in the supraoptic nucleus and the distant segments of their axons in the posterior lobe of the hypophysis in rats in conditions of salt loading lasting one, two, and three weeks. The number of vasopressin-immununoreactive neurons increased by the end of the second week of osmotic stimulation, due to the onset of vasopressin synthesis in neurons not synthesizing this hormone in normal physiological conditions. The vasopressin concentration decreased in cell bodies and axons during the first two weeks of salt loading, apparently because vasopressin release occurred at a greater level than vasopressin synthesis. During the third week, the intracellular vasopressin content remained essentially constant, demonstrating the establishment of dynamic equilibrium between the synthesis and release of the hormone. The number of tyrosine hydroxylase-immunoreactive neurons and the levels of tyrosine hydroxylase in neuron bodies and axons, at least in the largest swellings (Herring bodies), gradually increased, demonstrating that the rate of tyrosine hydroxylase was greater than its rate of enzymatic degradation. Thus, chronic stimulation of vasopressin neurons was accompanied by a series of adaptive reactions, the most important of which appears to be the expression of vasopressin and tyrosine hydroxylase synthesis by neurons which do not normally synthesize these compounds.

The differentiation of dopaminergic neurons in situ, in vivo, and in transplants.

This article summarizes results obtained from studies on the differentiation of dopaminergic neurons in animal hypothalamus and human substantia nigra in situ, in vitro, and in transplants, as well as the role of the microenvironment in regulating this process. Four stages were identified in the differentiation of dopaminergic neurons from rat hypothalamus: a) formation of neurons from neuroepithelial precursor cells, b) expression of specific synthetic products (enzymes and dopamine itself) and mechanisms for transmembrane dopamine transport (reuptake and secretion in response to membrane depolarization), c) formation of permanent and transient efferent connections, and d) formation of afferent innervation and synaptogenesis. Along with dopaminergic neurons, rat fetuses contained neurons expressing only one of the dopamine-synthesizing enzymes and probably taking part in in situ dopamine synthesis. Differentiation of dopaminergic neurons was sexually dimorphic in terms of the dynamics of neuron formation and expression of enzymes involved in dopamine synthesis. A neurotransplantation model showed that humoral factors of placental and maternal origin had no significant effect on the differentiation of the dopaminergic neurons of the hypothalamus. As regards the dopaminergic neurons of the substantia nigra, expression of their specific phenotype in human fetuses started with the synthesis of tyrosine hydroxylase and co-maturation of the specific dopamine reuptake mechanism during the sixth week of development. During the next four weeks, specific uptake increased, and this appears to be a measure of the number of neurons and the growth of their processes. These data provide the basis for regarding the period from week 6 to week 10 as optimal for transplantation of dopaminergic neurons into the striatum of patients with Parkinson's disease. Suspensions of fetal substantia nigra cells enriched with dopaminergic neurons were introduced stereotaxically into a patient's striatum through a cannula. Positron emission tomography studies showed that the transplanted neurons survived within the host brain, underwent differentiation, and started to synthesize dopamine. The results of clinical assessment performed in parallel with these studies suggested that the transplanted dopaminergic neurons were involved in regulating striatal target neurons.

[Swelling of neurosecretory fibers (Herring bodies) in the reorganized hypophyseal stalk following hypophysectomy]. / O krupnykh rasshireniiak neirosekretornykh volokon (telakh Gerringa) v reorganizovannom posle gipofizéktomii steble gipofiza krysy

Herring bodies were revealed in the reorganized hypophyseal stalk of rats two months after hypophysectomy both in normal laboratory condition and under salt load. We observed Herring bodies with a storage of neurosecretory granules and neurohormones, as well as with massive destruction and disappearance of neurosecretory granules due to release of hormones in neuroplasm. Many Herring bodies were characterized by degenerative changes probably associated with aging of neurosecretory cells or their lesion due to the operation. Occasionally we revealed Herring bodies which contained a network of dilated neurotubules, that probably reflected either the reparative phase of secretory cycle of corresponding neurosecretory cells or restoration of their functions after hypophysectomy. Herring bodies were often situated around capillaries, but they were separated from perivascular space with narrow sprouts of pituicytes.