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Introduction: Language delay cannot be ignored, and there is an urgent need to determine therapies that elicit better results in a short period. However, whether transcranial direct current stimulation (tDCS) alone or in combination with other therapies can promote recovery of language and cognitive function in children with language delay remains unknown. This study aims to explore the effects of tDCS combined with language-cognitive training and home-based rehabilitation on language and cognitive ability in children with language delay. Methods: Children with language delay who visited the Department of rehabilitation medicine or the pediatric outpatient clinic of the First People's Hospital of Foshan from January 2019 to December 2021, totaling 190 in number, were included and randomly divided into 4 groups, i.e., the family guidance group, the tDCS group, the language-cognitive training group, and the comprehensive training group. The family guidance group (47 cases) received home training. The tDCS group (46 cases) received home training and tDCS treatment. The language- cognitive training group (49 cases) adopted home training and language-cognitive training. The comprehensive training group (48 cases) took home training, language-cognitive training, and tDCS treatment. All groups received training 5 times a week for 4 weeks. The Sign-significant relations (S-S) test was applied to evaluate the language comprehension, language expression, basic learning ability, and attitude of communication of the children. Results: The language-cognitive training group and the comprehensive training group showed improvement after treatment (p < 0.05) regarding basic learning ability. The communication attitude of the four groups improved after intervention (p < 0.05). Particularly, the comprehensive training group had maximum improvement after intervention. No serious adverse reactions such as epilepsy, headache, and behavioral abnormalities were found. Conclusion: tDCS combined with language-cognitive training and home training can improve language and cognitive ability in children with language delay.
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Hepatocellular carcinoma (HCC), the most common primary malignancy of the liver, is one of the leading causes of cancer-related death and is associated with a poor prognosis. The tumor microenvironment (TME) of HCC comprises immune, immunosuppressive, and interstitial cells with hypoxic, angiogenic, metabolic reprogramming, inflammatory, and immunosuppressive features. Exosomes are nanoscale extracellular vesicles that secrete biologically active signaling molecules such as deoxyribonucleic acid (DNA), messenger ribonucleic acid (mRNA), microribonucleic acid (miRNA), proteins, and lipids. These signaling molecules act as messengers in the tumor microenvironment, especially the tumor immunosuppressive microenvironment. Exosomal circRNAs reshape the tumor microenvironment by prompting hypoxic stress response, stimulating angiogenesis, contributing to metabolic reprogramming, facilitating inflammatory changes in the HCC cells and inducing tumor immunosuppression. The exosomes secreted by HCC cells carry circRNA into immune cells, which intervene in the activation of immune cells and promote the overexpression of immune checkpoints to regulate immune response, leading tumor cells to acquire immunosuppressive properties. Furthermore, immunosuppression is the final result of a combination of TME-related factors, including hypoxia, angiogenesis, metabolic reprogramming, and inflammation changes. In conclusion, exosomal circRNA accelerates the tumor progression by adjusting the phenotype of the tumor microenvironment and ultimately forming an immunosuppressive microenvironment. HCC-derived exosomal circRNA can affect HCC cell proliferation, invasion, metastasis, and induction of chemoresistance. Therefore, this review aimed to summarize the composition and function of these exosomes, the role that HCC-derived exosomal circRNAs play in microenvironment formation, and the interactions between exosomes and immune cells. This review outlines the role of exosomal circRNAs in the malignant phenotype of HCC and provides a preliminary exploration of the clinical utility of exosomal circRNAs.
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Carcinoma Hepatocelular , Exossomos , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/patologia , RNA Circular/genética , RNA Circular/metabolismo , Neoplasias Hepáticas/patologia , Exossomos/metabolismo , Transdução de Sinais/genética , Microambiente TumoralRESUMO
Hemiplegic cerebral palsy (HCP) is a non-progressive movement and posture disorder that affects one side of the body. Constraint-induced movement therapy (CIMT) can improve the hand function of children with HCP. We used label-free proteomic quantification technology to evaluate proteomic changes in the bilateral M1 and spinal cord in HCP mouse induced by hypoxia/ischemia and CIMT. Nissl staining showed reduced neuron density in the HCP mice's lesioned and contralesional M1. The rotarod test and grip strength test showed motor dysfunction in mice with HCP and improved motor ability after CIMT. A total of 5147 proteins were identified. Fifty-one, five, and sixty common differentially expressed proteins (DEPs), which were co-regulated by HCP and CIMT, were found in the lesioned M1, the contralesional M1 and the spinal cord respectively. The significant proteins included alpha-centractin, metaxin complex, PKC, septin 11, choline transporter-like proteins, protein 4.1, teneurin-4, and so on, which mainly related to synapse stability, neuronal development and maintenance, axon development, and myelin formation. The KEGG pathways of HCP-induced DEPs mainly related to lipid metabolism, synaptic remodeling, SNARE interactions in vesicular transport and axon formation. The CIMT-induced DEPs were mainly related to synaptic remodeling and axon formation in the lesioned M1 and spinal cord. This study investigated the proteomic changes of the bilateral M1 and spinal cord as well as the CIMT-induced proteomic changes in HCP mice, which might provide new insights into the therapy of HCP.
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Paralisia Cerebral , Camundongos , Animais , Paralisia Cerebral/terapia , Hemiplegia , Proteômica , Movimento , PosturaRESUMO
BACKGROUND: Our previous study has confirmed that constraint-induced movement therapy (CIMT) could promote neural remodeling in hemiplegic cerebral palsy (HCP) mice through Nogo-A/NgR/RhoA/ROCK signaling, however, the upstream mechanism was still unclear. Therefore, the present study aimed to further explore the mechanism of CIMT regulating the expression of Nogo-A in HCP mice. METHOD: HCP mice were well established through ligating the left common carotid artery of 7-day-old pups and being placed in a hypoxic box which was filled with a mixture of 8% oxygen and 92% nitrogen. CIMT intervention was conducted by taping to fix the entire arm of the contralateral side (left) to force the mice to use the affected limb (right). Bioinformatics prediction and luciferase experiment were performed to confirm that miR-182-5p was targeted with Nogo-A. The beam test and grip test were applied to examine the behavioral performance under the intervention of c-Jun and CIMT. Also, immunofluorescence, Golgi staining, and transmission electron microscopy were conducted to show that the lenti-expression of c-Jun could increases the expression of myelin, and downregulates the expression of Nogo-A under the CIMT on HCP mice. RESULT: (1) The beam walking test and grip test experiment results showed that compared with the control group, the HCP + nCIMT group's forelimb grasping ability and balance coordination ability were decreased (P < 0.05). (2) The results of Golgi staining, and transmission electron microscopy showed that the thickness of myelin sheath and the density of dendritic spines in the HCP + nCIMT group were lower than those in the control group (P < 0.05). Compared with the HCP + nCIMT group, the cerebral cortex myelin sheath thickness, dendrite spine density and nerve filament expression were increased in HCP + CIMT group (P < 0.05). (3) Immunofluorescence staining showed that the expression of Nogo-A in the cerebral cortex of the HCP + nCIMT group was higher than that of the HCP + CIMT group (P < 0.05). Compared with the HCP + CIMT group, the expression of Nogo-A in the HCP + LC + CIMT group was decreased and, in the HCP, + SC + CIMT group was significantly increased (P < 0.05). Compared with the HCP + nCIMT group, the expression of c-Jun in the control, HCP + CIMT, HCP + LC + nCIMT and HCP + LC + CIMT groups was significantly increased, and in the HCP + SC + CIMT was decreased (P < 0.05). (4) Real-time quantitative polymerase chain reaction (RT-qPCR) results showed that the expression level of miR-182-5p in the HCP + LC + CIMT group was more increased than that in the HCP + nCIMT group (P < 0.05). The expression level of miR-182-5p in the HCP + LC + CIMT group was higher than that in the HCP + LC + nCIMT group and the HCP + SC + CIMT group (P < 0.05). CONCLUSION: These data identified that CIMT might stimulate the remodeling of neurons and myelin in the motor cortex by partially inhibiting the c-Jun/miR-182-5p/Nogo-A pathway, thereby facilitating the grasping performance and balance function of HCP mice.
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Paralisia Cerebral , MicroRNAs , Córtex Motor , Camundongos , Animais , Paralisia Cerebral/terapia , Proteínas Nogo , Hemiplegia/terapia , MicroRNAs/genéticaRESUMO
Cerebral palsy (CP) is a motor and postural disorder syndrome caused by the nonprogressive dysfunction of the developing brain. Previous studies strongly indicated that the Nogo-A gene might be related to the pathogenesis of CP. The objective of this research was to explore the relationship between Nogo-A polymorphisms (rs1012603, rs12464595, and rs2864052) and CP in Southern China. The Hardy-Weinberg equilibrium (HWE) testing, allele and genotype frequencies analysis, and haplotype association analysis were applied to the genotyping of 592 CP children and 600 controls. The results showed that the allele and genotype frequencies of rs1012603 of CP group were significantly different from the control group. The haplotype "TTGGG" was significantly associated with an increased risk of CP. The allele frequencies of rs1012603 were significant differences between CP with spastic diplegia, female CP cases, and controls. Furthermore, significant differences in allele and genotype frequencies were also noticed between GMFCS I of CP and controls for rs1012603, and significant differences in allele and genotype frequencies were observed between the ADL (>9) of CP and controls for rs1012603 and rs12464595. This study showed that the SNPs rs1012603 of Nogo-A were significantly correlated with CP, and the correlations were also found in spastic diplegia, GMFCS I of CP, ADL (>9) of CP, and female subgroups, indicating that Nogo-A might mainly affect mild types of CP and there might be sex-related differences.
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Paralisia Cerebral , Criança , Feminino , Humanos , Estudos de Casos e Controles , Paralisia Cerebral/genética , China , Proteínas Nogo/genética , Polimorfismo de Nucleotídeo Único/genética , MasculinoRESUMO
Colorectal cancer (CRC) is the third most common malignancy in the world and one of the leading causes of cancer death; its incidence is still increasing in most countries. The early diagnostic accuracy of CRC is low, and the metastasis rate is high, resulting in a low survival rate of advanced patients. MicroRNAs (miRNAs) are a small class of noncoding RNAs that can inhibit mRNA translation and trigger mRNA degradation, and can affect a variety of cellular and molecular targets. Numerous studies have shown that miRNAs are related to tumour progression, immune system activity, anticancer drug resistance, and the tumour microenvironment. Dysregulation of miRNAs occurs in a variety of malignancies, including CRC. In this review, we summarize the recent research progress of miRNAs, their roles in tumour progression and metastasis, and their clinical value as potential biomarkers or therapeutic targets for CRC. Furthermore, we combined the roles of miRNAs in tumorigenesis and development with the therapeutic strategies of CRC patients, which will provide new ideas for the diagnosis and treatment of CRC.
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Aim: To investigate the efficacy and safety of high-calorie formula vs. Chinese daily food on the nutritional status and motor function of undernourished children with cerebral palsy (CP). Methods: In this prospective, assessor-blind, and randomized controlled trial, we recruited children (1-10 years) with CP and undernutrition based on the WHO and the American Society for Parenteral and Enteral Nutrition criteria from the National Children's Medical Center. Participants were randomly allocated (1:1) to a high-calorie formula group or a Chinese daily food diet group (control group) for 6 months. Indirect calorimetry was used to estimate energy requirements. We compared the nutritional status and gross motor function of participants in both groups based on weight, height, z-scores (weight-for-age, height-for-age, weight-for-height, and BMI-for-age), and the Gross Motor Function Measure (GMFM), respectively, at baseline, 3-, and 6-months follow-up. In addition, the effective rate of nutritional intervention, and adverse events were simultaneously assessed. Results: From July 2020 to December 2021, a total of 119 participants were enrolled and randomized, and 110 participants completed the study (with 54 children in the high-calorie formula group and 56 children in the control group). After 6 months of treatment, the weight, height, z-scores (weight-for-height, weight-for-age, and BMI-for-age), and GMFM of both groups were significantly improved (p < 0.05). There were significant differences in changes in weight, weight-for-age z-scores, and GMFM between the two groups (p < 0.05). During the study period, 16 children experienced at least one mild adverse event [9 (16.7%) in the formula group and 7 (12.5%) in the control group]. Conclusion: Nutritional intervention with a high-calorie formula may be an effective and safe option in children with CP for improving undernutrition and gross motor dysfunction. Clinical trial registration: www.chictr.org.cn, identifier: ChiCTR2000033878.
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Constraint-induced movement therapy (CIMT) combined with repetitive transcranial magnetic stimulation (rTMS) have shown great potential in improving function in schoolchildren with unilateral cerebral palsy attributed to perinatal stroke. However, the prospect of application in preschool children with unilateral cerebral palsy (UCP) attributed to various brain disorders remains unclear. In this prospective, assessor-blinded, randomized controlled study, 40 preschool children with UCP (aged 2.5-6 years) were randomized to receive 10 days of CIMT combined with active or sham rTMS. Assessments were performed at baseline, 2 weeks, and 6 months post-intervention to investigate upper limb extremity, social life ability, and perceived changes by parents and motor-evoked potentials. Overall, 35 participants completed the trial. The CIMT plus active stimulation group had greater gains in the affected hand function (range of motion, accuracy, and fluency) than the CIMT plus sham stimulation group (P < 0.05), but there was no significant difference in muscular tone, social life ability, and perceived changes by parents between the two groups (P > 0.05). In addition, there was no significant difference in hand function between children with and without motor-evoked potential (P > 0.05). No participants reported severe adverse events during the study session. In short, the treatment of CIMT combined with rTMS is safe and feasible for preschool children with UCP attributed to various brain disorders. Randomized controlled studies with large samples and long-term effects are warranted.
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The long-term effect of botulinum neurotoxin A (BoNT-A) on children with cerebral palsy (CP) is unclear, and how the dynamic changes of metabolites impact the duration of effect remains unknown. To tackle this, we collected 120 plasma samples from 91 children with spastic CP for analysis, with 30 samples in each time point: prior to injection and 1, 3, and 6 months after injection. A total of 354 metabolites were identified across all the time points, 39 of which exhibited significant changes (with tentative IDs) (p values <0.05, VIP > 1). Principal component analysis and partial least-squares discriminant analysis disclosed a clear separation between different groups (p values <0.05). Network analysis revealed the coordinated changes of functional metabolites. Pathway analysis highlighted the metabolic pathways associated with energy consumption and glycine, serine, and threonine metabolism and cysteine and methionine metabolism. Collectively, our results identified the significant dynamic changes of plasma metabolite after BoNT-A injections on children with CP. Metabolic pathways associated with energy expenditure might provide a new perspective for the effect of BoNT-A in children with CP. Glycine, serine, and threonine metabolism and cysteine and methionine metabolism might be related to the duration of effect of BoNT-A.
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Toxinas Botulínicas Tipo A , Paralisia Cerebral , Fármacos Neuromusculares , Toxinas Botulínicas Tipo A/uso terapêutico , Paralisia Cerebral/complicações , Paralisia Cerebral/tratamento farmacológico , Criança , Cisteína , Glicina , Humanos , Injeções Intramusculares , Metionina , Espasticidade Muscular/complicações , Espasticidade Muscular/tratamento farmacológico , Fármacos Neuromusculares/uso terapêutico , Serina , Treonina , Resultado do TratamentoRESUMO
Background. Little is known about the induction of functional and brain structural reorganization in hemiplegic cerebral palsy (HCP) by constraint-induced movement therapy (CIMT). Objective. We aimed to explore the specific molecular mechanism of functional and structural plasticity related to CIMT in HCP. Methods. The mice were divided into a control group and HCP groups with different interventions (unconstraint-induced movement therapy [UNCIMT], CIMT or siRNA-Nogo-A [SN] treatment): the HCP, HCP+UNCIMT, HCP+CIMT, HCP+SN, and HCP+SN+CIMT groups. Rotarod and front-limb suspension tests, immunohistochemistry, Golgi-Cox staining, transmission electron microscopy, and Western blot analyses were applied to measure motor function, neurons and neurofilament density, dendrites/axon areas, myelin integrity, and Nogo-A/NgR/RhoA/ROCK expression in the motor cortex. Results. The mice in the HCP+CIMT group had better motor function, greater neurons and neurofilament density, dendrites/axon areas, myelin integrity, and lower Nogo-A/NgR/RhoA/ROCK expression in the motor cortex than the HCP and HCP+UNCIMT groups (P < .05). Moreover, the expression of Nogo-A/NgR/RhoA/ROCK, the improvement of neural remodeling and motor function of mice in the HCP+SN group were similar to those in the HCP+CIMT group (P > .05). The neural remodeling and motor function of the HCP+SN+CIMT group were significantly greater than those in the HCP+SN and HCP+CIMT groups (P < .05). Motor function were positively correlated with the density of neurons (r = 0.450 and 0.309, respectively; P < .05) and neurofilament (r = 0.717 and 0.567, respectively; P < .05). Conclusions. CIMT might promote the remodeling of neurons, neurofilament, dendrites/axon areas, and myelin in the motor cortex by partially inhibiting the Nogo-A/NgR/RhoA/ROCK pathway, thereby promoting the improvement of motor function in HCP mice.
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Paralisia Cerebral/reabilitação , Terapia por Exercício , Hemiplegia/reabilitação , Córtex Motor , Plasticidade Neuronal , Condicionamento Físico Animal , Transdução de Sinais , Animais , Comportamento Animal/fisiologia , Paralisia Cerebral/complicações , Modelos Animais de Doenças , Feminino , Hemiplegia/etiologia , Camundongos , Camundongos Endogâmicos C57BL , Córtex Motor/citologia , Córtex Motor/fisiopatologia , Plasticidade Neuronal/fisiologia , Proteínas Nogo/metabolismo , Receptores Nogo/metabolismo , Condicionamento Físico Animal/fisiologia , Gravidez , RNA Interferente Pequeno/metabolismo , Transdução de Sinais/fisiologia , Quinases Associadas a rho/metabolismo , Proteína rhoA de Ligação ao GTP/metabolismoRESUMO
The incidence of mild cognitive impairment in Parkinson's disease (PDMCI) is as high as 18-55%. However, the pathological mechanism of PDMCI is not yet clear. Our previous research showed that microvascular pathology and chronic cerebral hypoperfusion participated in the occurrence and development of PDMCI. Nogo-A has been suggested to be a negative regulator of microvascular regeneration in the central nervous system. Moreover, few insights have illuminated the mechanisms of Nogo-A and microvascular pathology in PDMCI. Therefore, we hypothesized that Nogo-A might be involved in the negative regulation of PDMCI angiogenesis. In this study, C57BL/6J mice were injected with Nogo-A-specific short hairpin RNA (shRNA-Nogo-A) in the lateral ventricle and intraperitoneally injected with a combination of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and probenecid. Subjects were classified into the following five groups for the Morris water maze test: control (CON), CONâ¯+â¯shRNA-GFP, CONâ¯+â¯shRNA-Nogo-A, PDMCI, and PDMCIâ¯+â¯shRNA-Nogo-A. Furthermore, blood-brain barrier (BBB) permeability, fluorescein isothiocyanate (FITC)-conjugated dextran, transmission electron microscopy (TEM), immunofluorescence and Western blot analyses were performed. The results showed that MPTP could cause spatial memory and behavioral impairment, significant microvascular impairment and increased Nogo-A expression. When Nogo-A expression was downregulated, the cognitive and microvascular impairments were alleviated, and the expression of sphingosine-1-phosphate receptor 2 (S1PR2) and the RhoA/ROCK signaling pathway were inhibited. These findings suggested that Nogo-A could bind to S1PR2, activate related signaling pathways, and lead to the inhibition of vascular remodeling in PDMCI mice. This study indicated that Nogo-A downregulation could mediate microvascular remodeling and provide further insights into the pathogenesis of PDMCI.