RESUMO
BACKGROUND: Despite the strong association between epilepsy and psychiatric comorbidities, few biological substrates are currently described. We have previously reported neuropathological alterations in mesial temporal lobe epilepsy (MTLE) patients with major depression and psychosis that suggest a morphological and neurochemical basis for psychopathological symptoms. Neuroinflammatory-related structures and molecules might be part of the altered neurochemical milieu underlying the association between epilepsy and psychiatric comorbidities, and such features have not been previously investigated in humans. METHODS: MTLE hippocampi of subjects without psychiatric history (MTLEW), MTLE + major depression (MTLE + D), and MTLE + interictal psychosis (MTLE + P) derived from epilepsy surgery and control necropsies were investigated for reactive astrocytes (glial fibrillary acidic protein (GFAP)), activated microglia (human leukocyte antigen, MHC class II (HLA-DR)), glial metallothionein-I/II (MT-I/II), and aquaporin 4 (AQP4) immunohistochemistry. RESULTS: We found an increased GFAP immunoreactive area in the molecular layers, granule cell layer, and cornus ammonis region 2 (CA2) and cornus ammonis region 1 (CA1) of MTLEW and MTLE + P, respectively, compared to MTLE + D. HLA-DR immunoreactive area was higher in cornus ammonis region 3 (CA3) of MTLE + P, compared to MTLE + D and MTLEW, and in the hilus, when compared to MTLEW. MTLEW cases showed increased MT-I/II area in the granule cell layer and CA1, compared to MTLE + P, and in the parasubiculum, when compared to MTLE + D and MTLE + P. Differences between MTLE and control, such as astrogliosis, microgliosis, increased MT-I/II, and decreased perivascular AQP4 in the epileptogenic hippocampus, were in agreement to what is currently described in the literature. CONCLUSIONS: Neuroinflammatory-related molecules in MTLE hippocampus show a distinct pattern of expression when patients present with a comorbid psychiatric diagnosis, similar to what is found in the pure forms of schizophrenia and major depression. Future studies focusing on inflammatory characteristics of MTLE with psychiatric comorbidities might help in the design of better therapeutic strategies.
Assuntos
Citocinas/metabolismo , Transtorno Depressivo Maior/epidemiologia , Epilepsia do Lobo Temporal/epidemiologia , Hipocampo/metabolismo , Adolescente , Aquaporina 4/metabolismo , Criança , Pré-Escolar , Comorbidade , Transtorno Depressivo Maior/patologia , Epilepsia do Lobo Temporal/patologia , Feminino , Proteína Glial Fibrilar Ácida/metabolismo , Antígenos HLA-DR/metabolismo , Humanos , Masculino , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/patologia , Índice de Gravidade de Doença , Estatísticas não ParamétricasRESUMO
Metabotropic glutamate receptor type 5 (mGluR5) upregulation in temporal lobe epilepsy (TLE) and the correlation of its expression with features of hippocampal sclerosis (HS) remains unclear. Here we characterized mGluR5 immunoreactivity in hippocampus, entorhinal cortex (EC), and subiculum of TLE specimens with confirmed HS, with neocortical TLE (non-HS) and necropsy controls. We correlated mGluR5 immunoreactivity with neuronal density, mossy fiber sprouting, astrogliosis (GFAP), and dendritic alterations (MAP2). TLE specimens showed increased mGluR5 expression, which was most pronounced in the EC, subiculum, CA2, and dentate gyrus outer molecular layer. Increased mGluR5 expression was seen in hippocampal head and body segments and was independent of neuronal density, astrogliosis, or dendritic alterations. Positive correlation between mGluR5 expression with mossy fiber sprouting and with MAP2 in CA3 and CA1 was found only in HS specimens. Negative correlation between mGluR5 expression with seizure frequency and epilepsy duration was found only in non-HS cases. Specimens from HS patients without previous history of febrile seizure (FS) showed higher mGluR5 and MAP2 expression in CA2. Our study suggests that mGluR5 upregulation is part of a repertoire of post-synaptic adaptations that might control overexcitation and excessive glutamate release rather than a dysfunction that leads to seizure facilitation. That would explain why non-HS cases, on which seizures are likely to originate outside the hippocampal formation, also exhibit upregulated mGluR5. On the other hand, lower mGluR5 expression was related to increased seizure frequency. In addition to its role in hyperexcitability, mGluR5 upregulation could play a role in counterbalance mechanisms along the hyperexcitable circuitry uniquely altered in sclerotic hippocampal formation. Inefficient post-synaptic compensatory morphological (dendritic branching) and glutamatergic (mGluR5 expression) mechanisms in CA2 subfield could potentially underlie the association of FS with HS and TLE.
Assuntos
Epilepsia do Lobo Temporal/patologia , Hipocampo/patologia , Receptor de Glutamato Metabotrópico 5/metabolismo , Adulto , Análise de Variância , Anticonvulsivantes/uso terapêutico , Contagem de Células , Eletroencefalografia , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/tratamento farmacológico , Feminino , Hipocampo/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas do Tecido Nervoso/metabolismo , Neuroglia/metabolismo , Neuroglia/patologia , Exame Neurológico , Neurônios/metabolismo , Neurônios/patologia , Esclerose/etiologia , Esclerose/patologia , Adulto JovemRESUMO
BACKGROUND: Despite strong association between epilepsy and psychiatric comorbidities, biological substrates are unknown. We have previously reported decreased mossy fiber sprouting in mesial temporal lobe epilepsy (MTLE) patients with psychosis and increased in those with major depression. Microtubule associated proteins (MAPs) are essentially involved in dendritic and synaptic sprouting. METHODS: MTLE hippocampi of subjects without psychiatric history, MTLE + major depression, and MTLE + interictal psychosis derived from epilepsy surgery and control necropsies were investigated for neuronal density, granular layer dispersion, and MAP2 and tau immunohistochemistry. RESULTS: Altered MAP2 and tau expression in MTLE and decreased tau expression in MTLE with psychosis were found. Granular layer dispersion correlated inversely with verbal memory scores, and with MAP2 and tau expression in the entorhinal cortex. Patients taking fluoxetine showed increased neuronal density in the granular layer and those taking haloperidol decreased neuronal density in CA3 and subiculum. CONCLUSIONS: Our results indicate relations between MAPs, granular layer dispersion, and memory that have not been previously investigated. Differential MAPs expression in human MTLE hippocampi with and without psychiatric comorbidities suggests that psychopathological states in MTLE rely on differential morphological and possibly neurochemical backgrounds. This clinical study was approved by our institution's Research Ethics Board (HC-FMRP no. 1270/2008) and is registered under the Brazilian National System of Information on Ethics in Human Research (SISNEP) no. 0423.0.004.000-07.
Assuntos
Epilepsia do Lobo Temporal/congênito , Hipocampo/metabolismo , Hipocampo/patologia , Proteínas Associadas aos Microtúbulos/metabolismo , Proteínas tau/metabolismo , Adolescente , Contagem de Células , Criança , Pré-Escolar , Comorbidade , Epilepsia do Lobo Temporal/metabolismo , Epilepsia do Lobo Temporal/patologia , Epilepsia do Lobo Temporal/psicologia , Feminino , Humanos , Masculino , Neurônios/patologiaRESUMO
Despite the strong association between epilepsy and psychiatric comorbidities, data on clinicopathologic correlations are scant. We previously reported differential mossy fiber sprouting (MFS) in mesial temporal lobe epilepsy (MTLE) patients with psychosis (MTLE + P) and major depression (MTLE + D). Because neurotrophins (NTs) can promote MFS, here, we investigated MFS, neuronal density and immunoreactivity for the NT nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and neurotrophin 3 (NT3) in hippocampi of 14 MTLE patients without a psychiatric history, 13 MTLE + D, 13 MTLE + P, and 10 control necropsies. Mossy fiber sprouting correlated with granular layer NGF immunoreactivity and seizure frequency. Patients with secondarily generalized seizures exhibited less NGF immunoreactivity versus patients with complex partial seizures. There was greater NT immunoreactivity in MTLE versus control groups but lesser NT immunoreactivity in MTLE + P versus MTLE patients; these findings correlated with neuropsychologic scores. Patients with MTLE + D taking fluoxetine showed greater BDNF immunoreactivity than those not taking fluoxetine; MTLE + P patients taking haloperidol had decreased neuronal density and immunoreactivity for NGF and BDNF in specific subfields versus those not taking haloperidol. There were no differences in NT3 immunoreactivity among the groups. These findings support a close association between MFS and NT expression in the hippocampi of MTLE patients and suggest that distinct structural and neurochemical milieu may contribute to the genesis or maintenance of psychiatric comorbidities in MTLE.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/metabolismo , Epilepsia do Lobo Temporal/metabolismo , Hipocampo/metabolismo , Fator de Crescimento Neural/metabolismo , Neurotrofina 3/metabolismo , Adulto , Idoso , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/metabolismo , Transtorno Depressivo Maior/patologia , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/patologia , Feminino , Hipocampo/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/complicações , Transtornos Psicóticos/metabolismo , Transtornos Psicóticos/patologiaRESUMO
Introduction: The neuronal loss and abnormal mossy fibers sprouting are frequently observed in patients with mesial temporal lobe epilepsy (MTLE). Beta-tubulin, a cytoskeleton protein, is critical for the maintenance of the neuritic structure. Objective: Considering the axonal reorganization in patients with MTLE, our objective was to analyze the beta-tubulin expression in the hippocampus of these patients. Methods: We evaluated the hippocampus of 38 MTLE patients and seven control cases. Histological sections were submitted to neo-Timm histochemistry to evaluate the sprouting of mossy fiber, and to immunohis- tochemistry for neuronal density evaluation (NeuN) and beta-tubulin expression. Results: The MTLE group showed lower neuronal density than the control group in the granular layer (GL), hilus, CA4, CA3, CA1, and presubiculum. The MTLE group showed higher gray value on the neo-Timm staining when compared to the control group in GL, IML, and outer mo- lecular layer (OML), and sprouting of thicker mossy fibers in the IML. When compared to the control group, group MTLE showed higher beta-tubulin expression in GL and lower expression in CA3 region. The aberrant sprouting of mossy fibers correlated inversely with the beta-tubulin expression in several subs of the hippocampal formation. Conclusions: The differential expression of beta-tubulin in the regions CA3 and GL of the MTLE group, as well as its correlation with neuronal loss and the mossy fiber sprouting, suggests a possible role of this protein in the neuropathological changes that occur in the hippocampus in chronic cases of MTLE.
Introdução: A perda neuronal e o brotamento anormal de fibras musgosas são observados com frequência em pacientes com epilepsia do lobo temporal mesial (ELTM). A beta-tubulina, uma proteína do citoesqueleto, é essencial para a manutenção da estrutura neurítica. Objetivo: Considerando a reorganização axonal nos pacientes com ELTM, nosso objetivo foi analisar a expressão de beta-tubulina no hipo- campo desses pacientes. Métodos: Foram avaliados 38 hipocampos de pacientes com ELTM e sete casos controle. Cortes histológicos foram submetidos à histoquímica de neo-Timm para avaliação do neobrotamento de fibras musgosas e à imuno-histoquímica para avaliações da densidade neuronal (NeuN) e da expressão de beta-tubulina. Resultados: O grupo ELTM apresentou menor densidade neuronal do que o grupo controle na camada granular (CG), hilo, CA4, CA3, CA1 e no pró-subículo. O grupo ELTM apresentou maior valor de cinza na coloração neo-Timm com relação ao grupo controle na CG, CMI e camada molecular externa (CME) e neobrotamento mais espesso de fibras musgosas na CMI. O grupo ELTM apresentou maior expressão de beta-tubulina na CG e menor expressão na região de CA3, quando comparado ao grupo controle. O neobrotamento aberrante de fibras musgosas correlacionou-se inversamente com a expressão de beta-tubulina em diversos subcampos da formação hipocampal. Conclusões: A expressão diferencial da beta-tubulina nas regiões da CA3 e CG do grupo ELTM, assim como suas correlações com a perda neuronal e o neobrotamento de fibras musgosas sugerem uma possível participação dessa proteína nas alterações neuropatológicas que ocorrem no hipocampo nos casos crônicos de ELTM.
Introducción: La pérdida neuronal y la brotación anormal de fibras musgosas se observan con frecuencia en los pacientes con epilepsia del lóbulo temporal mesial (ELTM). La beta-tubulina, una proteína del citoesqueleto, es crítica para el mantenimiento de la estructura neurítica. Objetivo: Teniendo en cuenta la reorganización axonal en pacientes con ELTM, nuestro objetivo fue analizar la expresión de beta-tubulina en el hipocampo de estos pacientes. Métodos: Se evaluó el hipocampo de 38 pacientes con ELTM y siete casos de control. Cortes histológicos fueron sometidos a la histoquímica neo-Timm para evaluar la brotación de fibras musgosas, y a inmunohistoquímica para la evaluación de la densidad neuronal (NeuN) y la expresión de beta-tubulina. Resultados: El grupo ELTM mostró una menor densidad neuronal que el grupo control en la capa granular (CG), hilo, CA4, CA3, CA1 y pró-subículo. El grupo ELTM mostró mayor valor de gris en la tinción neo-Timm en comparación con el grupo control en CG, CMI y en la capa externa molecular (CME), y la brotación de fibras musgosas más gruesas en la CMI. El grupo ELTM mostró una mayor expresión de beta- tubulina en CG y expresión más baja en la región CA3, cuando se compara con el grupo control. La brotación aberrante de fibras musgosa está inversamente correlacionada con la expresión de beta-tubulina en varios subcampos de la formación del hipocampo. Conclusiones: La expresión diferencial de beta-tubulina en las regiones CA3 y CG del grupo ELTM, así como su correlación con la pérdida neuronal y el surgimiento de fibras musgosas, sugiere un posible papel de esta proteína en los cambios neuropatológicos que se producen en el hipocampo en los casos crónicos de ELTM.
Assuntos
Humanos , Citoesqueleto , Epilepsia , Hipocampo , Moduladores de TubulinaRESUMO
INTRODUÇÃO: O citoesqueleto é uma complexa rede de proteínas que determina a forma da célula. Ele é fundamental para que ocorra a movimentação celular; proporciona o suporte estrutural e mobilidade de organelas intracelulares e a estrutura para movimentação e separação de cromossomos durante a divisão celular. Os componentes principais do citoesqueleto são os microfilamentos, os filamentos intermediários e os microtúbulos. Os microtúbulos são formados por dímeros de α e β tubulina que se associam à proteínas específicas, as proteínas asssociadas aos microtúbulos (MAPs). A associação diferencial entre estas proteínas possibilita ampla variedade na modulação de função dos componentes do citoesqueleto no meio celular. As MAPs expressas no sistema nervoso central (SNC), MAP2 e tau, possuem diferentes isoformas geradas por processamento alternativo. O objetivo da presente revisão é de descrever e discutir as principais funções das proteínas do citoesqueleto em condições normais e patológicas, com destaque na fisiopatologia das epilepsias. RESULTADOS: As MAPs possuem funções essenciais nas células neuronais, agem principalmente na formação estrutural destas células, garantindo sua morfologia e regulando funções específicas. Alterações nos níveis de expressão de proteínas estruturais estão envolvidas em diversas patologias do SNC como a esquizofrenia, a epilepsia do lobo temporal, as displasias corticais e as desordens do desenvolvimento. Estudos com modelos animais de epilepsia e tecido humano proveniente de pacientes epilépticos têm mostrado que as crises epilépticas podem modificar a expressão das proteínas do citoesqueleto. CONCLUSÕES: Apesar do significativo conhecimento existente sobre o citoesqueleto e proteínas associadas aos microtúbulos, não se sabe exatamente os mecanismos responsáveis pelas modificações estruturais encontradas em algumas patologias. Além do papel bem estabelecido do citoesqueleto como componente estrutural e citoarquitetônico, sua participação como facilitador do tráfico intracelular de neurotransmissores e outras macromoléculas é função ainda a ser melhor explorada e compreendida.
INTRODUCTION: The cytoskeleton is a complex network of protein fibers that determines the shape of cells. It is essential for the movements of cells and provides the structural support and movements of organelles within the cells, α and β the framework for moving and separating chromosomes during the cell division. The main components of the cytoskeleton are microfilaments, intermediate filaments and microtubules. Microtubules are assembled dimers of a and b tubulin that bind to specific proteins, the microtubules associated proteins (MAPs). Differential association between these proteins enables a wide variety in functional modulation of the cytoskeleton components in the cellular environment. The MAPs expressed in the central nervous system (CNS), MAP2 and tau, have different isoforms generated by alternative splicing. The aim of the present short review is to describe and discuss the key functions of cytoskeleton proteins in physiological and pathological states, mainly in the epileptic condition. RESULTS: The MAPs have critical roles in neurons, they act mainly on the structural formation of these cells, ensuring their morphology and regulating specific functions. Changes in the expression levels of structural proteins are involved in various CNS pathologies such as schizophrenia, temporal lobe epilepsy, cortical dysplasia and developmental disorders. Studies with animal models of epilepsy and human tissue from epileptic patients have shown that seizures can change the expression of cytoskeletal proteins. CONCLUSIONS: Despite the significant amount of knowledge on cytoskeleton and microtubules associated proteins, the precise mechanisms responsible for structural changes found in some pathological conditions are still not known. Besides the well-established role of the cytoskeleton as a structural and cytoarchitectural component, its participation in the facilitation of intracellular trafficking of neurotransmitters and other macromolecules is a function to be further explored and understood.
Assuntos
Humanos , Citoesqueleto , Epilepsia do Lobo Temporal , Transtornos do Neurodesenvolvimento , Neuropatologia , Proteínas Associadas aos MicrotúbulosRESUMO
INTRODUÇÃO: A neurotrofinas NGF, BDNF, NT-3 e NT-4 são os principais representantes da família das neurotrofinas no sistema nervoso central de mamíferos. Estão presentes em estágios específicos do crescimento e sobrevivência neuronal como a divisão celular, diferenciação e axogênese e também nos processos naturais de morte celular neuronal. A atividade biológica das neurotrofinas é mediada pelos receptores de tropomiosina quinase Trk. NGF ativa principalmente os receptores TrkA, BDNF e NT-4 interagem com os receptores TrkB e NT-3 com TrkC. Todas as NTs também podem se ligar, com menor afinidade, ao receptor p75NTR. Nesta breve revisão serão levantadas as principais evidências sobre o papel e expressão das principais neurotrofinas no hipocampo, com ênfase nas alterações que ocorrem em modelos animais de epilepsia. RESULTADOS: As neurotrofinas parecem ter um papel chave na plasticidade sináptica relacionada à epilepsia, onde elas poderiam agir tanto como fatores promotores da epileptogênese quanto como substâncias anti-epiléptogênicas endógenas. Além disso a expressão dos genes que codificam os fatores neurotróficos e seus receptores pode ser alterada pela atividade de crises em diversos modelos de epilepsia. CONCLUSÃO: Vários estudos têm demonstrado a relação entre a expressão das neurotrofinas e as alterações na plasticidade dos circuitos neuronais que ocorrem após danos cerebrais, tais como a epilepsia. O conhecimento das alterações na expressão das neurotrofinas na plasticidade neuronal pode nos auxiliar a entender como estas moléculas participam dos mecanismos epileptogênicos e dessa forma, dar início ao estudo de novas terapias e ao desenvolvimento de novas drogas que auxiliem no tratamento da epilepsia.
INTRODUCTION: NGF, BDNF, NT-3 and NT-4 are the major neurotrophins in the mammal central nervous system. These proteins play key roles in development of the nervous system, but they are also responsible for important functions in the adult brain, such as trophic support of adult neurons, cell plasticity and death. The neurotrophins activate three different members of the tropomyosin-related kinase (Trk) family of receptor tyrosine kinases. These three receptors exhibit distinct affinities for different neurotrophins, with NGF activating TrkA, BDNF and NT-4 activating TrkB, and NT-3 predominantly activating TrkC. All NTs can also interact with the receptor p75NTR, a member of the tumor necrosis factor receptor superfamily. RESULTS: NTs have a key role also in the neuronal plasticity related to epilepsy, and they are able to act as epileptogenic factors and anti-epileptogenic endogenous factors. Besides that, several studies have shown that status epilepticus and chronic seizures may alter gene and protein expression of these factors. CONCLUSION: Here, we briefly give a short review of current knowledge of the roles and expression of the major neurotrophins in the hippocampus, with emphasis to the changes that occur in animal models of epilepsy. The knowledge on how the mechanisms underlying the multiplicity of biological functions in which the neurotrophins take part may provide us key insights into the cellular mechanisms of neuronal function in health and disease.
Assuntos
Receptores de Fator de Crescimento Neural , Epilepsia do Lobo Temporal , Fatores de Crescimento NeuralRESUMO
INTRODUÇÃO: Relatos sobre a possibilidade de neurogênese no cérebro de mamíferos adultos existem desde o início do século XX. A dificuldade na verificação de tal evento, somada à firme convicção da maioria dos pesquisadores da época sobre a impossibilidade do nascimento de neurônios no sistema nervoso adulto, resultou em expressiva demora no avanço do conhecimento nesta área. O desenvolvimento de técnicas refinadas de estudo celular e a observação comprovada de neurogênese no cérebro de vertebrados adultos como o de pássaros canoros e roedores, serviu como importante alavanca para a desmistificação da impossibilidade de nascimento de neurônios no cérebro adulto. RESULTADOS: A descoberta da neurogênese em áreas específicas do cérebro adulto tem fomentado avanços em diversas áreas da pesquisa médica. No contexto de alterações neurológicas temos a constatação de neurogênese reativa no hipocampo de modelos animais de epilepsia do lobo temporal, logo após um episódio de estado de mal epiléptico. Diferenças filogenéticas entre roedores e humanos provavelmente existem, visto que há evidências de diminuição da neurogênese em crianças com epilepsia grave. A neurogênese pode estar também alterada frente ao uso de drogas, como parece ocorrer no tratamento com antidepressivos. CONCLUSÃO: O entendimento cada vez maior da neurogênese no cérebro adulto pode significar uma revolução no conceito da plasticidade do cérebro de um mamífero adulto, além de ter grande importância para o desenvolvimento de estratégias terapêuticas no tratamento de doenças neurodegenerativas e na possibilidade de promover a recuperação funcional de áreas lesadas do sistema nervoso central.
INTRODUCTION: Since the early XX century, there have been numerous reports considering the possibility of neurogenesis in the adult mammalian brain. However, it took 30 years before the widespread skepticism and the technical limitations were overcome. Refined cell technique developments and clear-cut evidences of neurogenesis in avian and rodent brains boosted additional research and counteracted the "no-new-neuron-in-the-adult-brain" myth. Now, the debate has focused on its importance to existing neural circuits, which promises interesting perspectives in medical research. RESULTS: Reactive neurogenesis in the hippocampus occurs in different experimental models of temporal lobe epilepsy, among them those that present spontaneous limbic seizures after an episode of status epilepticus. Phylogenetic differences between rodents and humans probably exist, since it has been described a reduction of neurogenesis in children with severe epilepsy. Neurogenesis may also be altered in many other conditions including chronic antidepressant drug treatment. CONCLUSION: Therefore, understanding the mechanisms and functional implications of adult neurogenesis in different brain regions can shed light into how such neuronal plasticity can help in the treatment of neurological disorders. In particular, cell therapy is a promising approach in the biomedical field that will possibly have great impact in the treatment of neurodegenerative diseases, as well as in the functional recovery of brain injuries.