RESUMEN
BACKGROUND: Neural tube (NT) closure is a complex developmental process that takes place in the early stages of embryogenesis and that is a key step in neurulation. In mammals, the process by which the neural plate generates the NT requires organized cell movements and tissue folding, and it terminates with the fusion of the apposed ends of the neural folds. RESULTS: Here we describe how almost identical cellular and molecular machinery is used to fuse the spinal neural folds as that involved in the repair of epithelial injury in the same area of the embryo. For both natural and wound activated closure of caudal neural tissue, hyaluronic acid and platelet-derived growth factor signaling appear to be crucial for the final fusion step. CONCLUSIONS: There seems to be no general wound healing machinery for all tissues but rather, a tissue-specific epithelial fusion machinery that embryos activate when necessary after abnormal epithelial opening.
Asunto(s)
Células Epiteliales/fisiología , Tubo Neural/embriología , Neurulación/fisiología , Cicatrización de Heridas/fisiología , Animales , Fusión Celular , Células Cultivadas , Embrión de Mamíferos , Desarrollo Embrionario/fisiología , Células Epiteliales/citología , Femenino , Feto/embriología , Ácido Hialurónico/metabolismo , Masculino , Ratones , Cresta Neural/embriología , Cresta Neural/fisiología , Placa Neural/embriología , Placa Neural/fisiología , Defectos del Tubo Neural/embriología , Factor de Crecimiento Derivado de Plaquetas/fisiología , EmbarazoRESUMEN
INTRODUCTION: Perinatal and pediatric diseases related to neurovascular disorders cause significant problems during life, affecting a population with a long life expectancy. Early diagnosis and assessment of the severity of these diseases are crucial to establish an appropriate neuroprotective treatment. Currently, physical examination, neuroimaging and clinical judgment are the main tools for diagnosis, although these tests have certain limitations. There is growing interest in the potential value of noninvasive biomarkers that can be used to monitor child patients at risk of brain damage, allowing accurate, and reproducible measurements. AREAS COVERED: This review describes potential biomarkers for the diagnosis of perinatal neurovascular diseases and discusses the possibilities they open for the classification and treatment of neonatal neurovascular diseases. EXPERT OPINION: Although high rates of ischemic and hemorrhagic stroke exist in pediatric populations, most studies have focused on biomarkers of hypoxic-ischemic encephalopathy. Inflammatory and neuronal biomarkers such as S-100B and GFAP, in combination with others yet to be discovered, could be considered as part of multiplex panels to diagnose these diseases and potentially for monitoring response to treatments. Ideally, noninvasive biofluids would be the best source for evaluating these biomarkers in proteomic assays in perinatal patients.
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Hipoxia-Isquemia Encefálica/genética , Enfermedades del Recién Nacido/genética , Neuronas/metabolismo , Proteoma/genética , Biomarcadores/metabolismo , Humanos , Hipoxia-Isquemia Encefálica/metabolismo , Hipoxia-Isquemia Encefálica/patología , Recién Nacido , Enfermedades del Recién Nacido/diagnóstico , Enfermedades del Recién Nacido/patología , Enfermedades del Recién Nacido/terapia , Neuronas/patología , Pediatría , Proteoma/metabolismoRESUMEN
The 2020-21 West Nile Virus (WNV) outbreak in Andalusia, Spain, was the largest reported in the country, with eight cases of West Nile Neuroinvasive Disease (WNND) diagnosed in a tertiary hospital. Diagnosis of WNND is based on detecting WNV RNA, viral isolation, or demonstrating a specific immune response against the virus, with additional tests used to support the diagnosis. Treatment remains supportive, with variable outcomes. The potential efficacy of plasma exchange (PLEX) in select cases raises the possibility of an autoimmune component secondary to infectious pathology of the central nervous system. The influence of climate change on the expansion of WNV into new regions is a significant concern. It is crucial for physicians practicing in high-risk areas to be knowledgeable about the disease for early prevention and effective control measures.
Asunto(s)
Fiebre del Nilo Occidental , Virus del Nilo Occidental , Humanos , Virus del Nilo Occidental/genética , Fiebre del Nilo Occidental/epidemiología , Fiebre del Nilo Occidental/diagnóstico , España/epidemiología , Sistema Nervioso Central/patología , Brotes de EnfermedadesRESUMEN
Background and Objectives: The most common adverse events (AEs) after alemtuzumab (ALZ) include adverse infusion reactions, infections, and autoimmune disorders. Skin AEs are common during infusion, but there are few reported cases of long-term skin autoimmune disease. Methods: A retrospective case series of patients developing long-term autoimmune skin disorders after ALZ administration in a tertiary care hospital. Results: Of 133 patients treated with ALZ, 8 patients (6.02%) developed 9 autoimmune cutaneous AEs, including 4 events of alopecia areata, 2 of vitiligo, 2 of chronic urticaria, and 1 of inflammatory atrichia. Three of them occurred between the first and the second infusion. Discussion: The lesions described are secondary to autoimmune disorders, probably related to immune dysregulation because of a differential lymphocyte repopulation after ALZ. Autoimmune cutaneous AEs may be frequent, and it would be recommended to monitor its appearance to treat them.