Adult neurogenesis of the median eminence contributes to structural reconstruction and recovery of body fluid metabolism in hypothalamic self-repair after pituitary stalk lesion.

Body fluid homeostasis is critical to survival. The integrity of the hypothalamo-neurohypophysial system (HNS) is an important basis of the precise regulation of body fluid metabolism and arginine vasopressin (AVP) hormone release. Clinically, some patients with central diabetes insipidus (CDI) due to HNS lesions can experience recovery compensation of body fluid metabolism. However, whether the hypothalamus has the potential for structural plasticity and self-repair under pathological conditions remains unclear. Here, we report the repair and reconstruction of a new neurohypophysis-like structure in the hypothalamic median eminence (ME) after pituitary stalk electrical lesion (PEL). We show that activated and proliferating adult neural progenitor cells differentiate into new mature neurons, which then integrate with remodeled AVP fibers to reconstruct the local AVP hormone release neural circuit in the ME after PEL. We found that the transcription factor of NK2 homeobox 1 (NKX2.1) and the sonic hedgehog signaling pathway, mediated by NKX2.1, are the key regulators of adult hypothalamic neurogenesis. Taken together, our study provides evidence that adult ME neurogenesis is involved in the structural reconstruction of the AVP release circuit and eventually restores body fluid metabolic homeostasis during hypothalamic self-repair.

Application of Bukuryoingohangekobokuto and Hangekobokuto for Perniosis with Ki Obstruction / 日本東洋医学雑誌

We experienced four cases of perniosis successfully treated with bukuryoingohangekobokuto, or hangekobokuto. Swollen tongue, pulsation at the pit of the navel, and tympanitic abdominal sounds were taken as common objective findings in all four cases. In addition, decreased surface body temperature was diagnosed at the bilateral hands and feet, so as to be distal from the trunk in palpation. These four cases had both symptoms of an eminent Ki obstruction, and a disorder of body fluid metabolism. For the two cases administered bukuryoingohangekobokuto especially, a state of strong Ki deficiency was diagnosed. Efficacy in each case was prompt. Thus, we consider bukuryoingohangekobokuto and hangekobokuto to be prescriptions worth trying for perniosis that does not responding to the usual Western medicines, or Kampo treatment.