Neuroprotective mechanism of trans,trans-Farnesol in an ICV-STZ-induced rat model of Alzheimer's pathology.

BACKGROUND: Alzheimer's disease (AD) is a prominent cause of dementia, resulting in neurodegeneration and memory impairment. This condition imposes a considerable public health burden on both patients and their families due to the patients' functional impairments as well as the psychological and financial constraints. It has been well demonstrated that its aetiology involves proteinopathy, mitochondriopathies, and enhanced reactive oxygen species (ROS) generation, which are some of the key features of AD brains that further result in oxidative stress, excitotoxicity, autophagy, and mitochondrial dysfunction. OBJECTIVE: The current investigation was created with the aim of elucidating the neurological defence mechanism of trans,trans-Farnesol (TF) against intracerebroventricular-streptozotocin (ICV-STZ)-induced Alzheimer-like symptoms and related pathologies in rodents. MATERIALS AND METHODS: The current investigation involved male SD rats receiving TF (25-100 mg/kg, per oral) consecutively for 21 days in ICV-STZ-treated animals. An in silico study was carried out to explore the possible interaction between TF and NADH dehydrogenase and succinate dehydrogenase. Further, various behavioural (Morris water maze and novel object recognition test), biochemical (oxidants and anti-oxidant markers), activities of mitochondrial enzyme complexes and acetylcholinesterase (AChE), pro-inflammatory (tumor necrosis factor-alpha; TNF-α) levels, and histopathological studies were evaluated in specific brain regions. RESULTS: Rats administered ICV-STZ followed by treatment with TF (25, 50, and 100 mg/kg) for 21 days had significantly better mental performance (reduced escape latency to access platform, extended time spent in target quadrant, and improved differential index) in the Morris water maze test and new object recognition test models when compared to control (ICV-STZ)-treated groups. Further, TF treatment significantly restored redox proportion, anti-oxidant levels, regained mitochondrial capacities, attenuated altered AChE action, levels of TNF-α, and histopathological alterations in certain brain regions in comparison with control. In in silico analysis, TF caused greater interaction with NADH dehydrogenase and succinate dehydrogenase. CONCLUSION: The current work demonstrates the neuroprotective ability of TF in an experimental model with AD-like pathologies. The study further suggests that the neuroprotective impacts of TF may be related to its effects on TNF-α levels, oxidative stress pathways, and mitochondrial complex capabilities.

A narrative review of the effects of dexamethasone on traumatic brain injury in clinical and animal studies: focusing on inflammation.

Traumatic brain injury (TBI) is a type of brain injury resulting from a sudden physical force to the head. TBI can range from mild, such as a concussion, to severe, which might result in long-term complications or even death. The initial impact or primary injury to the brain is followed by neuroinflammation, excitotoxicity, and oxidative stress, which are the hallmarks of the secondary injury phase, that can further damage the brain tissue. Dexamethasone (DXM) has neuroprotective effects. It reduces neuroinflammation, a critical factor in secondary injury-associated neuronal damage. DXM can also suppress the microglia activation and infiltrated macrophages, which are responsible for producing pro-inflammatory cytokines that contribute to neuroinflammation. Considering the outcomes of this research, some of the effects of DXM on TBI include: (1) DXM-loaded hydrogels reduce apoptosis, neuroinflammation, and lesion volume and improves neuronal cell survival and motor performance, (2) DXM treatment elevates the levels of Ndufs2, Gria3, MAOB, and Ndufv2 in the hippocampus following TBI, (3) DXM decreases the quantity of circulating endothelial progenitor cells, (4) DXM reduces the expression of IL1, (5) DXM suppresses the infiltration of RhoA + cells into primary lesions of TBI and (6) DXM treatment led to an increase in fractional anisotropy values and a decrease in apparent diffusion coefficient values, indicating improved white matter integrity. According to the study, the findings show that DXM treatment has neuroprotective effects in TBI. This indicates that DXM is a promising therapeutic approach to treating TBI.

Terapia genética de injeção intravítrea de rAAV2-ND4 para neuropatia óptica hereditária de Leber: uma revisão sistemática / rAAV2-ND4 intravitreal injection gene therapy for Leber's hereditary optic neuropathy: a systematic review

RESUMO A neuropatia óptica hereditária de Leber é uma doença mitocondrial hereditária neurodegenerativa. A taxa potencial de recuperação espontânea é controversa na literatura. A terapia genética tem sido estudada como suporte aos pacientes. O objetivo desta revisão foi avaliar qualitativamente a segurança, os efeitos adversos e a eficácia da terapia gênica disponível. Trata-se de uma revisão sistemática de artigos indexados nas bases de dados PubMed®, Biblioteca Virtual em Saúde, SciELO, Cochrane, ScienceDirect, Scopus e Lilacs no primeiro semestre de 2021. Os critérios de inclusão e filtros foram: artigos relacionados ao tema, estudos randomizados, ensaios clínicos, trabalhos em humanos, últimos 5 anos, nas línguas portuguesa, inglesa e espanhola e texto completo disponível gratuitamente. Os parâmetros de exclusão foram: artigos duplicados, fuga ao tema, artigos de revisão, trabalhos não disponíveis e que fugiam aos critérios de inclusão. O coeficiente de kappa foi 0,812. A terapia não apresentou efeitos adversos sérios em nenhum dos artigos selecionados, e os efeitos menores sofreram 100% de remissão espontânea após o tratamento. Apesar de NAbs terem sido encontrados no soro de alguns pacientes, não houve associação entre a resposta imune adaptativa e a injeção do vetor viral. O tratamento foi eficaz na melhora da acuidade e campo visual. Vários estudos confirmaram a eficácia da terapia gênica, em doses baixas e médias, na melhora da acuidade visual e também sobre os efeitos adversos comuns relacionados à altas doses. A resposta imune humoral e a variação dos NAbs no soro foi citada em mais de um artigo. A terapia foi eficaz na melhora da acuidade visual e os efeitos adversos que surgiram foram tratados facilmente. No entanto, a resposta imune humoral ainda precisa ser estudada.

ABSTRACT Leber's Hereditary Optic Neuropathy (LHON) is an inherited neurodegenerative mitochondrial disease. The potential rate of spontaneous recovery is controversial in the literature. Gene therapy has been studied to support patients. The objective of this review was to qualitatively assess the safety, adverse effects, and efficacy of available gene therapy. This is a systematic review of articles indexed in PubMed®, VHL, SciELO, Cochrane, ScienceDirect, Scopus, and Lilacs databases, in the first half of 2021. Inclusion criteria and filters were: articles related to the topic, randomized studies, clinical trials, work in humans, last 5 years, in Portuguese, English, and Spanish and full text available for free. The exclusion parameters were: duplicate articles, not related to the topic, review articles, not available works, and works that did not meet the inclusion criteria. The kappa coefficient was 0.812. The therapy had no serious adverse effects in any of the selected articles, and minor effects experienced 100% spontaneous remission after treatment. Although NAbs were found in the serum of some patients, there was no association between the adaptive immune response and the injection of the viral vector. The treatment was effective in improving acuity and visual field. Several studies have confirmed the effectiveness of gene therapy, at low and medium doses, in improving visual acuity and also on common adverse effects related to high doses. The humoral immune response and the variation in serum NAbs was cited in more than one article. The therapy was effective in improving visual acuity and the adverse effects that arose were easily treated. However, the humoral immune response still needs to be studied.

A Case of Infantile Mitochondrial Cardiomyopathy Treated with a Combination of Low-Dose Propranolol and Cibenzoline for Left Ventricular Outflow Tract Stenosis.

Hypertrophic cardiomyopathy is a common cardiac complication in mitochondrial disorders, and the morbidity rate in neonatal cases is up to 40%. The mortality rate within 3 months for neonatal-onset mitochondrial cardiomyopathy is known to be high because there is currently no established treatment.We report the case of a male infant with neonatal-onset mitochondrial disorder presenting lactic acidosis and hypertrophic cardiomyopathy. Genetic analysis of the patient revealed recurrent m.13513G>A, p.Asp393Asn in mitochondrially encoded NADH dehydrogenase 5 gene (MT-ND5). Low-dose propranolol was initially administered for cardiomyopathy; however, he developed hypertrophic obstructive cardiomyopathy (HOCM) at 3 months of age. To reduce the risk of hypoglycemia associated with high-dose propranolol, cibenzoline, a class Ia antiarrhythmic drug, was added at a dose of 2.5 mg/kg/day and increased weekly to 7.5 mg/kg/day with monitoring of the blood concentration of cibenzoline. Left ventricular outflow tract stenosis (LVOTS) dramatically improved from 5.4 to 1.3 m/second in LVOTS peak velocity after 6 weeks, without notable adverse effects. The plasma N-terminal pro-brain natriuretic peptide level decreased from 65,854 to 10,044 pg/mL. Furthermore, myocardial hypertrophy also improved, as the left ventricular mass index decreased from 173.1 to 108.9 g/m2 after 3 months of the treatment.The administration of cibenzoline, in conjunction with low-dose propranolol, may serve an effective treatment for HOCM in infantile patients with mitochondrial disorders.

Construction and detection of a novel type of recombinant human rAAV2/2-ND4.

PURPOSE: To construct a novel AAV-mediated gene delivery of the human ND4 complex I subunit and to detect its expression level in mitochondria for potential application in gene therapy for Leber's hereditary optic neuropathy (LHON). METHODS: A novel type of normal human ND4 gene was synthesized artificially to contain a mitochondrial targeting sequence that induces the translocation of this gene into mitochondria. This recombinant adeno-associated virus type 2/ serotype 2 (rAAV2/2)-mediated NADH dehydrogenase subunit 4 (ND4) gene was constructed, purified, condensed, and amplified by PCR. The physical titer of rAAV2/2-ND4 was determined by slot-blot hybridization using a digoxigenin-labeled H1 probe. Expression of ND4 in mitochondria was evaluated by immunofluorescence. RESULTS: The constructed rAAV2/2-ND4 specifically amplified the target gene band of ND4 and the physical titer of ND4 gene was 1.0x 10(11) vg/mL, confirming that the recombinant adenovirus vector contained the ND4 target gene. Expression of the ND4 gene was detected in mitochondria by immunofluorescence. CONCLUSION: A new type of rAAV2/2-ND4 was successfully constructed and may have potential in gene therapy for LHON.