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2.
Neurosci Lett ; 745: 135627, 2021 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-33440237

RESUMO

The review article briefly discusses a hypothesis based on the potential participation of iron dyshomeostasis and iron-mediated cell death (ferroptosis) in the pathogenesis of some neurodegenerative diseases. Iron dyshomeostasis (especially cellular iron overload) is considered to be a critical condition of neurodegeneration. The etiopathogenesis of many neurodegenerative diseases including Alzheimer's and Parkinson's diseases, Multiple sclerosis, and others, is different. However, there are several identical cellular processes, such as iron dyshomeostasis (an excessive iron deposition), iron-induced oxidative stress, the accumulation of lipid-generated reactive oxygen species, and ferroptosis that accompany these diseases. Based on the existing theoretical and experimental evidence, the article provides current insight into iron dyshomeostasis and ferroptosis as a contributing factor to the pathogenesis of neurodegeneration. In addition, special attention is addressed to the possible relationship between cellular iron overload and key pathological features of selected neurodegenerative diseases, such as ß-amyloid and tau proteins, α-synuclein, and demyelination. The mechanism by which ferroptosis may be involved in the pathogenesis of various neurodegenerative diseases is not fully elucidated. Further experimental and clinical studies are needed to clarify the hypothesis on the potential role of ferroptosis in the pathogenesis of neurodegenerative diseases.


Assuntos
Morte Celular/fisiologia , Ferroptose/fisiologia , Sobrecarga de Ferro/metabolismo , Ferro/metabolismo , Doenças Neurodegenerativas/metabolismo , Animais , Morte Celular/efeitos dos fármacos , Ferroptose/efeitos dos fármacos , Humanos , Quelantes de Ferro/farmacologia , Quelantes de Ferro/uso terapêutico , Sobrecarga de Ferro/epidemiologia , Sobrecarga de Ferro/terapia , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/terapia , Espécies Reativas de Oxigênio/antagonistas & inibidores , Espécies Reativas de Oxigênio/metabolismo
3.
Neurologia ; 35(9): 639-645, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32893069

RESUMO

INTRODUCTION: The elderly population is the group most threatened by COVID-19, with the highest mortality rates. This study aims to analyse the case fatality of COVID-19 in a cohort of patients with degenerative dementia. METHODS: We conducted a descriptive case-control study of a sample of patients diagnosed with primary neurodegenerative dementia. RESULTS: Twenty-four of the 88 patients with COVID-19 included in the study died: 10/23 (43.4%) patients diagnosed with dementia and 14/65 (21.5%) controls; this difference was statistically significant. DISCUSSION: Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Demência/epidemiologia , Doenças Neurodegenerativas/epidemiologia , Pandemias , Pneumonia Viral/mortalidade , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/epidemiologia , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Comorbidade , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Nefropatias/epidemiologia , Pneumopatias/epidemiologia , Masculino , Prevalência , Fatores de Risco , Fumar/epidemiologia , Espanha/epidemiologia
4.
Medicine (Baltimore) ; 99(27): e21156, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629752

RESUMO

BACKGROUND: Glaucoma is a common ophthalmic neurodegenerative disease and the main cause of blindness, which seriously affects the life and work of patients, without more effective treatment for optic nerve damage. Bushen Huoxue (BSHX) method is a traditional Chinese medicine (TCM) therapy that has been widely used as an alternative therapy to treat optic nerve damage in glaucoma patients with growing beneficial effect evidence, however, there is no current systematic review has addressed its effect for glaucoma. This study will conduct a systematic review and meta-analysis of the currently published randomized controlled trials (RCTs) of BSHX method for the treatment of glaucoma, aim to assess the efficacy and safety of BSHX method for patients with glaucoma. METHODS: We will thoroughly search literatures of RCTs related to BSHX method for glaucoma in PubMed, Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP and Wanfang database and other databases from the establishment of the database to November 2019, with no language restriction. After reviewing the title, abstract and full text, 2 reviewers will independently select the study, extract the data, after assess the risk of bias, we will conduct a meta-analysis of the data extracted from the included RCTs, including total effective rate, intraocular pressure (IOP), visual acuity, visual field, TCM syndrome score, and adverse events. The meta-analysis will be performed using Review Manager 5.3 software and the results will be based on either random effects or fixed effects models, depending on the heterogeneity. Trial sequential analysis (TSA) and Grading of Recommendations, Development and Evaluate system (GRADE) will be conduct to evaluate the reliability and quality of evidence. RESULTS: The results of the study will be published in a peer-reviewed journal, and provide a reasonable and high-quality evidence for the efficacy and safety of BSHX method for glaucoma. CONCLUSION: This study will be the first meta-analysis to evaluate the efficacy of BSHX method in the treatment of glaucoma comprehensively, and will to provide helpful evidence for the clinical treatment of this disease. REGISTRATION: PROSPERO CRD42020159897.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Glaucoma/tratamento farmacológico , Medicina Tradicional Chinesa/métodos , China/epidemiologia , Medicamentos de Ervas Chinesas/administração & dosagem , Feminino , Glaucoma/diagnóstico , Humanos , Pressão Intraocular/efeitos dos fármacos , Masculino , Doenças Neurodegenerativas/complicações , Doenças Neurodegenerativas/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Reprodutibilidade dos Testes , Segurança , Resultado do Tratamento , Acuidade Visual/efeitos dos fármacos , Campos Visuais/efeitos dos fármacos
5.
Neurologia ; 35(4): 245-251, 2020 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32364119

RESUMO

INTRODUCTION: SARS-CoV-2 was first detected in December 2019 in the Chinese city of Wuhan and has since spread across the world. At present, the virus has infected over 1.7 million people and caused over 100 000 deaths worldwide. Research is currently focused on understanding the acute infection and developing effective treatment strategies. In view of the magnitude of the epidemic, we conducted a speculative review of possible medium- and long-term neurological consequences of SARS-CoV-2 infection, with particular emphasis on neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin, based on the available evidence on neurological symptoms of acute SARS-CoV-2 infection. DEVELOPMENT: We systematically reviewed the available evidence about the pathogenic mechanisms of SARS-CoV-2 infection, the immediate and lasting effects of the cytokine storm on the central nervous system, and the consequences of neuroinflammation for the central nervous system. CONCLUSIONS: SARS-CoV-2 is a neuroinvasive virus capable of triggering a cytokine storm, with persistent effects in specific populations. Although our hypothesis is highly speculative, the impact of SARS-CoV-2 infection on the onset and progression of neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin should be regarded as the potential cause of a delayed pandemic that may have a major public health impact in the medium to long term. Cognitive and neuropsychological function should be closely monitored in COVID-19 survivors.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Síndrome da Liberação de Citocina/etiologia , Citocinas/fisiologia , Transtornos Mentais/etiologia , Doenças Neurodegenerativas/etiologia , Pandemias , Pneumonia Viral/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Síndrome da Liberação de Citocina/fisiopatologia , Síndrome da Liberação de Citocina/psicologia , Progressão da Doença , Humanos , Sistema Imunitário/fisiopatologia , Sistema Imunitário/virologia , Inflamação , Mediadores da Inflamação/fisiologia , Transtornos Mentais/epidemiologia , Modelos Imunológicos , Modelos Neurológicos , Doenças Neurodegenerativas/epidemiologia , Neuroimunomodulação/fisiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Saúde Pública , Fatores de Tempo
6.
Dermatol Ther ; 33(4): e13591, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32412679

RESUMO

During the last few months, the whole humanity is experiencing largest and most severe sudden influx of COVID-19 outbreak caused by the novel coronavirus (CoV) originated from Wuhan, China. According to the WHO reports, total 3 862 676 positive cases and 265 961 deaths have been recorded worldwide due to COVID-19 infection as of May 9, 2020. CoVs are a large family of viruses (enveloped, single-stranded RNA viruses), which includes severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome-related coronavirus (MERS-CoV). New SARS CoV2 is the members of Betacoronavirus genus. These viruses cause infections in bats, camels and humans, and a few other associated species. Despite many neurologic complications associated with SARS-CoV-2 infection, it is still unclear whether these symptoms results from direct neural injury or due to some other reason. Currently, it appears that most of the neurological symptoms of COVID-19 are nonspecific and secondary to the systemic illness. A single case of acute hemorrhagic necrotizing encephalopathy has been reported. SARS-CoV-2 associated Guillain-Barré syndrome is an atypical case. Till today, no convincing evidence is available to confirm that the SARS-CoV-2 virus directly affects nerves system in humans. However, postinfection surveillance will be necessary to identify the possible post-COVID-19 neurologic syndromes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Doenças Neurodegenerativas/etiologia , Pneumonia Viral/complicações , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Incidência , Doenças Neurodegenerativas/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia
7.
Brain Behav Immun ; 87: 53-54, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32311498

RESUMO

While all groups are affected by the COVID-19 pandemic, the elderly, underrepresented minorities, and those with underlying medical conditions are at the greatest risk. The high rate of consumption of diets high in saturated fats, sugars, and refined carbohydrates (collectively called Western diet, WD) worldwide, contribute to the prevalence of obesity and type 2 diabetes, and could place these populations at an increased risk for severe COVID-19 pathology and mortality. WD consumption activates the innate immune system and impairs adaptive immunity, leading to chronic inflammation and impaired host defense against viruses. Furthermore, peripheral inflammation caused by COVID-19 may have long-term consequences in those that recover, leading to chronic medical conditions such as dementia and neurodegenerative disease, likely through neuroinflammatory mechanisms that can be compounded by an unhealthy diet. Thus, now more than ever, wider access to healthy foods should be a top priority and individuals should be mindful of healthy eating habits to reduce susceptibility to and long-term complications from COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Dieta Ocidental/estatística & dados numéricos , Inflamação/epidemiologia , Obesidade/epidemiologia , Pneumonia Viral/epidemiologia , Imunidade Adaptativa/imunologia , Betacoronavirus , Infecções por Coronavirus/imunologia , Demência/epidemiologia , Demência/imunologia , Diabetes Mellitus Tipo 2/imunologia , Dieta , Suscetibilidade a Doenças , Humanos , Imunidade Inata/imunologia , Inflamação/imunologia , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/imunologia , Estado Nutricional , Obesidade/imunologia , Pandemias , Pneumonia Viral/imunologia
8.
J Integr Neurosci ; 19(1): 187-199, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32259897

RESUMO

Several epidemiological studies support low cancer rates in patients with neurodegenerative disorders, including Parkinson's disease, Huntington's disease, and Alzheimer's disease. Different mechanisms were raised as possible causes, from mutated tumor suppressor genes (PARKIN, PINK1) to small interfering RNA based on the CAG trinucleotide repeat expansions located in introns or untranslated regions. However, as every rule has an exception, some tumors have an increased incidence in these neurodegenerative diseases such as breast and skin cancer (melanoma). This mini-review aims to establish the epidemiology between these neurodegenerative disorders and cancer to determine the possible mechanisms involved and therefore set eventual therapeutic applications. According to our findings, we conclude the presence of an inverse relationship among most cancers and the aforementioned neurodegenerative disorders. However, this concept needs to be considered cautiously considering specific genetic and extra-genetic linkage factors for particular tumors.


Assuntos
Neoplasias/metabolismo , Doenças Neurodegenerativas/metabolismo , Animais , Humanos , Neoplasias/complicações , Neoplasias/epidemiologia , Doenças Neurodegenerativas/complicações , Doenças Neurodegenerativas/epidemiologia , Transdução de Sinais
10.
J Biol Regul Homeost Agents ; 34(1): 111-121, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32148012

RESUMO

During the menopause women may experience increased oxidative stress and decreased antioxidant capacity and, together with the decline of neurosteroids, this represents a risk factor for Alzheimer's disease. The aim of the present study was to test a functional food (FPP-ORI, Osato Research Institute, Gifu, Japan) on redox and mitochondrial efficiency in post-menopausal women. The study population consisting of 69 untreated post-menopausal women were given supplements as follows: Group A was given a multivitamin (MV) 1c 2 times a day, and group B was given FPP 4.5 g 2 times a day. Group C consisted of 23 fertile premenopausal women as the control group. The tests carried out on entry, and at 3 and 6 months were erythrocyte redox parameters, plasma oxidated proteins, brain-derived neurotrophic factor (BDNF) and peripheral blood mononuclear cell (PBMC) mitochondria cytochrome c oxidase Vmax activity. Menopausal women showed an increased malondialdehyde (MDA) (p<0.05 vs control) which was normalized by both treatments (p<0.05), but MV failed to do so in the BMI ≥26 subgroup (p<0.05). All other redox enzymes and BDNF were significantly lower in menopausal women and they responded only to FPP (p<0.05). Carbonyl protein level was higher in "BMI ≥ 26" subgroup (p<0.05) and reduced only by FPP (p<0.05). The PBMC cyclooxygenase to citrate synthase activity was reduced (<40%) in the menopausal group (p<0.01) and only FPP caused a significant restoration (p<0.05). Although preliminary, these data confirm the redox and mitochondrial dysfunction occurring in post-menopause and responsive to FPP but very poorly to high dosage antioxidants. This may lead to potential preventive opportunities in menopause-associated neurodegenerative disease.


Assuntos
Alimento Funcional , Mitocôndrias/patologia , Doenças Neurodegenerativas/epidemiologia , Pós-Menopausa , Antioxidantes/fisiologia , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Feminino , Humanos , Japão , Leucócitos Mononucleares , Malondialdeído/metabolismo , Oxirredução , Estresse Oxidativo , Projetos Piloto , Fatores de Risco
11.
JAMA Netw Open ; 3(3): e201541, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32207833

RESUMO

Importance: The association between exposure to hormone-modulating therapy (HMT) as breast cancer treatment and neurodegenerative disease (NDD) is unclear. Objective: To determine whether HMT exposure is associated with the risk of NDD in women with breast cancer. Design, Setting, and Participants: This retrospective cohort study used the Humana claims data set from January 1, 2007, to March 31, 2017. The Humana data set contains claims from private-payer and Medicare insurance data sets from across the United States with a population primarily residing in the Southeast. Patient claims records were surveyed for a diagnosis of NDD starting 1 year after breast cancer diagnosis for the duration of enrollment in the claims database. Participants were 57 843 women aged 45 years or older with a diagnosis of breast cancer. Patients were required to be actively enrolled in Humana claims records for 6 months prior to and at least 3 years after the diagnosis of breast cancer. The analyses were conducted between January 1 and 15, 2020. Exposure: Hormone-modulating therapy (selective estrogen receptor modulators, estrogen receptor antagonists, and aromatase inhibitors). Main Outcomes and Measures: Patients receiving HMT for breast cancer treatment were identified. Survival analysis was used to determine the association between HMT exposure and diagnosis of NDD. A propensity score approach was used to minimize measured and unmeasured selection bias. Results: Of the 326 485 women with breast cancer in the Humana data set between 2007 and 2017, 57 843 met the study criteria. Of these, 18 126 (31.3%; mean [SD] age, 76.2 [7.0] years) received HMT, whereas 39 717 (68.7%; mean [SD] age, 76.8 [7.0] years) did not receive HMT. Mean (SD) follow-up was 5.5 (1.8) years. In the propensity score-matched population, exposure to HMT was associated with a decrease in the number of women who received a diagnosis of NDD (2229 of 17 878 [12.5%] vs 2559 of 17 878 [14.3%]; relative risk, 0.89; 95% CI, 0.84-0.93; P < .001), Alzheimer disease (877 of 17 878 [4.9%] vs 1068 of 17 878 [6.0%]; relative risk, 0.82; 95% CI, 0.75-0.90; P < .001), and dementia (1862 of 17 878 [10.4%] vs 2116 of 17 878 [11.8%]; relative risk, 0.88; 95% CI, 0.83-0.93; P < .001). The number needed to treat was 62.51 for all NDDs, 93.61 for Alzheimer disease, and 69.56 for dementia. Conclusions and Relevance: Among patients with breast cancer, tamoxifen and steroidal aromatase inhibitors were associated with a decrease in the number who received a diagnosis of NDD, specifically Alzheimer disease and dementia.


Assuntos
Antineoplásicos Hormonais , Inibidores da Aromatase , Neoplasias da Mama , Moduladores de Receptor Estrogênico , Doenças Neurodegenerativas , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/administração & dosagem , Antineoplásicos Hormonais/efeitos adversos , Antineoplásicos Hormonais/uso terapêutico , Inibidores da Aromatase/administração & dosagem , Inibidores da Aromatase/efeitos adversos , Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/mortalidade , Comorbidade , Moduladores de Receptor Estrogênico/administração & dosagem , Moduladores de Receptor Estrogênico/efeitos adversos , Moduladores de Receptor Estrogênico/uso terapêutico , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Doenças Neurodegenerativas/induzido quimicamente , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/mortalidade , Estudos Retrospectivos , Fatores de Risco , Tamoxifeno/administração & dosagem , Tamoxifeno/efeitos adversos , Tamoxifeno/uso terapêutico
12.
CMAJ ; 192(8): E173-E181, 2020 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-32051130

RESUMO

BACKGROUND: Medical assistance in dying (MAiD) was legalized across Canada in June 2016. Some have expressed concern that patient requests for MAiD might be driven by poor access to palliative care and that social and economic vulnerability of patients may influence access to or receipt of MAiD. To examine these concerns, we describe Ontario's early experience with MAiD and compare MAiD decedents with the general population of decedents in Ontario. METHODS: We conducted a retrospective cohort study comparing all MAiD-related deaths with all deaths in Ontario, Canada, between June 7, 2016, and Oct. 31, 2018. Clinical and demographic characteristics were collected for all MAiD decedents and compared with those of all Ontario decedents when possible. We used logistic regression analyses to describe the association of demographic and clinical factors with receipt of MAiD. RESULTS: A total of 2241 patients (50.2% women) were included in the MAiD cohort, and 186 814 in the general Ontario decedent cohort. Recipients of MAiD reported both physical (99.5%) and psychologic suffering (96.4%) before the procedure. In 74.4% of cases, palliative care providers were involved in the patient's care at the time of the MAiD request. The statutory 10-day reflection period was shortened for 26.6% of people. Compared with all Ontario decedents, MAiD recipients were younger (mean 74.4 v. 77.0 yr, standardized difference 0.18);, more likely to be from a higher income quintile (24.9% v. 15.6%, standardized difference across quintiles 0.31); less likely to reside in an institution (6.3% v. 28.0%, standardized difference 0.6); more likely to be married (48.5% v. 40.6%) and less likely to be widowed (25.7% v. 35.8%, standardized difference 0.34); and more likely to have a cancer diagnosis (64.4% v. 27.6%, standardized difference 0.88 for diagnoses comparisons). INTERPRETATION: Recipients of MAiD were younger, had higher income, were substantially less likely to reside in an institution and were more likely to be married than decedents from the general population, suggesting that MAiD is unlikely to be driven by social or economic vulnerability. Given the high prevalence of physical and psychologic suffering, despite involvement of palliative care providers in caring for patients who request MAiD, future studies should aim to improve our understanding and treatment of the specific types of suffering that lead to a MAiD request.


Assuntos
Renda/estatística & dados numéricos , Estado Civil/estatística & dados numéricos , Neoplasias/epidemiologia , Cuidados Paliativos/estatística & dados numéricos , Suicídio Assistido/estatística & dados numéricos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Estudos de Coortes , Feminino , Acesso aos Serviços de Saúde , Humanos , Institucionalização/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/epidemiologia , Ontário/epidemiologia , Características de Residência , Doenças Respiratórias/epidemiologia , Estudos Retrospectivos , Viuvez/estatística & dados numéricos
13.
Spine (Phila Pa 1976) ; 45(7): E406-E410, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31725127

RESUMO

STUDY DESIGN: Retrospective analysis. OBJECTIVE: To investigate the prevalence of osteoporosis (OP) in patients undergoing lumbar fusion for lumbar degenerative diseases (LDD). SUMMARY OF BACKGROUND DATA: OP is related to many complications after lumbar fusion for patients with LDD. There are sparse data on the prevalence of OP among this specific population. Moreover, LDD can falsely elevate the bone mineral density measured by dual energy x-ray absorptiometry (DXA), leading to unreliable diagnostic results. Computed tomography (CT) Hounsfield unit (HU) values can help identify osteoporotic patients undetected by DXA. METHODS: A total of 479 patients aged≥50 years undergoing lumbar fusion for LDD were reviewed. The diagnosis of OP using DXA was based on World Health Organization criterion. The criterion for OP diagnosed on CT scan was the L1-HU value≤110. RESULTS: The prevalence of OP diagnosed on lumbar DXA, hip DXA, and both was 32.4%, 19.6%, 39.7%, respectively. The females had higher prevalence of OP diagnosed on DXA (spine and hip) than males (48.9% vs. 27.1%, P < 0.001). In females but not males, the prevalence of OP significantly increased with age (females, 50-59: 28.0%, 60-69: 58.1%, ≥70: 78.8%, P < 0.001). Patients having primary diagnosis of degenerative lumbar scoliosis had the higher prevalence of OP than the rest patients (56.5% vs. 36.8%, P = 0.002). Among the 324 patients diagnosed with non-OP by lumbar DXA, the prevalence of OP diagnosed on CT scan was 25.9%, it increased with age and was also highest in patients with degenerative lumbar scoliosis. CONCLUSION: OP was quite common among patients aged≥50 years undergoing lumbar fusion for LDD, especially for females aged≥60 years or patients having degenerative lumbar scoliosis. Older patients or patients having degenerative lumbar scoliosis are more likely to have unreliable lumbar T-scores. Measurements of HU values can help identify more osteoporotic patients in this population. LEVEL OF EVIDENCE: 3.


Assuntos
Absorciometria de Fóton/métodos , Vértebras Lombares/diagnóstico por imagem , Doenças Neurodegenerativas/diagnóstico por imagem , Osteoporose/diagnóstico por imagem , Fusão Vertebral/métodos , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea/fisiologia , Estudos de Coortes , Feminino , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/cirurgia , Osteoporose/epidemiologia , Osteoporose/cirurgia , Prevalência , Estudos Retrospectivos
14.
Clin Rheumatol ; 39(1): 159-166, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31523786

RESUMO

OBJECTIVES: The present study evaluated the associations between rheumatoid arthritis (RA) and neurodegenerative dementia using a Korean national sample cohort. METHODS: We designed two studies using the Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013. Study I included participants with dementia matched 1:4 with controls and analyzed the participants' history of RA. Study II included participants with RA matched 1:4 with controls and analyzed the occurrence of dementia. RA was defined by the presence of relevant ICD-10 codes (M05 or M06) and medication histories. Neurodegenerative dementia was defined using ICD-10 codes (G30 or F00). Crude and adjusted odds ratios (ORs) were analyzed using conditional logistic regression analyses. Crude and adjusted hazard ratios (HRs) were analyzed using the stratified Cox proportional hazard model. Subgroup analyses were performed on groups stratified by age and sex. RESULTS: The adjusted ORs for RA were 0.96 (95% CI = 0.78-1.16, P = 0.644) in the dementia group in study I. The adjusted HRs for dementia were 0.91 (95% CI = 0.76-1.10, P = 0.319) in the RA group in study II. No subgroup analysis reached the statistical significance level. CONCLUSION: We could not identify any significant relationship between RA and dementia.Key Points• Two studies were conducted to identify the relationship between rheumatoid arthritis and dementia using national cohort data.• Neither study showed any association between rheumatoid arthritis and dementia.


Assuntos
Artrite Reumatoide/epidemiologia , Demência/epidemiologia , Doenças Neurodegenerativas/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Fatores de Risco
16.
Crit Rev Biomed Eng ; 47(4): 323-347, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31679262

RESUMO

Previous studies suggest that extremely low-frequency (ELF) electric and magnetic fields (EMFs) may impact human health. However, epidemiologic studies have provided inconsistent results on the association between exposure to ELF EMFs and various health outcomes. This scoping review reports on primary investigations that were published during the ten-year period of 2007-2017 on the association between ELF EMFs and cancer, cardiovascular disease (CVD), reproductive health effects, and neurodegenerative diseases. We identified a total of 361 articles from two bibliographic databases (PubMed and EMBASE). Of these, 39 articles (19 cancer studies, two CVD studies, nine reproductive health studies, and ten neurodegenerative disease studies [with one repeated for two outcomes]) met inclusion criteria. Articles identified in this study focus on three different types of exposure: occupational (22 studies), residential (15 studies), and electric blanket (two studies). This review suggests that ELF EMFs may be associated with neurodegenerative diseases, specifically Alzheimer's disease; however, limited evidence was found to suggest that ELF EMFs are associated with several types of cancer, CVD, and reproductive outcomes. Additional epidemiological studies in large study populations with improved exposure assessments are needed to clarify current inconclusive relationships.


Assuntos
Exposição Ambiental , Campos Magnéticos/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Feminino , Humanos , Masculino , Neoplasias/epidemiologia , Neoplasias/etiologia , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/etiologia , Gravidez , Resultado da Gravidez , Saúde Pública , Saúde Reprodutiva
17.
PLoS Pathog ; 15(11): e1008142, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31730654

RESUMO

As a neurotropic virus, human Enterovirus 71 (EV71) infection causes hand-foot-and-mouth disease (HFMD) and may develop severe neurological disorders in infants. Toll-like receptor 7 (TLR7) acts as an innate immune receptor and is also a death receptor in the central nervous system (CNS). However, the mechanisms underlying the regulation of TLR7-mediated brain pathogenesis upon EV71 infection remain largely elusive. Here we reveal a novel mechanism by which EV71 infects astrocytes in the brain and induces neural pathogenesis via TLR7 and interleukin-6 (IL-6) in C57BL/6 mice and in human astroglioma U251 cells. Upon EV71 infection, wild-type (WT) mice displayed more significant body weight loss, higher clinical scores, and lower survival rates as compared with TLR7-/- mice. In the cerebral cortex of EV71-infected mice, neurofilament integrity was disrupted, and inflammatory cell infiltration and neurodegeneration were induced in WT mice, whereas these were largely absent in TLR7-/- mice. Similarly, IL-6 production, Caspase-3 cleavage, and cell apoptosis were significantly higher in EV71-infected WT mice as compared with TLR7-/- mice. Moreover, EV71 preferentially infected and induced IL-6 in astrocytes of mice brain. In U251 cells, EV71-induced IL-6 production and cell apoptosis were suppressed by shRNA-mediated knockdown of TLR7 (shTLR7). Moreover, in the cerebral cortex of EV71-infected mice, the blockade of IL-6 with anti-IL-6 antibody (IL-6-Ab) restored the body weight loss, attenuated clinical scores, improved survival rates, reduced the disruption of neurofilament integrity, decreased cell apoptotic induction, and lowered levels of Caspase-3 cleavage. Similarly, in EV71-infected U251 cells, IL-6-Ab blocked EV71-induced IL-6 production and cell apoptosis in response to viral infection. Collectively, it's exhibited TLR7 upregulation, IL-6 induction and astrocytic cell apoptosis in EV71-infected human brain. Taken together, we propose that EV71 infects astrocytes of the cerebral cortex in mice and human and triggers TLR7 signaling and IL-6 release, subsequently inducing neural pathogenesis in the brain.


Assuntos
Apoptose , Enterovirus Humano A/isolamento & purificação , Infecções por Enterovirus/complicações , Interleucina-6/metabolismo , Doenças Neurodegenerativas/epidemiologia , Receptor 7 Toll-Like/metabolismo , Animais , Astrócitos/metabolismo , Astrócitos/patologia , Astrócitos/virologia , Encéfalo/metabolismo , Encéfalo/patologia , Encéfalo/virologia , Pré-Escolar , Infecções por Enterovirus/virologia , Feminino , Humanos , Lactente , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Doenças Neurodegenerativas/metabolismo , Doenças Neurodegenerativas/virologia , Receptor 7 Toll-Like/genética
18.
Ann Neurol ; 86(6): 913-926, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31604369

RESUMO

OBJECTIVE: To assess the associations of several blood immune biomarkers with the future risks of amyotrophic lateral sclerosis and Parkinson disease in a prospective cohort study with 20 years of follow-up. METHODS: The Swedish Apolipoprotein-Related Mortality Risk study is a longitudinal cohort study including 812,073 participants with repeated blood biomarker measurements between 1985 and 1996 and a follow-up until 2011. Using a Cox model, we first estimated hazard ratios of amyotrophic lateral sclerosis and Parkinson disease in relation to leukocytes, immunoglobulin G, haptoglobin, and uric acid. We further described the temporal changes of these biomarkers during the 20 years prior to the diagnosis of these diseases. RESULTS: A total of 585 incident cases of amyotrophic lateral sclerosis and 3,769 incident cases of Parkinson disease were identified during the follow-up. Increasing concentrations of leukocytes, haptoglobin, and uric acid were associated with a lower risk of Parkinson disease. No statistically significant association was, however, noted between the studied biomarkers and amyotrophic lateral sclerosis. Parkinson disease patients appeared to have lower levels of leukocytes and haptoglobin between 20 and 10 years before diagnosis and lower levels of uric acid during the 20 years before diagnosis, compared to controls, although statistically significant differences were only noted during parts of the respective time intervals after multivariable adjustment. No clear differences were noted between patients with amyotrophic lateral sclerosis and controls. INTERPRETATION: If verified in studies of independent populations, our findings may suggest a different role of systemic inflammation on the risk of Parkinson disease compared to amyotrophic lateral sclerosis. ANN NEUROL 2019;86:913-926.


Assuntos
Esclerose Amiotrófica Lateral/sangue , Esclerose Amiotrófica Lateral/imunologia , Imunidade Celular/imunologia , Doença de Parkinson/sangue , Doença de Parkinson/imunologia , Idoso , Esclerose Amiotrófica Lateral/epidemiologia , Biomarcadores/sangue , Estudos de Coortes , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doenças Neurodegenerativas/sangue , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/imunologia , Doença de Parkinson/epidemiologia , Estudos Prospectivos , Suécia/epidemiologia , Fatores de Tempo
19.
Epidemiol Rev ; 41(1): 109-120, 2019 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-31565731

RESUMO

Nutrition and diet have been suggested to enhance or inhibit cognitive performance and the risk of several neurodegenerative diseases. We conducted a systematic review to elucidate the relationship between the inflammatory capacity of a person's diet and the risk of incident neurodegenerative diseases. We searched major medical databases for articles published through June 30, 2018. Original, full-text, English-language articles on studies with human participants which investigated the link between dietary inflammatory potential and risk of developing neurodegenerative diseases were included. Duplicate and irrelevant studies were removed, and data were compiled through critical analysis. Initially, 457 articles were collected via the searching method, of which 196 studies remained after removal of duplicates. Fourteen articles were screened and found to be relevant to the scope of the review. After critical analysis, 10 were included in the final review. In all studies but one, a higher dietary inflammatory index (DII) was related to higher risk of developing neurodegenerative disease symptoms, including memory and cognition decline and multiple sclerosis. Of 3 studies that assessed the association of DII with levels of circulating inflammation markers, 2 indicated that DII was positively correlated with inflammatory marker levels. Low literacy, an unhealthy lifestyle, and individual nutritional status were the factors involved in a diet with inflammatory potential. These findings enhance confidence that DII is an appropriate tool for measurement of dietary inflammatory potential and validate the role of diets with inflammatory potential in the pathophysiology of neurodegenerative diseases. DII may be correlated with levels of circulating inflammatory markers.


Assuntos
Dieta/efeitos adversos , Inflamação/etiologia , Doenças Neurodegenerativas/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cognição , Feminino , Humanos , Masculino , Memória , Pessoa de Meia-Idade , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/patologia , Adulto Jovem
20.
Rev Neurol (Paris) ; 175(10): 698-704, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31648732

RESUMO

The human environment and exposures arising therefrom are major contributors to neurological disorders ranging from stroke to neurodegenerative diseases. Reduction of exposure to environmental risk factors, with the goal of disease prevention or control, is addressed at the individual as well as the societal level and in recognition of differential subject vulnerability. We examine some practical solutions in high-income countries that may allow a better adaptation to environmental risks and reduce their adverse impact on the nervous system. We consider the citizen's role in reducing unhealthy exposures and explore new approaches to treatment.


Assuntos
Exposição Ambiental/prevenção & controle , Doença Ambiental , Neurologia/métodos , Exposição Ambiental/efeitos adversos , Exposição Ambiental/estatística & dados numéricos , Doença Ambiental/epidemiologia , Doença Ambiental/prevenção & controle , Doença Ambiental/terapia , Humanos , Doenças Neurodegenerativas/induzido quimicamente , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/prevenção & controle , Doenças Neurodegenerativas/terapia , Neurologia/tendências , Medicina do Trabalho/métodos , Medicina do Trabalho/tendências , Medição de Risco , Fatores de Risco , Mudança Social , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Acidente Vascular Cerebral/terapia
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