玫瑰痤疮面部潮红与红斑新认识

【摘要】 持续型面中部红斑与潮红是玫瑰痤疮最常见的临床表现,但对其病理机制了解甚少,并缺乏高证据等级临床研究支持。本文结合国内外研究进展及临床经验,强调将面部潮红与红斑作为独立的临床表型进行研究探讨的必要性,认为精神压力、焦虑和/或抑郁可能是其发病的使动环节。由精神因素出发,探索玫瑰痤疮面部潮红及红斑相关神经炎症与皮肤免疫及血管的关系具有潜在的临床意义。     

miR-122-5p调节创伤性脑外伤后小胶质细胞极化减弱炎症反应北大核心CSCD

目的探讨miR-122-5p对创伤性脑外伤后小胶质细胞凋亡、极化和炎症反应的影响。方法建立创伤性脑外伤(traumatic brain injury,TBI)小鼠模型和细胞模型。使用TBI小鼠脑匀浆刺激星型胶质细胞产生外泌体,microRNA微阵列分析外泌体中显著改变的microRNA。实时荧光定量PCR检测TBI小鼠模型和TBI细胞模型中miR-122-5p表达。使用TUNEL凋亡染色、免疫荧光共聚焦、蛋白质印迹研究miR-122-5p抑制剂在TBI神经炎症中对小胶质细胞凋亡、小胶质细胞M1/M2表型转化、NLRP3通路及NFκB磷酸化的作用。结果通过microRNA微阵列分析发现有83个下调miRNA(改变2倍以上,P<0.05),其中miR-122-5p显著下调(P<0.01),miR-122-5p在TBI小鼠及细胞模型中表达显著下降[(1.0±0.00)vs.(0.41±0.15),P<0.001];[(1.0±0.00)vs.(0.34±0.07),P<0.001]。TUNEL凋亡检测、免疫荧光染色结果表明抑制miR-122-5p表达,可以显著减轻LPS诱导的小胶质细胞凋亡[(8.03±1.30)vs.(3.17±0.34),P<0.001],促进小胶质细胞M1向M2表型转化,即M1表型极化减少[(56.96±13.70)vs.(34.70±3.47),P=0.002],M2表型极化增加[(30.46±3.67)vs.(40.74±2.49),P=0.005]。蛋白质印迹结果表明miR-122-5p抑制剂降低NLRP3炎症小体活化[(0.77±0.10)vs.(0.51±0.11),P=0.02],降低NFκB的磷酸化[(0.73±0.08)vs.(0.50±0.07),P=0.003]。结论miR-122-5p在TBI星形胶质细胞分泌的外泌体及小胶质细胞中表达下调,miR-122-5p抑制剂可以通过抑制TBI后NLRP3炎症小体通路的活化及NFκB的磷酸化,促进小胶质细胞M1向M2表型转化,减少小胶质细胞凋亡,从而减轻TBI后小胶质细胞炎症损伤。     

Closed head injury—an inflammatory disease?

Closed head injury (CHI) remains the leading cause of death and persisting neurological impairment in young individuals in industrialized nations. Research efforts in the past years have brought evidence that the intracranial inflammatory response in the injured brain contributes to the neuropathological sequelae which are, in large part, responsible for the adverse outcome after head injury. The presence of hypoxia and hypotension in the early resuscitative period of brain-injured patients further aggravates the inflammatory response in the brain due to ischemia/reperfusion-mediated injuries. The profound endogenous neuroinflammatory response after CHI, which is phylogenetically aimed at defending the intrathecal compartment from invading pathogens and repairing lesioned brain tissue, contributes to the development of cerebral edema, breakdown of the blood–brain barrier, and ultimately to delayed neuronal cell death. However, aside from these deleterious effects, neuroinflammation has been recently shown to mediate neuroreparative mechanisms after brain injury as well. This “dual effect” of neuroinflammation was the focus of extensive experimental and clinical research in the past years and has lead to an expanded basic knowledge on the cellular and molecular mechanisms which regulate the intracranial inflammatory response after CHI. Thus, head injury has recently evolved as an inflammatory and immunological disease much more than a pure traumatological, neurological, or neurosurgical entity. The present review will summarize the so far known mechanisms of posttraumatic neuroinflammation after CHI, based on data from clinical and experimental studies, with a special focus on the role of pro-inflammatory cytokines, chemokines, and the complement system.     

β-Amyloid exacerbates inflammation in astrocytes lacking fatty acid amide hydrolase through a mechanism involving PPAR-α, PPAR-γ and TRPV1, but not CB₁ or CB₂ receptors

BACKGROUND AND PURPOSE

The endocannabinoid system may regulate glial cell functions and their responses to pathological stimuli, specifically, Alzheimer''s disease. One experimental approach is the enhancement of endocannabinoid tone by blocking the activity of degradative enzymes, such as fatty acid amide hydrolase (FAAH).

EXPERIMENTAL APPROACH

We examined the role of FAAH in the response of astrocytes to the pathologic form of β-amyloid (Aβ). Astrocytes from wild-type mice (WT) and from mice lacking FAAH (FAAH-KO) were incubated with Aβ for 8, 24 and 48 h, and their inflammatory responses were quantified by elisa, western-blotting and real-time quantitative-PCR.

KEY RESULTS

FAAH-KO astrocytes were significantly more responsive to Aβ than WT astrocytes, as shown by the higher production of pro-inflammatory cytokines. Expression of COX-2, inducible NOS and TNF-α was also increased in Aβ-exposed KO astrocytes compared with that in WTs. These effects were accompanied by a differential pattern of activation of signalling cascades involved in mediating inflammatory responses, such as ERK1/2, p38MAPK and NFκ B. PPAR-α and PPAR-γ as well as transient receptor potential vanilloid-1 (TRPV1), but not cannabinoid CB₁ or CB₂ receptors, mediate some of the differential changes observed in Aβ-exposed FAAH-KO astrocytes. The pharmacological blockade of FAAH did not render astrocytes more sensitive to Aβ. In contrast, exogenous addition of several acylethanolamides (anandamide, palmitoylethanolamide and oleoylethanolamide) induced an antiinflammatory response.

CONCLUSIONS

The genetic deletion of FAAH in astrocytes exacerbated their inflammatory phenotype against Aβ in a process involving PPAR-α, PPAR-γ and TRPV1 receptors.     

环氧化酶-2与帕金森病

环氧化酶是花生四烯酸代谢产生前列腺素过程中的主要限速酶。住体内环氧化酶至少存在结构酶和历导酶两种同源异构体。在帕金森病患者尸检及帕金森病动物模型中均发现黑质Ⅸ诱导型同工酶环氧化酶-2的表达增高,环氧化酶-2在帕金森病发病机制中的作用倍受关注,选择性环氧化酶-2抑制剂可能成为帕金森病治疗的新药物。     

Microglia signaling as a target of donepezil

Donepezil is a reversible and noncompetitive cholinesterase inhibitor. The drug is considered as a first-line treatment in patients with mild to moderate Alzheimer's disease. Recently, anti-inflammatory and neuroprotective effects of the drug have been reported. “Cholinergic anti-inflammation pathway” has major implications in these effects. Here, we present evidence that donepezil at 5-20 μM directly acts on microglial cells to inhibit their inflammatory activation. Our conclusion is based on the measurement of nitric oxide and proinflammatory mediators using purified microglia cultures and microglia cell lines: donepezil attenuated microglial production of nitric oxide and tumor necrosis factor (TNF)-α, and suppressed the gene expression of inducible nitric oxide synthase, interleukin-1β, and TNF-α. Subsequent studies showed that donepezil inhibited a canonical inflammatory NF-κB signaling. Microglia/neuroblastoma coculture and animal experiments supported the anti-inflammatory effects of donepezil. Based on the studies using nicotinic acetylcholine receptor antagonists, the donepezil inhibition of microglial activation was independent of acetylcholine and its receptor. Thus, inflammatory activation signaling of microglia may be one of the direct targets of donepezil in the central nervous system. It should be noted, however, that there is a large gap between the therapeutic dose of the drug used clinically and the concentration of the drug that exerts the direct action on microglial cells.     

The peripheral benzodiazepine receptor (Translocator protein 18kDa) in microglia: from pathology to imaging

Microglia constitute the primary resident immune surveillance cell in the brain and are thought to play a significant role in the pathogenesis of several neurodegenerative disorders, such as Alzheimer's disease, multiple sclerosis, Parkinson's disease and HIV-associated dementia. Measuring microglial activation in vivo in patients suffering from these diseases may help chart progression of neuroinflammation as well as assess efficacy of therapies designed to modulate neuroinflammation. Recent studies suggest that activated microglia in the CNS may be detected in vivo using positron emission tomography (PET) utilizing pharmacological ligands of the mitochondrial peripheral benzodiazepine receptor (PBR (recently renamed as Translocator protein (18 kDa)). Beginning with the molecular characterization of PBR and regulation in activated microglia, we examine the rationale behind using PBR ligands to image microglia with PET. Current evidence suggests these findings might be applied to the development of clinical assessments of microglial activation in neurological disorders.     

Pharmacological complement inhibition at the C3 convertase level promotes neuronal survival, neuroprotective intracerebral gene expression, and neurological outcome after traumatic brain injury

The complement system represents an important mediator of neuroinflammation in traumatic brain injury. We have previously shown that transgenic mice with central nervous system-targeted overexpression of Crry, a potent murine complement inhibitor at the level of C3 convertases, are protected from complement-mediated neuropathological sequelae in brain-injured mice. This knowledge was expanded in the present study to a pharmacological approach by the use of a recombinant Crry molecule (termed Crry-Ig) which was recently made available in a chimeric form fused to the non-complement fixing mouse IgG1 Fc region. In a standardized model of closed head injury in mice, the systemic injection of 1 mg Crry-Ig at 1 h and 24 h after trauma resulted in a significant neurological improvement for up to 7 days, as compared to vehicle-injected control mice (P < 0.05, repeated measures ANOVA). Furthermore, the extensive neuronal destruction seen in the hippocampal CA3/CA4 sublayers in head-injured mice with vehicle injection only was shown to be preserved – to a similar extent as in “sham”-operated mice – by the posttraumatic injection of Crry-Ig. Real-time RT-PCR analysis revealed that the post-treatment with Crry-Ig resulted in a significant up-regulation of candidate neuroprotective genes in the injured hemisphere (Bcl-2, C1-Inh, CD55, CD59), as compared to the vehicle control group (P < 0.01, unpaired Student's t test). Increased intracerebral Bcl-2 expression by Crry-Ig treatment was furthermore confirmed at the protein level by Western blot analysis. These data suggest that pharmacological complement inhibition represents a promising approach for attenuation of neuroinflammation and secondary neurodegeneration after head injury.     

Accumulation of class switched IgD-IgM- memory B cells in the cerebrospinal fluid during neuroinflammation

Inflammatory diseases of the central nervous system (CNS) are characterized by cerebrospinal fluid (CSF) pleocytosis often involving the recruitment of B cells. Little is still known about B cells that are found in the CSF during neuroinflammation. To address the phenotype of these B cells, we studied the distribution of the major B cell subsets in peripheral blood (PB) and CSF of 25 patients with inflammatory diseases of the nervous system by flow cytometry. Six different B cell subsets were identified in PB and CSF according to the surface expression of IgM, IgD, CD27 and CD19. In all patients analysed, memory B cells outnumbered naïve B cells in the CSF, whereas naïve B cells were more prevalent in PB. The accumulation of memory B cells in the CSF was largely due to the recruitment of IgM−IgD− class switched memory B cells. The distribution of IgM+IgD+, IgM−IgD+, IgM+IgD− memory cells and immature cells did not differ significantly between CSF and PB. These findings demonstrate a selective recruitment of IgM−IgD− memory B cells to the CSF suggesting a specific role of these cells during neuroinflammation.     

Different parkinsonism models produce a time-dependent induction of COX-2 in the substantia nigra of rats

The present study investigated the effects on general activity, COX-2 and TH protein expression of intranigral neurotoxins LPS, MPTP or 6-OHDA infusion in rats. Results indicate that LPS produced an increase in locomotion frequency (3 and 7 days after surgery) and a strong up-regulation of COX-2 protein 16 and 24 h after surgery, as observed in the substantia nigra (SN). The MPTP model generated impairment in locomotion frequency 24 h after surgery. Besides, MPTP caused a marked up-regulation in COX-2 protein observed in the SN 16 h after surgery. Moreover, the 6-OHDA model produced severe motor impairment indicated by the decrease in locomotion (24 h) and rearing (24 h, 3 and 7 days) frequencies and also an increase in latency (24 h, 3 and 7 days) and immobility (24 h and 3 days) times. We also demonstrated an up-regulation of COX-2, which occurred in the SN 4-24 h after surgery. TH protein did not appear to be reduced in the striatum in the groups lesioned with the neurotoxins. In contrast, the TH content of SN was significantly reduced in the groups lesioned with the very same neurotoxins. For all the models analyzed, we observed no statistical differences in the expression of COX-2 in the striatum along the time-points. The results of the present study suggest that COX-2 induction patterns differ in function of the neurotoxin tested. Such time-dependent induction has been found to be relatively constant, a fact of great significance considering the importance of the neuroinflammatory process in Parkinson's disease.