The Latest Articles on Central Nervous System
Our staff editors continue to share exciting, interesting, and thought-provoking reading material in the recommended articles series.
This week, we would like to share several latest articles on Central Nervous System.
Title: Extracellular vesicles: Critical bilateral communicators in periphery-brain crosstalk in central nervous system disorders
Authors: Danning Wang, Shaodi Guan, Pei Lu, Yali Li, Hui Xu
Type: Review
Abstract:
Growing evidence shows that there is a comorbid mechanism between the central nervous system (CNS) and the peripheral organs. The bilateral transmission of signal molecules in periphery-brain crosstalk plays an important role in the underlying mechanism, which result from complex networks of neurohumoral circuits. Secreted by almost all cells and considered innovative information transport systems, extracellular vesicles (EVs) encapsulate and deliver nucleic acids, proteins, lipids, and various other bioactive regulators. Moreover, EVs can cross the blood-brain barrier (BBB), they are also identified primarily as essential communicators between the periphery and the CNS. In addition to transporting molecules under physiological or pathological conditions, EVs also show novel potential in targeted drug delivery. In this review, we discuss the mechanisms implicated in the transport of EVs in crosstalk between the peripheral and the central immune systems as well as in crosstalk between the peripheral organs and the brain in CNS disorders, especially in neurodegenerative diseases, stroke, and trauma. This work will help in elucidating the contributions of EVs to brain health and disorders, and promote the development of new strategies for minimally invasive treatment.
Access this article: https://doi.org/10.1016/j.biopha.2023.114354
Title: Ageotypes revisited: The brain and central nervous system dysfunction as a major nutritional and lifestyle target for healthy aging
Authors: Maria G. Grammatikopoulou, Efstathios Skoufas, Spyridon Kanellakis, Despina Sanoudou, Georgios A. Pavlopoulos, Aristides G. Eliopoulos, Kalliopi K. Gkouskou
Type: Research Article
Abstract:
Undeniably, biological age can significantly differ between individuals of similar chronological age. Longitudinal, deep multi-omic profiling has recently enabled the identification of individuals with distinct aging phenotypes, termed 'ageotypes'. This effort has provided a plethora of data and new insights into the diverse molecular mechanisms presumed to drive aging. Translational opportunities stemming from this knowledge continue to evolve, providing an opportunity for the provision of nutritional interventions aiming to decelerate the aging process. In this framework, the contemporary ageotypes classification was revisited via in silico analyses, with the brain and nervous system being identified as the primary targets of age-related biomolecules, acting through inflammatory and metabolic pathways. Nutritional and lifestyle factors affecting these pathways in the brain and central nervous system that could help guide personalized recommendations for the attainment of healthy aging are discussed.
Access this article: https://doi.org/10.1016/j.maturitas.2023.01.013
Title: Central nervous system relapse in younger patients with diffuse large B-cell lymphoma - a LYSA and GLA/ DSHNHL analysis
Authors: Catherine Thieblemont, Bettina Altmann, Fabian Frontzek, Loic Renaud, Loic Chartier, Nicolas Ketterer, Christian Recher, Viola Poeschel, Olivier Fitoussi, Gerhard Held, Olivier Casasnovas, Corinne Haioun, Franck Morschhauser, Bertram Glass, Nicolas Mounier, Herve Tilly, Andreas Rosenwald, German Ott, Georg Lenz, Thierry Molina, Norbert Schmitz
Type: Research Article
Abstract:
The majority of patients with diffuse large B-cell lymphoma (DLBCL) can be cured with immunochemotherapy comprising rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Patients suffering progression or relapse in the central nervous system (CNS) face dismal outcomes. The impact of more aggressive regimens used in front-line therapy has not systematically been investigated in this context. To this end, we analyzed a large cohort of 2203 younger DLBCL patients treated on ten German and French prospective phase II and III trials following first-line therapy with R-CHOP, R-CHOEP (R-CHOP+etoposide), dose-escalated R-CHOEP followed by repetitive stem cell transplantation (R-MegaCHOEP), or rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycine, prednisone (R-ACVBP) followed by consolidation including multiple drugs crossing the blood-brain-barrier (BBB). DLBCL patients with age-adjusted International Prognostic Index (aaIPI) of 0-1 showed very low cumulative incidence (CI) rates of CNS relapse regardless of first-line therapy and CNS prophylaxis (3-year CI 0% - 1%). Younger high-risk patients with aaIPI of 2-3 had 3-year CI rates of 1.6% and 4% after R-ACVBP plus consolidation or R-(Mega)CHO(E)P, respectively (Hazard Ratio 2.4 (95% confidence interval: 0.8-7.4), p=0.118). Thus, for younger high-risk patients, front-line regimens incorporating agents crossing the BBB may reduce often fatal CNS relapse.
Access this article: https://doi.org/10.1182/bloodadvances.2022008888
Title: Protecting the injured central nervous system: Do anesthesia or hypothermia ameliorate secondary injury?
Authors: Jacob A. Davis, James W. Grau
Type: Review
Abstract:
Traumatic injury to the central nervous system (CNS) and stroke initiate a cascade of processes that expand the area of tissue loss. The current review considers recent studies demonstrating that the induction of an anesthetic state or cooling the affected tissue (hypothermia) soon after injury can have a therapeutic effect. We first provide an overview of the neurobiological processes that fuel tissue loss after traumatic brain injury (TBI), spinal cord injury (SCI) and stroke. We then examine the rehabilitative effectiveness of therapeutic anesthesia across a variety of drug categories through a systematic review of papers in the PubMed database. We also review the therapeutic benefits hypothermia, another treatment that quells neural activity. We conclude by considering factors related to the safety, efficacy and timing of treatment, as well as the mechanisms of action. Clinical implications are also discussed.
Access this article: https://doi.org/10.1016/j.expneurol.2023.114349
Title: Outcomes of Patients Treated in the UK Proton Overseas Programme: Central Nervous System Group
Authors: S. Gaito, E. Hwang, A. France, M. Aznar, N. Burnet, A. Crellin, A.L. Holtzman, D.J. Indelicato, B. Timmerman, G. Whitfield, E. Smith
Type: Research Article
Abstract:
Aims
In 2008, the UK National Health Service started the Proton Overseas Programme (POP), to provide access for proton beam therapy (PBT) abroad for selected tumour diagnoses while two national centres were being planned. The clinical outcomes for the patient group treated for central nervous system (CNS), base of skull, spinal and paraspinal malignancies are reported here.
Materials and methods
Since the start of the POP, an agreement between the National Health Service and UK referring centres ensured outcomes data collection, including overall survival, local tumour control and late toxicity data. Clinical and treatment-related data were extracted from this national patient database. Grade ≥ 3 late toxicities were reported following Common Terminology Criteria for Adverse Events (CTCAE) v 4.0 definition, occurring later than 90 days since the completion of treatment.
Results
Between 2008 and September 2020, 830 patients were treated within the POP for the above listed malignancies. Overall survival data were available for 815 patients and local control data for 726 patients. Toxicity analysis was carried out on 702 patients, with patients excluded due to short follow-up ( < 90 days) and/or inadequate toxicity data available. After a median follow-up of 3.34 years (0.06–11.58), the overall survival was 91.2%. The local control rate was 85.9% after a median follow-up of 2.81 years (range 0.04–11.58). The overall grade ≥ 3 late toxicity incidence was 11.97%, after a median follow-up of 1.72 years (0.04–8.45). The median radiotherapy prescription dose was 54 GyRBE (34.8–79.2).
Conclusions
The results of this study indicate the safety of PBT for CNS tumours. Preliminary clinical outcomes following PBT for paediatric/teen and young adult and adult CNS tumours treated within the POP are encouraging, which reflects accurate patient selection and treatment quality. The rate of late effects compares favourably with published cohorts. Clinical outcomes from this patient cohort will be compared with those of UK-treated patients since the start of the national PBT service in 2018.
Access this article: https://doi.org/10.1016/j.clon.2023.01.024
