Cephaloconiosis: a free radical perspective on the proposed particulate-induced etiopathogenesis of Alzheimer's dementia and related disorders

Gut Microbiota Disorder, Gut Epithelial and Blood-Brain Barrier Dysfunctions in Etiopathogenesis of Dementia: Molecular Mechanisms and Signaling Pathways

Emerging evidences indicate a critical role of the gut microbiota in etiopathogenesis of dementia, a debilitating multifactorial disorder characterized by progressive deterioration of cognition and behavior that interferes with the social and professional functions of the sufferer. Available data suggest that gut microbiota disorder that triggers development of dementia is characterized by substantial reduction in specific species belonging to the Firmicutes and Bacteroidetes phyla and presence of pathogenic species, predominantly, pro-inflammatory bacteria of the Proteobacteria phylum. These changes in gut microbiota microecology promote the production of toxic metabolites and pro-inflammatory cytokines, and reduction in beneficial substances such as short chain fatty acids and other anti-inflammatory factors, thereby, enhancing destruction of the gut epithelial barrier with concomitant activation of local and distant immune cells as well as dysregulation of enteric neurons and glia. This subsequently leads to blood-brain barrier dysfunctions that trigger neuroinflammatory reactions and predisposes to apoptotic neuronal and glial cell death, particularly in the hippocampus and cerebral cortex, which underlie the development of dementia. However, the molecular switches that control these processes in the histo-hematic barriers of the gut and brain are not exactly known. This review integrates very recent data on the molecular mechanisms that link gut microbiota disorder to gut epithelial and blood-brain barrier dysfunctions, underlying the development of dementia. The signaling pathways that link gut microbiota disorder with impairment in cognition and behavior are also discussed. The review also highlights potential therapeutic options for dementia.

Current Perspectives and Mechanisms of Relationship between Intestinal Microbiota Dysfunction and Dementia: A Review

BACKGROUND

Accumulating data suggest a crucial role of the intestinal microbiota in the development and progression of neurodegenerative diseases. More recently, emerging reports have revealed an association between intestinal microbiota dysfunctions and dementia, a debilitating multifactorial disorder, characterized by progressive deterioration of cognition and behavior that interferes with the social and professional life of the sufferer. However, the mechanisms of this association are not fully understood.

SUMMARY

In this review, I discuss recent data that suggest mechanisms of cross-talk between intestinal microbiota dysfunction and the brain that underlie the development of dementia. Potential therapeutic options for dementia are also discussed. The pleiotropic signaling of the metabolic products of the intestinal microbiota together with their specific roles in the maintenance of both the intestinal and blood-brain barriers as well as regulation of local, distant, and circulating immunocytes, and enteric, visceral, and central neural functions are integral to a healthy gut and brain.

KEY MESSAGES

Research investigating the effect of intestinal microbiota dysfunctions on brain health should focus on multiple interrelated systems involving local and central neuroendocrine, immunocyte, and neural signaling of microbial products and transmitters and neurohumoral cells that not only maintain intestinal, but also blood brain-barrier integrity. The change in intestinal microbiome/dysbiome repertoire is crucial to the development of dementia.

The Free Radical Theory of Aging: A Critique and Unresolved Questions

La théorie des radicaux libres du vieillissement est très critiquée. Ce compte-rendu traite des effets biologiques des radicaux libres au cours du processus du vieillissement, de la relation entre le vieillissement et la maladie (comment ces deux concepts peuvent être affectés par les radicaux libres) et des effets des radicaux libres tout au long du cycle de vie. Cet article met en relief des aspects qui demandent une étude plus approfondie.

Iron, brain and restless legs syndrome

Iron is the most important transitional metal in the body, as it is implicated in many metabolic processes, mostly related to its capacity as an electron donor/acceptor. Iron deficiency has been long been known to cause anaemia, iron excess to cause haemochromatosis. As excess free iron can cause oxidative damage, it is important that the levels of iron in the body are tightly regulated which appears to be done only by digestive absorption, as there is no known regulating mechanism for elimination of iron. The amount of free iron is also kept to a minimum thanks to binding to transferrin for transport, and to ferritin for storage. Recent research has put emphasis on the possible role of excess iron in the brain in several degenerative diseases. Iron deficiency in the central nervous system is known to cause motor impairment and cognitive deficits; more recently, it has been suggested that it may play a role in the pathophysiology of the restless leg syndrome. 2001 Harcourt Publishers Ltd

Alzheimer's disease risk factors as related to cerebral blood flow: additional evidence

In a previous report, Alzheimer's disease risk factors, including alcohol abuse, depression, Down's syndrome, cerebral glucose metabolism defect, head trauma, old age, Parkinson's disease, sleep disturbance, and underactivity, were shown to have an association with reduced cerebral blood flow. In this report an attempt is made to strengthen a hypothesis that reduced cerebral blood flow may be a required cofactor in the cause of Alzheimer's disease with examples of additional putative risks, including aluminum, ApoE 4 alleles, estrogen deficiency, family history of dementia, low education-attainment, olfactory deficit, and underactivity coupled with gender, considered to have a relationship or potential relationship with reduced cerebral blood flow. Factors, believed to ameliorate Alzheimer's disease, associated with improved or stabilized cerebral blood flow are tabulated. A tentative cerebral blood flow nomogram is shown as a potential model to possibly help predict Alzheimer's disease susceptibility.

Menopause

The area of menopausal medicine is undergoing rapid evolution as millions of baby boomers enter this life stage. This group came of age at a time when all cultural values and institutions, including the basic assumptions underlying the healthcare of women, underwent intense scrutiny. As a result, alternative approaches to everything from childbirth to menopause have become increasingly mainstream. This article gives the healthcare provider both the philosophical background and practical solutions necessary to assist the menopausal woman in choosing an individualized program to minimize her risk for disease and maximize her postmenopausal health potential by combining the best of both conventional and alternative medical approaches.

Deleterious network hypothesis of Alzheimer's disease

Numerous studies indicate that aberrant amyloid precursor protein metabolism, elevated peroxidative damage, depressed energy metabolism and altered calcium homeostasis are four pivotal deleterious factors in the pathogenesis of Alzheimer's disease. Cumulative evidence further suggests that these four factors are intimately interrelated, forming a deleterious network. Based on this new concept of 'deleterious network', a unifying hypothesis-the deleterious network hypothesis of Alzheimer's disease-is proposed. The main ideas of the hypothesis are delineated as follows: increases in free radical damage, alterations in amyloid precursor protein metabolism, impairment of energy metabolism and abnormalities of calcium homeostasis are four cornerstones of a deleterious network. Various risk factors of Alzheimer's disease can triger the network by promoting the occurrence of one of these key components, resulting in the biological abnormalities of Alzheimer's disease. Based on this new theory, a majority of the important observations about Alzheimer's disease can be explained consistently and succinctly.

Alzheimer's disease risk factors as related to cerebral blood flow

Inconsistencies within results of case-control studies on Alzheimer's disease risk factors led to a search of the literature for a potential cofactor. Reduced cerebral blood flow was selected and literature was surveyed for evidence of a cerebral blood flow linkage with the more than 40 putative risks. Alcohol abuse, depression, head trauma, underactivity, old age, sleep disturbance, glucose utilization, Down's syndrome, and Parkinson's disease are risk factors where an association with reduced cerebral blood flow is documented. Studies were cited showing that improved cerebral blood flow is associated with factors thought to be helpful in Alzheimer's disease, such as education or occupational attainment, exercise, headache, smoking, and arthritis/anti-inflammatory drugs to the extent that aspirin is used. Sugar consumption is identified as a potential risk factor with glucose management in Alzheimer's disease also shown to involve reduced cerebral blood flow. An hypothesis is developed showing how compromised regional cerebral blood flow could fit as a cofactor for genetic, autoimmune, and neurotoxic aspects of Alzheimer's disease.

The promotion of iron-induced generation of reactive oxygen species in nerve tissue by aluminum

Aluminum is suspected to play a role in several neurological disorders. Reactive oxygen species (ROS) lead to oxidative stress, which is thought to be a possible mechanism for neurological damage. Interactions between aluminum and iron, a known promoter of prooxidant events, were studied in cerebral tissues using a fluorescent probe to measure rates of generation of ROS. Al2(SO4)3 alone failed to stimulate ROS production over a wide range of concentrations (50-1000 microM). The aluminum-deferrioxamine chelate in the absence of iron could also not potentiate ROS formation. However, Al2(SO4)3 potentiated FeSO4-induced ROS, with a maximal effect at 10 microM Fe and 500 microM Al. Kaolin, a hydrated aluminum silicate, did not potentiate iron-induced ROS formation. Ferritin had a minor stimulatory effect on ROS generation, but this was not potentiated by the concurrent presence of Al2(SO4)3. Transferrin had no effect on basal rates of ROS generation, but when Al2(SO4)3 was also present, ROS production was enhanced. It is concluded that: 1. There is a potentiation of iron-induced ROS by aluminum salts; 2. Free or complexed aluminum alone is not a key producer of ROS; and 3. High rates of ROS production are unlikely to be owing to the displacement by aluminum iron from its biologically sequestered locations.

Oxidative stress in some dementia types

By analogy to some pathologies (such as demyelinating diseases, arthritis and inflammatory processes) where the loss of cellular integrity is the starting point of tissue oxidative damage, it is proposed that some dementia types could be derived from a similar mechanism. The following oxidative events are proposed: (a) different agents could alter capillary or neuron integrity with the subsequent leakage of oxidases, proteases and transition metals from cellular compartments; (b) the persistence of the damaging agent, possible depletion of antioxidative defenses and concomitant loss of neuron function; (c) alteration of adjacent cells in the same manner; and (d) finally localized brain necrosis and progression of the dementia.

Field dependent transverse relaxation rate increase may be a specific measure of tissue iron stores

The degree to which MRI magnet field strength affects measured transverse relaxation rates (R2) defines a measure termed the field dependent R2 increase (FDRI). We report here the results of in vivo and in vitro experiments that were conducted to evaluate whether FDRI is a potentially useful measure of tissue iron stores. T2 relaxation times were obtained using two clinical MRI instruments operating at 0.5 and 1.5 Tesla, and relaxation rates (R2) were calculated as the reciprocal of T2. The in vivo experiment measured R2 in human brain frontal white matter, caudate nucleus, putamen, and globus pallidus. The FDRI was very highly correlated with published brain iron levels for the four regions examined. The in vitro experiment measured R2 in agarose gel-based phantoms containing physiologic forms and amounts proteins involved in iron storage and transport (ferritin, apoferritin, transferrin, and apotransferrin). Significant field dependence was observed only for the ferritin phantoms. The differences in the R2 values obtained at the two field strengths were striking, and were proportional to the ferritin levels of the phantoms. These studies suggest that FDRI may be a specific measure of tissue ferritin. The quantitative significance of the results to imaging and possible applications to the clinical investigation of pathologic states are discussed.

Oxidative damage in Alzheimer's dementia, and the potential etiopathogenic role of aluminosilicates, microglia and micronutrient interactions

While evidence implicating free radical oxidative processes in the etiopathogenesis of Alzheimer's dementia is accumulating, the specific cellular and biochemical mechanisms involved remain to be identified. The potential pathogenic role of microglial cells in neurodegenerative processes is indicated by the finding that purified murine microglial cells exposed in vitro to various model aluminosilicate particles stimulate the generation of tissue-injurious free radical reactive oxygen metabolites. Analogous inorganic aluminosilicate deposits have been reported to occur in the core of the characteristic senile plaques found in the brains of Alzheimer disease subjects. The possible modulation of free radical oxidative activity by antioxidant micronutrients and pharmacological agents, provides a rational basis for further preventative and therapeutic clinical investigations.