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Magyar-Sumegi ZD, Csendes M, Lendvai-Emmert D, Sebestyen G, Tamas V, Bandi S, Czigler A, Yabluchanskiy A, Tarantini S, Ungvari Z, Czeiter E, Amrein K, Orsi G, Perlaki G, Buki A, Toth P. Chronic impairment of neurovascular coupling and cognitive decline in young survivors of severe traumatic brain injury. GeroScience 2025:10.1007/s11357-025-01683-w. [PMID: 40360822 DOI: 10.1007/s11357-025-01683-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2025] [Accepted: 04/25/2025] [Indexed: 05/15/2025] Open
Abstract
Severe traumatic brain injury (TBI) leads to chronic cognitive decline, imposing a significant societal burden. The regulation of cerebral blood flow (CBF) is critical for cognitive function, and acute disruptions in CBF regulation predict poor TBI outcomes. However, the long-term effects of TBI on CBF regulation and their association with cognitive function remain poorly understood. This study aimed to investigate whether severe TBI results in chronic CBF dysregulation and whether this contributes to long-term cognitive deficits. Additionally, we examined the role of TBI-induced insulin-like growth factor 1 (IGF-1) deficiency in cerebrovascular dysfunction. We assessed cognitive function, basal CBF (via phase contrast MRI), CBF autoregulation (via transcranial Doppler), and neurovascular coupling (NVC) in 33 TBI survivors (mean age 37.6 years, ~ 10 years post-injury) and 21 age-matched healthy controls. Serum IGF-1 levels were also measured. TBI survivors exhibited significant impairments in memory and executive function compared to controls. While basal CBF and autoregulation remained intact, NVC responses were chronically impaired and correlated with cognitive deficits. However, IGF-1 levels did not differ between groups and were not associated with NVC impairment or cognitive function. Our findings indicate that severe TBI results in chronic impairment of neurovascular coupling, which likely contributes to long-term cognitive deficits. These results highlight the need for further research to identify underlying neurovascular mechanisms and develop interventions to restore NVC and cognitive function in TBI survivors.
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Affiliation(s)
- Zsofia Dina Magyar-Sumegi
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
- Doctoral School of Clinical Neurosciences, Medical School, University of Pecs, Pecs, Hungary
| | - Mark Csendes
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
| | | | - Gabriella Sebestyen
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
- Doctoral School of Clinical Neurosciences, Medical School, University of Pecs, Pecs, Hungary
| | - Viktoria Tamas
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
| | - Szabolcs Bandi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pecs, Pecs, Hungary
| | - Andras Czigler
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Doctoral College Health Sciences Division/Institute of Preventive Medicine and Public Health, International Training Program in Geroscience, Semmelweis University, Budapest, Hungary
| | - Stefano Tarantini
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Doctoral College Health Sciences Division/Institute of Preventive Medicine and Public Health, International Training Program in Geroscience, Semmelweis University, Budapest, Hungary
| | - Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Doctoral College Health Sciences Division/Institute of Preventive Medicine and Public Health, International Training Program in Geroscience, Semmelweis University, Budapest, Hungary
| | - Endre Czeiter
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
- HUN-REN-PTE Clinical Neuroscience MR Research Group, University of Pecs, Pecs, Hungary
- Molecular Medicine Research Group, Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Krisztina Amrein
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
- HUN-REN-PTE Clinical Neuroscience MR Research Group, University of Pecs, Pecs, Hungary
- Molecular Medicine Research Group, Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Gergely Orsi
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
| | - Gabor Perlaki
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary
| | - Andras Buki
- Department of Neurosurgery, Faculty of Medicine and Health, Orebro University, Orebro, Sweden
| | - Peter Toth
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary.
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- Doctoral College Health Sciences Division/Institute of Preventive Medicine and Public Health, International Training Program in Geroscience, Semmelweis University, Budapest, Hungary.
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Zhong J, Li G, Lv Z, Chen J, Wang C, Shao A, Gong Z, Wang J, Liu S, Luo J, Yang S, Wu S, Ning L, Wang Z, Li J, Wu Y. Neuromodulation of Cerebral Blood Flow: A Physiological Mechanism and Methodological Review of Neurovascular Coupling. Bioengineering (Basel) 2025; 12:442. [PMID: 40428061 PMCID: PMC12108752 DOI: 10.3390/bioengineering12050442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2025] [Revised: 04/20/2025] [Accepted: 04/21/2025] [Indexed: 05/29/2025] Open
Abstract
Neurovascular coupling (NVC) refers to the dynamic regulation of cerebral blood flow via neuronal activity, a mechanism crucial for maintaining normal brain function. This review elucidates the intricate physiological mechanisms underlying NVC, emphasizing the coordinated roles of neurons, glial cells, and vascular cells in mediating activity-induced changes in blood flow. We examine how NVC is impaired in neurological disorders such as Alzheimer's disease and stroke, where the dysfunction of this coupling contributes to neurodegeneration and neurological deficits. A broad range of techniques for assessing NVC is discussed-encompassing the established modalities like transcranial Doppler, near-infrared spectroscopy, and functional magnetic resonance imaging (fMRI), as well as emerging technologies such as functional ultrasound imaging and miniaturized endoscopy that enable high-resolution monitoring in deep brain regions. We also highlight the computational modeling approaches for simulating NVC dynamics and identify the novel biomarkers of NVC dysfunction with potential utility in early diagnosis. Finally, emerging translational applications-including neuromodulation techniques and targeted pharmacological interventions-are explored as means to restore normal neurovascular function. These advancements underscore the clinical significance of NVC research, paving the way for improved diagnostic tools and therapeutic strategies in neurological disorders.
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Affiliation(s)
- Jiawen Zhong
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Gen Li
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Zexiang Lv
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Jingbo Chen
- Faculty of Naval Medicine, Naval Medical University, Shanghai 200433, China;
| | - Chunyan Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Ansheng Shao
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Zhiwei Gong
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Junjie Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Siqiao Liu
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Jun Luo
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Shuping Yang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Sibei Wu
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Lin Ning
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Zhinong Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Jiahao Li
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
| | - Yu Wu
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China; (J.Z.); (Z.L.); (A.S.); (Z.G.); (J.W.); (S.L.); (J.L.); (S.Y.); (S.W.); (L.N.); (Z.W.); (J.L.)
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Gáspár Z, Szabó BG, Ceglédi A, Lakatos B. Human herpesvirus reactivation and its potential role in the pathogenesis of post-acute sequelae of SARS-CoV-2 infection. GeroScience 2025; 47:167-187. [PMID: 39207648 PMCID: PMC11872864 DOI: 10.1007/s11357-024-01323-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
The emergence of SARS-CoV-2 has precipitated a global pandemic with substantial long-term health implications, including the condition known as post-acute sequelae of SARS-CoV-2 infection (PASC), commonly referred to as Long COVID. PASC is marked by persistent symptoms such as fatigue, neurological issues, and autonomic dysfunction that persist for months beyond the acute phase of COVID-19. This review examines the potential role of herpesvirus reactivation, specifically Epstein-Barr virus (EBV) and cytomegalovirus (CMV), in the pathogenesis of PASC. Elevated antibody titers and specific T cell responses suggest recent herpesvirus reactivation in some PASC patients, although viremia is not consistently detected. SARS-CoV-2 exhibits endothelial trophism, directly affecting the vascular endothelium and contributing to microvascular pathologies. These pathologies are significant in PASC, where microvascular dysfunction may underlie various chronic symptoms. Similarly, herpesviruses like CMV also exhibit endothelial trophism, which may exacerbate endothelial damage when reactivated. Evidence suggests that EBV and CMV reactivation could indirectly contribute to the immune dysregulation, immunosenescence, and autoimmune responses observed in PASC. Additionally, EBV may play a role in the genesis of neurological symptoms through creating mitochondrial dysfunction, though direct confirmation remains elusive. The reviewed evidence suggests that while herpesviruses may not play a direct role in the pathogenesis of PASC, their potential indirect effects, especially in the context of endothelial involvement, warrant further investigation.
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Affiliation(s)
- Zsófia Gáspár
- School of PhD Studies, Semmelweis University, Üllői Street 26, 1085, Budapest, Hungary
- South Pest Central Hospital, National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, 1097, Budapest, Hungary
| | - Bálint Gergely Szabó
- School of PhD Studies, Semmelweis University, Üllői Street 26, 1085, Budapest, Hungary.
- South Pest Central Hospital, National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, 1097, Budapest, Hungary.
- Departmental Group of Infectious Diseases, Department of Internal Medicine and Haematology, Semmelweis University, Albert Flórián Street 5-7, 1097, Budapest, Hungary.
| | - Andrea Ceglédi
- South Pest Central Hospital, National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, 1097, Budapest, Hungary
| | - Botond Lakatos
- School of PhD Studies, Semmelweis University, Üllői Street 26, 1085, Budapest, Hungary
- South Pest Central Hospital, National Institute of Haematology and Infectious Diseases, Albert Flórián Street 5-7, 1097, Budapest, Hungary
- Departmental Group of Infectious Diseases, Department of Internal Medicine and Haematology, Semmelweis University, Albert Flórián Street 5-7, 1097, Budapest, Hungary
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Nagy B, Protzner AB, Czigler B, Gaál ZA. Resting-state neural dynamics changes in older adults with post-COVID syndrome and the modulatory effect of cognitive training and sex. GeroScience 2025; 47:1277-1301. [PMID: 39210163 PMCID: PMC11872858 DOI: 10.1007/s11357-024-01324-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
Post-COVID syndrome manifests with numerous neurological and cognitive symptoms, the precise origins of which are still not fully understood. As females and older adults are more susceptible to developing this condition, our study aimed to investigate how post-COVID syndrome alters intrinsic brain dynamics in older adults and whether biological sex and cognitive training might modulate these effects, with a specific focus on older females. The participants, aged between 60 and 75 years, were divided into three experimental groups: healthy old female, post-COVID old female and post-COVID old male. They underwent an adaptive task-switching training protocol. We analysed multiscale entropy and spectral power density of resting-state EEG data collected before and after the training to assess neural signal complexity and oscillatory power, respectively. We found no difference between post-COVID females and males before training, indicating that post-COVID similarly affected both sexes. However, cognitive training was effective only in post-COVID females and not in males, by modulating local neural processing capacity. This improvement was further evidenced by comparing healthy and post-COVID females, wherein the latter group showed increased finer timescale entropy (1-30 ms) and higher frequency band power (11-40 Hz) before training, but these differences disappeared following cognitive training. Our results suggest that in older adults with post-COVID syndrome, there is a pronounced shift from more global to local neural processing, potentially contributing to accelerated neural aging in this condition. However, cognitive training seems to offer a promising intervention method for modulating these changes in brain dynamics, especially among females.
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Affiliation(s)
- Boglárka Nagy
- Institute of Cognitive Neuroscience and Psychology, HUN-REN Research Centre for Natural Sciences, Budapest, Hungary.
| | - Andrea B Protzner
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
| | | | - Zsófia Anna Gaál
- Institute of Cognitive Neuroscience and Psychology, HUN-REN Research Centre for Natural Sciences, Budapest, Hungary
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Fekete M, Lehoczki A, Szappanos Á, Toth A, Mahdi M, Sótonyi P, Benyó Z, Yabluchanskiy A, Tarantini S, Ungvari Z. Cerebromicrovascular mechanisms contributing to long COVID: implications for neurocognitive health. GeroScience 2025; 47:745-779. [PMID: 39777702 PMCID: PMC11872997 DOI: 10.1007/s11357-024-01487-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2024] [Accepted: 12/17/2024] [Indexed: 01/11/2025] Open
Abstract
Long COVID (also known as post-acute sequelae of SARS-CoV-2 infection [PASC] or post-COVID syndrome) is characterized by persistent symptoms that extend beyond the acute phase of SARS-CoV-2 infection, affecting approximately 10% to over 30% of those infected. It presents a significant clinical challenge, notably due to pronounced neurocognitive symptoms such as brain fog. The mechanisms underlying these effects are multifactorial, with mounting evidence pointing to a central role of cerebromicrovascular dysfunction. This review investigates key pathophysiological mechanisms contributing to cerebrovascular dysfunction in long COVID and their impacts on brain health. We discuss how endothelial tropism of SARS-CoV-2 and direct vascular infection trigger endothelial dysfunction, impaired neurovascular coupling, and blood-brain barrier disruption, resulting in compromised cerebral perfusion. Furthermore, the infection appears to induce mitochondrial dysfunction, enhancing oxidative stress and inflammation within cerebral endothelial cells. Autoantibody formation following infection also potentially exacerbates neurovascular injury, contributing to chronic vascular inflammation and ongoing blood-brain barrier compromise. These factors collectively contribute to the emergence of white matter hyperintensities, promote amyloid pathology, and may accelerate neurodegenerative processes, including Alzheimer's disease. This review also emphasizes the critical role of advanced imaging techniques in assessing cerebromicrovascular health and the need for targeted interventions to address these cerebrovascular complications. A deeper understanding of the cerebrovascular mechanisms of long COVID is essential to advance targeted treatments and mitigate its long-term neurocognitive consequences.
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Affiliation(s)
- Monika Fekete
- Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - Andrea Lehoczki
- Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary.
- Doctoral College, Health Sciences Program, Semmelweis University, Budapest, Hungary.
| | - Ágnes Szappanos
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Department of Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary
| | - Attila Toth
- Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, 4032, Hungary
- Research Centre for Molecular Medicine, University of Debrecen, Debrecen, 4032, Hungary
| | - Mohamed Mahdi
- Laboratory of Retroviral Biochemistry, Department of Biochemistry and Molecular Biology, University of Debrecen, 4032, Debrecen, Hungary
- Infectology Clinic, University of Debrecen Clinical Centre, 4031, Debrecen, Hungary
| | - Péter Sótonyi
- Department of Vascular and Endovascular Surgery, Heart and Vascular Centre, Semmelweis University, 1122, Budapest, Hungary
| | - Zoltán Benyó
- Institute of Translational Medicine, Semmelweis University, 1094, Budapest, Hungary
- Cerebrovascular and Neurocognitive Disorders Research Group, HUN-REN , Semmelweis University, 1094, Budapest, Hungary
| | - Andriy Yabluchanskiy
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral College/Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Stefano Tarantini
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral College/Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral College/Institute of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Park E, Liu E, Baker AJ. In vivo characterization of ACE2 expression in Sprague-Dawley rats and cultured primary brain pericytes highlights the utility of Rattus norvegicus in the study of COVID-19 brain pathophysiology. Brain Res 2025; 1848:149333. [PMID: 39542232 DOI: 10.1016/j.brainres.2024.149333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 11/08/2024] [Accepted: 11/11/2024] [Indexed: 11/17/2024]
Abstract
A high number of COVID-19 patients report ongoing neurological impairments including headache, fatigue and memory impairments. Our understanding of COVID-19 disease mechanisms in the brain is limited and relies on post-mortem human tissues, in vitro studies in various cell lines (both human and animal) as well as preclinical studies in a variety of species. Notably the use of rats in the study of COVID-19 has been scarce in part due to early reports of low infectivity of the original Wuhan strain in mice and rats. Evidence has shown that subsequent strains that have mutated from the original strain are capable of infection in rats. Here we present an immunohistological characterization of ACE2 expression in the rat brain perivascular region. We found ACE2 to be expressed in pericytes but not endothelial cells or astrocytes in the perivascular space. We further examined the uptake of Omicron variants 1.1.529 and BA.2 receptor binding domains (RBD) of the SARS-CoV2 spike protein in primary brain pericytes derived from rats. We demonstrate that rat primary brain pericytes are susceptible to SARS-CoV2 spike protein uptake and induce functional changes in pericytes associated with a reduction in tight junction protein expression. These data provide evidence that rat primary cell responses to SARS-CoV2 infection are consistent with reports of infectivity in other species (transgenic mice expressing hACE2, ferrets, hamsters) and supports the use of this model organism with a long history of use in the study of disease which should be leveraged for study of COVID-19 in the brain.
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Affiliation(s)
- Eugene Park
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON Canada
| | - Elaine Liu
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON Canada
| | - Andrew J Baker
- St. Michael's Hospital, Unity Health Toronto, Toronto, ON Canada; Institute of Medical Science and the Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
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McDonald MJ, Marsh ML, Fears SD, Shariffi B, Kanaley JA, Limberg JK. Impact of acute sleep restriction on cerebrovascular reactivity and neurovascular coupling in young men and women. J Appl Physiol (1985) 2025; 138:282-288. [PMID: 39661323 DOI: 10.1152/japplphysiol.00648.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 12/02/2024] [Accepted: 12/02/2024] [Indexed: 12/12/2024] Open
Abstract
Chronic exposure to shortened sleep is associated with an increased risk of Alzheimer's disease and dementia. Previous studies show insufficient (e.g., poor or fragmented) sleep impairs cerebrovascular reactivity to metabolic stress and may have a detrimental effect on the link between cerebral blood flow (CBF) and neural activity (i.e., neurovascular coupling, NVC). The purpose of this study was to examine the effect of acute sleep restriction on CBF in response to a metabolic (carbon dioxide, CO2) and a cognitive stressor. We hypothesized sleep restriction (4-h time in bed) would attenuate CBF and NVC. Sixteen young adults (8 M/8 F, 28 ± 8 yr, 25 ± 3 kg/m2) completed two morning visits following a night of normal (7.38 ± 0.82 h) or restricted (4.27 ± 0.93 h, P < 0.001) sleep duration. Middle cerebral artery velocity (MCAv, transcranial Doppler ultrasound) was measured at rest and during 1) 5 min of carbogen air-breathing and 2) five trials consisting of a period of eyes closed (30 s), followed by eyes open (40 s) while being challenged with a validated visual paradigm (Where's Waldo). Baseline MCAv was unaffected by acute sleep restriction (control: 64 ± 14 cm/s; restricted 61 ± 13 cm/s; P = 0.412). MCAv increased with CO2; however, there was no effect of restricted sleep (P = 0.488). MCAv increased in response to visual stimulation; the peak NVC response was reduced from control following restricted sleep (control: 16 ± 12%; restricted: 9 ± 7%; P = 0.008). Despite no effect of acute sleep restriction on resting CBF or the response to CO2 in young men and women, NVC was attenuated following a night of shortened sleep. These data support an important role for sleep in NVC and may have implications for the development of neurodegenerative disease states, such as Alzheimer's and dementia.NEW & NOTEWORTHY Chronic exposure to shortened sleep is associated with an increased risk of Alzheimer's disease and dementia. We examined the effect of acute sleep restriction (4-h time in bed) on cerebral blood flow in response to a metabolic (carbon dioxide) and a cognitive stimulus. Despite no effect of acute sleep restriction on resting cerebral blood flow or the response to carbon dioxide in young men and women, neurovascular coupling was attenuated following a night of shortened sleep.
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Affiliation(s)
- Matthew J McDonald
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Megan L Marsh
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Sharon D Fears
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Brian Shariffi
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Jill A Kanaley
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri, United States
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He Z, Sun J. The role of the neurovascular unit in vascular cognitive impairment: Current evidence and future perspectives. Neurobiol Dis 2025; 204:106772. [PMID: 39710068 DOI: 10.1016/j.nbd.2024.106772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Revised: 12/12/2024] [Accepted: 12/16/2024] [Indexed: 12/24/2024] Open
Abstract
Vascular cognitive impairment (VCI) is a progressive cognitive impairment caused by cerebrovascular disease or vascular risk factors. It is the second most common type of cognitive impairment after Alzheimer's disease. The pathogenesis of VCI is complex, and neurovascular unit destruction is one of its important mechanisms. The neurovascular unit (NVU) is responsible for combining blood flow with brain activity and includes endothelial cells, pericytes, astrocytes and many regulatory nerve terminals. The concept of an NVU emphasizes that interactions between different types of cells are essential for maintaining brain homeostasis. A stable NVU is the basis of normal brain function. Therefore, understanding the structure and function of the neurovascular unit and its role in VCI development is crucial for gaining insights into its pathogenesis. This article reviews the structure and function of the neurovascular unit and its contribution to VCI, providing valuable information for early diagnosis and prevention.
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Affiliation(s)
- Zhidong He
- Department of Neurosurgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130031, Jilin, China
| | - Jing Sun
- Department of Neurology, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130031, Jilin, China..
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9
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Owens CD, Pinto CB, Szarvas Z, Muranyi M, da C. Pinaffi-Langley AC, Peterfi A, Mukli P, Detwiler S, Olay L, Kaposzta Z, Smith K, Kirkpatrick AC, Saleh Velez F, Tarantini S, Csiszar A, Ungvari ZI, Prodan CI, Yabluchanskiy A. COVID-19 Exacerbates Neurovascular Uncoupling and Contributes to Endothelial Dysfunction in Patients with Mild Cognitive Impairment. Biomolecules 2024; 14:1621. [PMID: 39766328 PMCID: PMC11726736 DOI: 10.3390/biom14121621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Revised: 12/04/2024] [Accepted: 12/12/2024] [Indexed: 01/15/2025] Open
Abstract
Mild cognitive impairment (MCI) affects nearly 20% of older adults worldwide, with no targetable interventions for prevention. COVID-19 adversely affects cognition, with >70% of older adults with Long COVID presenting with cognitive complaints. Neurovascular coupling (NVC), an essential mechanism of cognitive function, declines with aging and is further attenuated in neurocognitive disorders. The effect of COVID-19 on NVC responses has yet to be addressed in older adults who are vulnerable to dementia progression. Participants with MCI and a history of COVID-19 (COV+, N = 31) and MCI participants with no history of infection (COV- N = 11) participated in this cross-sectional study to determine if COVID-19 affects cerebrocortical NVC responses and vascular function. Functional near-infrared spectroscopy was used to measure cerebrocortical NVC responses, and endothelial function was assessed via insonation of the brachial artery during a flow-mediated dilation protocol. NVC responses were elicited by the working memory n-back paradigm. NVC in the left dorsolateral prefrontal cortex and endothelial function was decreased in the COV+ group compared to the COV- group. These data provide mechanistic insight into how COVID-19 may exacerbate long-term cognitive sequela seen in older adults, highlighting the urgent need for further research and clinical trials to explore novel therapeutic interventions aimed at preserving/restoring NVC.
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Affiliation(s)
- Cameron D. Owens
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
| | - Camila B. Pinto
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
| | - Zsofia Szarvas
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, 1089 Budapest, Hungary
| | - Mihaly Muranyi
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
| | - Ana Clara da C. Pinaffi-Langley
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA
| | - Anna Peterfi
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, 1089 Budapest, Hungary
| | - Peter Mukli
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, 1089 Budapest, Hungary
- Department of Physiology, Faculty of Medicine, Semmelweis University, 1087 Budapest, Hungary
| | - Sam Detwiler
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
| | - Lauren Olay
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
| | - Zalan Kaposzta
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, 1089 Budapest, Hungary
- Department of Physiology, Faculty of Medicine, Semmelweis University, 1087 Budapest, Hungary
| | - Kenneth Smith
- Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA;
| | - Angelia C. Kirkpatrick
- Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA; (A.C.K.); (C.I.P.)
- Cardiovascular Disease Section, Department of Medicine, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA
| | - Faddi Saleh Velez
- Department of Neurology, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA;
| | - Stefano Tarantini
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, 1089 Budapest, Hungary
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Anna Csiszar
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, 1089 Budapest, Hungary
| | - Zoltan I. Ungvari
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, 1089 Budapest, Hungary
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
| | - Calin I. Prodan
- Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA; (A.C.K.); (C.I.P.)
- Department of Neurology, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA;
| | - Andriy Yabluchanskiy
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences, Oklahoma City, OK 73117, USA; (C.D.O.); (C.B.P.); (Z.S.); (M.M.); (A.C.d.C.P.-L.); (A.P.); (P.M.); (S.D.); (L.O.); (Z.K.); (S.T.); (A.C.); (Z.I.U.)
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Institute of Preventive Medicine and Public Health, Semmelweis University, 1089 Budapest, Hungary
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA
- Peggy and Charles Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
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10
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Berra S, Parolin D, Suffritti C, Folcia A, Zanichelli A, Gusso L, Cogliati C, Riva A, Gidaro A, Caccia S. Patterns of C1-Inhibitor Plasma Levels and Kinin-Kallikrein System Activation in Relation to COVID-19 Severity. Life (Basel) 2024; 14:1525. [PMID: 39768234 PMCID: PMC11679851 DOI: 10.3390/life14121525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 11/16/2024] [Accepted: 11/19/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Although more than four years have passed since the pandemic began, SARS-CoV-2 continues to be of concern. Therefore, research into the underlying mechanisms that contribute to the development of the disease, especially in more severe forms, remains a priority. Sustained activation of the complement (CS), contact (CAS), and fibrinolytic and kinin-kallikrein systems (KKS) has been shown to play a central role in the pathogenesis of the disease. Since the C1 esterase inhibitor (C1-INH) is a potent inhibitor of all these systems, its role in the disease has been investigated, but some issues remained unresolved. METHODS We evaluated the impact of C1-INH and KKS on disease progression in a cohort of 45 COVID-19 patients divided into groups according to disease severity. We measured plasma levels of total and functional C1-INH and its complexes with kallikrein (PKa), reflecting KKS activation and kallikrein spontaneous activity. RESULTS We observed increased total and functional plasma concentrations of C1-INH in COVID-19 patients. A direct correlation (positive Spearman's r) was observed between C1-INH levels, especially functional C1-INH, and the severity of the disease. Moreover, a significant reduction in the ratio of functional over total C1-INH was evident in patients exhibiting mild to intermediate clinical severity but not in critically ill patients. Accordingly, activation of the KKS, assessed as an increase in PKa:C1-INH complexes, was explicitly observed in the mild categories. CONCLUSIONS Our study's findings on the consumption of C1-INH and the activation of the KKS in the less severe stages of COVID-19 but not in the critical stage suggest a potential role for C1-INH in containing disease severity. These results underscore the importance of C1-INH in the early phases of the disease and its potential implications in COVID-19 progression and/or long-term effects.
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Affiliation(s)
- Silvia Berra
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (S.B.); (D.P.); (C.S.); (A.F.); (L.G.); (C.C.); (A.R.)
- Department of Internal Medicine, Ospedale Fatebenefratelli, 20121 Milan, Italy
| | - Debora Parolin
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (S.B.); (D.P.); (C.S.); (A.F.); (L.G.); (C.C.); (A.R.)
| | - Chiara Suffritti
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (S.B.); (D.P.); (C.S.); (A.F.); (L.G.); (C.C.); (A.R.)
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, 20122 Milan, Italy
| | - Andrea Folcia
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (S.B.); (D.P.); (C.S.); (A.F.); (L.G.); (C.C.); (A.R.)
- Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Andrea Zanichelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy;
- Operative Unit of Medicine, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milan, Italy
| | - Luca Gusso
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (S.B.); (D.P.); (C.S.); (A.F.); (L.G.); (C.C.); (A.R.)
- Internal Medicine Unit, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Chiara Cogliati
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (S.B.); (D.P.); (C.S.); (A.F.); (L.G.); (C.C.); (A.R.)
- Department of Internal Medicine, Ospedale Luigi Sacco, 20157 Milan, Italy
| | - Agostino Riva
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (S.B.); (D.P.); (C.S.); (A.F.); (L.G.); (C.C.); (A.R.)
- Department of Infectious Diseases, Ospedale Luigi Sacco, 20157 Milan, Italy
| | - Antonio Gidaro
- Department of Internal Medicine, Ospedale Luigi Sacco, 20157 Milan, Italy
| | - Sonia Caccia
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20157 Milan, Italy; (S.B.); (D.P.); (C.S.); (A.F.); (L.G.); (C.C.); (A.R.)
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11
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Kempuraj D, Dourvetakis KD, Cohen J, Valladares DS, Joshi RS, Kothuru SP, Anderson T, Chinnappan B, Cheema AK, Klimas NG, Theoharides TC. Neurovascular unit, neuroinflammation and neurodegeneration markers in brain disorders. Front Cell Neurosci 2024; 18:1491952. [PMID: 39526043 PMCID: PMC11544127 DOI: 10.3389/fncel.2024.1491952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Accepted: 10/07/2024] [Indexed: 11/16/2024] Open
Abstract
Neurovascular unit (NVU) inflammation via activation of glial cells and neuronal damage plays a critical role in neurodegenerative diseases. Though the exact mechanism of disease pathogenesis is not understood, certain biomarkers provide valuable insight into the disease pathogenesis, severity, progression and therapeutic efficacy. These markers can be used to assess pathophysiological status of brain cells including neurons, astrocytes, microglia, oligodendrocytes, specialized microvascular endothelial cells, pericytes, NVU, and blood-brain barrier (BBB) disruption. Damage or derangements in tight junction (TJ), adherens junction (AdJ), and gap junction (GJ) components of the BBB lead to increased permeability and neuroinflammation in various brain disorders including neurodegenerative disorders. Thus, neuroinflammatory markers can be evaluated in blood, cerebrospinal fluid (CSF), or brain tissues to determine neurological disease severity, progression, and therapeutic responsiveness. Chronic inflammation is common in age-related neurodegenerative disorders including Alzheimer's disease (AD), Parkinson's disease (PD), and dementia. Neurotrauma/traumatic brain injury (TBI) also leads to acute and chronic neuroinflammatory responses. The expression of some markers may also be altered many years or even decades before the onset of neurodegenerative disorders. In this review, we discuss markers of neuroinflammation, and neurodegeneration associated with acute and chronic brain disorders, especially those associated with neurovascular pathologies. These biomarkers can be evaluated in CSF, or brain tissues. Neurofilament light (NfL), ubiquitin C-terminal hydrolase-L1 (UCHL1), glial fibrillary acidic protein (GFAP), Ionized calcium-binding adaptor molecule 1 (Iba-1), transmembrane protein 119 (TMEM119), aquaporin, endothelin-1, and platelet-derived growth factor receptor beta (PDGFRβ) are some important neuroinflammatory markers. Recent BBB-on-a-chip modeling offers promising potential for providing an in-depth understanding of brain disorders and neurotherapeutics. Integration of these markers in clinical practice could potentially enhance early diagnosis, monitor disease progression, and improve therapeutic outcomes.
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Affiliation(s)
- Duraisamy Kempuraj
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Kirk D. Dourvetakis
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Jessica Cohen
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Daniel Seth Valladares
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Rhitik Samir Joshi
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Sai Puneeth Kothuru
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
- College of Psychology, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Tristin Anderson
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Baskaran Chinnappan
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Amanpreet K. Cheema
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
| | - Nancy G. Klimas
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
- Miami VA Geriatric Research Education and Clinical Center (GRECC), Miami Veterans Affairs Healthcare System, Miami, FL, United States
| | - Theoharis C. Theoharides
- Dr. Kiran C. Patel College of Osteopathic Medicine, Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, United States
- Department of Immunology, Tufts, University School of Medicine, Boston, MA, United States
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