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Li B, Gu Z, Wang W, Du B, Wu C, Li B, Wang T, Yin G, Gao X, Chen J, Bi X, Zhang H, Sun X. The associations between peripheral inflammatory and lipid parameters, white matter hyperintensity, and cognitive function in patients with non-disabling ischemic cerebrovascular events. BMC Neurol 2024; 24:86. [PMID: 38438839 PMCID: PMC10910845 DOI: 10.1186/s12883-024-03591-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The global prevalence of VCI has increased steadily in recent years, but diagnostic biomarkers for VCI in patients with non-disabling ischemic cerebrovascular incidents (NICE) remain indefinite. The primary objective of this research was to investigate the relationship between peripheral serological markers, white matter damage, and cognitive function in individuals with NICE. METHODS We collected clinical data, demographic information, and medical history from 257 patients with NICE. Using the MoCA upon admission, patients were categorized into either normal cognitive function (NCF) or VCI groups. Furthermore, they were classified as having mild white matter hyperintensity (mWMH) or severe WMH based on Fazekas scores. We then compared the levels of serological markers between the cognitive function groups and the WMH groups. RESULTS Among 257 patients with NICE, 165 were male and 92 were female. Lymphocyte count (OR = 0.448, P < 0.001) and LDL-C/HDL-C (OR = 0.725, P = 0.028) were protective factors for cognitive function in patients with NICE. The sWMH group had a higher age and inflammation markers but a lower MoCA score, and lymphocyte count than the mWMH group. In the mWMH group, lymphocyte count (AUC = 0.765, P < 0.001) and LDL-C/HDL-C (AUC = 0.740, P < 0.001) had an acceptable diagnostic value for the diagnosis of VCI. In the sWMH group, no significant differences were found in serological markers between the NCF and VCI groups. CONCLUSION Lymphocyte count, LDL-C/HDL-C were independent protective factors for cognitive function in patients with NICE; they can be used as potential biological markers to distinguish VCI in patients with NICE and are applicable to subgroups of patients with mWMH.
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Affiliation(s)
- Binghan Li
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Zhengsheng Gu
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Weisen Wang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Bingying Du
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Chenghao Wu
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Bin Li
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Tianren Wang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Ge Yin
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xin Gao
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Jingjing Chen
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Xiaoying Bi
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Hailing Zhang
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China.
| | - Xu Sun
- Department of Neurology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai, China.
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Gao X, Chen J, Yin G, Liu Y, Gu Z, Sun R, Sun X, Jiao X, Wang L, Wang N, Zhang Y, Kan Y, Bi X, Du B. Hyperforin ameliorates neuroinflammation and white matter lesions by regulating microglial VEGFR 2 /SRC pathway in vascular cognitive impairment mice. CNS Neurosci Ther 2024; 30:e14666. [PMID: 38468126 PMCID: PMC10927933 DOI: 10.1111/cns.14666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/03/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024] Open
Abstract
AIM To explore the neuroprotective potential of hyperforin and elucidate its underlying molecular mechanisms involved in its therapeutic effects against vascular cognitive impairment (VCI). METHODS The active compounds and possible targets of Hypericum perforatum L. that may be effective against VCI were found by network pharmacology in this research. We utilized bilateral common carotid artery occlusion (BCCAO) surgery to induce a VCI mouse model. Morris water maze (MWM) and Y-maze tests were used to assess VCI mice's cognitive abilities following treatment with hyperforin. To evaluate white matter lesions (WMLs), we utilized Luxol fast blue (LFB) stain and immunofluorescence (IF). Neuroinflammation was assessed using IF, western blot (WB), and enzyme-linked immunosorbent assay (ELISA). The effects of hyperforin on microglia were investigated by subjecting the BV2 microglial cell line to oxygen-glucose deprivation/reperfusion (OGD/R) stimulation. The expressions of VEGFR2 , p-SRC, SRC, VEGFA, and inflammatory markers including IL-10, IL-1β, TNF-α, and IL-6 were subsequently assessed. RESULTS The VEGFR2 /SRC signaling pathway is essential for mediating the protective properties of hyperforin against VCI according to network pharmacology analysis. In vivo findings demonstrated that hyperforin effectively improved BCCAO-induced cognitive impairment. Furthermore, staining results showed that hyperforin attenuated WMLs and reduced microglial activation in VCI mice. The hyperforin treatment group's ELISA results revealed a substantial decrease in IL-1β, IL-6, and TNF-α levels. According to the results of in vitro experiments, hyperforin decreased the release of pro-inflammatory mediators (TNF-α, IL-6, and IL-1β) and blocked microglial M1-polarization by modulating the VEGFR2 /SRC signaling pathway. CONCLUSION Hyperforin effectively modulated microglial M1 polarization and neuroinflammation by inhibiting the VEGFR2 /SRC signaling pathways, thereby ameliorating WMLs and cognitive impairment in VCI mice.
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Affiliation(s)
- Xin Gao
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Jingjing Chen
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Ge Yin
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Yanqun Liu
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Zhengsheng Gu
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Rui Sun
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Xu Sun
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Xuehao Jiao
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Ling Wang
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Nuo Wang
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine and DentistryUniversity of AlbertaEdmontonAlbertaCanada
| | - Yuting Kan
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Xiaoying Bi
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
| | - Bingying Du
- Department of Neurology, Shanghai Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghaiChina
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Zahr N, Pfefferbaum A. Serum albumin and white matter hyperintensities. Res Sq 2024:rs.3.rs-3822513. [PMID: 38260299 PMCID: PMC10802700 DOI: 10.21203/rs.3.rs-3822513/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Urine albumin, high in kidney disease, predicts cardiovascular incidents and CNS white matter hyperintensity (WMH) burdens. Serum albumin - a more general biomarker which can be low in several disorders - including kidney and liver disease, malnutrition, and inflammation - also predicts cardiovascular events and is associated with cognitive impairment in several clinical populations; relations between serum albumin and WMH prevalence, however, have rarely been evaluated. In a sample of 160 individuals with alcohol use disorder (AUD), 142 infected with HIV, and 102 healthy controls, the hypothesis was tested that lower serum albumin levels would predict larger WMH volumes and worse cognitive performance irrespective of diagnosis. After considering traditional cardiovascular risk factors (e.g., age, sex, body mass index (BMI), nicotine use, hypertension, diabetes) and study-relevant variables (i.e., primary diagnoses, race, socioeconomic status, hepatitis C virus status), serum albumin survived false discovery rate (FDR)-correction in contributing variance to larger periventricular but not deep WMH volumes. This relationship was salient in the AUD and HIV groups, but not the control group. In secondary analyses, serum albumin and periventricular WMH along with age, sex, diagnoses, BMI, and hypertension were considered for hierarchical contribution to variance in performance in 4 cognitive domains. Albumin survived FDR-correction for significantly contributing to visual and verbal learning and memory performance after accounting for diagnosis. Relations between albumin and markers of liver integrity [e.g., aspartate transaminase (AST)] and blood status (e.g., hemoglobin, red blood cell count, red cell distribution width) suggest that in this sample, albumin reflects both liver dysfunction and hematological abnormalities. The current results suggest that albumin, a simple serum biomarker available in most clinical settings, can predict variance in periventricular WMH volumes and performance in visual and verbal learning and memory cognitive domains. Whether serum albumin contributes mechanistically to periventricular WMH prevalence will require additional investigation.
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Gu Z, Sun X, Wu C, Li B, Chen J, Wang W, Gao X, Tan Y, Li B, Yin G, Xu Y, Song C, Du B, Bi X. Lower 25-hydroxyvitamin D is associated with severer white matter hyperintensity and cognitive function in patients with non-disabling ischemic cerebrovascular events. J Stroke Cerebrovasc Dis 2023; 32:107311. [PMID: 37659193 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/04/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the potential correlations among serum 25-hydroxyvitamin D [25(OH)D] levels, white matter hyperintensity (WMH) and cognitive function in patients with non-disabling ischemic cerebrovascular events (NICE). METHODS This was a prospective investigation of 160 NICE patients with age of 40 years or older. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). White matter lesions were evaluated by WMH using Fazekas scores. Spearman correlation analysis and linear regression models were used to identify the associations between serum 25(OH)D levels and cognitive function. Binary logistic regression analysis models were used to evaluate the predictable value of serum 25(OH)D levels and WMH for cognitive impairment. RESULTS Patients with inadequate 25(OH)D levels had lower MoCA score (P=0.008), and a higher proportion of severe WMH (P=0.043). Spearman correlation analysis demonstrated that serum 25(OH)D concentrations were positively associated with MoCA score (rs=0.185, P=0.019) while negatively related to the proportion of severe WMH (sWMH) (rs=-0.166, P=0.036).The association between 25(OH)D concentrations and MoCA score remained significant in linear regression (adjusted β=0.012, 95%CI:0.001-0.203).Adjusted binary logistic regression analysis showed that the odds ratio of cognitive impairment with insufficient 25(OH)D concentration was 5.038 (95%CI:1.154-21.988) compared with the sufficient group and the sWMH (OR=2.728, 95%CI:1.230-6.051) was identified as an independent risk factor for cognitive decline in NICE patients. CONCLUSION Serum 25(OH)D levels and white matter lesions were independently and significantly associated with cognitive impairment in NICE patients.
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Affiliation(s)
- Zhengsheng Gu
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xu Sun
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Chenghao Wu
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Binghan Li
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Jingjing Chen
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Weisen Wang
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xin Gao
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yuhao Tan
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Bin Li
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Ge Yin
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yawen Xu
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Chenrui Song
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Bingying Du
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China.
| | - Xiaoying Bi
- Department of Neurology, Changhai Hospital, the First Affiliated Hospital of Naval Medical University, Shanghai, China.
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