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McCoy HM, Polcyn R, Banik NL, Haque A. Regulation of enolase activation to promote neural protection and regeneration in spinal cord injury. Neural Regen Res 2023; 18:1457-1462. [PMID: 36571342 PMCID: PMC10075133 DOI: 10.4103/1673-5374.361539] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Spinal cord injury (SCI) is a debilitating condition characterized by damage to the spinal cord resulting in loss of function, mobility, and sensation with no U.S. Food and Drug Administration-approved cure. Enolase, a multifunctional glycolytic enzyme upregulated after SCI, promotes pro- and anti-inflammatory events and regulates functional recovery in SCI. Enolase is normally expressed in the cytosol, but the expression is upregulated at the cell surface following cellular injury, promoting glial cell activation and signal transduction pathway activation. SCI-induced microglia activation triggers pro-inflammatory mediators at the injury site, activating other immune cells and metabolic events, i.e., Rho-associated kinase, contributing to the neuroinflammation found in SCI. Enolase surface expression also activates cathepsin X, resulting in cleavage of the C-terminal end of neuron-specific enolase (NSE) and non-neuronal enolase (NNE). Fully functional enolase is necessary as NSE/NNE C-terminal proteins activate many neurotrophic processes, i.e., the plasminogen activation system, phosphatidylinositol-4,5-bisphosphate 3-kinase/protein kinase B, and mitogen-activated protein kinase/extracellular signal-regulated kinase. Studies here suggest an enolase inhibitor, ENOblock, attenuates the activation of Rho-associated kinase, which may decrease glial cell activation and promote functional recovery following SCI. Also, ENOblock inhibits cathepsin X, which may help prevent the cleavage of the neurotrophic C-terminal protein allowing full plasminogen activation and phosphatidylinositol-4,5-bisphosphate 3-kinase/mitogen-activated protein kinase activity. The combined NSE/cathepsin X inhibition may serve as a potential therapeutic strategy for preventing neuroinflammation/degeneration and promoting neural cell regeneration and recovery following SCI. The role of cell membrane-expressed enolase and associated metabolic events should be investigated to determine if the same strategies can be applied to other neurodegenerative diseases. Hence, this review discusses the importance of enolase activation and inhibition as a potential therapeutic target following SCI to promote neuronal survival and regeneration.
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Affiliation(s)
- Hannah M McCoy
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Rachel Polcyn
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Naren L Banik
- Department of Microbiology and Immunology; Department of Neurosurgery, Medical University of South Carolina; Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Azizul Haque
- Department of Microbiology and Immunology; Department of Neurosurgery, Medical University of South Carolina; Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
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Huggins AA, McTeague LM, Davis MM, Bustos N, Crum KI, Polcyn R, Adams ZW, Carpenter LA, Hajcak G, Halliday CA, Joseph JE, Danielson CK. Neighborhood Disadvantage Associated With Blunted Amygdala Reactivity to Predictable and Unpredictable Threat in a Community Sample of Youth. Biol Psychiatry Glob Open Sci 2022; 2:242-252. [PMID: 35928141 PMCID: PMC9348572 DOI: 10.1016/j.bpsgos.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Childhood socioeconomic disadvantage is a form of adversity associated with alterations in critical frontolimbic circuits involved in the pathophysiology of psychiatric disorders. Most work has focused on individual-level socioeconomic position, yet individuals living in deprived communities typically encounter additional environmental stressors that have unique effects on the brain and health outcomes. Notably, chronic and unpredictable stressors experienced in the everyday lives of youth living in disadvantaged neighborhoods may impact neural responsivity to uncertain threat. METHODS A community sample of children (N = 254) ages 8 to 15 years (mean = 12.15) completed a picture anticipation task during a functional magnetic resonance imaging scan, during which neutral and negatively valenced photos were presented in a temporally predictable or unpredictable manner. Area Deprivation Index (ADI) scores were derived from participants' home addresses as an index of relative neighborhood disadvantage. Voxelwise analyses examined interactions of ADI, valence, and predictability on neural response to picture presentation. RESULTS There was a significant ADI × valence interaction in the middle temporal gyrus, anterior cingulate cortex, hippocampus, and amygdala. Higher ADI was associated with less amygdala activation to negatively valenced images. ADI also interacted with predictability. Higher ADI was associated with greater activation of lingual and calcarine gyri for unpredictably presented stimuli. There was no three-way interaction of ADI, valence, and predictability. CONCLUSIONS Neighborhood disadvantage may impact how the brain perceives and responds to potential threats. Future longitudinal work is critical for delineating how such effects may persist across the life span and how health outcomes may be modifiable with community-based interventions and policies.
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Affiliation(s)
- Ashley A. Huggins
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, North Carolina
| | - Lisa M. McTeague
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
| | - Megan M. Davis
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nicholas Bustos
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Kathleen I. Crum
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Rachel Polcyn
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
| | - Zachary W. Adams
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Laura A. Carpenter
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Greg Hajcak
- Department of Biomedical Sciences, Florida State University, Tallahassee, Florida
| | - Colleen A. Halliday
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
| | - Jane E. Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Carla Kmett Danielson
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
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Polcyn R, Capone M, Matzelle D, Hossain A, Chandran R, Banik NL, Haque A. Enolase inhibition alters metabolic hormones and inflammatory factors to promote neuroprotection in spinal cord injury. Neurochem Int 2020; 139:104788. [PMID: 32650031 DOI: 10.1016/j.neuint.2020.104788] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 04/14/2020] [Revised: 06/10/2020] [Accepted: 06/20/2020] [Indexed: 12/17/2022]
Abstract
Enolase inhibition is a potential therapeutic strategy currently being investigated for treatment of spinal cord injury (SCI) as it reduces pro-inflammatory cytokines and chemokines, alters metabolic factors, and reduces gliosis in acute SCI. Herein, the role of enolase in SCI has been examined to better understand the effects of this enzyme on inflammation, metabolic hormones, glial cell activation, and neuroprotection under these shorter injury conditions. Immunohistochemical analyses of inflammatory markers vimentin, Cox-2, and caspase-1 indicated that enolase inhibition attenuated the elevated levels of inflammation seen following SCI. Iba1, GFAP, NFP, and CSPG staining indicated that enolase inhibition with prolonged administration of ENOblock reduced microglia/astrocyte activation and lead to enhanced neuroprotection in SCI. An analysis of metabolic hormones revealed that ENOblock treatment significantly upregulated plasma concentrations of peptide YY, glucagon-like peptide 1, glucose-dependent insulinotropic peptide, glucagon, and insulin hormones as compared to vehicle-treated controls (Mann-Whitney, p ≤ 0.05). ENOblock did not have a significant effect on plasma concentrations of pancreatic polypeptide. Interestingly, ENOblock treatment inhibited chondroitin sulfate proteoglycan (CSPG), which is produced by activated glia and serves to block regrowth of axons across the lesion site following injury. An increased level of NeuN and MBP with reduced caspase-1 was detected in SCI tissues after ENOblock treatment, suggesting preservation of myelin and induction of neuroprotection. ENOblock also induced improved motor function in SCI rats, indicating a role for enolase in modulating inflammatory and metabolic factors in SCI with important implications for clinical consideration.
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Affiliation(s)
- Rachel Polcyn
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA
| | - Mollie Capone
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA; Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas Street Charleston, SC 29425, USA
| | - Denise Matzelle
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas Street Charleston, SC 29425, USA; Ralph H. Johnson Veterans Administration Medical Center, 109 Bee St, Charleston, SC 29401, USA
| | - Azim Hossain
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA
| | - Raghavendar Chandran
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas Street Charleston, SC 29425, USA
| | - Naren L Banik
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA; Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas Street Charleston, SC 29425, USA; Ralph H. Johnson Veterans Administration Medical Center, 109 Bee St, Charleston, SC 29401, USA
| | - Azizul Haque
- Department of Microbiology and Immunology, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC 29425, USA.
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Polcyn R, Capone M, Matzelle D, Lueking B, Walker A, Kau E, Haque A, Banik N. Cytokine/chemokine dysregulation in progressive MS patient is apparent and can be modulated by calpain inhibition. Metab Brain Dis 2020; 35:255-261. [PMID: 31853829 PMCID: PMC9773329 DOI: 10.1007/s11011-019-00521-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/21/2019] [Indexed: 12/24/2022]
Abstract
This study examines the cytokine/chemokine profile of a 62-year-old African American male with progressive multiple sclerosis (MS). MRI images of the MS patient demonstrated generalized white matter involvement with multiple lesions in the periventricular area. A 42-plex Discovery Assay® (Eve Technologies) of the patient's plasma and peripheral blood mononuclear cells (PBMCs) supernatant or PBMC-derived T cell supernatant samples from two separate clinic visits revealed vastly differing cytokine/chemokine levels. In addition, certain cytokine/chemokine profiles had notable differences when compared to the larger patient group or patients' PBMCs treated with a calpain inhibitor in vitro. Interestingly, large numbers of cytokines/chemokines and growth factors in MS PBMCs are modulated by calpain inhibition, suggesting the clinical significance of these findings in designing better therapeutics against progressive MS.
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Affiliation(s)
- Rachel Polcyn
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Mollie Capone
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St, MSC606, Charleston, SC, 29425, USA
| | - Denise Matzelle
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St, MSC606, Charleston, SC, 29425, USA
- Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Brittany Lueking
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Aljoeson Walker
- Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
- Department of ophthalmology, Medical University of South Carolina, Charleston, SC, USA
| | - Elizabeth Kau
- Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Azizul Haque
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
| | - Naren Banik
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St, MSC606, Charleston, SC, 29425, USA.
- Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA.
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Polcyn R, God J, Capone M, Matzelle D, Banik NL, Haque A. A Missing Link between Neuron Specific Enolase Release and Poor Prognosis in Aging Patients with B-cell Lymphoma. ACTA ACUST UNITED AC 2018; 9. [PMID: 30464859 PMCID: PMC6242283 DOI: 10.4172/2155-9899.1000e121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Rachel Polcyn
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA
| | - Jason God
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA
| | - Mollie Capone
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA
| | - Denise Matzelle
- Department of Neurosurgery, Medical University of South Carolina, Charleston, USA.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Naren L Banik
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA.,Department of Neurosurgery, Medical University of South Carolina, Charleston, USA.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Azizul Haque
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA
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Chandran R, Capone M, Matzelle D, Polcyn R, Kau E, Haque A, Banik NL. Distinct Cytokine and Chemokine Expression in Plasma and Calpeptin-Treated PBMCs of a Relapsing-Remitting Multiple Sclerosis Patient: A Case Report. Neurochem Res 2018; 43:2224-2231. [PMID: 30291537 DOI: 10.1007/s11064-018-2655-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 09/26/2018] [Accepted: 10/01/2018] [Indexed: 11/30/2022]
Abstract
The cytokine/chemokine expression signature of a 60-year-old African American male with relapsing-remitting multiple sclerosis (RRMS) was analyzed using patient blood samples obtained from two separate visits to the clinic. Thirty-six different cytokines, chemokines, and growth factors were detected in the plasma of the RRMS patient using a multiplexed bead-based immunoassay. Results indicated that at least ten of these factors with a concentration of > 100 pg/mL are identified as pro-inflammatory. Calpain inhibition led to an anti-inflammatory effect, as indicated by a decrease in expression of pro-inflammatory cytokines/chemokines such as GM-CSF, IFNγ, and IL-17A, and a relative increase in two of the anti-inflammatory cytokines (IL-13 and IL-4) in the peripheral blood mononuclear cells activated with anti-CD3/CD28. Overall, these results suggest that the unique cytokine/chemokine pattern observed in the plasma of the RRMS patient can be used as a prognostic marker and calpain inhibition may be used as a novel therapeutic strategy for treating excessive inflammatory response specific to RRMS patients.
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Affiliation(s)
- Raghavendar Chandran
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St. MSC606 Suite 301, Charleston, SC, 29425, USA
| | - Mollie Capone
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St. MSC606 Suite 301, Charleston, SC, 29425, USA.,Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Denise Matzelle
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St. MSC606 Suite 301, Charleston, SC, 29425, USA.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Rachel Polcyn
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Elizabeth Kau
- Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Azizul Haque
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
| | - Naren L Banik
- Department of Neurosurgery, Medical University of South Carolina, 96 Jonathan Lucas St. MSC606 Suite 301, Charleston, SC, 29425, USA. .,Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA. .,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA.
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Haque A, Polcyn R, Matzelle D, Banik NL. New Insights into the Role of Neuron-Specific Enolase in Neuro-Inflammation, Neurodegeneration, and Neuroprotection. Brain Sci 2018; 8:E33. [PMID: 29463007 PMCID: PMC5836052 DOI: 10.3390/brainsci8020033] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 01/18/2023] Open
Abstract
Neurodegeneration is a complex process that leads to irreversible neuronal damage and death in spinal cord injury (SCI) and various neurodegenerative diseases, which are serious, debilitating conditions. Despite exhaustive research, the cause of neuronal damage in these degenerative disorders is not completely understood. Elevation of cell surface α-enolase activates various inflammatory pathways, including the production of pro-inflammatory cytokines, chemokines, and some growth factors that are detrimental to neuronal cells. While α-enolase is present in all neurological tissues, it can also be converted to neuron specific enolase (NSE). NSE is a glycolytic enzyme found in neuronal and neuroendocrine tissues that may play a dual role in promoting both neuroinflammation and neuroprotection in SCI and other neurodegenerative events. Elevated NSE can promote ECM degradation, inflammatory glial cell proliferation, and actin remodeling, thereby affecting migration of activated macrophages and microglia to the injury site and promoting neuronal cell death. Thus, NSE could be a reliable, quantitative, and specific marker of neuronal injury. Depending on the injury, disease, and microenvironment, NSE may also show neurotrophic function as it controls neuronal survival, differentiation, and neurite regeneration via activation of phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) and mitogen-activated protein kinase (MAPK) signaling pathways. This review discusses possible implications of NSE expression and activity in neuroinflammation, neurodegeneration, and neuroprotection in SCI and various neurodegenerative diseases for prognostic and therapeutic potential.
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Affiliation(s)
- Azizul Haque
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29401, USA.
| | - Rachel Polcyn
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29401, USA.
| | - Denise Matzelle
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29401, USA.
- Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401, USA.
| | - Naren L Banik
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC 29401, USA.
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29401, USA.
- Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401, USA.
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Affiliation(s)
- Rachel Polcyn
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA
| | - Mollie Capone
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA.,Department of Neurosurgery, Medical University of South Carolina, Charleston, USA
| | - Azim Hossain
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA
| | - Denise Matzelle
- Department of Neurosurgery, Medical University of South Carolina, Charleston, USA.,Department of Immunology, Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Naren L Banik
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA.,Department of Neurosurgery, Medical University of South Carolina, Charleston, USA.,Department of Immunology, Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC, USA
| | - Azizul Haque
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, USA
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Polcyn R, Capone M, Hossain A, Matzelle D, Banik NL, Haque A. Neuron specific enolase is a potential target for regulating neuronal cell survival and death: implications in neurodegeneration and regeneration. ACTA ACUST UNITED AC 2017; 4:254-257. [PMID: 29423430 PMCID: PMC5800407 DOI: 10.20517/2347-8659.2017.59] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Rachel Polcyn
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Mollie Capone
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA.,Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Azim Hossain
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Denise Matzelle
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401, USA
| | - Naren L Banik
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA.,Department of Neurosurgery, Medical University of South Carolina, Charleston, SC 29425, USA.,Ralph H. Johnson Veterans Administration Medical Center, Charleston, SC 29401, USA
| | - Azizul Haque
- Department of Microbiology and Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
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