Multiple system atrophy: Clinical, evolutive and histopathological characteristics of a series of cases / Atrofia multisistémica: características clínicas, anatomopatológicas y evolución de una serie de casos

Background and objective: Multiple system atrophy is a rare and fatal neurodegenerative disorder, characterized by autonomic dysfunction in association with either parkinsonism or cerebellar signs. The pathologic hallmark is the presence of alpha-synuclein aggregates in oligodendrocytes, forming glial cytoplasmic inclusions. Clinically, it may be difficult to distinguish form other parkinsonisms or ataxias, particularly in the early stages of the disease. In this case series we aim to describe in detail the features of MSA patients. Material and methods: Unified MSA Rating Scale (UMSARS) score, structural and functional imaging and cardiovascular autonomic testing, are summarized since early stages of the disease. Results: UMSARS proved to be useful to perform a follow-up being longitudinal examination essential to stratify risk of poor outcome. Neuropathological diagnosis showed an overlap between parkinsonian and cerebellar subtypes, with some peculiarities that could help to distinguish from other subtypes. Conclusion: A better description of MSA features with standardized test confirmed by means of neuropathological studies could help to increase sensitivity.(AU)

Antecedentes y objetivo: La atrofia multisistémica es un trastorno neurodegenerativo raro y letal que se caracteriza por una disfunción autonómica en asociación con parkinsonismo o signos cerebelosos. La marca anatomopatológica es la presencia de agregados de α-sinucleína en los oligodendrocitos, que forman inclusiones citoplasmáticas gliales. Desde un punto de vista clínico, puede ser difícil de distinguir de otros parkinsonismos o ataxias, particularmente en las primeras etapas de la enfermedad. En esta serie de casos, nuestro objetivo es describir en detalle las características de los pacientes con atrofia multisistémica. Material y métodos: Se resumen los datos objetidos de la puntuación de la Escala de calificación unificada de la atrofia multisistémica (UMSARS), imágenes estructurales y funcionales y las pruebas autonómicas cardiovasculares realizadas desde las primeras etapas de la enfermedad. Resultados: La escala UMSAR demostró ser útil para hacer un seguimiento: el examen longitudinal esencial fue para estratificar el riesgo de peor evolución. El diagnóstico neuropatológico mostró un solapamiento entre los subtipos parkinsoniano y cerebeloso, con algunas peculiaridades que podrían ayudar a distinguir los subtipos. Conclusión: Una mejor descripción de las características de la atrofia multisistémica en casos confirmados mediante neuropatología podría ayudar a aumentar la sensibilidad del diagnóstico.(AU)

Multiple system atrophy: Clinical, evolutive and histopathological characteristics of a series of cases.

BACKGROUND AND OBJECTIVE: Multiple system atrophy is a rare and fatal neurodegenerative disorder, characterized by autonomic dysfunction in association with either parkinsonism or cerebellar signs. The pathologic hallmark is the presence of alpha-synuclein aggregates in oligodendrocytes, forming glial cytoplasmic inclusions. Clinically, it may be difficult to distinguish form other parkinsonisms or ataxias, particularly in the early stages of the disease. In this case series we aim to describe in detail the features of MSA patients. MATERIAL AND METHODS: Unified MSA Rating Scale (UMSARS) score, structural and functional imaging and cardiovascular autonomic testing, are summarized since early stages of the disease. RESULTS: UMSARS proved to be useful to perform a follow-up being longitudinal examination essential to stratify risk of poor outcome. Neuropathological diagnosis showed an overlap between parkinsonian and cerebellar subtypes, with some peculiarities that could help to distinguish from other subtypes. CONCLUSION: A better description of MSA features with standardized test confirmed by means of neuropathological studies could help to increase sensitivity.

Estresse juvenil de curta frequência e intensidade não afeta a substância branca cerebral de ratos / Juvenile stress of short frequency and intensity does not affect rats´ brain white matter

O objetivo deste estudo foi avaliar os efeitos duradouros de dois tipos de estresse sobre o corpo caloso (CC). Foram estudados 42 ratos Wistar machos divididos aleatoriamente em três grupos: Grupo Controle (GC), Estresse Físico (EF, imobilização) e Estresse Psicológico (EP, exposição ao predador). Os procedimentos de estresse ocorreram durante três dias consecutivos na idade juvenil (P25-P27) e foram analisados na idade adulta (P74). Os cérebros foram coletados, processados com a técnica de Klüver-Barrera, e secções foram analisadas por meio de morfometria. Os resultados demonstraram que não houve alterações em aspectos gerais como peso dos animais, e histológicos como espessura do CC e quantidade dos núcleos gliais nesta região. O estudo sugere que os efeitos duradouros de ambos os modelos de estresse juvenil de curta frequência (3 dias) e intensidade (90 minutos/EF e 20 minutos/EP) não foram nem prejudiciais e nem protetores, o que pode ser considerado uma adaptação positiva.

The current study evaluates the lasting effects of two types of stress on the corpus callosum (CC). Forty-two male Wistar rats were randomly divided into three groups: Control Group (CG), Physical Stress (FS, immobilization) and Psychological Stress (PS, exposure to predators). Stress procedures occurred for three consecutive days at the juvenile stage (P25-P27) and analyzed at the adult age (P74); brains were retrieved and processed by Klüver-Barrera technique and sections were analyzed by morphometry. Results showed that there were no changes in the general aspects such as animal weight, and in the histological aspects such as CC thickness and quantity of the region´s glia nuclei. Current research suggests that the lasting effects of both models of juvenile stress of short frequency (3 days) and intensity (90 minutes/FS and 20 minutes/PS) were neither detrimental nor protective, featuring a positive adaptation.

Multiple system atrophy: Clinical, evolutive and histopathological characteristics of a series of cases.

BACKGROUND AND OBJECTIVE: Multiple system atrophy is a rare and fatal neurodegenerative disorder, characterized by autonomic dysfunction in association with either parkinsonism or cerebellar signs. The pathologic hallmark is the presence of alpha-synuclein aggregates in oligodendrocytes, forming glial cytoplasmic inclusions. Clinically, it may be difficult to distinguish form other parkinsonisms or ataxias, particularly in the early stages of the disease. In this case series we aim to describe in detail the features of MSA patients. MATERIAL AND METHODS: Unified MSA Rating Scale (UMSARS) score, structural and functional imaging and cardiovascular autonomic testing, are summarized since early stages of the disease. RESULTS: UMSARS proved to be useful to perform a follow-up being longitudinal examination essential to stratify risk of poor outcome. Neuropathological diagnosis showed an overlap between parkinsonian and cerebellar subtypes, with some peculiarities that could help to distinguish from other subtypes. CONCLUSION: A better description of MSA features with standardized test confirmed by means of neuropathological studies could help to increase sensitivity.

Development and optimisation of an animal model for the study of ganglion cells in degenerative diseases of the retina and optic nerve. / Desarrollo y optimización de un modelo animal para el estudio de las células ganglionares en enfermedad degenerativa de la retina y nervio óptico.

INTRODUCTION: Multiple sclerosis is an autoimmune, chronic and inflammatory disease of the central nervous system with axonal demyelination, gliosis and neurodegeneration. It is considered a frequent cause of neurological disability in young adults. In this work, an Experimental Autoimmune Encephalomyelitis (EAE) model was optimised by injecting a myelin oligodendrocyte glycoprotein (MOG35-55). The ophthalmological effects were studied, as well as its use as an experimental model in other studies of retinal ganglion cell degeneration (RGC) and optic nerve (ON). MATERIAL AND METHODS: The study included 16 mice of 10 weeks that were placed into 2 study groups: a control group of 10 animals and another group of 6 animals with EAE that were injected with MOG35-55. The animals of the EAE model were monitored using motor disability scales. The retinas and optic nerves were processed for morphological examination by optical microscopy and ultrastructure studies. RESULTS: The animal models presented with motor symptoms of spinal cord injury, with the first symptoms appearing between the 7th and 19th day post-injection, with a maximum disability mean of 3.5 points. In the retina, the mean RGC in the EAE group was 0.0891µm, compared with 0.1678µm of the control group (p=.0003). The ON was strongly affected with reactive gliosis, increased axonal damage and decreased density axonal (control group 0.38038 axons/µm2 versus EAE group 0.16 axons/µm2, p=.00032). CONCLUSIONS: In this work an animal model of EAE has been characterised and detailed for the study of demyelinating alterations in the retina and the ON. Its characteristics make it an excellent tool for the study of neurodegenerative ophthalmic diseases.

Estabelecimento de metodologia de diferenciação de células tronco embrionárias de camundongo em células precursoras de oligodendrócitos: uma plataforma para triagem de novas drogas remielinizantes / Establishment of a mouse embryonic stem cell line differentiation methodology into oligodendrocyte precursor cells: a platform for remyelinating drug screening.

The myelin sheath plays a crucial role in nerve function. In the Central Nervous System, the myelin sheath is produced by oligodendrocytes (OL), which are differentiated from oligodendrocyte precursor cells (OPC). Several neurological disorders, including multiple sclerosis, display damage in the myelin sheath and failure in the remyelination. Therefore, researching for new compounds that act in the OPCs differentiation to OLs is a promising strategy to treat demyelinating diseases. In this study, we established a methodology that allows the generation of OPCs in large quantities from two lineages of mouse embryonic stem cells (mESCs; lineages HM-1 and USP-1). Initially, mESCs were induced to differentiate into neural precursors and, later, to OPCs by adding growth factors such as FGF, EGF and PDGF. The characteristic and predominant expression of Olig2, Sox-10, PDGFRα and NG2 observed by immunofluorescence, and the double labeling of PDGFRα and NG2 by flow cytometry, confirmed the OPCs generation from mESCs. Therefore, this study shows an efficient and reproducible methodology for generating OPCs capable of being used in screening assays or in OLs lineage biology studies.

A bainha de mielina desempenha um papel crucial nas funções nervosas. No sistema nervoso central, a bainha de mielina é produzida por oligodendrócitos (OLs), os quais são diferenciados a partir de células precursoras de oligodendrócitos (OPCs). Em várias desordens neurológicas, entre elas, a Esclerose Múltipla, a bainha de mielina é danificada e a remielinização deixa de acontecer. Desse modo, a busca por novos compostos que atuem na diferenciação de OPCs a OLs, é um caminho promissor na terapia de doenças desmielinizantes. Neste estudo, estabelecemos uma metodologia que permitiu gerar OPCs a partir de duas linhagens de células tronco embrionárias de camundongos (mESCs – linhagens USP-1 e HM-1). Inicialmente, as mESCs foram induzidas a diferenciar em precursores neurais e, posteriormente, a OPCs, pela adição de fatores de crescimento como FGFb, EGF e PDGF-AA. A expressão característica e predominante de Olig2, Sox10, PDGFRα e NG2 observada por imunofluorescência e a dupla marcação de PDGFRα e NG2 por citometria de fluxo (com rendimentos de 88,3-87,3%) confirmaram a obtenção de OPCs a partir de mESCs. Estas células podem ser expandidas por 5 passagens adicionais e ainda serem capazes de gerar bilhões de OPC puros. Portanto, o estudo apresenta uma metodologia eficiente e reprodutível que permite a geração de um modelo a ser empregado em triagem de novas drogas ou no estudo da biologia da linhagem de OLs.

Biochemical events related to glial response in spinal cord injury / Eventos bioquímicos de respuesta glial en la fisiopatología de la lesión de médula espinal

Abstract Introduction: Spinal cord injury (SCI) is a devastating event with physical, psychological and socioeconomic implications. Morphophysiological changes are observed in the tissue close to the injury, which allow determining the functional recovery of the medullary segment and the effector organs that depend on the injured axonal tracts. Objective: To describe the most relevant sequential biochemical events of glial cells response after SCI. Materials and methods: A search of scientific publications released in the past 18 years was carried out in PubMed and Science Direct databases, with the terms spinal cord injury (SCI), SCI pathophysiology, SCI inflammation, microglia in SCI, glial scar and chondroitin sulfate proteoglycans (CSPG). Results: The pathophysiological processes resulting from SCI are determinant for the neurological recovery of patients. Activation of glial cells plays an important role in promoting bioactive molecules and the formation of physical barriers that inhibit neural regeneration. Conclusion: Knowledge of neurobiological changes after SCI allows a greater understanding of the pathophysiology and favors the search for new therapeutic alternatives that limit the progression of the primary injury and minimize secondary damage, responsible for neurological dysfunction.

Resumen Introducción. La lesión de la médula espinal (LME) es un evento devastador con implicaciones físicas, psicológicas y socioeconómicas. En el tejido cercano a la lesión se instauran cambios morfofisiológicos que determinan la recuperación funcional del segmento medular y de los órganos efectores dependientes de los tractos axonales lesionados. Objetivo. Describir los eventos bioquímicos secuenciales más relevantes de la respuesta de las células gliales posterior a la LME. Materiales y métodos. Se realizó una búsqueda de publicaciones científicas de los últimos 18 años en las bases de datos PubMed y ScienceDirect, bajo los términos en inglés spinal cord injury (SCI), SCI pathophysiology, SCI inflammation, microglia in SCI, glial scar y chondroitin sulfate proteoglycans (CSPG). Resultados. Los procesos fisiopatológicos que se producen después de la LME determinan la recuperación neurológica de los pacientes. La activación de las células gliales juega un papel importante, ya que promueve la producción de moléculas bioactivas y la formación de barreras físicas que inhiben la regeneración neural. Conclusión. El conocimiento de los cambios neurobiológicos ocurridos tras la LME permite una mayor comprensión de la fisiopatología y favorece la búsqueda de nuevas alternativas terapéuticas que limiten la progresión de la lesión primaria y que minimicen el daño secundario responsable de la disfunción neurológica.

Vitamin D and remyelination in multiple sclerosis. / Vitamina D y remielinización en la esclerosis múltiple.

INTRODUCTION: Several studies have found an association between multiple sclerosis and vitamin D (VD) deficiency, which suggests that VD may play a role in the immune response. However, few studies have addressed its role in remyelination. DEVELOPMENT: The VD receptor and the enzymes transforming VD into metabolites which activate the VD receptor are expressed in central nervous system (CNS) cells, which suggests a potential effect of VD on the CNS. Both in vitro and animal model studies have shown that VD may play a role in myelination by acting on factors that influence the microenvironment which promotes both proliferation and differentiation of neural stem cells into oligodendrocyte progenitor cells and oligodendrocytes. It remains unknown whether the mechanisms of internalisation of VD in the CNS are synergistic with or antagonistic to the mechanisms that facilitate the entry of VD metabolites into immune cells. CONCLUSIONS: VD seems to play a role in the CNS and our hypothesis is that VD is involved in remyelination. Understanding the basic mechanisms of VD in myelination is necessary to manage multiple sclerosis patients with VD deficiency.

Inibição do receptor de glutamato do tipo NMDA em um modelo de hipóxia-isquemia prenatal: avaliação morfofuncional do cerebelo / Inhibition of glutamate NMDA receptor in a prenatal hipoxia-ischemia model: morphofunctional analises of cerebellum

Lesões sistêmicas peri e pré-natais alteram o desenvolvimento do SNC, levando a problemas cognitivos e motores em crianças que podem perdurar por toda a vida. Um tipo particular de lesão é a hipóxia-isquemia (HI), caracterizada pela interrupção momentânea ou permanente do fluxo sanguíneo. Um dos mecanismos propostos para as lesões decorrentes da HI é a excitotoxicidade glutamatérgica. O uso de inibidores da neurotransmissão glutamatérgica tem sido estudados em diversos modelos de HI. Neste trabalho, avaliamos os efeitos morfofuncionais da administração de um antagonista não-competitivo do receptor de glutamato NMDA sobre o desenvolvimento do cerebelo. Ratas no 18º dia de gestação foram anestesiadas, os cornos uterinos expostos e as 4 artérias uterinas obstruídas por 45 minutos (Grupo H). Animais controle tiveram os úteros expostos, sem a obstrução (Grupo S). Após a cirurgia a gestação prosseguiu. Somente animais nascidos a termo foram utilizados. Um dia após o nascimento, metade de cada ninhada foi designada para receber MK801, 0,3mg/kg/dia, (grupos SM e HM) e a outra metade recebeu solução salina (grupos SS e HS), por 5 dias. Após anestesia e perfusão-fixação com paraformaldeído 4% aos 9, 23, 30 e 60 dias pós-natais, cortes parassagitais do cerebelo foram obtidos em criótomo e submetidos à imunohistoquímica para calbindina, GFAP, GLAST, PDGFRα e MBP. A partir de 45 dias de vida, os animais foram testados em vários de testes comportamentais: labirinto em cruz elevado (LCE), campo vazado (CV), ROTAROD, teste de caminhada sobre barras (ladder test) e teste do comprimento da passada (stride length). Aos 9 dias, a espessura da árvore dendrítica era menor nos animais SM, HS/HM, demonstrando efeitos deletérios tanto do MK801 quanto da HI. Menor número de células PDGFRα+ foi observado nos animais HS/HM, sem efeitos da administração de MK801. Aos 23 dias, maior número de células PDGFRα+ foi observado nos animais HM comparado aos outros 3 grupos, indicando efeito ...

Peri and prenatal systemic lesions alter CNS development leading to motor and cognitive problems in children that might persist throughout life. A particular kind of injury, the hypoxic ischemic (HI), is characterized by a permanent or temporary blockage of blood flow. One of the proposed mechanisms downstream from a HI event is called glutamatergic excitotoxicity. The administration of glutamate inhibitors has been studied in HI models for several years. In this work, we evaluated the effects of administration of a non-competitive antagonist of glutamate receptor, NMDA, on cerebellar development and behavioral tests of HI animals. Pregnant rats in the 18th gestational day were anesthetized, the uterine horns were exposed and the four uterine arteries were clamped for 45 minutes (group H). Sham controls had the uterine horns exposed, but no arteries were clamped (group S). Gestation proceeded after surgery. Only full term animals were used. One day after birth half the animals was assigned to receive either SALINE (groups SS and HS) or MK801 (groups SM and HM). Animals were anesthetized and perfused with 4% paraformaldehyde at 9, 23, 30 and 60 days of age. Parasagittal cerebellar sections were submitted to Calbindin, GFAP, GLAST, PDGFRα and MBP immunohistochemistry. Beginning at P45 animals were subjected to a battery of behavioral tests: elevated plus maze (EPM), hole board (HB), ROTAROD, ladder test and stride length. At P9 the dendritic tree of Purkinje cells were thinner in SM, HS/HM animals, indicating that both HI and MK801 are deleterious regarding this Purkinje cell differentiation. A lower number of PDGFRα+ cells was observed in HS/HM animals, with no effects of MK801 administration. At P23 a greater number of PDGFRα+ cells was found in HM animals when compared to the other 3 groups, demonstrating a neuroprotector effect of MK801. A lower number of myelinated fibers (MBP+) was observed in HS animals at P9, and MK801 administration reverse this ...

Análise proteômica da esquizofrenia / Large-scale analyses of schizophrenia proteome

Valioso conhecimento a respeito de esquizofrenia tem sido gerado recentemente para decifrar sua patobiologia e revelar biomarcadores. Entretanto, esforços ainda são necessários, especialmente se levarmos em conta que essa debilitante desordem mental afeta aproximadamente 30 milhões de pessoas ao redor do mundo. Considerando que esquizofrenia é resultado de uma complexa interação entre fatores ambientais, função genética alterada e expressão proteica diferencial sistemática, a proteômica é provavelmente uma ferramenta adequada ao estudo dessa desordem. Aqui sintetizamos os principais achados em estudos proteômicos e posteriores direções a serem tomadas de forma a melhor compreender a bioquímica da esquizofrenia, bem como revelar biomarcadores.

Valuable knowledge about schizophrenia has been recently generated for deciphering its pathobiology and revealing biomarkers. However, efforts are still needed, especially if we take in account that this debilitating mental disorder affects approximately 30 million people worldwide. Considering that schizophrenia is a result of a complex interaction among environmental factors altered gene function and systematic differential protein expression, proteomics is likely to be a suitable tool for studying this disorder. Here we synthetize the main findings by proteomic studies and further directions to be taken in order to better comprehend the biochemistry of schizophrenia as well as reveal biomarkers. In addition, we summarize proteomic methodologies used in such studies

Lesão da substância branca e doenças neurodegenerativas / White matter injury and neurodegenerative diseases

Objetivo: revisar a literatura científica sobre degeneração da substância branca, incluindo lesão do cilindro axonal, da bainha de mielina e oligodendrócitos, enfatizando o papel deste evento patológico na perda tecidual e deficiências funcionais subjacentes às doenças neurodegenerativas agudas e crônicas. Método: revisão de literatura através de pesquisa bibliográfica na base de dados PUBMED/MEDLINE. Considerações Finais: o comprometimento patológico da substância branca é um mecanismo importante dafisiopatologia de doenças neurodegenerativas agudas e crônicas. Pesquisas translacionais nesta área devem ser realizadas para o desenvolvimento de novas abordagens terapêuticas para essas desordens neurais. Um objetivo importante destes estudos deve ser a proteção dos tratos de substância branca do sistema nervoso central humano, os quais podem degenerar durante doenças, incluindo trauma cerebral e medular, acidente vascular encefálico e esclerose múltipla.

Objective: review the literature on the white matter pathology, including axonal damage, myelin impairment and oligodendrocyte degeneration, emphasizing the importance of this pathological event on the underlying functional deficits following neurodegenerative diseases. Method: bibliography search using PUBME/MEDLlNE databases. Final considerations: the pathological impairment of white matter is an important mechanism underlying the pathophysiology of both acute and chronic neurodegenerative disorders. Translational researches should beaccomplished for the development of new therapeutic approaches for human brain disorders. An important aim of these investigations must be the protection of the human white matter tracts, which are damaged following neural disorders, including brain and spinal cord trauma, stroke and multiple sclerosis.