Immunopathogenesis and immunotherapeutic approaches of neurodegenerative and cerebrovascular diseases with cognitive impairment. The current state of the problem and prospects

2021 ◽  
Vol 26 (5) ◽  
pp. 4-15
Author(s):  
A. A. Smirnova ◽  
L. N. Prakhova ◽  
A. G. Ilves
Keyword(s):  
Cerebral Ischemia ◽  
Cognitive Decline ◽  
Cerebrovascular Disorders ◽  
Modern Society ◽  
Cerebrovascular Diseases ◽  
Medical Laboratory ◽  
Chronic Cerebral Ischemia ◽  
Age Related ◽  
Limited Effectiveness ◽  
Molecular Patterns

Cognitive impairments (CI) are a serious problem in modern society, because they significantly reduce patients’ quality of life and tend to progress. Age-related diseases such as neurodegenerative — first of all Alzheimer’s disease (AD) and cerebrovascular disorders are key causes leading to CI. At present, approaches to treating these diseases have limited effectiveness in restoring cognitive functions, and do not change disease course, although they can slow cognitive decline.Understanding the immunopathogenesis of neurodegenerative and cerebrovascular diseases defines new targets and approaches to their treatment. In addition, suppression of neuroinflammation is advisable in the cases of early nonclarified cognitive decline, when information from routine medical, laboratory and instrumental examination of patients is insufficient to identify the causes of CI.This article summarizes current understanding of the immunopathogenesis of AD and chronic cerebral ischemia. The mechanism of neuroinflammation is presented as a cascade of sequential events that are closed in a self-perpetuating inflammatory response in the end. So called damage-associated molecular patterns, specific receptors that can bind them (pattern recognition receptors), intracellular signal transduction in microglia, cytokines and adhesion molecules are considered as potential points of application of immunomodulatory therapy. The review provides information on the current level of development of immunotherapy of AD, chronic cerebral ischemia and offers the prospect of its application.

Potential Protective Effect of Dl-3-n-Butylphthalide on Chronic Cerebral Ischemia Brain Injury

2021 ◽  
Vol 21 ◽  
Author(s):  
Fangfang Zhao ◽  
Yumin Luo
Keyword(s):  
Oxidative Stress ◽  
Cerebral Ischemia ◽  
Brain Dysfunction ◽  
Cerebrovascular Diseases ◽  
Pathophysiological Mechanism ◽  
Chronic Cerebral Ischemia ◽  
Celery Seed ◽  
Prevention And Treatment ◽  
Ischemic Cerebrovascular Diseases ◽  
The Common

: Chronic cerebral ischemia is one of the common ischemic cerebrovascular diseases. Chronic cerebral ischemia can lead to brain dysfunction, and its pathophysiological mechanism involves inflammation, blood-brain barrier destruction, oxidative stress, and other factors. Due to it being difficult to detect, it is easily overlooked, and it is often only observed following onset of cognitive dysfunction. At present, there are few drugs for this treatment. DL-3-N-BUTYLPHTHALIDE (NBP), a compound extracted from celery seed, may play an important role in protecting against brain damage caused by chronic cerebral ischemia. Therefore, we pay more attention to the prevention and treatment of NBP on chronic cerebral ischemia.

scholarly journals Cerebral small vessel disease’s impact on the development of chronic cerebral ischemia: paradigms of treatment

2020 ◽  
pp. 16-24 ◽  
Author(s):  
E. Yu. Soloveva ◽  
I. P. Amelina
Keyword(s):  
Cerebral Ischemia ◽  
Small Vessel Disease ◽  
Cerebrovascular Disorders ◽  
Phospholipid Composition ◽  
Clinical Manifestations ◽  
Pharmacological Therapy ◽  
The Body ◽  
Small Vessel ◽  
Chronic Cerebral Ischemia ◽  
Vessel Disease

The article is dedicated to the issues of treatment of cerebral small vessel disease (CSVD), one of the most common pathological processes that is a leading cause of different types of cerebrovascular disorders and cognitive impairment. It also discusses the reasons for the development of small vessel pathology, which is usually referred to as the “chronic cerebral ischemia” in the Russian neurology. Emphasis is made on the etiopathogenetic factors affecting small calibre vessels, in which the metabolic-angiogenic mechanisms, in particular endothelial dysfunction and oxidative stress, are dominant.Difficulties in studying CSVD are explained by the disease course features and the insufficient introduction of unified approaches to the terminology and diagnosis. The article presents new data on the pathogenesis of small vessel disease based on the clinical and pathological findings and achievements of neuroimaging. A modern classification is provided, the clinical manifestations of vascular cognitive disorders associated with chronic cerebrovascular insufficiency are described in detail.The authors consider the issue of choosing and using drugs for the treatment of cerebrovascular diseases through the lens of understanding their own clinical experience and scientific research findings. They provide data of their own research on the antioxidant status and changes in the phospholipid composition of blood plasma in patients with chronic cerebral ischemia during separate and combined administration of 2-ethyl-6-methyl-3-hydroxypyridine-succinate (Neurox) and citicoline (Neupilept), which are natural metabolites and are involved in biochemical processes throughout the body. Based on the literature review and their own data, the authors conclude that complex pharmacological therapy can be effectively used in patients with CSVD, which is due to various points of “application” of pharmacological activity in the pathogenetic processes chain.

scholarly journals Investigation of SWI - basal nucleus intensity and fractional anisotropy of cerebral pathways in patients with chronic cerebral ischemia

2018 ◽  
pp. 43-51
Author(s):  
M. Petrenko ◽  
S. Grabovetskii
Keyword(s):  
Cerebral Ischemia ◽  
Cognitive Decline ◽  
Fractional Anisotropy ◽  
Small Vessel Disease ◽  
Life Quality ◽  
Small Vessel ◽  
Chronic Cerebral Ischemia ◽  
Basal Nucleus ◽  
Vessel Disease ◽  
Probable Relationship

Mild parkinsonian signs (MPS) and cognitive decline are common symptoms of small vessel disease (SVD), and are associated with reduced life quality and duration. There is a probable relationship between the neuroimaging features and SVD symptoms. Objective of this study was to identify whether there is an association between SWI basal nucleus hypointensity, fractional anisotropy and SVD symptoms such as cognitive decline and MPS.

scholarly journals DNA Methylation in Neurodegenerative and Cerebrovascular Disorders

2020 ◽  
Vol 21 (6) ◽  
pp. 2220 ◽  
Author(s):  
Olaia Martínez-Iglesias ◽  
Iván Carrera ◽  
Juan Carlos Carril ◽  
Lucía Fernández-Novoa ◽  
Natalia Cacabelos ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Gene Expression Regulation ◽  
Methylation Status ◽  
Cerebrovascular Disorders ◽  
Cerebrovascular Diseases ◽  
Epigenetic Mechanism ◽  
Mrna Levels ◽  
Serum Samples ◽  
Global Methylation ◽  
Age Related

DNA methylation is an epigenetic mechanism by which methyl groups are added to DNA, playing a crucial role in gene expression regulation. The aim of the present study is to compare methylation status of healthy subjects with that of patients with Alzheimer’s, Parkinson’s or Cerebrovascular diseases. We also analyze methylation status of a transgenic Alzheimer’s disease mouse model (3xTg-AD). Our results show that both global methylation (n = 141) and hydroxymethylation (n = 131) levels are reduced in DNA samples from buffy coats of patients with neurodegenerative disorders and age-related cerebrovascular disease. The importance of methylation and hydroxymethylation reduction is stressed by the finding that DNMT3a mRNA levels are also downregulated in buffy coats of patients with Dementia (n = 25). Global methylation is also reduced in brain, liver and serum samples of 3xTg-AD vs. wild type mice, such as DNMT3a mRNA levels that are also decreased in the brain of 3xTg-AD (n = 10). These results suggest that the use of global methylation and hydroxymethylation levels, together with the study of DNMT3a expression, could be useful as a new diagnostic biomarker for these prevalent disorders.

PARAMETERS OF LIGHT-TRANSMISSION AGGREGOMETRY OF PLATELETS AND TECH-POLYMER-TEST IN CHRONIC CEREBRAL ISCHEMIA WITH TRANSIENT ISCHEMIC ATTACKS

2018 ◽  
Author(s):  
Ю.И. Степанова ◽  
Н.И. Нечипуренко ◽  
Л.И. Алехнович
Keyword(s):  
Cerebral Ischemia ◽  
Light Transmission ◽  
Cerebrovascular Diseases ◽  
Control Group ◽  
Chronic Cerebral Ischemia ◽  
Acute Cerebral Ischemia ◽  
Light Transmission Aggregometry ◽  
Ischemic Cerebrovascular Diseases ◽  
Ischemic Attack ◽  
Diagnostics And Therapy

Цель исследования: провести сравнительный анализ состояния системы гемостаза у пациентов с транзиторной ишемической атакой (ТИА) на фоне хронической ишемии мозга (ХИМ) для оптимизации диагностики и терапии острых ишемических цереброваскулярных заболеваний. Материалы и методы. Обследовано 19 пациентов с ТИА (длительностью не более 24 часов) и 44 пациента с ХИМ в первые и на 8 ± 2 сутки госпитализации. Контрольную группу составили 55 практически здоровых добровольцев. Определяли параметры оптической агрегатометрии тромбоцитов (ОАТ) и Тех-Полимер-теста (ТПТ). Результаты. Продемонстрированы статистически значимые различия состояния первичного и вторичного гемостаза у пациентов с ТИА в сравнении с данными здоровых добровольцев и лиц с ХИМ без ТИА. Заключение. Проведение ОАТ и ТПТ в динамике острой ишемии мозга позволяет получить дополнительный диагностический инструмент для дифференциации пациентов с ТИА на фоне ХИМ и оценить эффективность антитромботической терапии. Aim: to perform a comparative analysis of hemostasis in patients with transient ischemic attack (TIA) in chronic cerebral ischemia (CCI) for optimization of diagnostics and therapy of acute ischemic cerebrovascular diseases. Materials and methods. We examined 19 patients with TIA (not above 24 hours) and 44 patients with CCI at the fi rst day and on 8 ± 2 days of hospitalization. The control group consisted of 55 practically healthy volunteers. The parameters of lighttransmission aggregometry (LTA) of platelets and Tech-Polymer-test (TPT) were determined. Results. Statistically signifi cant diff erences in primary and secondary hemostasis in patients with TIA and CCI were shown in comparison with parameters of healthy persons and patients with CCI without TIA. Conclusion. Using of LTA and TPT in dynamics of acute cerebral ischemia allows to obtain an additional diagnostic instrument for differentiating patients with TIA and CCI and to evaluate the effectiveness of antithrombotic therapy.

scholarly journals Findings of the study of cognitive evoked potentials in persons exposed to radiation

2020 ◽  
Vol 18 (4) ◽  
pp. 85-91
Author(s):  
E. A. Litvinchuk ◽  
T. E. Kantina ◽  
E. Yu. Burtovaya
Keyword(s):  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Evoked Potentials ◽  
Cognitive Decline ◽  
Clinical Examination ◽  
Cognitive Impairments ◽  
Peak Latency ◽  
Chronic Cerebral Ischemia ◽  
Cognitive Evoked Potentials ◽  
Number Of Patients

Introduction. After exposure to radiation, an increase in the long-term of cerebrovascular pathology is noted in exposed individuals. Cognitive impairments have a growing importance in the pattern of cerebrovascular diseases which significantly deteriorates social and medical forecast of a patient.The objective of the research is to study cognitive evoked potentials in exposed persons with chronic cerebral ischemia (CCI).Materials and methods. Two groups of patients were examined: the main group consisted of 69 persons exposed to radiation as a result of the “Mayak” PA activity, the comparison group included 110 unexposed residents of the Techa riverside settlements who were diagnosed with chronic cerebral ischemia. The following methods were used in the study: clinical, evaluation method of cognitive evoked potentials (EP), and statistical methods.Results. In the course of clinical examination, it was revealed that the number of people with organic cognitive impairment and syndrome of cognitive decline is statistically significantly higher in the group of the exposed persons with CCI (p < 0.001, p = 0.003, respectfully). It was stated that the studied groups were statistically significantly different in N1 peak latency (ð = 0.030), N2 – P3 inter-peak latency (p = 0.003), N2 – N3 inter-peak latency (p = 0.011).Conclusion. According to the results of clinical examination and study of cognitive EP, cognitive impairments are more expressed in the group of the exposed persons with CCI which is manifested in an increase in the number of patients with syndrome of cognitive decline and organic cognitive impairment in this group; in the change of a latency period of a number of components that characterize both the perception process and the very process of recognition and decision-making.

scholarly journals Disorders of the immune status in patients with chronic cerebral ischemia; differentiated pharmacological correction

2018 ◽  
Vol 4 (2) ◽  
pp. 105-123
Author(s):  
Anastasiya Shulginova ◽  
Alexander Konoplya ◽  
Natalya Bystrova
Keyword(s):  
Cerebral Ischemia ◽  
Arterial Hypertension ◽  
Cerebrovascular Diseases ◽  
Pharmacological Therapy ◽  
Control Group ◽  
Etiologic Factor ◽  
Immune Disorders ◽  
Chronic Cerebral Ischemia ◽  
Immune Disorder ◽  
Pharmacological Correction

Introduction: Chronic cerebral ischemia (CCI) accounts for 60-75% of all cerebrovascular diseases in Russia and around the world. The problem: the issues concerning the role of immunity in the pathogenesis of CCI depending on the main etiologic factor and stage of the disease are hardly elaborated, which makes the main pharmacological correction impossible. The objective of the study is to establish the immune disorder patterns in patients with CCI I-II associated with arterial hypertension and to develop differentiated pharmacological methods for their correction. Material and methods: The results of treatment of 104 patients of Kursk Regional Clinical Hospital with CCI associated with II-stage arterial hypertension were analyzed: 52 patients were with CCI I stage (2th-4th groups of 12-14 patients) and 52 patients were with CCI II stage (5th -7th groups of 12-14 patients), aged 50±5, who received the basic pharmacological therapy (enalapril and vinpocetine). The patients of the 2nd and 5th groups additionally received ceraxon and mexicor, those of the 3rd and the 6th groups additionally received immunomodulator glutoxim, and those from the 4th and 7th groups received polyoxidonium. Twenty-two healthy donors were in the control group. Immune disorders were assessed by the parameters of the functional activity of neutrophils, levels of cytokines in plasma, components of the complement and inhibitors. Results and discussion: In the case of CCI I and II stages similar proinflamatory immune disorders were detected, which is indicative of immune inflammation. The inclusion of glutoxime and polyoxidonium in a complex pharmacotherapy helps reduce the severity of immune and neuropsychic status indicators, which are more evident in case of stage II. Conclusions: In case of CCI I stage, the medications used can be arranged according to their clinico-immunological efficacy in ascending order: ceraxon+mexicore ® ceraxon+mexicor+glutoxim ® ceraxon+mexicor+polyoxidonium, and in case of CCI II stage: ceraxon+mexicor ® ceraxon+mexicor+polyoxidonium = ceraxon+mexicor+glutoxim.

scholarly journals Chronic cerebrovascular diseases: use of vinpocetine in neurological practice (Round Table proceedings)

2018 ◽  
Vol 10 (4) ◽  
pp. 139-145 ◽  
Author(s):  
V. A. Parfenov ◽  
S. A. Zhivolupov ◽  
V. V. Zakharov ◽  
L. A. Belova ◽  
O. V. Lagoda ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Neurological Diseases ◽  
Round Table ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Chronic Cerebral Ischemia ◽  
Dyscirculatory Encephalopathy ◽  
Clinical Presentations

The paper presents the proceedings of the Round Table with the participation of leading neurologists, which is devoted to chronic cerebrovascular diseases. It is noted that chronic cerebral ischemia (CCI), or dyscirculatory encephalopathy (DEP), is one of the most common neurological diagnoses in our country. The pathogenesis, clinical presentations, diagnosis and treatment of CCI (DEP) and its matching with vascular cognitive impairment (CI), which is regarded in foreign literature as the main manifestation of chronic cerebrovascular disease (CVD) were considered. The authors analyze clinical trials evaluating the efficacy of vinpocetine (Cavinton) in chronic CVD, dizziness, CI, as well as the use of new vinpocetine formulations, such as Cavinton Comforte, in various neurological diseases, dysphagia in particular, in poststroke patients.

Activity Engagement in Cognitive Aging: A Review of the Evidence

2013 ◽  
Vol 23 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Yvonne Rogalski ◽  
Muriel Quintana
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cognitive Aging ◽  
Social Activity ◽  
Current Evidence ◽  
Omega 3 ◽  
Neuroprotective Effects ◽  
Activity Engagement ◽  
Age Related ◽  
Age Related Cognitive Decline

The population of older adults is rapidly increasing, as is the number and type of products and interventions proposed to prevent or reduce the risk of age-related cognitive decline. Advocacy and prevention are part of the American Speech-Language-Hearing Association’s (ASHA’s) scope of practice documents, and speech-language pathologists must have basic awareness of the evidence contributing to healthy cognitive aging. In this article, we provide a brief overview outlining the evidence on activity engagement and its effects on cognition in older adults. We explore the current evidence around the activities of eating and drinking with a discussion on the potential benefits of omega-3 fatty acids, polyphenols, alcohol, and coffee. We investigate the evidence on the hypothesized neuroprotective effects of social activity, the evidence on computerized cognitive training, and the emerging behavioral and neuroimaging evidence on physical activity. We conclude that actively aging using a combination of several strategies may be our best line of defense against cognitive decline.

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