• Title/Summary/Keyword: Blood­brain barrier

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Fulminant Course of Acute Necrotizing Encephalopathy Followed by Serial MRI: A Case Report (급격하게 진행한 급성 괴사성 뇌병증 환자의 연속 자기공명영상 소견: 증례 보고)

  • Ji Young Lee;Kyung Mi Lee;Eung Koo Yeon;Eun Hye Lee;Eui Jong Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1274-1280
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    • 2021
  • Acute necrotizing encephalopathy (ANE) is a rare but distinctive type of influenza-associated encephalopathy characterized by symmetric multiple lesions with an invariable thalamic involvement. Although the exact pathogenesis of ANE remains unclear, the most prevalent hypothesis is the "cytokine storm," which results in blood-brain-barrier breakdown. We present the case of a 10-year-old boy with fulminant ANE confirmed with serial MRI studies, including diffusion-weighted imaging and susceptibility-weighted imaging. A comparison of these serial images demonstrated detailed and longitudinal changes in MRI findings during the clinical course corresponding to pathophysiological changes. Our case clarifies the pathogenesis of ANE brain lesions using serial imaging studies and suggests that early immunomodulatory therapy reduces brain damage.

Recent Advancements of Treatment for Leptomeningeal Carcinomatosis

  • Gwak, Ho-Shin;Lee, Sang Hyun;Park, Weon Seo;Shin, Sang Hoon;Yoo, Heon;Lee, Seung Hoon
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.1-8
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    • 2015
  • Treatment of Leptomeningeal carcinomatosis (LMC) from solid cancers has not advanced noticeably since the introduction of intra-cerebrospinal fluid (CSF) chemotherapy in the 1970's. The marginal survival benefit and difficulty of intrathecal chemotherapy injection has hindered its wide spread use. Even after the introduction of intraventricular chemotherapy with Ommaya reservoir, frequent development of CSF flow disturbance, manifested as increased intracranial pressure (ICP), made injected drug to be distributed unevenly and thus, the therapy became ineffective. Systemic chemotherapy for LMC has been limited as effective CSF concentration can hardly be achieved except high dose methotrexate (MTX) intravenous administration. However, the introduction of small molecular weight target inhibitors for primary cancer treatment has changed the old concept of 'blood-brain barrier' as the ultimate barrier to systemically administered drugs. Conventional oral administration achieves an effective concentration at the nanomolar level. Furthermore, many studies report that a combined treatment of target inhibitor and intra-CSF chemotherapy significantly prolongs patient survival. Ventriculolumbar perfusion (VLP) chemotherapy has sought to increase drug delivery to the subarachnoid CSF space even in patients with disturbed CSF flow. Recently authors performed phase 1 and 2 clinical trial of VLP chemotherapy with MTX, and 3/4th of patients with increased ICP got controlled ICP and the survival was prolonged. Further trials are required with newly available drugs for CSF chemotherapy. Additionally, new LMC biologic/pharmacodynamic markers for early diagnosis and monitoring of the treatment response are to be identified with the help of advanced molecular biology techniques.

Immortalization of Swine Umbilical Vein Endothelial Cells with Human Telomerase Reverse Transcriptase

  • Hong, Hai Xia;Zhang, Yan Ming;Xu, Hao;Su, Zheng Yuan;Sun, Pei
    • Molecules and Cells
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    • v.24 no.3
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    • pp.358-363
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    • 2007
  • Swine endothelial cells are commonly used as an in vitro model for studying features of the blood-brain barrier and some hemorrhagic diseases. However, primary cultures of swine cells have finite lifespans. To establish immortalized swine umbilical vein endothelial cells (SUVECs) using human telomerase reverse transcriptase (hTERT), the plasmid pCI-neo-hTERT was transfected into SUVECs by lipofection. Clones were selected for G418 resistance, and positive clones were amplified. One of the clones was cultured for up to 50 passages. Factor VIII-related antigen and CD34 were detected. The immortalized cells shared the properties of normal cells, such as contact inhibition, serum requirement and anchorage dependence. Karyotype analysis revealed that the immortalized cells were in the diploid range. In addition, both in vivo and in vitro assays of tumorigenicity showed no neoplastic transformation. Furthermore, NO, $PGI_2$, and ET-1 concentrations in the transfected cells were normal. These results suggest that the SUVECs immortalized by hTERT retain their original characteristics.

Ocular Complications after Injection of Intra-arterial Carboplatin in Gliomas - Report of Three Cases - (신경교종에서 뇌동맥내 Carboplatin주입후 발생한 안구 합병증 - 3례보고 -)

  • Kim, Joo-Han;Lee, Jang-Bo;Chung, Yong-Gu;Park, Jung-Yul;Lee, Hun-Kap;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.638-641
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    • 2001
  • Carboplatin intra-arterial chemotherapy(IAC) has an advantage of increased uptake during the first passage of the drugs through tumor capillaries. Although not common, this type of therapy is known to cause neurological complications, myelosuppression, and ototoxicity. However, the incidence of ocular toxicity is reported to be rare. Eleven of our patients with glioma(Grade II Astrocytoma : 3, Grade III Astrocytoma : 1, Grade IV Astrocytoma : 5, Gliofibroma : 1, Oligodendroglioma : 1) underwent IAC regimen with carboplatin($300mg/m^2$) which were administrated after blood-brain barrier disruption. Of there, 3 patients had ocular complications after supra-ophthalmic IAC injection of carboplatin but fully recovered following steroid therapy. Although our results from IAC seem to be favorable for these patients, we suggest that its complications, such as ocular toxicity, need to be carefully considered prior to treatment.

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Mannitol induces selective astroglial death in the CA1 region of the rat hippocampus following status epilepticus

  • Ko, Ah-Reum;Kang, Tae-Cheon
    • BMB Reports
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    • v.48 no.9
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    • pp.507-512
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    • 2015
  • In the present study, we addressed the question of whether treatment with mannitol, an osmotic diuretic, affects astrogliovascular responses to status epilepticus (SE). In saline-treated animals, astrocytes exhibited reactive astrogliosis in the CA1-3 regions 2-4 days after SE. In the mannitol-treated animals, a large astroglial empty zone was observed in the CA1 region 2 days after SE. This astroglial loss was unrelated to vasogenic edema formation. There was no difference in SE-induced neuronal loss between saline- and mannitol-treated animals. Furthermore, mannitol treatment did not affect astroglial loss and vasogenic edema formation in the dentate gyrus and the piriform cortex. These findings suggest that mannitol treatment induces selective astroglial loss in the CA1 region independent of vasogenic edema formation following SE. These findings support the hypothesis that the susceptibility of astrocytes to SE is most likely due to the distinctive heterogeneity of astrocytes independent of hemodynamics. [BMB Reports 2015; 48(9): 507-512]

99mTc(CO)3-Labeled Histidine-Arylpiperazines as Potential Radiotracers for a Neuroreceptor Targeting

  • Choi, Kang-hyuk;Hong, Young-Don;Choi, Ok-Ja;Choi, Sun-Ju
    • Bulletin of the Korean Chemical Society
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    • v.27 no.8
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    • pp.1189-1193
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    • 2006
  • In order to develop radiopharmaceuticals for targeting a serotonin receptor such as $5-HT_{1A}$, histidine-$C_n$-arylpiperazines (AP) (C = alkyl, n = 2, 3, 4) were prepared in five steps with yields of 25%, 37% and 51%, respectively, and radiolabeled with the $[^{99m}Tc(CO)_3(H_2O)+3]^+$. The $^{99m}Tc(CO)_3$-Histidine-Cn-APs were prepared with a high yield (>99%) and characterized as a tridentate complex with a neutral charge to pass through the blood-brain barrier (BBB). The rhenium complexes with $Re(CO)_3$ were also synthesised and comparative experiments were achieved to evaluate the nature of the $^{99m}Tc$ complexes.

뮤코다당증의 장기 치료 효과와 한계점 극복을 위한 노력

  • Son, Yeong-Bae
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.29-36
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    • 2014
  • Mucopolysaccharidoses (MPSs) are a group of rare inherited metabolic diseases caused by deficiency of lysosomal enzymes. MPSs are clinically heterogeneous and characterized by progressive deterioration in visceral, skeletal and neurological functions. The aim of this article is to review the treatment of MPSs, the unmet needs of current treatments and vision for the future including recent clinical trials. Until recently, supportive care was the only option available for the management of MPSs. Hematopoietic stem cell transplantation (HSCT), another potentially curative treatment, is not routinely advocated in clinical practice due to its high risk profile and lack of evidence for efficacy. From the early 2000s, enzyme replacement therapy (ERT) was approved and available for the treatment of MPS I, II and VI. ERT is effective for the treatment of many somatic symptoms, particularly walking ability and respiratory function, and remains the mainstay of MPS treatment. However, no benefit was found in the neurological symptoms because the enzymes do not readily cross the blood-brain barrier (BBB). In recent years, intrathecal (IT) ERT, substrate reduction therapy (SRT) and gene therapy have been rapidly gaining greater recognition as potential therapeutic avenues. Although still under investigation, IT ERT, SRT and gene therapy are promising MPS treatments that may prevent the neurodegeneration not improved by ERT.

Mitochondrial Affinity of Guanidine-rich Molecular Transporters Built on myo- and scyllo-Inositol Scaffolds: Stereochemistry Dependency

  • Ghosh, Subhash C.;Kim, Bo-Ram;Im, Jung-Kyun;Lee, Woo-Sirl;Im, Chang-Nim;Chang, Young-Tae;Kim, Wan-Il;Kim, Kyong-Tai;Chung, Sung-Kee
    • Bulletin of the Korean Chemical Society
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    • v.31 no.12
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    • pp.3623-3631
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    • 2010
  • We prepared several novel molecular transporters built on myo- and scyllo-inositol scaffolds with variations in the number of guanidine residues, linker chain lengths and patterns. Some of these transporters were found to localize in mitochondria, and the mitochondrial affinity seems to be substantially related to the scaffold stereochemistry.

Advanced T and Natural Killer Cell Therapy for Glioblastoma

  • Wan-Soo Yoon;Dong-Sup Chung
    • Journal of Korean Neurosurgical Society
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    • v.66 no.4
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    • pp.356-381
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    • 2023
  • Although immunotherapy has been broadly successful in the treatment of hematologic malignancies and a subset of solid tumors, its clinical outcomes for glioblastoma are still inadequate. The results could be due to neuroanatomical structures such as the blood-brain-barrier, antigenic heterogeneity, and the highly immunosuppressive microenvironment of glioblastomas. The antitumor efficacy of endogenously activated effector cells induced by peptide or dendritic cell vaccines in particular has been insufficient to control tumors. Effector cells, such as T cells and natural killer (NK) cells can be expanded rapidly ex vivo and transferred to patients. The identification of neoantigens derived from tumor-specific mutations is expanding the list of tumor-specific antigens for glioblastoma. Moreover, recent advances in gene-editing technologies enable the effector cells to not only have multiple biological functionalities, such as cytokine production, multiple antigen recognition, and increased cell trafficking, but also relieve the immunosuppressive nature of the glioblastoma microenvironment by blocking immune inhibitory molecules, which together improve their cytotoxicity, persistence, and safety. Allogeneic chimeric antigen receptor (CAR) T cells edited to reduce graft-versus-host disease and allorejection, or induced pluripotent stem cell-derived NK cells expressing CARs that use NK-specific signaling domain can be a good candidate for off-the-shelf products of glioblastoma immunotherapy. We here discuss current progress and future directions for T cell and NK cell therapy in glioblastoma.

Serotonin and Energy Metabolism (세로토닌과 에너지 대사)

  • Kyoung-Kon Kim
    • Archives of Obesity and Metabolism
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    • v.3 no.1
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    • pp.35-42
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    • 2024
  • Serotonin, a biogenic amine widely found in many organisms, functions as both a neurotransmitter and hormone. Although serotonin is involved in various physiological processes, this study aimed to review its role in energy metabolism. Given that serotonin cannot cross the blood-brain barrier and is synthesized by two different isoforms of tryptophan hydroxylase in the central nervous system (CNS) and peripheral tissues, it is reasonable to assume that serotonin in the CNS and peripheral tissues functions independently. Recent studies have demonstrated how serotonin influences energy metabolism in metabolic target organs such as the intestines, liver, pancreas, and adipose tissue. In summary, serotonin in the CNS induces satiety and appetite suppression, stimulates thermogenesis, and reduces body weight. Conversely, serotonin in the periphery increases intestinal motility, stimulates gluconeogenesis in the liver, suppresses glucose uptake by hepatocytes, promotes fat uptake by liver cells, stimulates insulin secretion while suppressing glucagon secretion in the pancreatic islets, promotes lipogenesis in white adipose tissue, inhibits lipolysis and browning of white adipose tissue, and suppresses thermogenesis in brown adipose tissue, thereby storing energy and increasing body weight. However, considering that most experimental results were obtained using mice and conducted under specific nutritional conditions, such as high-fat diets, whether serotonin acts in the same way in humans, whether it will act similarly in individuals with normal versus obese weights, and whether its effects vary depending on the type of food consumed, remain unknown.