Nervous System Lesions Research Articles

Pathogenetic and pharmacodynamic features of succinic acid derivative application for various diseases of the cardiovascular and nervous systems

This study revealed the pathogenetic patterns of the development of hypoxic and ischemic disorders in various pathological conditions and substantiated approaches to the use of drugs with antihypoxic activity. The role of the receptor interaction of succinic acid in the composition of succinate-containing antihypoxants with succinate receptor SUCNR1 has been demonstrated. The pharmacodynamic properties of the combined preparation of succinic acid that also contains vitamin precursors of the cofactors of Krebs cycle dehydrogenases nicotinamide (precursor of NAD) and riboflavin mononucleotide (precursor of FAD) and precursor of purine nucleotides (inosine) (cytoflavin) for intravenous drip and oral administration were analyzed. Literature data were also analyzed to evaluate the effectiveness of the use of the metabolic corrector of energy-dependent and hypoxic conditions (cytoflavin) in various central nervous system and cardiovascular diseases. In the case of ischemic disorders of cerebral and coronary blood flow, the effects of the drug are concentrated on the penumbra zone (ischemic penumbra), which is associated with the intravenous administration of the drug to its metabolic activity by influencing endothelial cells, restoring microcirculation, and enhancing the oxygen transport function of the blood. Among the new areas of drug use, the use of cytoflavin in the complex therapy of traumatic brain injuries, traumatic shock, acute respiratory distress syndrome, toxic lesions of the central nervous system, multiple organ failure syndrome, and post-COVID syndrome is promising.

Assessment of Stx-1A gene polymorphism (rs1569061) in relation to the development of multiple sclerosis in Egyptian patients

Multiple sclerosis (MS) is a multifactorial polygenic disease; results from autoimmune and neurodegenerative processes which lead to multifocal lesions of the central nervous system. Axonal degeneration was found to be prominent in the inflammation period of MS and contribute to the progression of disability. Soluble N-ethylmaleimide sensitive factor attachment receptor (SNARE) complex plays a vital role in the release of neurotransmitter by synaptic vesicle fusion. Stx-1A protein (Stx-1A), a major component of the SNARE complex, is widely expressed in brain tissue. This study intended to evaluate the prevalence of the Stx-1A gene polymorphism (rs1569061) in the Egyptian population with MS and to investigate its association with various clinical factors. This study included 65 adult Egyptian MS patients and 35 age- and sex-matched normal control subjects. Diagnosis of MS was made by an experienced neurologist according to revised McDonald criteria. All Patients underwent full history taking, included Age of onset of MS, disease duration, disease course and degree of disability according to the Expanded Disability Status Scale (EDSS) and family history of neurological diseases. Stx-1A gene polymorphism (rs1569061) genotyping was performed by TaqMan assay based quantitative real time (qPCR) and verified by sanger sequencer. Genotype and allele frequencies of (rs1569061) did not differ significantly between case and control groups. No difference was detected when comparing the genotype frequency and the allele frequency to different disease parameters. Discrepancy of the minor allele frequency (MAF) of Stx-1A gene (rs1569061) between different populations was noted. In conclusion, our study in Stx-1A gene polymorphism (rs1569061) and MS showed that no difference between the patient and control as regards gene frequency and allele frequency. Predicting no association between the studied polymorphism and MS in the Egyptian population. However, discrepancy between different population was noted as regards the MAF for Stx-1A gene (rs1569061).

SEPSIS-LIKE СИНДРОМ У НОВОРОЖДЕННОГО РЕБЕНКА ПРИ НАРУШЕНИИ ЦИКЛА ОБРАЗОВАНИЯ МОЧЕВИНЫ

Sepsis-like syndrome is a septic–like syndrome. The pathogenesis of Sepsis-like syndrome is based on the hyperproduction of proinflammatory cytokines. Hereditary metabolic disorders, including in violation of the urea formation cycle, can occur with the clinic of Sepsis-like syndrome. Ammonium easily penetrates the blood-brain barrier, causes neurotoxic effects, damages glial cells, increases osmolarity, which leads to cerebral edema. The symptoms are similar to hypoxic-ischemic lesions of the central nervous system, meningoencephalitis, intrauterine infections, which leads to a differential diagnostic search for causes and the need to exclude an infectious disease. The article presents a clinical case of a newborn with a Sepsis-like syndrome clinic. The girl was born from 2 births naturally at the age of 38 weeks. In the first day of life, there were signs of respiratory failure. She was on mixed feeding. From the 5th day of life, the deterioration of the condition caused by the syndrome of central nervous system depression, with an increase in depression of consciousness up to coma, the development of seizures. Differential diagnosis was performed with intrauterine infections, sepsis, as there was leukocytosis in the blood, increased ESR, ferritin, procalcitonin, and seeding from the cerebrospinal fluid of Micoplasma hominis. The presence of low urea content in the blood serum, up to its absence, made it possible to suspect hereditary metabolic diseases with a violation in the urea cycle. The conducted examinations revealed a total increase in the concentration of amino acids in the blood using the method of tandem mass spectrometry, metabolites in urine and hyperammonemia up to 354 mcg/dl. The newborn received antibacterial therapy, anticonvulsant therapy, sodium benzoate, and was transferred to a specialized therapeutic mixture "Nutrigen". Despite the therapy, neurological symptoms increased and the girl died at the age of 3 months. This clinical case showed the difficulties of differentiation. diagnosis of causes in the presence of Sepsis-like syndrome in newborn children.

Possibility of correction of cerebral blood flow disorders and central nervous system damage with citicoline in patients with coronary artery disease in combination with COVID-19

ABSTRACT. The review describes some pathogenetic mechanisms of central nervous system lesions in patients with coronary artery disease in combination with coronavirus disease (COVID-19) and presents the current possibilities of their pharmacotherapy. The analysis of experimental and clinical trials has shown that the multifactorial effect of citicoline on the main pathogenic links of brain damage in COVID-19 and numerous positive clinical effects make it a promising drug in the treatment of patients with coronary artery disease in combination with COVID-19 and post-COVID syndrome.

COVID-19 liver damage. Features of laboratory and instrumental diagnostics

The aim of the study - to analyze the pathogenesis of liver damage in COVID-19, as well as to study the features of diagnosis. Research materials: literature and own data on the peculiarities of the pathogenesis of liver damage were analyzed, as well as an assessment of laboratory and instrumental diagnostics in patients with COVID-19. The results of the research. In patients, liver damage was manifested by an increase in liver enzymes, as well as a diffuse decrease in its density during CT. The severity of the disease is caused by a cytokine storm caused by a dysfunctional immune response to the virus, viral virulence factors, as well as the presence of concomitant diseases, especially those associated with liver pathology, such as cirrhosis or steatosis. Conclusions. The new COVID-19 coronavirus infection caused by SARS-CoV-2 continues to spread worldwide. The main target is the organs of the respiratory system. However, among the patients with COVID-19, there were lesions of the central nervous system, intestines, myocardium and liver. Liver dysfunction in most cases should be considered as a result of secondary damage due to CVD, ARDS, hypoxia, multiple organ failure, exposure to immune factors, and taking hepatotoxic drugs.

The proton-sensing receptors TDAG8 and GPR4 are differentially expressed in human and mouse oligodendrocytes: Exploring their role in neuroinflammation and multiple sclerosis.

Acidosis is one of the hallmarks of demyelinating central nervous system (CNS) lesions in multiple sclerosis (MS). The response to acidic pH is primarily mediated by a family of G protein-coupled proton-sensing receptors: OGR1, GPR4 and TDAG8. These receptors are inactive at alkaline pH, reaching maximal activation at acidic pH. Genome-wide association studies have identified a locus within the TDAG8 gene associated with several autoimmune diseases, including MS. Accordingly, we here found that expression of TDAG8, as opposed to GPR4 or OGR1, is upregulated in MS plaques. This led us to investigate the expression of TDAG8 in oligodendrocytes using mouse and human in vitro and in vivo models. We observed significant upregulation of TDAG8 in human MO3.13 oligodendrocytes during maturation and in response to acidic conditions. However, its deficiency did not impact normal myelination in the mouse CNS, and its expression remained unaltered under demyelinating conditions in mouse organotypic cerebellar slices. Notably, our data revealed no expression of TDAG8 in primary mouse oligodendrocyte progenitor cells (OPCs), in contrast to its expression in primary human OPCs. Our investigations have revealed substantial species differences in the expression of proton-sensing receptors in oligodendrocytes, highlighting the limitations of the employed experimental models in fully elucidating the role of TDAG8 in myelination and oligodendrocyte biology. Consequently, the study does not furnish robust evidence for the role of TDAG8 in such processes. Nonetheless, our findings tentatively point towards a potential association between TDAG8 and myelination processes in humans, hinting at a potential link between TDAG8 and the pathophysiology of MS and warrants further research.

Real-Life Treatment Outcome of Botulinum Toxin A Injection on Overactive Bladder and Voiding Dysfunction in Patients with Central Nervous System Lesions.

Neurogenic lower urinary tract dysfunction (NLUTD) is common in patients with neurological lesions in the central nervous system (CNS). Medical treatment usually cannot adequately relieve NLUTD. This study reported the real-life treatment outcome of botulinum toxin A (BoNT-A) for overactive bladders (OAB) and voiding dysfunction in patients with CNS lesions. We retrospectively analyzed the first-time treatment outcome of 74 patients who received detrusor 100 U BoNT-A for OAB and 45 patients who received a urethral sphincter 100 U BoNT-A injection for voiding dysfunction. The treatment outcome, therapeutic duration, and adverse events (AE) after BoNT-A were compared among different CNS lesions and among patients with different urodynamic characteristics. The study included 74 patients receiving detrusor injections for OAB (36 with cerebrovascular accidents, 13 with Parkinson's disease, and 25 with dementia) and 45 patients receiving a urethral sphincter injection for voiding dysfunction (26 with cerebrovascular accidents, 7 with Parkinson's disease, and 12 with dementia). After detrusor BoNT-A treatment, urinary continence was achieved in 28.4% of patients with neurogenic OAB, postoperative difficult urination in 59.5%, acute urinary retention (AUR) in 9.5%, and urinary tract infection (UTI) in 14.9%, with a therapeutic duration of 6.43 months. There were no differences among subgroups or between patients with detrusor overactivity (DO) and DO with detrusor underactivity (DU) in terms of treatment outcomes and AEs. The improvement rate of urethral sphincter BoNT-A injections was 75.6% without any difference among subgroups. After treatment, 24.4% of the patients had exacerbated urinary incontinence, 33.3% had persistent difficult urination, and 15.6% had UTI. Patients with dementia had higher rates of difficult urination and UTI, higher postvoid residual volume, and a shorter therapeutic duration. Patients with DU and those without urethral sphincter dyssynergia had less favorable outcomes after their urethral sphincter BoNT-A injection. The therapeutic efficacy of detrusor BoNT-A injection for OAB due to CNS lesions is limited, with high rates of difficult urination, AUR, and UTI. Although urethral sphincter BoNT-A injection is effective in treating voiding dysfunction; however, exacerbated urinary incontinence and persistent difficult urination remain a problem, particularly in patients with dementia.

Features of severe forms of new coronavirus infection (COVID-19) in children

BACKGROUND: The problem of the complicated course of COVID-19 and deaths in children with severe comorbid pathology is relevant. Severe forms of the disease are often the cause of critical conditions and deaths, including decompensated respiratory failure, acute respiratory distress syndrome, septic shock, cardiac, hepatic, renal insufficiency, coagulation disorders, damage to the central nervous system.
 AIM: The aim is to analyze the features of the course of COVID-19 in children who require mandatory hospitalization in specialized hospitals for background pathology, to identify predictors of the development of severe forms of COVID-19 in order to choose the optimal ways of treating this pathology.
 MATERIALS AND METHODS: Under the supervision of the St. Petersburg State Pediatric Medical University in the department for children with new coronavirus infection COVID-19 with intensive care and intensive care wards in the period 2020–2022 with a confirmed diagnosis of “new coronavirus infection” there were 791 patients aged 0 to 17 years. The diagnosis was made on the basis of clinical and epidemiological data, the results of a comprehensive laboratory and instrumental study. The severity of the disease was determined in accordance with the methodological recommendations of the Ministry of Health of the Russian Federation.
 RESULTS: The severe form of COVID-19 was diagnosed in 34 patients out of 791 (4.3%). Adverse outcomes were 1.4%. In 27 out of 34 children (79.4%), new coronavirus infection occurred against the background of severe comorbid pathology. Pneumonia was diagnosed in 91.2% of cases. 88.2% of patients needed oxygen therapy.
 CONCLUSIONS: Severe forms of COVID-19 in children are characterized by high fever with severe intoxication, respiratory tract damage with a significant volume of lung damage (CT-3 and CT-4) with the development of multiple organ failure. Predictors that require mandatory hospitalization in specialized hospitals for background pathology in severe forms of COVID-19 are: primary immunodeficiency conditions, oncohematological pathology with postcytostatic aplasia of hematopoiesis, severe organic lesions of the central nervous system, epilepsy, protein-energy deficiency of 3–4 degrees, bronchopulmonary dysplasia, atypical emolytic uremic syndrome with acute kidney damage. Comprehensive treatment of such patients should be carried out by a multidisciplinary team in a specialized department with extensive diagnostic and therapeutic capabilities.

Emerging imaging markers in radiologically isolated syndrome: implications for earlier treatment initiation.

The presence of central nervous system lesions fulfilling the criteria of dissemination in space and time on MRI leads to the diagnosis of a radiologically isolated syndrome (RIS), which may be an early sign of multiple sclerosis (MS). However, some patients who do not fulfill the necessary criteria for RIS still evolve to MS, and some T2 hyperintensities that resemble demyelinating lesions may originate from mimics. In light of the recent recognition of the efficacy of disease-modifying therapy (DMT) in RIS, it is relevant to consider additional imaging features that are more specific of MS. We performed a narrative review on cortical lesions (CL), the central vein sign (CVS), and paramagnetic rim lesions (PRL) in patients with RIS. In previous RIS studies, the reported prevalence of CLs ranges between 20.0 and 40.0%, CVS + white matter lesions (WMLs) between 87.0 and 93.0% and PRLs between 26.7 and 63.0%. Overall, these imaging findings appear to be frequent in RIS cohorts, although not consistently taken into account in previous studies. The search for CLs, CVS + WML and PRLs in RIS patients could lead to earlier identification of patients who will evolve to MS and benefit from DMTs.

Efficacy of combined rehabilitation programs for infants with perinatal hypoxic-ischemic encephalopathy

Efficacy of combined rehabilitation programs for infants with perinatal hypoxic-ischemic encephalopathy

Osmotic demyelinating syndrome and its manifestations

Osmotic demyelination syndrome (ODS) is a rare and severe dysmetabolic lesion of the central nervous system which is difficult to diagnose. Its prevalence in the general population reaches 0.5 %, and in intensive care nits — 2.5 %. Within the framework of ODS, central pontine myelinolysis with demyelination of the pons and extrapontine myelinolysis with foci of demyelination in the cerebellum and cerebral hemispheres are distinguished. Clinical cases of ODS that developed against the background of dehydration are presented

Biomarkers of Brain Ischemia (Review)

Introduction. Strokes remain the second leading cause of death and the third leading cause of disability. Additional serum biomarker testing should be used to better diagnose transient ischemic attack (TIA), but most neurospecific biomarkers have low prognostic specificity and sensitivity. Timely identification of TIA and differential diagnosis of stroke in the first hour will ensure a shorter period of patient recovery and reduce the risk of mortality and disability. Serum biomarker studies should be included to overcome the difficulty of diagnosing TIA.Text. Neurospecific biomarkers such as S100B, GFAP, and NSE are used to diagnose acute ischemic damage to glial cells and neurons. S100B and GFAP are detected in astrocytes and NSE in neurons and cells of the neuroendocrine system. Elevated serum concentrations of these biomarkers are associated with various pathological conditions such as strokes and brain injuries and other central nervous system (CNS) lesions. Dynamic monitoring of biomarker concentrations makes it possible to evaluate the efficacy of the ongoing therapy and to identify predictors of patient deterioration for prompt correction of therapeutic procedures. To create a diagnostic panel it is necessary to study metabolic processes in ischemic tissue, taking into account concomitant diagnoses and results of neuroimaging, and to use breakthrough advances in machine learning and big data.Conclusion. The review showed that none of the assessed biomarkers can be recommended for the diagnosis of cerebral circulation disorders, but the combination of several neurospecific biomarkers can significantly improve diagnostic efficiency and find application in the differential diagnosis of stroke, intracranial hematoma, and other brain lesions for the purpose of early pharmacotherapy of CNS lesions and as surrogate endpoints during clinical trials.

Cytologic features of canine melanotroph and corticotroph pituitary adenomas.

The introduction of intraoperative cytology revolutionized neurosurgical procedures in human medicine, providing real-time diagnostic guidance to surgeons and contributing to improved patient outcomes. In the realm of veterinary medicine, the understanding of pituitary tumors in dogs and cats remains limited due to challenges in obtaining antemortem samples of central nervous system lesions. The aim of this study was to describe the cytologic features of pituitary adenomas in 12 dogs that underwent hypophysectomy. The series included nine melanotroph adenomas and three corticotroph adenomas. Definitive diagnosis was based on histopathology and immunohistochemistry. Cytologically, the adenomas had high numbers of bare nuclei and intact cells that were round to polygonal and situated individually or in small clusters. The intact cells had round to oval, eccentric nuclei with finely stippled chromatin and one to three prominent nucleoli and ample to abundant lightly basophilic to amphophilic, grainy cytoplasm with distinct borders, and variable numbers of discrete vacuoles. Mild-to-moderate anisocytosis and anisokaryosis, occasional binucleation, rare and atypical mitotic figures, and nuclear molding were also observed. The results suggest that intraoperative cytology of canine pituitary adenomas holds promise as a valuable diagnostic tool, aiding swift differentiation from other sellar masses before histologic confirmation. Cytologic characterization of pituitary adenomas in dogs is exceptionally rare in the scientific literature, making this study one of the first to offer a comprehensive description of these cytologic features.

Significance of accurately interpreting the Bielschowsky tilt test in the differential diagnosis of superior oblique muscle paralysis

Superior oblique muscle paralysis is a common type of vertical rotatory strabismus with various subtypes. Regardless of the subtype, the Bielschowsky tilt test plays a crucial role in the diagnosis of superior oblique muscle paralysis and is often considered a significant criterion for diagnosis and differential diagnosis. However, the sensitivity and specificity of the Bielschowsky tilt test for diagnosing superior oblique muscle paralysis are not 100% due to the mechanism involved. The test is not solely based on extraocular muscle imbalance but also involves reflex pathways of the vestibular system and central nervous system. Consequently, lesions affecting corresponding areas may yield positive results in the Bielschowsky tilt test. Additionally, vestibular and central nervous system lesions can also cause strabismus, leading to a lack of one-to-one correspondence between a positive Bielschowsky tilt test and superior oblique muscle paralysis. Therefore, correctly interpreting the role of the Bielschowsky tilt test in superior oblique muscle paralysis is of paramount importance for the effective clinical management and treatment of associated conditions.

Multi-organ dysfunction and outcomes in pregnancy associated COVID-19 infection – descriptive review of pathological findings

Objective(s)Comparative clinical and morphological characterization of lesions of the vascular and nervous system in cases of maternal death associated with COVID-19.Study designThe study included autopsy in 12 cases of maternal death with a positive intravital result for SARS-CoV-2 by reverse transcription polymerase chain reaction. For histopathology, tissue samples were taken from the internal organs of each patient. Pieces of organs were fixed and stained according to the standard protocol. The relative number of microvessels with vasculitis and fibers of the peripheral nervous system with infiltration by immune cells was studied. All morphological changes were classified depending on the severity of the damage.ResultsThe average age of patients with a fatal outcome was 35 ± 4.4 years. Time to death after onset of symptoms averaged 16 ± 4.4 days. Dystrophic lesions (necrosis and apoptosis) of the villous and extravillous trophoblast and decidual tissue were observed in the studied placentas. Histopathological signs of mild and severe lesions of the peripheral nervous system in the organs of the gastrointestinal tract were detected in 2 (16.7%) and 10 (83.3%) cases, respectively, in the myocardium in 4 (33.3%) and 8 (66.7%) cases. Histopathological signs of severe damage to the microvascular bed in the organs of the gastrointestinal tract were registered in 9 (75%) cases.Conclusion(s)The main clinical feature of this cohort was that death occurred in a long-term period, in most cases with a negative PCR. The histopathological pattern was a non-acute injury with an immune component of the microvascular bed and the autonomic nervous system with predominant damage to the myocardium and intestines.What does this study add to the clinical workThis study makes it possible to even better study the immunopathological profile in organs and tissues in pregnant women with a fatal outcome when affected by a viral infection, in particular Covid-19. This knowledge can be used when humanity encounters other viral pandemics in the future.

Uptake of surface-functionalized thermo-responsive polymeric nanocarriers in corticospinal tract motor neurons

Nanocarrier drug delivery systems are attractive options for targeted delivery of survival- and regeneration-enhancing therapeutics to neurons damaged by degenerative or traumatic central nervous system (CNS) lesions. Functional groups on nanocarrier surfaces allow derivatization with molecules to target specific cells but may affect cellular interactions and nanocarrier uptake. We synthesized differently sized –COOH and –NH2 surface functionalized polymeric nanocarriers (SFNCs) by emulsion copolymerization and assessed uptake by different cell types in mixed cortical cultures. Following 60-min incubation with SFNCs, mean intensity measurements of fluorescently labeled SFNCs indicated that corticospinal tract motor neurons (CSMNs) took up more COOH- or NH2- functionalized SFNCs with similar sizes (150 nm), compared to glia. However, larger diameter (750 nm) SFNCs were taken up at higher concentrations compared to smaller COOH-derivatized SFNCs (150 nm). These data suggest that larger SFNCs may provide an advantage for enhanced uptake by targeted neurons.

Wrist extensor pathomechanics: implications for tendon and nerve transfer.

Central and peripheral nervous system lesions may disrupt the intricate balance of the prime movers of the wrist. In spasticity, hyperactive wrist flexors create a flexion moment and, if untreated, can lead to flexion contractures. In patients with C6 spinal cord injury and tetraplegia, the posterior interosseus nerve is typically affected by a complex pattern of upper and/or lower motoneuron lesions causing radial deviation of the wrist due to loss of ulnar deviation actuators. In this report, we illustrate severe pathomechanics that may occur even with relatively modest changes in wrist balance. These results illustrate how thorough understanding of muscle-tendon-joint interaction aids in designing tendon and nerve reconstructive surgeries to normalize wrist positions and balance in neuromuscular conditions.

Intraoperative Touch Imprint Cytology of Brain Neoplasms: A Useful High-Diagnostic Tool in 93 Consecutive Cases; Differential Diagnoses, Pitfalls, and Traps.

Intraoperative cytological examination of central nervous system (CNS) lesions was first introduced in 1920 by Eisenhardt and Cushing for rapid evaluation of neurosurgical specimens and to guide surgical treatment. It is recognized that this method not only confirms the adequacy of biopsy in CNS samples but also indicates the presence and preliminary diagnosis of lesional tissue. A total of 93 patients who underwent touch imprint cytology (TIC) for CNS tumors or lesions between 2018 and 2023 were included in the study. All cases were correlated with the final histopathological diagnosis, and pitfalls and difficulties encountered with discrepancies were noted. The most common primary CNS tumors were gliomas and meningiomas, while secondary (metastatic) tumors were predominantly lung, breast, and gastrointestinal system carcinomas. Sensitivity, specificity, positive predictive value, and negative predictive value for diagnosis with TIC were 94.1%, 100%, and 61.5%, respectively. Final histopathological diagnosis by TIC was made in 88 cases (94.6%) and the discrepancy was found in 5 cases (5.37%). Three of the five discrepancies (3.2%) were haematolymphoid malignancies (two lymphomas and one plasma cell neoplasia), one glioblastoma, and one hemangioblastoma case. TIC is a fast, safe, and inexpensive diagnostic tool used during intraoperative neuropathology consultation. Awareness of the pitfalls of using this method during intraoperative consultation will enable high-diagnostic accuracy.

Clinical characteristics of 13 cases of Coronavirus infection complicated with severe central nervous system lesions in Shanxi children’s hospital

BackgroundThe new coronavirus Omicron variant strain spread rapidly worldwide and is currently the primary mutant strain prevalent in the world.ObjectiveTo explore the clinical features of severe central nervous system lesions in children infected with novel coronavirus Omicron mutant strain, so as to provide a reference for clinical diagnosis and treatment.Materials and methodsThe clinical data of 13 children diagnosed with novel coronavirus Omicron variant strain complicated with severe central nervous system infection from December 13, 2022, to January 31, 2023, in the Children’s Intensive Care Medicine Department of Shanxi Children’s Hospital were retrospectively analyzed.ResultsAmong the 13 children, there were 9 males (69%) and 4 females (31%); the ages ranged from 1-year-old 16 days to 13 years old, with a median age of 9 years old, and most of them were school-age children (84.6%). The 13 children were usually healthy, but this time they were all positive for the new coronavirus nucleic acid test. The 13 children had obvious signs of the abnormal nervous system when they were admitted to the hospital, among which 12 cases (92.3%) showed convulsions, 11 children had obvious disturbance of consciousness (84.6%) when they were admitted to the hospital, and 5 children had circulatory disorders (38.4%). Among the 13 children, 2 were cured (15.3%), 5 children had serious sequelae (38.4%) when they were discharged from the hospital, and 6 children died of severe illness (46.3%).ConclusionThis study illuminates the clinical characteristics of severe central nervous system complications in children with coronavirus variant infection, highlighting rapid onset, swift progression, relatively poor prognosis, and notable symptoms such as high fever, convulsions, altered consciousness, elevated interleukin-6 levels, increased cerebrospinal fluid lactate levels, and early imaging changes.

Microglia/macrophage polarization regulates spontaneous remyelination in intermittent cuprizone model of demyelination

Central nervous system (CNS) lesions can repeatedly be de-and remyelinated during demyelinating diseases such as multiple sclerosis (MS). Here, we designed an intermittent demyelination model by 0.3 % Cuprizone feeding in C57/BL6 mice followed by two weeks recovery. Histochemical staining of luxol fast blue (LFB) was used for study of remyelination, detection of glial and endothelial cells was performed by immunohistochemistry staining for the following antibodies: anti Olig2 for oligodendrocyte progenitor cells, anti APC for mature oligodendrocytes, anti GFAP for astrocytes, and anti Iba-1 for microglia/macrophages, anti iNOS for M1 microglia/macrophage phenotype, anti TREM-2 for M2 microglia/macrophage phenotype and anti CD31 for endothelial cells. Also, real-time polymerase chain reaction was performed for assessment of the expression of the targeted genes. LFB staining results showed enhanced remyelination in the intermittent cuprizone (INTRCPZ) group, which was accompanied by improved motor function, increased mature oligodendrocyte cells, and reduction of astrogliosis and microgliosis. Moreover, switching from M1 to M2 polarity increased in the INTRCPZ group that was in association with downregulation of pro-inflammatory and upregulation of anti-inflammatory genes. Finally, evaluation of microvascular changes revealed a remarkable decrease in the endothelial cells in the cuprizone (CPZ) group which recovered in the INTERCPZ group. The outcomes demonstrate enhanced myelin content during recovery in the intermittent demyelination model which is in association with reshaping macrophage polarity and modification of glial and endothelial cells.