Nerve Processes Research Articles

The lymphatic vasculature associated with the peripheral nervous system: structures and functions

The lymphatic vasculature is widely considered to be a unidirectional transport system, which can collect excess fluid and metabolic waste in the interstitial space, and mediate immune cell transport, the absorption of certain special substances (such as lipids) and other functions. In clinical and basic research, the lymphatic vasculature appears to have generally received less attention than the blood vascular system. However, recent research on lymphatic vessels has greatly enriched our knowledge and directed our attention to the lymphatic vasculature. Furthermore, lymphatic vessels are not only widely distributed, but also have important functions in the cardiovascular, reproductive, respiratory, digestive, and central nervous systems (CNS), and their dysfunction may be the basis for the pathogenesis of various diseases. In the CNS, the existence and role of lymphatic vessels have been well confirmed and revealed. Although from a traditional point of view, the peripheral nervous system (PNS) is different from the CNS, there have something in common in some structures. We reviewed recent research on lymphatic vessels in the PNS, aiming to confirm the existence and to understand the structures and functions in the physiological and pathological processes of peripheral nerves. This review is intended to help open up a new field of research prospectively.

Convergent effects of neuropeptides on the feeding central pattern generator of Aplysia californica.

These experiments focus on an interneuron (B63) that is part of the feeding central pattern generator (CPG) in Aplysia californica. Previous work has established that B63 is critical for program initiation regardless of the type of evoked activity. B63 receives input from a number of different elements of the feeding circuit. Program initiation occurs reliably when some are activated, but we show that it does not occur reliably with activation of others. When program initiation is reliable, modulatory neuropeptides are released. For example, previous work has established that an ingestive input to the feeding CPG, cerebral buccal interneuron 2 (CBI-2), releases feeding circuit activating peptide (FCAP) and cerebral peptide 2 (CP-2). Afferents with processes in the esophageal nerve (EN) that trigger egestive motor programs release small cardioactive peptide (SCP). Previous studies have described divergent cellular and molecular effects of FCAP/CP-2 and SCP on the feeding circuit that specify motor activity. Here, we show that FCAP/CP-2 and SCP additionally increase the B63 excitability. Thus, we show that peptides that have well-characterized divergent effects on the feeding circuit additionally act convergently at the level of a single neuron. Since convergent effects of FCAP/CP-2 and SCP are not necessary for specifying the type of network output, we ask why they might be important. Our data suggest that they have an impact during a task switch, i.e., when there is a switch from egestive to ingestive activity.NEW & NOTEWORTHY The activity of multifunctional central pattern generators (CPGs) is often configured by neuromodulators that exert divergent effects that are necessary to specify motor output. We demonstrate that ingestive and egestive inputs to the feeding CPG in Aplysia act convergently (as well as divergently). We ask why this convergence may be important and suggest that it may be a mechanism for a type of arousal that occurs during task switching.

High-Resolution Digital Panorama of Multiple Structures in Whole Brain of Alzheimer's Disease Mice.

Simultaneously visualizing Amyloid-β (Aβ) plaque with its surrounding brain structures at the subcellular level in the intact brain is essential for understanding the complex pathology of Alzheimer's disease, but is still rarely achieved due to the technical limitations. Combining the micro-optical sectioning tomography (MOST) system, whole-brain Nissl staining, and customized image processing workflow, we generated a whole-brain panorama of Alzheimer's disease mice without specific labeling. The workflow employed the steps that include virtual channel splitting, feature enhancement, iso-surface rendering, direct volume rendering, and feature fusion to extract and reconstruct the different signals with distinct gray values and morphologies. Taking advantage of this workflow, we found that the denser-distribution areas of Aβ plaques appeared with relatively more somata and smaller vessels, but show a dissimilar distributing pattern with nerve tracts. In addition, the entorhinal cortex and adjacent subiculum regions present the highest density and biggest diameter of plaques. The neuronal processes in the vicinity of these Aβ plaques showed significant structural alternation such as bending or abrupt branch ending. The capillaries inside or adjacent to the plaques were observed with abundant distorted micro-vessels and abrupt ending. Depicting Aβ plaques, somata, nerve processes and tracts, and blood vessels simultaneously, this panorama enables us for the first time, to analyze how the Aβ plaques interact with capillaries, somata, and processes at a submicron resolution of 3D whole-brain scale, which reveals potential pathological effects of Aβ plaques from a new cross-scale view. Our approach opens a door to routine systematic studies of complex interactions among brain components in mouse models of Alzheimer's disease.

Sympathetic axonal sprouting induces changes in macrophage populations and protects against pancreatic cancer

Neuronal nerve processes in the tumor microenvironment were highlighted recently. However, the origin of intra-tumoral nerves remains poorly known, in part because of technical difficulties in tracing nerve fibers via conventional histological preparations. Here, we employ three-dimensional (3D) imaging of cleared tissues for a comprehensive analysis of sympathetic innervation in a murine model of pancreatic ductal adenocarcinoma (PDAC). Our results support two independent, but coexisting, mechanisms: passive engulfment of pre-existing sympathetic nerves within tumors plus an active, localized sprouting of axon terminals into non-neoplastic lesions and tumor periphery. Ablation of the innervating sympathetic nerves increases tumor growth and spread. This effect is explained by the observation that sympathectomy increases intratumoral CD163+ macrophage numbers, which contribute to the worse outcome. Altogether, our findings provide insights into the mechanisms by which the sympathetic nervous system exerts cancer-protective properties in a mouse model of PDAC.

Integrative Hedonic and Homeostatic Food Intake Regulation by the Central Nervous System: Insights from Neuroimaging.

Food intake regulation in humans is a complex process controlled by the dynamic interaction of homeostatic and hedonic systems. Homeostatic regulation is controlled by appetitive signals from the gut, adipose tissue, and the vagus nerve, while conscious and unconscious reward processes orchestrate hedonic regulation. On the one hand, sight, smell, taste, and texture perception deliver potent food-related feedback to the central nervous system (CNS) and influence brain areas related to food reward. On the other hand, macronutrient composition stimulates the release of appetite signals from the gut, which are translated in the CNS into unconscious reward processes. This multi-level regulation process of food intake shapes and regulates human ingestive behavior. Identifying the interface between hormones, neurotransmitters, and brain areas is critical to advance our understanding of conditions like obesity and develop better therapeutical interventions. Neuroimaging studies allow us to take a glance into the central nervous system (CNS) while these processes take place. This review focuses on the available neuroimaging evidence to describe this interaction between the homeostatic and hedonic components in human food intake regulation.

Research Progress on Leucine-Rich Alpha-2 Glycoprotein 1: A Review.

Leucine-rich alpha⁃2 glycoprotein 1 (LRG1) is an important member of the leucine-rich repetitive sequence protein family. LRG1 was mainly involved in normal physiological activities of the nervous system, such as synapse formation, synapse growth, the development of nerve processes, neurotransmitter transfer and release, and cell adhesion molecules or ligand-binding proteins. Also, LRG1 affected the development of respiratory diseases, hematological diseases, endocrine diseases, tumor diseases, eye diseases, cardiovascular diseases, rheumatic immune diseases, infectious diseases, etc. LRG1 was a newly discovered important upstream signaling molecule of transforming growth factor⁃β (TGF⁃β) that affected various pathological processes through the TGF⁃β signaling pathway. However, research on LRG1 and its involvement in the occurrence and development of diseases was still in its infancy and the current studies were mainly focused on proteomic detection and basic animal experimental reports. We could reasonably predict that LRG1 might act as a new direction and strategy for the treatment of many diseases.

Signals in nerves from the philosophical viewpoint

The signals in nerve include electrical, mechanical and thermal components and are characterized by the complexity of processes. The modelling of these signals is analyzed from the viewpoint of DeLanda who has demonstrated the possibility to expose the philosophical theories of Deleuze by using the notions from nonlinear dynamics. It is demonstrated that the mathematical modelling of processes in nerves by authors of this paper follows the general ideas of multiplicity and causal interactions described by DeLanda.

Interactions Among Nerve Regeneration, Angiogenesis, and the Immune Response Immediately After Sciatic Nerve Crush Injury in Sprague-Dawley Rats.

To preliminarily explore the primary changes in the expression of genes involved in peripheral nerve processes, namely, regeneration, angiogenesis, and the immune response, and to identify important molecular therapeutic targets, 45 Sprague-Dawley (SD) rats were randomly divided into a control group and an injury group. In the injury group, tissue samples were collected at 4 and 7 days after the injury for next-generation sequencing (NGS) analysis combined with gene ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Venn diagram construction to identify the differentially expressed mRNAs (DEmRNAs) associated with regeneration, angiogenesis, and the immune response of the nerve. The expression of genes in the distal and proximal ends of the injured nerve after injury was analyzed by qRT-PCR. NGS revealed that compared with the control group, the injury group had 4020 DEmRNAs 4 days after injury and 3278 DEmRNAs 7 days after injury. A bioinformatics analysis showed that C-C chemokine receptor type 5 (CCR5), Thy1 cell surface antigen (Thy1), Notch homolog 1 (Notch1), and semaphorin 4A (Sema4A) were all associated with regeneration, angiogenesis, and the immune response of the nerve at both 4 and 7 days after injury, but qPCR revealed no significant difference in the expression of Thy1 (P = 0.29) or Sema4A (P = 0.82) in the proximal end, whereas a significant difference was observed in CCR5 and Notch1 (P < 0.05). The trend in the Notch1 change was basically consistent with the RNA-seq result after injury, which implied its indispensable role during endothelial cell proliferation and migration, macrophage recruitment, and neurotrophic factor secretion.

Application of 3D Image Technology in Motor and Sensory Nerve Classification

Objective. To explore the application of 3D image technology in motor and sensory nerve classification. Methods. A total of 200 sections of the 5cm-long popliteal fossa peroneal nerve from adult volunteers were cut and frozen. The slices were 10 m thick, and the interval between the slices was 0.25 mm. Acetylcholinesterase histochemical staining was used to observe the changes of nerve bundles under the microscope. The stained sections were transformed into digital images by the digital camera system, and the images were stitched to obtain a two-dimensional panoramic image 100 times magnified. The properties of the functional bundles were manually judged. Using Amira 3.1 three‐dimensional reconstruction software to realize the three-dimensional reconstruction and visualization of nerve can not only accurately perceive the complex three-dimensional surface structure of nerve, but also arbitrarily display, rotate, scale, and segment the three-dimensional structure inside nerve, and carry out three-dimensional measurement in time. It has made preliminary achievements in brachial plexus, lumbosacral plexus, neural stem functional bundle (group), and intramuscular nerve routing and distribution, including the regeneration process of sensory nerve and three-dimensional reconstruction and visualization of composite tissue containing sensory nerve. Conclusion. Based on histology and computer technology, the functional band of short peroneal nerve can be reconstructed in 3D, which provides a feasible basis for the three-dimensional reconstruction of the functional band of the long peripheral nerve.

Compatibility Features between Athletes-Players with Different Efficiency of Team Activities

The aim of the article is to compare the parameters of compatibility (psychophysiological and socio-psychological) among athletes-players with different efficiency of team activities. Methods. Athletes representing various kinds of sports (football, basketball, etc.) took part in the research. Psychophysiological compatibility was studied using the cinematometric methodology of E.P. Ilyin, the method of diagnosing the temperament of Y. Streliau, and free conversation. The following methodologies were used for measurement of parameters of socio-psychological compatibility of athletes: «Sociometry» modificated by I.P. Volkov; methodology «Attitude to training and competitive activity» by Y.A. Kolomeitsev; methodology «Orientation of Personality» by V. Smekal and M. Kucher modificated by Y.A. Kolomeitsev; methodology «Motives of sports activity» by E.A. Kalinin. The efficiency of sports activities was calculated by the coefficient efficiency of the player presented in the competition statistics. According to the design, the research is a comparative analysis of compatibility parameters of sports team members who differ in their efficiency indicators. Results of the research. With the help of comparative analysis it was found the statistically reliable differences in various samples of athletes, namely: among members of one team who possess identical indicators of inertia – mobility of nerve processes, also their subjective assessments of the game partner and high success rates coincided; athletes with a high sociometric status in the team turned out to be significantly more productive than teammates with a lower status; the general motivation for sports activities is quite expected to be significantly higher in the group of highly productive athletes; at the same time, less productive players are dominated by a focus on themselves; and there are no differences in the severity of focus on interactions in different groups. Conclusions. The empirical data proves that the content of separate components of compatibility (psychophysiological and sociopsychological) differs significantly among players with different success of sports activities. A hypothesis about the indirect nature of the connection between compatibility in the «athlete-athlete» system and the performance of team activities was raised.

Capsaicin-Sensitive Vagal Afferent Nerve-Mediated Interoceptive Signals in the Esophagus.

Heartburn and non-cardiac chest pain are the predominant symptoms in many esophageal disorders, such as gastroesophageal reflux disease (GERD), non-erosive reflux disease (NERD), functional heartburn and chest pain, and eosinophilic esophagitis (EoE). At present, neuronal mechanisms underlying the process of interoceptive signals in the esophagus are still less clear. Noxious stimuli can activate a subpopulation of primary afferent neurons at their nerve terminals in the esophagus. The evoked action potentials are transmitted through both the spinal and vagal pathways to their central terminals, which synapse with the neurons in the central nervous system to induce esophageal nociception. Over the last few decades, progress has been made in our understanding on the peripheral and central neuronal mechanisms of esophageal nociception. In this review, we focus on the roles of capsaicin-sensitive vagal primary afferent nodose and jugular C-fiber neurons in processing nociceptive signals in the esophagus. We briefly compare their distinctive phenotypic features and functional responses to mechanical and chemical stimulations in the esophagus. Then, we summarize activation and/or sensitization effects of acid, inflammatory cells (eosinophils and mast cells), and mediators (ATP, 5-HT, bradykinin, adenosine, S1P) on these two nociceptive C-fiber subtypes. Lastly, we discuss the potential roles of capsaicin-sensitive esophageal afferent nerves in processing esophageal sensation and nociception. A better knowledge of the mechanism of nociceptive signal processes in primary afferent nerves in the esophagus will help to develop novel treatment approaches to relieve esophageal nociceptive symptoms, especially those that are refractory to proton pump inhibitors.

Review of Perineural Invasion in Keratinocyte Carcinomas.

Perineural invasion is an infiltrative process of peripheral nerves by the primary neoplasm within the immediate vicinity. Aggressive forms of keratinocyte carcinomas, such as basal cell and squamous cell carcinomas, may feature perineural invasion, which is often associated with tumor recurrence and poorer prognosis. Diagnosis requires a high clinical suspicion. Imaging and histopathology are used to assess for extent of disease while surgical excision with complete circumferential peripheral and margin assessment is the treatment goal. However, there is still significant uncertainty about adjuvant chemotherapy and definitive management guidelines. Here, we summarize the current understanding of this complex pathogenic process, the clinical presentation, and the significance of perineural inflammation. We also discuss the recommendations about staging, prognosis, adjuvant radiotherapy, and general guidelines for managing keratinocyte carcinomas with perineural invasion. A better understanding of perineural invasion is essential to improve diagnosis, tailor interventions, and mitigate patient morbidity and mortality.

Perifeer zenuwletsel en het effect van vitamines op het herstelproces

Peripheral nerve injury and the effect of vitamins on the recovery process Although peripheral nerve injuries are usually not life-threatening, they can have a significant impact on the patient’s quality of life and daily functioning, with typical symptoms such as complete paralysis or severe neuropathic pain. The peripheral nervous system is capable of some regeneration and recovery, allowing conservative treatment in mild to moderate nerve damage. For severe peripheral nerve injuries surgical reconstruction remains the golden standard. However, despite the extensive knowledge of the pathophysiology of peripheral nerve trauma, a full functional recovery after a severe peripheral nerve injury is rare with the current therapeutic options. Success depends on a variety of factors: location and severity of the injury, age and physical condition of the patient, therapeutical approach, … Therefore, it is important to search for the best possible means to achieve maximal functional recovery. This article first discusses the current knowledge about the pathophysiology of peripheral nerve trauma, highlighting the most important factors that influence the recovery process. Subsequently, it will render a review of the influence of vitamins A/B/C/D/E/K on this recovery process: vit B and D seem to enhance the regeneration process of nerves and the functional recovery of the end organ, while vit C and E show an important antinociceptive effect.

Effects of the release technique by pressing on the latent myofascial trigger point of the upper trapezius muscle: random controlled clinical trial

Introduction. Latent myofascial trigger points (LMTPs) are responsible for intense and spontaneous pain. Non-traumatic mechanical neck pain is characterized by the presence of pressure hyperalgesia in the cervical spine, which equally affects the cervical muscles, such as upper trapezius, since these muscles receive their innervation from the CII–IV levels.The goal of research — to find out how the release technique by pressing on the LMTP of the upper trapezius immediately affects the pressure pain threshold (PPT) of this muscle, of the elevator muscle of scapula, the greater occipital nerve (GON), the supra-orbital nerve (V1) and articular processes of CIII–IV bilaterally, as well as on the range of active neck movements (RANM).Materials and methods. Sixty subjects diagnosed with LMTP in the antero-superior fibers of the upper trapezius muscle were included in the study. PPT values were measured bilaterally in the upper trapezius, elevator muscle of scapula, GON, V1, and CIII–IV articular processes using a digital algometer. RANM in flexion, extension, homolateral lateral flexion, contralateral lateral flexion, homolateral rotation, and contralateral rotation were measured with a bubble inclinometer. The intervention group received the MTP release technique, and the control group received a placebo technique with ultrasound without intensity.Results. The results obtained show that the release technique by pressing on the LMTP of the upper trapezius is effective in increasing the PPT in this muscle immediately after its application (p&lt;0,01). It was also verified that the increase in the PPT in the upper trapezius, after the release of the LMTP, was accompanied by a simultaneous increase in the PPT in the contralateral upper trapezius, as well as in the elevator muscle of scapula bilaterally, GON bilaterally, CIII–IV articular processes bilaterally and V1 homolaterally. In both groups there was a significant increase in RANM (p&lt;0,01). However, in the intervention group this increase was significantly higher, which may be quite relevant from a clinical point of view.Conclusions. The release technique by pressing on the LMTP of the upper trapezius muscle is a useful technique in osteopathy, since it contributes to the increase in PPT and RANM immediately after its application.

Химико-токсикологическая оценка опасности при обращении с ракетным топливом 2-диметиламиноэтилазидом и его производными

The hazard was studied related to toxic effects on the production personnel of the aerospace industry for the experimental rocket fuels of 2-dimethylaminoethylazide and its derivatives — 2-azido-N-methylethanamine and 2-azido-N-cyclopropylethanamine used for liquid propellant rocket engines. The calculation and analysis of physical and chemical constants that characterize the bioavailability of substances based on the rules of N.V. Lazarev, С.A. Lipinsky, and S.M. Jorgensen are made. Pharmacophore analysis and search for active sites of a number of receptors related to carcinogenesis, psychotropic and nerve processes, and the cardiovascular system were performed in the Schrödinger software package. Molecular docking of the receptors and the studied compounds was performed, and the results were analyzed in AutoDock Vina. The values are determined concerning approximately safe exposure levels, hazard classes of substances, and the maximum possible concentrations (volatility) of the rocket fuels that occur in the event of an emergency leak. Through the use of probit method the assessment was related to the immediate non-carcinogenic health risks that service personnel are exposed to in the event of accidental fuel leaks (irritating effect, diseases of the respiratory, nervous, and cardiovascular systems). The results have practical application in the search and synthesis of the rocket fuels - safe analogues of the more toxic heptyl (1,1-dimethylhydrazine), the use of which leads to the development of occupational diseases in the operating personnel and environmental pollution by the aerospace industry facilities.

Влияние кодируемых L-аминокислот на органотипическую культуру тканей различного генеза

The study of the regulatory mechanisms of two basic processes in multicellular systems, i. e., proliferation and apoptosis, stands high on the agenda of modern biology and medicine. Recent data show that the coded L-amino acids are not only the plastic material for the synthesis of protein, they can also regulate cellular processes, increasing or decreasing proliferation and apoptosis. These processes provide the development of a living organism. Hydrophobic properties of amino acids are one of their key characteristics. They depend on the combination of the proton-donor and proton-acceptor groups. Hydrophobic properties make it possible for L-amino acids to participate in the hydrogen linking with the solvent molecules. The aim of study was to identify the effect of amino acids with different hydrophobic properties on the organotypic culture of rat brain cortex and spleen tissues. It was shown that in the tissues of ectodermal genesis proliferation was stimulated mainly by the amino acids with hydrophobic properties, but the same amino acids inhibited proliferation in the tissues of mesodermal genesis. The tissue-specific effect of L-amino acids is the foundation for the synthesis of short peptides in new drug products developed to enhance regeneration processes in nerve and immune tissue.

Immunological and molecular basics of the primary open angle glaucoma pathomechanism

Glaucoma is a degenerative process of the optic nerve. Increased intraocular pressure is believed to be the main factor leading to the glaucomatous damage. The in vitro and in vivo animal glaucoma research models provide insight into the molecular changes in the retina in response to the injury factor. The damage is a complex process incorporating molecular and immunological changes. Such changes involve NF kB activity and complement activation. The processes affect the human antigen, JNK, MAPK, p53, MT2 and DBA/2J molecular pathways, activate the autophagy processes and compromise neuroprotective mechanisms. Activation and inhibition of immunological responses contribute to cell injury. The immunological mechanisms of glaucomatous degeneration include glial response, the complement, tumor necrosis factor α (TNF-α) pathways and toll-like receptors athways. Oxidative stress and excitotoxicity are factors contributing to cell death in glaucoma. The authors present an up-to-date review of the mechanisms involved and update on research focusing on a possible innovative glaucoma treatment.

Chapter 20 - The vomeronasal organ: History, development, morphology, and functional neuroanatomy

The human vomeronasal organ (VNO) is an accessory olfactory organ located on the anteroinferior part of the nasal septum, 1.5-2.5cm from the nostrils. Its main role is pheromone reception and, through its anatomical connections with the central nervous system, especially parts of the hypothalamus, modulation of both social and sexual behavior, although these relations have been established only in nonprimates and very little is yet established for the structure and function of the human VNO. Morphologically, the human VNO is a pit or duct-shaped structure, comprised of three cellular layers-basal cells, neural cells with olfactory cell morphology and immunohistochemical phenotype, and ciliated respiratory epithelium. Medially and connected to the VNO, a small nerve fiber is found that runs longitudinally to the nasal septum and is considered by some to be a distant process of the Cranial Nerve 0 or terminal nerve. In addition to pheromone reception, the human VNO has also been associated with several pathological conditions, including sinus septi nasi, posttraumatic stress disorder, and ectopic olfactory esthesioblastoma.

RESEARCH OF REPARATIVE MECHANISMS IN THE OPTIC NERVE IN TOXIC NEUROPATHY CAUSED BY Cr (VI)

Intoxication lesions of the optic nerve (toxic optic neuropathy, TON) most often occur under the influence of exogenous factors, including heavy metals. Сell survival under stress have involves heat shock proteins (HSPs). The aim of the research. To assess the optic nerve’s immunoreactivity to heat shock proteins of the HSP70 and HSP90α families and reveal its relationship with the severity of morphological changes in toxic optic neuropathy caused by Cr (VI). Materials and methods. The study was conducted on 48 mature male rats. The experimental groups were given to drink water with Cr(VI) for 20, 40 and 60 days. This type of water is typical for the water basins in the northern districts of the Sumy region. Optic nerves сhanges under the influence of Cr(VI) have investigated by the morphometric method. Neuroglial cells and capillary endothelial cells were assessed by immunohistochemistry by HSP70α and HSP90 expression for intensity and spatial distribution. Results. The data analysis revealed that Cr (VI) has a neurotoxic effect on the optic nerve with the development of edema, which is manifested by the thickening of nerve fibers. The dynamics of HSP70 immunoexpression in the endothelium of the optic nerve capillaries of rats on 20 and 40 experimental days was characterized by stable values and was 1.5 times higher than the control. The maximum number of positively stained cells for the HSP70 marker was detected in endothelial cells of the microvasculature for 60 days – 82.44±12.42 %. HSP70 levels in neuroglia cells of optic nerve have decreased on day 40 (55.66±11.56% p=0.05) and lower than the control (70.44±4.81 %.) group. Optic nerve capillaries was highest immunoactivity on HSP90 in group II endothelial cells – 51.22±14.57% (p=0.05). The activity of HSP90α protein in optic neuroglia cells was characterized by a gradual increase in the duration of the experiment and was higher by 12, 4 % in experimental group III (81.77±21.67 %) compared with control (71.66±4.95 %). Conclusions. Our study provides an insight into the significant difference in the immunoreactivity of heat shock proteins of the HSP70 and HSP90α families in neuroglia and endothelial cells of the optic nerve capillaries under the influence of Cr(VI). The results obtained suggest that Cr (VI) has a neurotoxic effect on the optic nerve with the development of edema, which is manifested by the thickening of nerve fibers. A comparison of the dynamics of the development of the dystrophic process in the optic nerve with the results of the immunohistochemical analysis showed, that an increase in the thickness of nerve fibers is accompanied by an increase in immunoreactive neuroglial cells (HSP90α) and endothelial cells (HSP70).

IDENTIFYING POST-PARTUM OPTIC NEURITIS IN RURAL AREAS: A CASE REPORT

Background: Optic neuritis is an inflammatory demyelinating process that causes acute impairment of vision that may appear in one or both eyes, either simultaneously or successively. Case: A 22-year-old woman admitted to Neurology Clinic with chief complaint of sudden vision loss in both eyes simultaneously in the last two days. Additional complaints like headache and dizziness also occur. The patient was in her 7th day of post-partum period when this happened. There was no problem during pregnancy nor delivery. The initial visual acuity was 1/300 in both eyes. The patient then admitted and treated with high-dose corticosteroid. After treatment, the patient went home with visual acuity of more than 6/60. Discussion: This patient may have B6, B12, and folic acid deficiency that can cause demyelinating process of optic nerve. It is also possible as an early manifestation of Multiple Sklerosis, an autoimmune process that arises during post-partum period. Conclusion: Pregnancy has a protective effect to autoimmune disease, whereas post-partum period is immunologically more vulnerable to autoimmune disease. Keywords: optic neuritis, post-partum, sudden vision loss