Biomedical research has revealed many similarities between neurodegenerative diseases at the cellular level, including atypical protein assemblies. These similarities suggest that therapeutic advances against one neurodegenerative disease might ameliorate other diseases as well. enter image description here In each disease, neurons gradually lose function as the disease progresses with age. It is though that repeated viral exposures, even seemingly innocuous, can significantly elevate risks of neurodegenerative disease, including up to 15 years after infection.

Yet the search for a specific viral or auto-immune origin in these diseases have mostly failed. This article published on medRxiv by scientists from Netherlands, aims at identifying overlap at genetic level between four investigated neurodegenerative disorders (Alzheimer’s disease, amyotrophic lateral sclerosis, Lewy body dementia, and Parkinson’s disease).

As these diseases are mostly associated with age, they have a poor heritability, so it would be difficult to associate with some gene.

As in previous studies, the authors failed to identify any region, gene, gene-set, cell or tissue type that was shared between all four neurodegenerative diseases. However, they found that HLA locus was significantly associated with these traits. It is not clear how it is associated because the scientists used a tool named FUMA. FUMA is an automatic tool which annotates GWAS findings and prioritizes the most likely causal SNPs and genes. Yet it is a bit obscure like all these "ontological" tools, like too often in molecular biology it is a qualitative, not quantitative tool.

HLA is a part of the genome which plays an important role in immune systems. The major histocompatibility complex (MHC) is a large locus on vertebrate DNA containing a set of closely linked polymorphic genes that code for cell surface proteins essential for the adaptive immune system. This genetic complex is called HLA in humans.

These cell surface proteins are called MHC molecules. The proteins encoded by HLAs are those on the outer part of body cells that are (in effect) unique to that person. The immune system uses the HLAs to differentiate self cells and non-self cells. Any cell displaying that person's HLA type belongs to that person and is therefore not an invader.

While this study does not try to explain what is the relation between those diseases and the HLA region, it is possible to make some guesses.

If aging (and DNA) degradation is a function of the number of viral attacks during life, then it makes sense to find a correlation between immune system and these non-communicable diseases.

But again many studies have not found any relations between viral or auto-immune insults and neurodegenarative diseases.

Des scientifiques de l'université de Virginie ont découvert que l'exposition aux inhibiteurs nucléosidiques de la transcriptase inverse était associée à une incidence significativement plus faible de la maladie d'Alzheimer dans deux des plus grandes bases de données d'assurance maladie aux États-Unis.

La signalisation immunitaire innée via l'inflammasome NLRP3 semble être impliquée dans la pathogenèse de la maladie d'Alzheimer, du diabète ou de la dégénérescence maculaire. enter image description here NLRP3 is expressed predominantly in macrophages and as a component of the inflammasome, it  detects products of damaged cells such as extracellular ATP and crystalline uric acid. Activated NLRP3 in turn triggers an immune response. Mutations in the NLRP3 gene are associated with a number of organ specific autoimmune diseases.

Dans la présente étude, les scientifiques démontrent que l'exposition aux NRTI inhibiteurs de l'inflammasome est associée à une incidence significativement plus faible de la maladie d'Alzheimer dans deux des plus grandes bases de données d'assurance maladie aux États-Unis. Une thérapie qui inhibe l'activation de l'inflammasome pourrait donc peut-être être neuroprotectrice dans la maladie d'Alzheimer.

Cependant, les toxicités associées à l'utilisation systémique des NRTI, réduisent l'enthousiasme pour de telles entreprises thérapeutiques. Fait intéressant, la fonction anti-inflammatoire des NRTI est indépendante de leur capacité à inhiber la transcriptase inverse. Les dérivés alkylés de NRTI modifiés connus sous le nom de Kamuvudines, conservent la capacité d'inhiber l'activation de l'inflammasome mais n'ont pas la capacité d'inhiber la transcriptase inverse et, par conséquent, n'ont pas non plus les toxicités associées aux NRTI classiques.

Tout au long des analyses de bases de données d'assurance maladie, des mesures ont été prises pour atténuer les biais potentiels et promouvoir la validité interne. Au départ, les scientifiques ont ajusté un grand nombre de variables démographiques et cliniques en les incluant comme covariables de facteurs de risque fixes. Dans l'ensemble, ces mesures appuient la validité et les conclusions des analyses de bases de données.

Bien que les échantillons de la base de données aient été limités aux patients atteints du VIH ou de l'hépatite B, il est tentant de supposer que les résultats de l'étude peuvent être généralisés à d'autres populations de patients.

Ainsi, les effets neuroprotecteurs des NRTI et de la Kamuvudine-9 dans la maladie d'Alzheimer s'étendent probablement au-delà du cadre d'une infection virale coexistante.

Ceci est cohérent avec des études antérieures par nous et d'autres qui démontrent les avantages anti-inflammatoires des NRTI et de la Kamuvudine-9 dans d'autres modèles de maladies non infectieuses.

Les auteurs présentent également des éléments indiquant que le traitement par Kamuvudine-9 de souris âgées 5xFAD (un modèle génétique de la maladie d'Alzheimer) inverse considérablement les déficits de mémoire spatiale et d'apprentissage et améliore leurs performances par rapport à celles des jeunes souris non modifiées génétiquement.

Néanmoins, des essais contrôlés randomisés prospectifs chez l'homme sont justifiés pour mieux comprendre les effets des NRTI ou de la Kamuvudine-9 sur les résultats cliniques dans la maladie d'Alzheimer. En effet, des essais sont en cours sur deux NRTI, la lamivudine (NCT04552795) et l'emtricitabine (NCT04500847), dans la maladie d'Alzheimer. Il convient de noter que l'utilisation isolée d'inhibiteurs nucléosidiques de la transcriptase inverse peut faciliter le développement d'une résistance virale. De plus, les NRTI ont été associés à une toxicité mitochondriale hors cible en raison de leur inhibition de la gamma polymérase mitochondriale23. Il convient donc de tester si Kamuvudine-9, qui ne présente pas ces inconvénients, pourrait être une alternative plus sûre aux NRTI en milieu clinique.

Il convient de noter qu'Inflammasome Therapeutics, une société privée de Newton, Massachusetts est fondée par Ambati et Paul Ashton.

Low-dose whole brain radiation therapy for Alzheimer’s dementia

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Studies in health risks from medical radiation diagnostic procedures, radiotherapy and environmental nuclear contamination as well as for Earth-orbit and space missions have shown that low-dose irradiation (10 cGy) causes down-regulation of neural pathways associated with cognitive dysfunctions that are also down-regulated in normal human aging and Alzheimer's disease. enter image description here Curiously Mice exposed to high-dose radiation (2 Gy)did not show these effects and associations. Intriguily, there are also reports indicating stimulatory or beneficial effects after exposure to cell phone radiofrequency radiation.

Increased brain glucose consumption after exposure to radiofrequency radiation, as confirmed by PET studies, may be a potential mechanism in this phenomenon. Some scientists think that this is related to the possible beneficial effects of infrared exposure that are sometimes asserted.

Moreover, Schuz et al. in 2009 reported that long-term cell phone users had a 30–40% decreased risk of hospitalization due to AD and vascular dementia!

Following similar observations, Beaumont Cancer Center in Michigan USA, began treated patients Alzheimer's disease with ionizing radiation at doses of 30 to 60 Gray (Gy) given in 2 Gy fractions.

In 2015 in Canada, a patient in hospice with Alzheimer's disease was treated with ionizing radiation to her brain using repeated CT scans. Improvement in cognition, speech, movement, and appetite was observed. These improvements were so momentous that she was discharged from the hospice to a long-term care home.

This was described in a report which was criticized for failing to acknowledge alternate hypotheses and confounding variables.

Two clinical trials were conducted in Canada with 5 patients in one case and 4 patients in the other, but no results were posted which presumably was due to an absence of positive results. Yet minor improvements on quantitative measures were noted. It should be noted that for having statistical significance a clinical trial should enroll several hundreds to thousands patients. Otherwise it's easy to make unsubstantiated claims.

A clinical trial with 5 patients was interrupted by COVID-19.

It seems history is repeated, a new publication describes another clinical trial with 5 patients, this time in USA at Barrow Neurological Institute.

Five patients were treated with LD-WBRT (a new acronym for radiotherapy) (2Gy x 5). Three subjects were female and two male. Four of the 5 patients experienced minimal improvement or stability in MMSE-2 scores comparing baseline before treatment and post-treatment scores at 12 months. The mini–mental state examination (MMSE) or Folstein test is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. Three patients saw their scores improve, another remained stable, and the last experienced a considerable drop in the MMSE score. Curiously the publication does not provide any clinical trial registration number.

Metabolism is the conversion of energy from food into energy for life-sustaining tasks such as breathing, circulating blood, building and repairing cells, digesting food, and eliminating waste. enter image description here For sedentary adults, basal metabolic rate (the metabolic rate at rest) accounts for about 50% to 70% of total energy output, dietary thermogenesis for 10% to 15%, and physical activity for the remaining 20% to 30%.

At approximately 60 years old, BMR begin to decline, along with fat mass. However, declines in energy expenditure exceed that expected from reduced body mass alone. This is similar that what is found in several neurodegenerative diseases, albeit at a much slower rate.

Numerous studies suggest that metabolic dysfunction increases the risk of Alzheimer's disease. For instance, impaired glucose metabolism in the brain has been linked to Alzheimer's disease and may start several years before the onset of clinical symptoms.

Due to the long incubation period between exposure and results, randomized controlled trials, the gold standard for causal reasoning, are not feasible. In addition causation and confounding often substantially impede or mislead the interpretation of results from epidemiological studies. So scientists use Mendelian randomization, which is a method for obtaining unbiased estimates of the effects of a putative causal variable without conducting a traditional randomized controlled trial.

In a new publication, scientists determined the causal relationship between BMR and Alzheimer's disease by two-way Mendelian randomization and investigated the impact of factors associated with BMR on Alzheimer's disease.

The authors searched for a possible causal relationship between Alzheimer's disease and factors related with BMR, hyperthyroidism and type 2 diabetes, height and weight.

BMR was found to have a causal relationship with Alzheimer's disease, but there was no causal relationship between hyperthyroidism or type 2 diabetes in one hand and Alzheimer's disease in the other hand.

The authors' study showed that higher BMR reduced the risk of Alzheimer's disease, and patients with Alzheimer's disease had a lower BMR.

A person may be able to change their BMR through regular cardiovascular exercise.

Read the original article on Pubmed

We all know about TUDCA, a bile acid which has been used medicinally for centuries, is used in combination with sodium phenylbutyrate, in treatment of amyotrophic lateral sclerosis (ALS). TUDCA is also used in retinal degenerative disorders and is studied in Parkinson's disease.

There is evidence that there are differences in the serum levels of bile acids in males and females and their risk of developing Alzheimer's disease.

The authors of a new publication on medRxiv previously reported that serum bile acids are associated with Alzheimer's disease. It remains unclear, however, how changes in serum bile acids may relate to the development of Alzheimer's disease in a sex-dependent manner.

They analyzed 33 bile acids in the sera of 4219 samples from 1180 subjects in a Alzheimer's disease cohort and they examined the associations between bile acids and mild cognitive impairment (MCI) progression and clinical markers. enter image description here

The scientists found that significant alterations in bile acids profiles occurred at an early stage of MCI and were associated with the onset and progression of MCI. These changes were more dramatic in men than in women. Bile acids markers improved the ability to diagnose MCI and predict its progression. enter image description here

Many studies hint at a role of cholesterol in neurodegenerative diseases. For example protein clearance ability is age-related, regulated by brain cholesterol. Bile acids have metabolic actions in the body resembling those of hormones in triglyceride metabolism, glucose metabolism, and liver growth.

Half of the amount of cholesterol produced by the body is used for bile acid synthesis. Bile acid sequestrants are used to lower the level of LDL cholesterol circulating in the blood. As many aged people are prescribed bile acid sequestrants it could be worth to investigate the link between this kind of medication and the apparition of some neurodegenerative diseases.

Read the original article on medRxiv

This article is a bit unusual as it claims a relationship between several genes in ALS (Lou Gerigh disease), including APP which is associated with Alzheimer's disease. On the overall it says that C9 ALS is a problem of ribosome quality control (RQC) which leads to cellular stress response. It suggests that C9, FUS, TDP-43 mutations influence mTORC2 protein which in turn alters the translation mechanism. When the translation mechanism is altered, cellular stress response is activated and protein production nearly stops, rendering the cell non-functional. It's the start of the disease.

ALS is a muscle wasting disease characterized by degeneration of lower motor neurons and axons and loss of upper motor neurons and their corticospinal tracts. FTD is a progressive neuronal atrophy with neuronal loss in the frontal and temporal cortices and associated behavioral and personality changes and impairment of language skills. Advances in human genetics have identified multiple genetic mutations commonly associated with ALS and FTD, revealing that these two diseases are related and may represent a continuum of a broad neurodegenerative disorder. C9orf72 mutation is present in approximately 40% of familial ALS and 8-10 % of sporadic ALS. It is currently the most common demonstrated mutation related to ALS - far more common than SOD1.

The research on association of C9ORF72 with ALS or FTD is relatively recent and its mechanisms are not clear. This obviously impairs the proposal of new drugs. Gene expression or translation is the process in which ribosomes in the cytoplasm or endoplasmic reticulum synthesize proteins after the process of transcription of DNA to RNA in the cell's nucleus. Yet during translation elongation, ribosomes may slowdown or even stall for various reasons. The polypeptide later folds into an active protein and is sent to its final location to perform its functions in the cell.

RAN translation, is an irregular mode of mRNA translation that can occur in eukaryotic cells. RAN translation produces a variety of dipeptide repeat proteins (DPR) by translation of expanded hexanucleotide repeats present in an intron of the C9orf72 gene. The expansion of the hexanucleotide repeats and thus accumulation of dipeptide repeat proteins are thought to cause cellular toxicity that leads to neurodegeneration in ALS disease.

Previous studies of protein quality control have focused on how proteins were handled after translation. However, rproblems with proteostasis are prevalent even with translating nascent peptide chains still associated with ribosomes, necessitating ribosome-associated quality control (RQC) mechanisms.

Mutations in other genes that are commonly linked to ALS/FTD have also shed lights on disease pathogenesis such as TDP-43 and FUS. Other genes linked to ALS/FTD include VCP, a member of the AAA ATPase family with established function in the recycling and degradation of ubiquitinated proteins, and genes with functions in protein clearance or maintenance of protein homeostasis. In addition, upregulation of APP, a protein whose aberrant processing or metabolism having been implicated in Alzheimer’s disease (AD), was observed at early stages of ALS and FTD, presumably as a compensatory response to neuronal damage or impairment of axonal transport. However, the relationships among the various ALS/FTD genes remain underexplored.

It is therefore important to understand cellular mechanisms underlying the quality control of poly(GR). Previous studies of protein quality control have focused on how proteins were handled after translation, e.g., by chaperone-mediated refolding, or proteasome- and lysosome-mediated degradation. However, recent studies reveal that problems with proteostasis are prevalent even with translating nascent peptide chains still associated with ribosomes, necessitating ribosome-associated quality control (RQC) mechanisms.

In the case of poly(GR), it was shown that its translation was frequently stalled, presumably due to positively charged arginine residues interacting with negatively-charged residues lining the exit tunnel of 60S ribosome. Stalled poly(GR) translation activates the RQC process, the inadequacy of which can lead to the accumulation of aberrant, C-terminally modified (CAT-tailed) poly(GR) species that can perturb proteostasis and contribute to poly(GR) accumulation and neuromuscular degeneration.

In this study, the scientists from USA and China set out to test whether the other ALS/FTD associated genes may participate in the quality control of poly(GR). Strikingly, they discovered that overexpression of APP, FUS, and TDP-43 restrains poly(GR) protein expression. Mechanistically, APP, FUS and TDP-43 act through the mTORC2/AKT/VCP axis to regulate the RQC of poly(GR) translation. Inhibition of the mTORC2/AKT/VCP axis could restore poly(GR) protein expression attenuated by APP, FUS, or TDP-43. Their data strongly implicate the mTORC2/AKT/VCP axis as a major regulator of protein quality control in ALS/FTD.

Their data support the working model that mutated APP, FUS, and TDP-43 are upstream regulators of the mTORC2/AKT/VCP axis, which regulates the RQC of poly(GR) during its translation stalling. Moreover, they suggest that APP, FUS, and TDP-43 can also induce repression of global translation when ribosome stalling is persistent.

APP acts through the mTORC2/AKT signaling axis to regulate the RQC of C9-ALS/FTD-associated poly(GR) translation. The involvement of APP in ALS has previously been studied in the context of ALS, and APP or its metabolite was found to exacerbate ALS-related phenotypes in the SOD1-G93A mouse model. This new results suggest that APP can activate mTORC2/AKT signaling to alleviate stalled translation of poly(GR) and restrain the expression of aberrant poly(GR) translation products, at least at the initial stage. It is possible that in ALS/FTD setting, APP is upregulated as a protective response in response to neuronal damage at an early stage of disease as previously suggested

It is difficult to not think about the controverse about the role of amyloid plaques found in the brains of Alzheimer's disease patients. Amyloid beta is a fragment from the larger amyloid-beta precursor protein (APP) a transmembrane protein that penetrates the neuron's membrane. APP is critical to neuron growth, survival, and post-injury repair. While the authors write only about ALS, chronic upregulation of APP may contribute not only to ALS, but also also to Alzheimer's disease due to the accumulation of APP metabolites, the stalled translation of APP itself, or the prolonged activation of stress response pathways by APP may lead to the depression of global translation.

Indeed the authors found that integrated stress response as indicated by eIF2α phosphorylation was heightened in transgenic flies expressing poly(GR). This is presumably caused by the ribosome stalling occurring during poly(GR) translation.

A similar situation may occur with TDP-43 and FUS. In fact, both mutations in TDP-43 and FUS genes have been shown to associate with stalled ribosomes, and in the case of TDP-43, its association with stalled ribosomes provides neuroprotection function in the face of sublethal stress.

Intriguingly, the authors showed that the a portion of APP (APP-C99) is sufficient to activate the mTORC2/AKT axis and regulate GR80 translation, whereas the Aβ-42 portion of APP was without effect. This finding resonates with recent revelation of aberrant APP-C99 as the etiological driver of Alzheimer’s disease.

Remarkably, the translation of this portion of APP is also frequently stalled, the inadequate RQC of which can generate aberrant translation products that precipitate hallmarks of Alzheimer’s disease. It is therefore fascinating that overexpression one stalled translation product (APP-C99) would abrogate the stalled translation of another portion (GR-80).

Future studies will investigate at the biochemical level how APP/APP-C99, FUS, and TDP-43 signal to the mTORC2/AKT/VCP axis to regulate the RQC of stalled poly(GR) translation, whether endogenous stalled peptides that serve as RQC substrate(s) may also targeted by this pathway, and how this signaling process may be targeted for therapeutic purposes.

Forecasting individual progression trajectories in Alzheimer's disease.

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The anticipation of progression of Alzheimer's disease is crucial for evaluations of secondary prevention measures thought to modify the disease trajectory. However, it is difficult to forecast the natural progression of Alzheimer's disease, notably because several functions decline at different ages and different rates in different patients. enter image description here Disease modeling uses computational and statistical methods to address this question. These models learn the variability of disease progression from observational longitudinal cohort data and can then predict the progression of patients from their historical data. They require various clinical or biomarker assessments at one or several time points as input.

European authors evaluate in Nature communications Alzheimer's disease Course Map, a statistical model predicting the progression of neuropsychological assessments and imaging biomarkers for a patient from current medical and radiological data at early disease stages.

Alzheimer's disease Course Map is a spatiotemporal atlas of Alzheimer's disease progression. It summarizes the variability in the progression of a series of neuropsychological assessments, the propagation of hypometabolism and cortical thinning across brain regions and the deformation of the shape of the hippocampus. The analysis of these variations highlights strong genetic determinants for the progression, like possible compensatory mechanisms at play during disease progression. AD Course Map also predicts the patient's cognitive decline with a better accuracy than the 56 methods benchmarked in the open challenge TADPOLE. Finally, AD Course Map is used to simulate cohorts of virtual patients developing Alzheimer's disease.

The scientists from France, Germany and Italy propose a software tool using a disease progression model for participant selection in clinical trials. The goal is to enrich the selected population of participants likely to display progression during the trial, a concept called prognostic enrichment.

The scientists tested the method on more than 96,000 cases, with a pool of more than 4,600 patients from four continents.

They measured the accuracy of the method for selecting participants displaying a progression of clinical endpoints during a hypothetical trial.

They show that enriching the population with the predicted progressors decreases the required sample size by 38% to 50%, depending on trial duration, outcome, and targeted disease stage, from asymptomatic individuals at risk of Alzheimer's disease to subjects with early and mild Alzheimer's disease.

In conclusion this method introduces no biases regarding sex or geographic locations and is robust to missing data. It performs best at the earliest stages of disease and is therefore highly suitable for use in prevention trials.

Read the original article on Pubmed

Caffeic acid is an organic compound. The structure of caffeic acid (aromatic core, conjugated double bond, and hydroxyl groups) allows it to function as an antioxidant.

Caffeic acid (50 mg/kg) reduces blood glucose levels in streptozocin-induced diabetic mice.

In depressed rats, caffeic acid (10 and 30 mg/kg) normalized noradrenalin and tryptophan levels in a dose-dependent manner.

BDNF, a neurotrophin that modulates neuroplasticity in the brain, is regularly decreased in depressed patients.Caffeic acid also increased the expression of brain-derived neurotrophic factor (BDNF) in stressed mice; the effect was mediated by 5-lipoxygenase inhibition [106].

The main components of plaques found in the brains of patients with Alzheimer’s disease consist of β-amyloid peptides and tau proteins. enter image description here The essential step for tau protein aggregation is tau phosphorylation which may also play a role in initiating β-amyloid toxicity. One of the kinases that phosphorylate tau protein is glycogen synthase kinase-3 beta (GSK3β); insulin signaling inhibits the activity of this kinase. Therefore, a hypothesis suggests that GSK3β deregulation in neurons may be a key point in developing Alzheimer’s disease.

In the brain of hyperinsulinemic rats, caffeic acid normalized superoxide dismutase (SOD) activity and glutathione levels, inhibited glycogen synthase kinase 3β (GSK3β) activity, and decreased the level of β-amyloid and phosphorylated tau protein.

Feeding hyperinsulinemic rats with caffeic acid (30 mg/kg b.w./day) for 30 weeks significantly improved their memory and learning impairments caused by a high-fat diet.

The concurrent effects of caffeic acid on atherosclerotic lesions and cognitive decline were explored in a new article by using the ApoE (Alzheimer) mice model.

A two months' administration of 20 mg/kg caffeic acid or saline was given once two days intraperitoneally to 5-month-old female ApoE mice.

The scientists found that the caffeic acid treatment reduced the atherosclerotic lesions in the whole aorta and aortic sinus of the resulting 7-month-old ApoE mice by roughly 50%, compared with the saline control.

Meanwhile, the cognitive decline of treated mice were significantly alleviated, as measured by Y-maze and Morris water maze tasks. A reduced accumulation of β-amyloid in the hippocampus was also observed. These effects were associated with elevated serum HDL-c concentration, upregulated ABCA1 and ABCG1 mRNA levels, as well as decrease local inflammation and reduced levels of serum pro-inflammatory cytokines including TNF-α, IL-6 and MCP-1.

These obtained results suggested the preventive and therapeutic potential of caffeic acid against atherosclerosis and Alzheimer's disease during aging.

Free caffeic acid can be found in a variety of herbs of the mint family, especially thyme, sage and spearmint (at about 20 mg per 100 g), and in spices, such as Ceylon cinnamon and star anise (at about 22 mg per 100 g).

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Au cours du processus de vieillissement, il y a une augmentation de l'incidence de plusieurs maladies, y compris le déclin de la santé physique et mentale, qui ont un effet en cascade sur d'autres problèmes de santé. La démence et les troubles cognitifs font partie des maladies non transmissibles ou des problèmes liés à l'âge les plus importants. Bien qu'il n'existe actuellement aucun remède contre la démence, les stratégies non pharmaceutiques telles que l'activité physique ou les interventions d'exercice physique sont considérées comme essentielles pour prévenir l'apparition de la maladie. En particulier, la santé cardio-respiratoire s'est avérée être associée à une meilleure cognition et à un risque plus faible de démence.

Le santé cardio-respiratoire est définie comme la capacité des systèmes circulatoire, respiratoire et musculaire à fournir de l'oxygène pendant une activité physique soutenue. Elle est généralement évaluée en tant que pic de consommation d'oxygène (VO2peak). Cependant, pour obtenir une mesure exacte et précise du santé cardio-respiratoire, un test d'effort cardiopulmonaire incrémental (CPET) jusqu'à épuisement est nécessaire. La CPET comporte certains risques physiques et sanitaires, en particulier pour les personnes âgées, et nécessite l'utilisation d'équipements de haute précision et coûteux qui entravent sa mise en œuvre.

De plus, l'argument que les tests de santé cardio-respiratoire ne devraient pas être utilisé dans la pratique clinique de routine est obsolète. Kaminsky et al. ont récemment souligné que les unités commerciales d'épreuves d'effort métaboliques sont faciles à utiliser, fournissent une analyse en temps réel des échanges respiratoires et même un système d'électrocardiogramme intégré à des prix faibles. La mise en œuvre du CPET dans les hôpitaux doit maintenant être envisagée.

Cependant, bien que les tests de santé cardio-respiratoire ne soit pas couramment utilisé dans la pratique clinique, une alternative est l'utilisation d'estimations des tests de santé cardio-respiratoire. Plusieurs études ont déjà développé des ensembles d'équations basées sur des études de larges populationr et visant à construire des équations simple pour prédire les résultats des tests de santé cardio-respiratoire. On nomme l'ensemble de ces équations: eCRF.

Boots et al. ont montré que l'eCRF était aussi associé à la fonction cognitive, cependant, ce travail incluait seulement des personnes âgées de 20 à 70 ans, et ils utilisaient une équation qui n'était pas spécifique aux personnes âgées.

Par conséquent, les objectifs de cette nouvelle étude de Ana Carbonell-Baeza and David Jiménez-Pavón du Biomedical Research and Innovation Institute of Cádiz (INiBICA), étaient:

  • d'analyser la précision des équations existantes pour prédire les tests de santé cardio-respiratoire chez les personnes âgées et de développer de nouvelles équations pour prédire les résultats de tests de santé cardio-respiratoire (eCRF) dans ce groupe de population spécifique.
  • d'analyser les associations de santé cardio-respiratoire (mesurée objectivement par un test en laboratoire et estimée par les équations) avec un ensemble complet de tests de performance cognitive.

Cependant les auteurs de cette nouvelle étude ont constaté qu'aucune équation de eCRF existant, n'a permis d'obtenir un bon rapport de prédiction après application à leur échantillon d'étude.

Ils ont donc élaboré un nouvel ensemble spécifique d'équations eCRF pour les personnes âgées a été développé avec des valeurs prédictives allant de 74 à 87 % qui pourraient être utilisées en fonction des besoins, de la disponibilité de l'équipement, des ressources ou du contexte de mesure (c'est-à-dire, milieu clinique ou maison de retraite).

De plus, l'eCRF est positivement associé, de la même manière que les tests de santé cardio-respiratoire mesuré objectivement, aux performances sur le langage, la fluidité, la flexibilité cognitive, l'attention et la mémoire de travail, indépendamment du sexe, de l'âge et du niveau d'éducation.

Ainsi, l'augmentation du santé cardio-respiratoire pourrait être un facteur de protection contre la détérioration de la fonction cognitive associée au vieillissement chez les personnes âgées.

Nervonic acid is recommended to pregnant and nursing women as it can speed up the development in infants. It is particularly abundant in the white matter of animal brains and in peripheral nervous tissue. Yet there are very few studies on it in the realm of neurodegenerative diseases. enter image description here In this study, the authors applied behavioral, transcriptomic and metabolomic approaches to analyze the neuroprotective effect of nervonic acid and its molecular mechanism in Alzheimer's disease model mice.

They shown that nervonic acid improved motor skills and learning and memory abilities of mice at the behavioral level.

To further understand the specific pathways involved in this protective effect, the authors applied the metabolomics and transcriptomics profilings and focused on the expression patterns of genes that nervonic acid might alter, particularly those related to the accumulation of metabolites in the brain.

In lipopolysaccharide (LPS) induced Alzheimer's disease mice, pathways related to neuroinflammation (two imprecise notions) are significantly increased compared with the normal control, and pathways related to neuronal growth and synaptic plasticity are significantly downregulated.

When nervonic acid was used for protection in this mice model of Alzheimer, these signaling pathways induced by LPS were partially reversed. At the same time, compared with the Alzheimer's disease model group, upregulation of arachidonic acid metabolism, purine metabolism, and primary bile acid biosynthesis and downregulation of amino acid metabolic pathways were particularly pronounced in the nervonic acid treatment group.

Nervonic acid improved the spatial and learning behavior of the mice impaired by LPS administration.

In summary, authors' results show that in LPS mice model, nervonic acid can significantly ameliorate neuroinflammation and deterioration of learning and memory, and exerts a neuroprotective function through regulation of multiple gene transcription and metabolism pathways.

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