Nature Reviews Neurology最新文献

Immune mechanisms and shared immune targets in neurodegenerative diseases 神经退行性疾病的免疫机制和共享免疫靶点

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-12-16 DOI: 10.1038/s41582-024-01046-7

Howard L. Weiner

{"title":"Immune mechanisms and shared immune targets in neurodegenerative diseases","authors":"Howard L. Weiner","doi":"10.1038/s41582-024-01046-7","DOIUrl":"https://doi.org/10.1038/s41582-024-01046-7","url":null,"abstract":"The immune system plays a major part in neurodegenerative diseases. In some, such as multiple sclerosis, it is the primary driver of the disease. In others, such as Alzheimer disease, amyotrophic lateral sclerosis and Parkinson disease, it has an amplifying role. Immunotherapeutic approaches that target the adaptive and innate immune systems are being explored for the treatment of almost all neurological diseases, and the targets and approaches are often common across diseases. Microglia are the primary immune cells in the brain that contribute to disease pathogenesis, and are consequently a common immune target for therapy. Other therapeutic approaches target components of the peripheral immune system, such as regulatory T cells and monocytes, which in turn act within the CNS. This Review considers in detail how microglia, monocytes and T cells contribute to the pathogenesis of multiple sclerosis, Alzheimer disease, amyotrophic lateral sclerosis and Parkinson disease, and their potential as shared therapeutic targets across these diseases. The microbiome is also highlighted as an emerging therapeutic target that indirectly modulates the immune system. Therapeutic approaches being developed to target immune function in neurodegenerative diseases are discussed, highlighting how immune-based approaches developed to treat one disease could be applicable to multiple other neurological diseases.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"254 1","pages":""},"PeriodicalIF":38.1,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring the role of sex hormones and gender diversity in multiple sclerosis

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-12-11 DOI: 10.1038/s41582-024-01042-x

Cassie Nesbitt, Anneke Van Der Walt, Helmut Butzkueven, Ada S. Cheung, Vilija G. Jokubaitis

{"title":"Exploring the role of sex hormones and gender diversity in multiple sclerosis","authors":"Cassie Nesbitt, Anneke Van Der Walt, Helmut Butzkueven, Ada S. Cheung, Vilija G. Jokubaitis","doi":"10.1038/s41582-024-01042-x","DOIUrl":"https://doi.org/10.1038/s41582-024-01042-x","url":null,"abstract":"Sex and sex hormones are thought to influence multiple sclerosis (MS) through effects on inflammation, myelination and neurodegeneration, and exogenous hormones have been explored for their therapeutic potential. However, our understanding of how sex hormones influence MS disease processes and outcomes remains incomplete. Furthermore, our current knowledge is derived primarily from studies that focus exclusively on cisgender populations with exclusion of gender-diverse people. Gender-affirming hormone therapy comprising exogenous sex hormones or sex hormone blocking agents are commonly used by transgender and gender-diverse individuals, and it could influence MS risk and outcomes at various stages of disease. A better understanding of the impact and potential therapeutic effects of both endogenous and exogenous sex hormones in MS is needed to improve care and outcomes for cisgender individuals and, moreover, for gender-diverse populations wherein an evidence base does not exist. In this Perspective, we discuss the effects of endogenous and exogenous sex hormones in MS, including their potential therapeutic benefits, and examine both established sex-based dimorphisms and the potential for gender-diverse dimorphisms. We advocate for future research that includes gender-diverse people to enhance our knowledge of the interplay of sex and sex hormones in MS, leading to the development of more effective and inclusive treatment strategies and improvement of care for all individuals with MS.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"4 1","pages":""},"PeriodicalIF":38.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Addressing disparities in neurology by enhancing inclusive practice

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-12-11 DOI: 10.1038/s41582-024-01048-5

Lisa Kiani

引用次数: 0

The global and regional burden of diabetic peripheral neuropathy

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-12-05 DOI: 10.1038/s41582-024-01041-y

Masha G. Savelieff, Melissa A. Elafros, Vijay Viswanathan, Troels S. Jensen, David L. Bennett, Eva L. Feldman

{"title":"The global and regional burden of diabetic peripheral neuropathy","authors":"Masha G. Savelieff, Melissa A. Elafros, Vijay Viswanathan, Troels S. Jensen, David L. Bennett, Eva L. Feldman","doi":"10.1038/s41582-024-01041-y","DOIUrl":"https://doi.org/10.1038/s41582-024-01041-y","url":null,"abstract":"Diabetic peripheral neuropathy (DPN) is length-dependent peripheral nerve damage arising as a complication of type 1 or type 2 diabetes in up to 50% of patients. DPN poses a substantial burden on patients, who can experience impaired gait and loss of balance, predisposing them to falls and fractures, and neuropathic pain, which is frequently difficult to treat and reduces quality of life. Advanced DPN can lead to diabetic foot ulcers and non-healing wounds that often necessitate lower-limb amputation. From a socioeconomic perspective, DPN increases both direct health-care costs and indirect costs from loss of productivity owing to neuropathy-related disability. In this Review, we highlight the importance of understanding country-specific and region-specific variations in DPN prevalence to inform public health policy and allocate resources appropriately. We also explore how identification of DPN risk factors can guide treatment and prevention strategies and aid the development of health-care infrastructure for populations at risk. We review evidence that metabolic factors beyond hyperglycaemia contribute to DPN development, necessitating a shift from pure glycaemic control to multi-targeted metabolic control, including weight loss and improvements in lipid profiles.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"94 1","pages":""},"PeriodicalIF":38.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

α-Synuclein pathology as a target in neurodegenerative diseases 作为神经退行性疾病靶点的 α-突触核蛋白病理变化

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-11-28 DOI: 10.1038/s41582-024-01043-w

Hyejin Park, Tae-In Kam, Valina L. Dawson, Ted M. Dawson

{"title":"α-Synuclein pathology as a target in neurodegenerative diseases","authors":"Hyejin Park, Tae-In Kam, Valina L. Dawson, Ted M. Dawson","doi":"10.1038/s41582-024-01043-w","DOIUrl":"https://doi.org/10.1038/s41582-024-01043-w","url":null,"abstract":"α-Synuclein misfolds into pathological forms that lead to various neurodegenerative diseases known collectively as α-synucleinopathies. In this Review, we provide a comprehensive overview of pivotal advances in α-synuclein research. We examine structural features and physiological functions of α-synuclein and summarize current insights into key post-translational modifications, such as nitration, phosphorylation, ubiquitination, sumoylation and truncation, considering their contributions to neurodegeneration. We also highlight the existence of disease-specific α-synuclein strains and their mechanisms of pathological spread, and discuss seed amplification assays and PET tracers as emerging diagnostic tools for detecting pathological α-synuclein in clinical settings. We also discuss α-synuclein aggregation and clearance mechanisms, and review cell-autonomous and non-cell-autonomous processes that contribute to neuronal death, including the roles of adaptive and innate immunity in α-synuclein-driven neurodegeneration. Finally, we highlight promising therapeutic approaches that target pathological α-synuclein and provide insights into emerging areas of research.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"90 1","pages":""},"PeriodicalIF":38.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Moving beyond immunoglobulin therapy for CIDP with efgartigimod 依加替莫德超越免疫球蛋白疗法治疗 CIDP

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-11-28 DOI: 10.1038/s41582-024-01045-8

Jan D. Lünemann

引用次数: 0

Diets to promote healthy brain ageing 促进大脑健康老化的饮食

IF 38.1 1区医学

Nature Reviews Neurology Pub Date : 2024-11-21 DOI: 10.1038/s41582-024-01036-9

Sokratis Charisis, Mary Yannakoulia, Nikolaos Scarmeas

{"title":"Diets to promote healthy brain ageing","authors":"Sokratis Charisis, Mary Yannakoulia, Nikolaos Scarmeas","doi":"10.1038/s41582-024-01036-9","DOIUrl":"https://doi.org/10.1038/s41582-024-01036-9","url":null,"abstract":"Diet is a modifiable lifestyle factor with a proven role in cardiovascular disease risk reduction that might also play an important part in cognitive health. Evidence from observational studies has linked certain healthy dietary patterns to cognitive benefits. However, clinical trials of diet interventions have demonstrated either null or, at best, small effects on cognitive outcomes. In this Review, we summarize the currently available evidence from observational epidemiology and clinical trials regarding the potential role of diet in the prevention of cognitive decline and dementia. We further discuss possible methodological limitations that might have hindered the ability of previous diet intervention trials to capture potential neuroprotective effects. Considering the overwhelming and continuously expanding societal, economic and health-care burden of Alzheimer disease and other dementias, future nutritional research must address past methodological challenges to accurately and reliably inform clinical practice guidelines and public health policies. Within this scope, we provide a roadmap for future diet intervention trials for dementia prevention. We discuss study designs involving both intensive personalized interventions — to evaluate pharmacokinetic and pharmacodynamic properties, establish neuroprotective thresholds, and test hypothesized biological mechanisms and effects on brain health and cognition through sensitive and precise biomarker measures — and large-scale, pragmatic public health interventions to study population-level benefits.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"180 1","pages":""},"PeriodicalIF":38.1,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intracerebral haemorrhage — mechanisms, diagnosis and prospects for treatment and prevention 脑出血--机制、诊断以及治疗和预防前景。

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-11-15 DOI: 10.1038/s41582-024-01035-w

David J. Seiffge, Simon Fandler-Höfler, Yang Du, Martina B. Goeldlin, Wilmar M. T. Jolink, Catharina J. M. Klijn, David J. Werring

{"title":"Intracerebral haemorrhage — mechanisms, diagnosis and prospects for treatment and prevention","authors":"David J. Seiffge, Simon Fandler-Höfler, Yang Du, Martina B. Goeldlin, Wilmar M. T. Jolink, Catharina J. M. Klijn, David J. Werring","doi":"10.1038/s41582-024-01035-w","DOIUrl":"10.1038/s41582-024-01035-w","url":null,"abstract":"Intracerebral haemorrhage (ICH) is a devastating condition associated with high mortality and substantial residual disability among survivors. Effective treatments for the acute stages of ICH are limited. However, promising findings from randomized trials of therapeutic strategies, including acute care bundles that target anticoagulation therapies, blood pressure control and other physiological parameters, and trials of minimally invasive neurosurgical procedures have led to renewed optimism that patient outcomes can be improved. Currently ongoing areas of research for acute treatment include anti-inflammatory and haemostatic treatments. The implementation of effective secondary prevention strategies requires an understanding of the aetiology of ICH, which involves vascular and brain parenchymal imaging; the use of neuroimaging markers of cerebral small vessel disease improves classification with prognostic relevance. Other data underline the importance of preventing not only recurrent ICH but also ischaemic stroke and cardiovascular events in survivors of ICH. Ongoing and planned randomized controlled trials will assess the efficacy of prevention strategies, including antiplatelet agents, oral anticoagulants or left atrial appendage occlusion (in patients with concomitant atrial fibrillation), and optimal management of long-term blood pressure and statin use. Together, these advances herald a new era of improved understanding and effective interventions to reduce the burden of ICH. Effective treatments for the acute stages of intracerebral haemorrhage are currently limited. In this Review, the authors consider advances in therapeutic strategies and neurosurgical procedures, including acute care bundles, that promise a new era of interventions.","PeriodicalId":19085,"journal":{"name":"Nature Reviews Neurology","volume":"20 12","pages":"708-723"},"PeriodicalIF":28.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dementia risk scores in diverse populations 不同人群的痴呆症风险评分

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-11-13 DOI: 10.1038/s41582-024-01039-6

Lisa Kiani

引用次数: 0

Oligodendrocyte progenitor cell transplant for MS 少突胶质祖细胞移植治疗多发性硬化症

IF 28.2 1区医学

Nature Reviews Neurology Pub Date : 2024-11-13 DOI: 10.1038/s41582-024-01038-7

Lisa Kiani

引用次数: 0