Fibroblasts are typically described as cells that produce extracellular matrix,contribute to the formation of connective tissue,and maintain the structural framework of tissues.Fibroblasts are the first cell type to b...Fibroblasts are typically described as cells that produce extracellular matrix,contribute to the formation of connective tissue,and maintain the structural framework of tissues.Fibroblasts are the first cell type to be transdifferentiated into inducible pluripotent stem cells(iPSCs),demonstrating their versatility and reprogrammability.Currently,there is relatively extensive characterization of the anatomical,molecular,and functional diversity of fibroblasts in different peripheral organs and tissues.With recent advances in single cell RNA sequencing,heterogeneity and diversity of fibroblasts in the central nervous system(CNS)have also begun to emerge.Based on their distinct anatomical locations in the meninges,perivascular space,and choroid plexus,as well as their molecular diversity,important roles for fibroblasts in the CNS have been proposed.Here,we draw inspirations from what is known about fibroblasts in peripheral tissues,in combination with their currently identified CNS locations and molecular characterizations,to propose potential functions of CNS fibroblasts in health and disease.Future studies,using a combination of technologies,will be needed to determine the bona fide in vivo functions of fibroblasts in the CNS.展开更多
Hematopoietic cell transplantation（HCT） is widely performed for neoplastic and non-neoplastic diseases. HCT involves intravenous infusion of hematopoietic progenitor cells from human leukocyte antigen（HLA）-matched...Hematopoietic cell transplantation（HCT） is widely performed for neoplastic and non-neoplastic diseases. HCT involves intravenous infusion of hematopoietic progenitor cells from human leukocyte antigen（HLA）-matched donor（allogeneic） or from the patient（autologous）. Before HCT, the patient is prepared with high dose chemotherapy and/or radiotherapy to destroy residual malignant cells and to reduce immunologic resistance. After HCT, chemotherapy is used to prevent graft rejection and graft versus host disease（Gv HD）. Neurological complications are related to the type of HCT, underlying disease, toxicity of the conditioning regimens, immunosuppression caused by conditioning regimens, vascular complications generated by thrombocytopenia and/or coagulopathy, Gv HD and inappropriate immune response. In this review, neurological complications are presented according to time of onset after HCT：（1） early complications（in the first month）-related to harvesting of stem cells, during conditioning（drug toxicity, posterior reversible encephalopathy syndrome）, related to pancytopenia,（2） intermediate phase complications（second to sixth month）-central nervous system infections caused by prolonged neutropenia and progressive multifocal leukoencephalopathy due to JC virus,（3） late phase complications（after sixth month）-neurological complications of Gv HD, second neoplasms and relapses of the original disease.展开更多
Endogenous endophthalmitis is a rare condition with a poor long-term visual prognosis and significant mortality, often associated with the hematogenous spread of intravitreal infections and subsequent disruption of th...Endogenous endophthalmitis is a rare condition with a poor long-term visual prognosis and significant mortality, often associated with the hematogenous spread of intravitreal infections and subsequent disruption of the blood-ocular barrier. Its anatomical proximity to the central nervous system (CNS) poses a high risk of infection dissemination, although cases documented in the literature are rare, and endogenous endophthalmitis is typically described as secondary to neuroinfections. We report the case of an 82-year-old female patient with a history of hypertension who presented with fever, decreased visual acuity, severe headache, chemosis, and conjunctival injection. Endogenous endophthalmitis was diagnosed, and antimicrobial treatment was initiated alongside surgical intervention by the ophthalmology service. However, the patient’s condition worsened neurologically, and Streptococcus pneumoniae was identified in cerebrospinal fluid cultures. Despite intensive medical treatment, the patient’s clinical course was poor, leading to death.展开更多
BACKGROUND Data regarding the neuroradiology features of the West Nile virus neuroinvasive disease(WNV NID)is rather scarce.To contribute to the knowledge of the WNV NID,we present a patient with a combination of ence...BACKGROUND Data regarding the neuroradiology features of the West Nile virus neuroinvasive disease(WNV NID)is rather scarce.To contribute to the knowledge of the WNV NID,we present a patient with a combination of encephalitis and acute flaccid paresis,with cauda equina arachnoiditis as the main magnetic resonance(MR)finding.CASE SUMMARY A 72-year-old female patient was admitted due to fever,headache and gait instability.During the first several days she developed somnolence,aphasia,urinary incontinence,constipation,and asymmetric lower extremities weakness.Cerebrospinal fluid analysis indicated encephalitis.Native brain computed tomography and MR were unremarkable,while spinal MR demonstrated cauda equina enhancement without cord lesions.Virology testing revealed WNV IgM and IgG antibodies in serum and cerebrospinal fluid,which confirmed acute WNV NID.The treatment was supportive.After two months only a slight improvement was noticed but cognitive impairment,loss of sphincter control and asymmetric inferior extremities weakness remained.The patient died after a month on chronic rehabilitation.CONCLUSION Cauda equina arachnoiditis is a rare,but possible neuroradiological feature in acute flaccid paresis form of WNV NID.展开更多
Importance:Central nervous system infection is a severe illness in children.Little is known about the long-term outcome in children with central nervous system infection of various etiologies.Objective:The aims of thi...Importance:Central nervous system infection is a severe illness in children.Little is known about the long-term outcome in children with central nervous system infection of various etiologies.Objective:The aims of this study were to investigate the long-term outcomes of childhood acute central nervous system infection and to examine possible prognostic factors.Methods:Of 172 children who were treated for acute central nervous system infection from January 2009 through December 2009,139 were eligible for follow-up evaluations.A structured interview was conducted with the parents 3.8-4.7 years after hospital discharge.The global outcome was determined in all patients using the Pediatric Version of the Glasgow Outcome Scale-Extended.Clinical features of the acute episode were retrieved from medical records.Results:The outcome was favorable in 109 of 139 patients (78%),38 (27%) were mildly impaired,six (4%) were moderately impaired,14 (10%) were severely impaired and two (1%) were in a vegetative state.There were eight deaths.The most frequent symptoms were difficulty concentrating (16%),epilepsy (12%),limb paralysis (12%),memory impairment (10%),speech disorders (9%),irritability (9%).Significant risk factors for epilepsy included the presence of recurrent seizures or status epilepticus,the existence of pure spikes in the electroencephalogram,brain parenchyma abnormalities on neuroimaging and herpes simplex virus encephalitis (HSVE).A multivariate analysis identified three factors that were independently associated with poor outcome:coma,brain parenchyma abnormalities on neuroimaging and HSVE.Interpretation:Most children with acute central nervous system infection experienced a favorable outcome 3.8-4.7 years after discharge from the hospital.Minor to severe disability persists in a high proportion of cases.Coma,brain parenchymal abnormalities on neuroimaging and HSVE may predict poor long-term outcome.展开更多
基金supported by grants from the National Natural Science Foundation of China(32030049)the Ministry of Science and Technology of China(2021ZD0202500).
文摘Fibroblasts are typically described as cells that produce extracellular matrix,contribute to the formation of connective tissue,and maintain the structural framework of tissues.Fibroblasts are the first cell type to be transdifferentiated into inducible pluripotent stem cells(iPSCs),demonstrating their versatility and reprogrammability.Currently,there is relatively extensive characterization of the anatomical,molecular,and functional diversity of fibroblasts in different peripheral organs and tissues.With recent advances in single cell RNA sequencing,heterogeneity and diversity of fibroblasts in the central nervous system(CNS)have also begun to emerge.Based on their distinct anatomical locations in the meninges,perivascular space,and choroid plexus,as well as their molecular diversity,important roles for fibroblasts in the CNS have been proposed.Here,we draw inspirations from what is known about fibroblasts in peripheral tissues,in combination with their currently identified CNS locations and molecular characterizations,to propose potential functions of CNS fibroblasts in health and disease.Future studies,using a combination of technologies,will be needed to determine the bona fide in vivo functions of fibroblasts in the CNS.
文摘Hematopoietic cell transplantation（HCT） is widely performed for neoplastic and non-neoplastic diseases. HCT involves intravenous infusion of hematopoietic progenitor cells from human leukocyte antigen（HLA）-matched donor（allogeneic） or from the patient（autologous）. Before HCT, the patient is prepared with high dose chemotherapy and/or radiotherapy to destroy residual malignant cells and to reduce immunologic resistance. After HCT, chemotherapy is used to prevent graft rejection and graft versus host disease（Gv HD）. Neurological complications are related to the type of HCT, underlying disease, toxicity of the conditioning regimens, immunosuppression caused by conditioning regimens, vascular complications generated by thrombocytopenia and/or coagulopathy, Gv HD and inappropriate immune response. In this review, neurological complications are presented according to time of onset after HCT：（1） early complications（in the first month）-related to harvesting of stem cells, during conditioning（drug toxicity, posterior reversible encephalopathy syndrome）, related to pancytopenia,（2） intermediate phase complications（second to sixth month）-central nervous system infections caused by prolonged neutropenia and progressive multifocal leukoencephalopathy due to JC virus,（3） late phase complications（after sixth month）-neurological complications of Gv HD, second neoplasms and relapses of the original disease.
文摘Endogenous endophthalmitis is a rare condition with a poor long-term visual prognosis and significant mortality, often associated with the hematogenous spread of intravitreal infections and subsequent disruption of the blood-ocular barrier. Its anatomical proximity to the central nervous system (CNS) poses a high risk of infection dissemination, although cases documented in the literature are rare, and endogenous endophthalmitis is typically described as secondary to neuroinfections. We report the case of an 82-year-old female patient with a history of hypertension who presented with fever, decreased visual acuity, severe headache, chemosis, and conjunctival injection. Endogenous endophthalmitis was diagnosed, and antimicrobial treatment was initiated alongside surgical intervention by the ophthalmology service. However, the patient’s condition worsened neurologically, and Streptococcus pneumoniae was identified in cerebrospinal fluid cultures. Despite intensive medical treatment, the patient’s clinical course was poor, leading to death.
基金Croatian Science Foundation,Project No. IP 2016-06-7456 CRONEUROARBOEuropean Union’s Horizon 2020 Research and Innovation Programme,No. 653316。
文摘BACKGROUND Data regarding the neuroradiology features of the West Nile virus neuroinvasive disease(WNV NID)is rather scarce.To contribute to the knowledge of the WNV NID,we present a patient with a combination of encephalitis and acute flaccid paresis,with cauda equina arachnoiditis as the main magnetic resonance(MR)finding.CASE SUMMARY A 72-year-old female patient was admitted due to fever,headache and gait instability.During the first several days she developed somnolence,aphasia,urinary incontinence,constipation,and asymmetric lower extremities weakness.Cerebrospinal fluid analysis indicated encephalitis.Native brain computed tomography and MR were unremarkable,while spinal MR demonstrated cauda equina enhancement without cord lesions.Virology testing revealed WNV IgM and IgG antibodies in serum and cerebrospinal fluid,which confirmed acute WNV NID.The treatment was supportive.After two months only a slight improvement was noticed but cognitive impairment,loss of sphincter control and asymmetric inferior extremities weakness remained.The patient died after a month on chronic rehabilitation.CONCLUSION Cauda equina arachnoiditis is a rare,but possible neuroradiological feature in acute flaccid paresis form of WNV NID.
文摘Importance:Central nervous system infection is a severe illness in children.Little is known about the long-term outcome in children with central nervous system infection of various etiologies.Objective:The aims of this study were to investigate the long-term outcomes of childhood acute central nervous system infection and to examine possible prognostic factors.Methods:Of 172 children who were treated for acute central nervous system infection from January 2009 through December 2009,139 were eligible for follow-up evaluations.A structured interview was conducted with the parents 3.8-4.7 years after hospital discharge.The global outcome was determined in all patients using the Pediatric Version of the Glasgow Outcome Scale-Extended.Clinical features of the acute episode were retrieved from medical records.Results:The outcome was favorable in 109 of 139 patients (78%),38 (27%) were mildly impaired,six (4%) were moderately impaired,14 (10%) were severely impaired and two (1%) were in a vegetative state.There were eight deaths.The most frequent symptoms were difficulty concentrating (16%),epilepsy (12%),limb paralysis (12%),memory impairment (10%),speech disorders (9%),irritability (9%).Significant risk factors for epilepsy included the presence of recurrent seizures or status epilepticus,the existence of pure spikes in the electroencephalogram,brain parenchyma abnormalities on neuroimaging and herpes simplex virus encephalitis (HSVE).A multivariate analysis identified three factors that were independently associated with poor outcome:coma,brain parenchyma abnormalities on neuroimaging and HSVE.Interpretation:Most children with acute central nervous system infection experienced a favorable outcome 3.8-4.7 years after discharge from the hospital.Minor to severe disability persists in a high proportion of cases.Coma,brain parenchymal abnormalities on neuroimaging and HSVE may predict poor long-term outcome.
