Neuro faces of beneficial T cells:essential in brain,impaired in aging and neurological diseases,and activated functionally by neurotransmitters and neuropeptides

T cells are essential for a healthy life,performing continuously:immune surveillance,recognition,protection,activation,suppression,assistance,eradication,secretion,adhesion,migration,homing,communications,and additional tasks.This paper describes five aspects of normal beneficial T cells in the healthy or diseased brain.First,normal beneficial T cells are essential for normal healthy brain functions:cognition,spatial learning,memory,adult neurogenesis,and neuroprotection.T cells decrease secondary neuronal degeneration,increase neuronal survival after central nervous system(CNS) injury,and limit CNS inflammation and damage upon injury and infection.Second,while pathogenic T cells contribute to CNS disorders,recent studies,mostly in animal models,show that specific subpopulations of normal beneficial T cells have protective and regenerative effects in seve ral neuroinflammatory and neurodegenerative diseases.These include M ultiple Sclerosis(MS),Alzheimer’s disease,Parkinson’s disease,Amyotrophic Lateral Sclerosis(ALS),stro ke,CNS trauma,chronic pain,and others.Both T cell-secreted molecules and direct cell-cell contacts deliver T cell neuroprotective,neuro regenerative and immunomodulato ry effects.Third,normal beneficial T cells are abnormal,impaired,and dysfunctional in aging and multiple neurological diseases.Different T cell impairments are evident in aging,brain tumors(mainly Glioblastoma),seve re viral infections(including COVID-19),chro nic stress,major depression,schizophrenia,Parkinson’s disease,Alzheimer’s disease,ALS,MS,stro ke,and other neuro-pathologies.The main detrimental mechanisms that impair T cell function are activation-induced cell death,exhaustion,senescence,and impaired T cell stemness.Fo urth,several physiological neurotransmitters and neuro peptides induce by themselves multiple direct,potent,beneficial,and therapeutically-relevant effects on normal human T cells,via their receptors in T cells.This scientific field is called "Nerve-Driven Immunity".The main neurotransmitters and neuropeptides that induce directly activating and beneficial effects on naive normal human T cells are:dopamine,glutamate,GnRH-Ⅱ,neuropeptide Y,calcitonin gene-related peptide,and somatostatin.Fifth, "Personalized Adoptive Neuro-Immunotherapy".This is a novel unique cellular immunotherapy,based on the "Nerve-Driven Immunity" findings,which was recently designed and patented for safe and repeated rejuvenation,activation,and improvement of impaired and dysfunctional T cells of any person in need,by ex vivo exposure of the person’s T cells to neurotransmitters and neuropeptides.Personalized adoptive neuro-immunotherapy includes an early ex vivo personalized diagnosis,and subsequent ex vivo in vivo personalized adoptive therapy,tailo red according to the diagnosis.The Personalized Adoptive Neuro-Immunotherapy has not yet been tested in humans,pending validation of safety and efficacy in clinical trials,especially in brain tumors,chronic infectious diseases,and aging,in which T cells are exhausted and/or senescent and dysfunctional.

Humanization for neurological disease modeling:A roadmap to increase the potential of Drosophila model systems

Neuroscience and neurology research is dominated by experimentation with rodents.Around 75%of neurology disease-associated genes have orthologs in Drosophila mel-anogaster,the fruit fly amenable to complex neurological and behavioral investiga-tions.However,non-vertebrate models including Drosophila have so far been unable to significantly replace mice and rats in this field of studies.One reason for this situ-ation is the predominance of gene overexpression(and gene loss-of-function)meth-odologies used when establishing a Drosophila model of a given neurological disease,a strategy that does not recapitulate accurately enough the genetic disease condi-tions.I argue here the need for a systematic humanization approach,whereby the Drosophila orthologs of human disease genes are replaced with the human sequences.This approach will identify the list of diseases and the underlying genes that can be adequately modeled in the fruit fly.I discuss the neurological disease genes to which this systematic humanization approach should be applied and provide an example of such an application,and consider its importance for subsequent disease modeling and drug discovery in Drosophila.I argue that this paradigm will not only advance our un-derstanding of the molecular etiology of a number of neurological disorders,but will also gradually enable researchers to reduce experimentation using rodent models of multiple neurological diseases and eventually replace these models.

Clinical application prospects and transformation value of dental follicle stem cells in oral and neurological diseases

Since dental pulp stem cells(DPSCs)were first reported,six types of dental SCs(DSCs)have been isolated and identified.DSCs originating from the craniofacial neural crest exhibit dental-like tissue differentiation potential and neuroectodermal features.As a member of DSCs,dental follicle SCs(DFSCs)are the only cell type obtained at the early developing stage of the tooth prior to eruption.Dental follicle tissue has the distinct advantage of large tissue volume compared with other dental tissues,which is a prerequisite for obtaining a sufficient number of cells to meet the needs of clinical applications.Furthermore,DFSCs exhibit a significantly higher cell proliferation rate,higher colony-formation capacity,and more primitive and better anti-inflammatory effects than other DSCs.In this respect,DFSCs have the potential to be of great clinical significance and translational value in oral and neurological diseases,with natural advantages based on their origin.Lastly,cryopreservation preserves the biological properties of DFSCs and enables them to be used as off-shelf products for clinical applications.This review summarizes and comments on the properties,application potential,and clinical transformation value of DFSCs,thereby inspiring novel perspectives in the future treatment of oral and neurological diseases.

Efficacy and safety of nerve growth factor for the treatment of neurological diseases:a meta-analysis of 64 randomized controlled trials involving 6,297 patients

OBJECTIVE： China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine. More than 10 years ago, in 2003, nerve growth factor injection was listed as a national drug. The goal of this article is to evaluate comprehensively the efficacy and safety of nerve growth factor for the treatment of neurological diseases. DATA RETRIEVAL： A computer-based retrieval was performed from six databases, including the Cochrane Library, PubMed, EMBASE, Sino Med, CNKI, and the VIP database, searching from the clinical establishment of nerve growth factor for treatment until December 31, 2013. The key words for the searches were ＂nerve growth factor, randomized controlled trials＂ in Chinese and in English. DATA SELECTION： Inclusion criteria： any study published in English or Chinese referring to randomized controlled trials of nerve growth factor; patients with neurological diseases such as peripheral nerve injury, central nerve injury, cranial neuropathy, and nervous system infections; patients older than 7 years; similar research methods and outcomes assessing symptoms; and measurement of nerve conduction velocities. The meta-analysis was conducted using Review Manager 5.2.3 software. MAIN OUTCOME MEASURES： The total effective rate, the incidence of adverse effects, and the nerve conduction velocity were recorded for each study. RESULTS： Sixty-four studies involving 6,297 patients with neurological diseases were included. The total effective rate in the group treated with nerve growth factor was significantly higher than that in the control group （P 〈 0.0001, RR： 1.35, 95%CI： 1.30-1.40）. The average nerve conduction velocity in the nerve growth factor group was significantly higher than that in the control group （P 〈 0.00001, MD. 4.59 m/s, 95%CI： 4.12-5.06）. The incidence of pain or sclero- ma at the injection site in the nerve growth factor group was also higher than that in the control group （P 〈 0.00001, RR： 6.30, 95%CI： 3.53-11.27）, but such adverse effects were mild. CONCLUSION： Nerve growth factor can significantly improve nerve function in patients with nervous system disease and is safe and effective.

The gut microbiome:implications for neurogenesis and neurological diseases

There is an increasing recognition of the strong links between the gut microbiome and the brain,and there is persuasive evidence that the gut microbiome plays a role in a variety of physiological processes in the central nervous system.This review summarizes findings that gut microbial composition alterations are linked to hippocampal neurogenesis,as well as the possible mechanisms of action;the existing literature suggests that microbiota influence neurogenic processes,which can result in neurological disorders.We consider this evidence from the perspectives of neuroinflammation,microbial-derived metabolites,neurotrophins,and neurotransmitters.Based on the existing research,we propose that the administration of probiotics can normalize the gut microbiome.This could therefore also represent a promising treatment strategy to counteract neurological impairment.

Exosomes in neurological disease, neuroprotection, repair and therapeutics: problems and perspectives

Exosomes：Exosomes are a sub-population of micro-vesicles ranging from 40–100 nm that were earlier thought as artefacts under electron microscope.They recently came into attention for their storage of biological information,cell-to-cell communication,serving as biomarkers and potential use in neural protection and regeneration （Kalani et al., 2013, 2014a）.

Multiple facets of poly(ADP-ribose) polymerase-1 in neurological diseases

The highly conserved abundant nuclear protein poly （ADP-ribose） polymerase-1 （PARP-1） is activated by DNA damage. PARP-1 activation is associated in DNA repair, cell death and inflammation. Since oxidative stress induced robust DNA damage and wide spread inflamma- tory responses are common pathologies of various CNS diseases, the attention towards PARP-1 as a therapeutic target has been amplifying. This review highlights the multiple roles of PARP- 1 in neurological diseases and po- tential of PARP- 1 inhibitors to enter clinical translation.

Pharmacological inhibition of cation-chloride cotransporters for neurological diseases

γ-Aminobutyric acid（GABA）is a major neurotransmitter and plays important roles in both the developing and mature central nervous system（CNS）.One way that GABA can act is by binding to fast,ionotropic GABAA receptors in neurons.The binding of GABA to GABAA receptors causes a conformational change that opens ion channels.

MSC based gene delivery methods and strategies improve the therapeutic efficacy of neurological diseases

Mesenchymal stem cells(MSCs)are promising seed cells for neural regeneration therapy owing to their plasticity and accessibility.They possess several inherent characteristics advantageous for the transplantation-based treatment of neurological disorders,including neural differentiation,immunosuppression,neurotrophy,and safety.However,the therapeutic efficacy of MSCs alone remains unsatisfactory in most cases.To improve some of their abilities,many studies have employed genetic engineering to transfer key genes into MSCs.Both viral and nonviral methods can be used to overexpress therapeutic proteins that complement the inherent properties.However,to date,different modes of gene transfer have specific drawbacks and advantages.In addition,MSCs can be functionalized through targeted gene modification to facilitate neural repair by promoting neural differentiation,enhancing neurotrophic and neuroprotective functions,and increasing survival and homing abilities.The methods of gene transfer and selection of delivered genes still need to be optimized for improved therapeutic and targeting efficacies while minimizing the loss of MSC function.In this review,we focus on gene transport technologies for engineering MSCs and the application of strategies for selecting optimal delivery genes.Further,we describe the prospects and challenges of their application in animal models of different neurological lesions to broaden treatment alternatives for neurological diseases.

Gut microbiota:a new insight into neurological diseases

In the last decade,it has become increasingly recognized that a balanced gut microbiota plays an important role in maintaining the health of the host.Numerous clinical and preclinical studies have shown that changes in gut microbiota composition are associated with a variety of neurological diseases,e.g.,Parkinson’s disease,Alzheimer’s disease,and myasthenia gravis.However,the underlying molecular mechanisms are complex and remain unclear.Behavioral phenotypes can be transmitted from humans to animals through gut microbiota transplantation,indicating that the gut microbiota may be an important regulator of neurological diseases.However,further research is required to determine whether animal-based findings can be extended to humans and to elucidate the relevant potential mechanisms by which the gut microbiota regulates neurological diseases.Such investigations may aid in the development of new microbiota-based strategies for diagnosis and treatment and improve the clinical management of neurological disorders.In this review,we describe the dysbiosis of gut microbiota and the corresponding mechanisms in common neurological diseases,and discuss the potential roles that the intestinal microbiome may play in the diagnosis and treatment of neurological disorders.

Targeting the blood-brain barrier to delay aging-accompanied neurological diseases by modulating gut microbiota,circadian rhythms,and their interplays

AbstracTthe blood-brain barrier(BBB)impairment plays a crucial role in the pathological processes of aging-accompanied neurological diseases(AAND).Meanwhile,circadian rhythms disruption and gut microbiota dysbiosis are associated with increased morbidity of neurological diseases in the accelerated aging population.Importantly,circadian rhythms disruption and gut microbiota dysbiosis are also known to induce the generation of toxic metabolites and pro-inflammatory cytokines,resulting in disruption of BBB integrity.Collectively,this provides a new perspective for exploring the relationship among circadian rhythms,gut microbes,and the BBB in aging-accompanied neurological diseases.In this review,we focus on recent advances in the interplay between circadian rhythm disturbances and gut microbiota dysbiosis,and their potential roles in the BBB disruption that occurs in AAND.Based on existing literature,we discuss and propose potential mechanisms underlying BBB damage induced by dysregulated circadian rhythms and gut microbiota,which would serve as the basis for developing potential interventions to protect the BBB in the aging population through targeting the BBB by exploiting its links with gut microbiota and circadian rhythms for treating AAND.

Neuronal regulated cell death in aging-related neurodegenerative diseases:key pathways and therapeutic potentials

Regulated cell death(such as apoptosis,necroptosis,pyroptosis,autophagy,cuproptosis,ferroptosis,disulfidptosis)involves complex signaling pathways and molecular effectors,and has been proven to be an important regulatory mechanism for regulating neuronal aging and death.However,excessive activation of regulated cell death may lead to the progression of aging-related diseases.This review summarizes recent advances in the understanding of seven forms of regulated cell death in age-related diseases.Notably,the newly identified ferroptosis and cuproptosis have been implicated in the risk of cognitive impairment and neurodegenerative diseases.These forms of cell death exacerbate disease progression by promoting inflammation,oxidative stress,and pathological protein aggregation.The review also provides an overview of key signaling pathways and crosstalk mechanisms among these regulated cell death forms,with a focus on ferroptosis,cuproptosis,and disulfidptosis.For instance,FDX1 directly induces cuproptosis by regulating copper ion valency and dihydrolipoamide S-acetyltransferase aggregation,while copper mediates glutathione peroxidase 4 degradation,enhancing ferroptosis sensitivity.Additionally,inhibiting the Xc-transport system to prevent ferroptosis can increase disulfide formation and shift the NADP^(+)/NADPH ratio,transitioning ferroptosis to disulfidptosis.These insights help to uncover the potential connections among these novel regulated cell death forms and differentiate them from traditional regulated cell death mechanisms.In conclusion,identifying key targets and their crosstalk points among various regulated cell death pathways may aid in developing specific biomarkers to reverse the aging clock and treat age-related neurodegenerative conditions.

RNA-binding proteins in neurological diseases

Emerging studies support that RNA-binding proteins （RBPs） play critical roles in human biology and pathogenesis. RBPs are essential players in RNA processing and metabolism, including pre-mRNA splicing, polyadenylation, transport, surveillance, mRNA localization, mRNA stability control, translational control and editing of various types of RNAs. Aberrant expression of and mutations in RBP genes affect various steps of RNA processing, altering target gene function. RBPs have been associ- ated with various diseases, including neurological diseases. Here, we mainly focus on selected RNA-binding proteins including Nova-i/Nova-2, HuR/HuB/HuC/HuD, TDP-43, Fus, Rbfoxl/Rbfox2, QKI and FMRP, discussing their function and roles in human diseases.

The Discrepancy of Neurological Diseases between China and Western Countries in Recent Two Decades

INTRODUCTION Neurological diseases are characterized by high frequency of disability and mortality with pathogenesis largely unknown. Genetic, refractory, and rare diseases account tbr a large proportion of neurological diseases： sympathetically, limited curable treatments are available. Hundreds of millions of people worldwide are affected by neurological disorders. The diagnosis and treatment of neurological disorders have made significant progress in recent years, especially in the past two decades with the rapid development of technology.

Awareness Status of Chronic Disabling Neurological Diseases among Elderly Veterans

Background：The awareness,treatment and prevention of chronic diseases are generally poor among the elderly population of China,whereas the prevention and control of chronic diseases in elderly veteran communities have been ongoing for more than 30 years.Therefore,investigating the awareness status of chronic disabling neurological diseases （CDND） and common chronic diseases （CCD） among elderly veterans may provide references for related programs among the elderly in the general population.Methods：A cross-sectional survey was conducted among veterans ≥60 years old in veteran communities in Beijing.The awareness of preventive strategies against dementia,Alzheimer＆#39;s disease （AD）,Parkinson＆#39;s disease （PD）,sleep disorders,cerebrovascular disease （CVD） and CCD such as hypertension,and the approaches used to access this information,including media,word of mouth （verbal communication among the elderly） and health care professionals,were investigated via face-to-face interviews.Results：The awareness rates for CCD and CVD were approximately 100%,but that forAD was the lowest at 〈10%.The awareness rates for sleep disorders,PD and dementia,were 51.0-89.4%.Media was the most commonly selected mode of communication by which veterans acquired knowledge about CCD and CVD.Media was used by approximately 80% of veterans.Both health care professionals and word of mouth were used by approximately 50% of veterans.With respect to the source of information about CDND excluding AD,the rates of the use of health care professionals,word of mouth and media were 10.6-28.2%,56.5-76.5%,and approximately 50%,respectively.Conclusions：The awareness of CDND among elderly veterans was significantly lower than that of CCD.More information about CDND should be disseminated by health care professionals.Appropriate guidance will promote the rapid and extensive dissemination of information about the prevention of CDND by media and word-of-mouth peer education.

Potential Role of Akkermansia muciniphila in Parkinson's Disease and Other Neurological/Autoimmune Diseases

The composition of the gut microbiota,including Akkermatisia muciniphila(A.muciniphila),is altered in many neurological diseases and may be involved in the pathophysiological processes of Parkinson’s disease(PD).A.muciniphila,a mucin-degrading bacterium,is a potential next-generation microbe that has anti-inflammatory properties and is responsible for keeping the body healthy.As the role of A.muciniphila in PD has become increasingly apparent,we discuss the potential link between A.muciniphila and various neurological diseases(including PD)in the current review.

Neurological diseases caused by coronavirus infection of the respiratory airways

Infections of the central nervous system(CNS)infections are critical problems for public health.They are caused by several different organisms,including the respiratory coronaviruses(Co Vs).Co Vs usually infect the upper respiratory tract causing the common cold.However,in infants,and in elderly and immunocompromised persons,they can also affect the lower respiratory tract causing pneumonia and various syndromes of respiratory distress.Co Vs also have neuroinvasive capabilities because they can spread from the respiratory tract to the CNS.Once infection begins in the CNS cells,it can cause various CNS problems such as status epilepticus,encephalitis,and long-term neurological disease.This neuroinvasive properties of Co Vs may damage the CNS as a result of misdirected host immune response,which could be associated with autoimmunity in susceptible individuals(virus-induced neuro-immunopathology)or associated with viral replication directly causing damage to the CNS cells(virus-induced neuropathology).In December 2019,a new disease named COVID-19 emerged which is caused by Co Vs.The significant clinical symptoms of COVID-19 are related to the respiratory system,but they can also affect the CNS,causing acute cerebrovascular and intracranial infections.We describe the possible invasion routes of coronavirus in this review article,and look for the most recent findings associated with the neurological complications in the recently published literature.

Considerations on Intervention Goal and Efficacy Evaluation of Traditional Chinese Medicine in the Treatment of Neurological Diseases

In the last several years, traditional Chinese medicine （TCM） has made much progress in the treatment of neurological diseases. The living space of TCM in neurological diseases lies in refractory diseases, aging and chronic diseases caused by multiple factors as well as sub-health state and chronic fatigue state. The effect model of TCM mainly consists of whole effect, self-organization, self-stable model, holographic effect and butterfly effect. The effective point of TCM in neurological diseases lies mainly in end-points and health-related events. Moreover, TCM has advantages in the evaluation of symptoms, syndrome and quality of life （QOL）. Some key indexes should be included when evaluating the efficacy of TCM in neurological diseases. Meanwhile, the advantages of TCM such as end-points, health-related events and QOL should be highlighted. Multi-subject researching methods could be adopted to make a comprehensive evaluation of subjective and objective indexes. The clinical evidence on the TCM efficacy evaluation may come from RCTs, and other types of designs can also be considered.

Pyroptosis and neurological diseases

Pyroptosis is a new process of programmed cell death,which has been discovered and confirmed in recent years.Its cardinal features include activation of caspase-1 and a massive release of inflammatory cytokines(interleukin(IL)-1β,IL-18),etc.The morphological characteristics,occurrence and regulatory mechanisms of the pyroptosis greatly,differ from other cell death mechanisms such as apoptosis and necrosis.It has already been proven that pyroptosis participates and plays an important role in a wide range of neuronal diseases.Here,we review the current understanding of the pyroptosis and its roles in neurological diseases.

High-Intensity Interval Training v/s Steady-State Cardio in Rehabilitation of Neurological Patients

Neuropathy is nerve damage that can cause chronic neuropathic pain, which is challenging to cure and has a significant financial burden. Exercise therapies, including High-Intensity Interval Training (HIIT) and steady-state cardio, are being explored as potential treatments for neuropathic pain. This systematic review compares the effectiveness of HIIT and steady-state cardio for improving function in neurological patients. This article provides an overview of the systematic review conducted on the effects of exercise on neuropathic patients, with a focus on high-intensity interval training (HIIT) and steady-state cardio. The authors conducted a comprehensive search of various databases, identified relevant studies based on predetermined inclusion criteria, and used the EPPI automation application to process the data. The final selection of studies was based on validity and relevance, with redundant articles removed. The article reviews four studies that compare high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on various health outcomes. The studies found that HIIT can improve aerobic fitness, cerebral blood flow, and brain function in stroke patients;lower diastolic blood pressure more than MICT and improve insulin sensitivity and skeletal muscle mitochondrial content in obese individuals, potentially helping with the prevention and management of type 2 diabetes. In people with multiple sclerosis, acute exercise can decrease the plasma neurofilament light chain while increasing the flow of the kynurenine pathway. The available clinical and preclinical data suggest that further study on high-intensity interval training (HIIT) and its potential to alleviate neuropathic pain is justified. Randomized controlled trials are needed to investigate the type, intensity, frequency, and duration of exercise, which could lead to consensus and specific HIIT-based advice for patients with neuropathies.