Browsing by Subject "CNS injury"

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    Blood Biomarkers for Detection of Brain Injury in COVID-19 Patients
    (Mary Ann Liebert, 2021) DeKosky, Steven T.; Kochanek, Patrick M.; Valadka, Alex B.; Clark, Robert S. B.; Chou, Sherry H. Y.; Au, Alicia K.; Horvat, Christopher; Jha, Ruchira M.; Mannix, Rebekah; Wisniewski, Stephen R.; Wintermark, Max; Rowell, Susan E.; Welch, Robert D.; Lewis, Lawrence; House, Stacey; Tanzi, Rudolph E.; Smith, Darci R.; Vittor, Amy Y.; Denslow, Nancy D.; Davis, Michael D.; Glushakova, Olena Y.; Hayes, Ronald L.; Pediatrics, School of Medicine
    The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus attacks multiple organs of coronavirus disease 2019 (COVID-19) patients, including the brain. There are worldwide descriptions of neurological deficits in COVID-19 patients. Central nervous system (CNS) symptoms can be present early in the course of the disease. As many as 55% of hospitalized COVID-19 patients have been reported to have neurological disturbances three months after infection by SARS-CoV-2. The mutability of the SARS-COV-2 virus and its potential to directly affect the CNS highlight the urgency of developing technology to diagnose, manage, and treat brain injury in COVID-19 patients. The pathobiology of CNS infection by SARS-CoV-2 and the associated neurological sequelae of this infection remain poorly understood. In this review, we outline the rationale for the use of blood biomarkers (BBs) for diagnosis of brain injury in COVID-19 patients, the research needed to incorporate their use into clinical practice, and the improvements in patient management and outcomes that can result. BBs of brain injury could potentially provide tools for detection of brain injury in COVID-19 patients. Elevations of BBs have been reported in cerebrospinal fluid (CSF) and blood of COVID-19 patients. BB proteins have been analyzed in CSF to detect CNS involvement in patients with infectious diseases, including human immunodeficiency virus and tuberculous meningitis. BBs are approved by the U.S. Food and Drug Administration for diagnosis of mild versus moderate traumatic brain injury and have identified brain injury after stroke, cardiac arrest, hypoxia, and epilepsy. BBs, integrated with other diagnostic tools, could enhance understanding of viral mechanisms of brain injury, predict severity of neurological deficits, guide triage of patients and assignment to appropriate medical pathways, and assess efficacy of therapeutic interventions in COVID-19 patients.
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    Restoring cellular energetics promotes axon regeneration and functional recovery after spinal cord injury
    (Cell Press, 2020-03-03) Han, Qi; Xie, Yuxiang; Ordaz, Josue D.; Huh, Andrew J.; Huang, Ning; Wu, Wei; Liu, Naikui; Chamberlain, Kelly A.; Sheng, Zu-Hang; Xu, Xiao-Ming; Neurological Surgery, School of Medicine
    Axonal regeneration in the central nervous system (CNS) is a highly energy-demanding process. Extrinsic insults and intrinsic restrictions lead to an energy crisis in injured axons, raising the question of whether recovering energy deficits facilitates regeneration. Here, we reveal that enhancing axonal mitochondrial transport by deleting syntaphilin (Snph) recovers injury-induced mitochondrial depolarization. Using three CNS injury mouse models, we demonstrate that Snph-/- mice display enhanced corticospinal tract (CST) regeneration passing through a spinal cord lesion, accelerated regrowth of monoaminergic axons across a transection gap, and increased compensatory sprouting of uninjured CST. Notably, regenerated CST axons form functional synapses and promote motor functional recovery. Administration of the bioenergetic compound creatine boosts CST regenerative capacity in Snph-/- mice. Our study provides mechanistic insights into intrinsic regeneration failure in CNS and suggests that enhancing mitochondrial transport and cellular energetics are promising strategies to promote regeneration and functional restoration after CNS injuries.