The article reviews the recent findings on the use of optical coherence tomography angiography (OCTA) in neurology. OCTA is a new addition to the powerful and complementary technology of the OCT. Due to its noninvasiveness, and reproducibility, it is possible to obtain high-resolution 3D images of the vessels of the human eye. As the vessels of the retina with the presence of endothelial cell’s tight junctions resemble the brain vessels, it was hypothesized that the imaging of the retinal vessels might bring insight into brain vessels. OCTA has been effectively used to predict retinal vessel abnormalities in dementia, demyelization, optic disc neuropathies, and inherited degenerative diseases. Most common findings were decrease of vascular density and flow and an increase of avascular zones. Although OCTA is a relative new technology, recent studies show that it can be successfully applied in neurology.

/pdf/principles-of-octa-and-applications-in-clinical-neurology-1u01or1m9z.pdf

Principles of OCTA and Applications in Clinical Neurology.

Mechanisms leading to low platelet count in immune thrombocytopenia (ITP) involves both decreased production and increased destruction of platelet. However, the contribution of these pathologic mechanisms to clinical outcome of individual patients is uncertain. Here we evaluated different pathogenic mechanisms including in vitro megakaryopoiesis, platelet/megakaryocyte (MK) desialylation and MK apoptosis, and compared these effects with thrombopoyesis and platelet apoptosis in the same cohort of ITP patients. Normal umbilical cord blood-CD34+ cells, mature MK derived cells or platelets were incubated with plasma from ITP patients. Despite inhibition of thrombopoiesis previously observed, megakaryopoiesis was normal or even increased. Plasma from ITP patients affected the sialylation pattern of control platelets and this effect occurred concomitantly with apoptosis in 35% ITP samples. However, none of these abnormalities were observed in control MKs incubated with ITP plasma. Addition of mononuclear cells as immune effectors did not lead to phosphatidylserine exposure in MK, ruling out an antibody-mediated cytotoxic effect. These results suggest that both desialylation and apoptosis may be relevant mechanisms leading to platelet destruction although, they do not interfere with MK function. Analysis of these thrombocytopenic factors in individual patients showed no specific distribution pattern. However, the presence of circulating antiplatelet autoantibodies was associated with higher incidence of abnormalities. In conclusion, the causes of thrombocytopenia are multifactorial and may occur together, providing a rational basis for the use of combination therapies targeting concomitant ITP mechanisms in patients with refractory disease.

/pdf/multiple-concomitant-mechanisms-contribute-to-low-platelet-1lcan5enml.pdf

Multiple concomitant mechanisms contribute to low platelet count in patients with immune thrombocytopenia.

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by platelet destruction and reduced platelet production resulting in decreased platelet level and an increased risk of bleeding. Based on the immunologic mechanism of ITP, front-line standard therapy consists of corticosteroids and intravenous immunoglobulins (IVIG). If patients do not respond to the first-line treatment, or if continuous therapy is required, the disorder is called refractory ITP, and second-line therapy is indicated. This treatment may consist of rituximab, thrombopoietin receptor agonists, splenectomy, or cytotoxic drugs. Despite significant advances, many patients do not respond to any the treatments listed below, and new treatment options need to be developed for this relapsed and refractory group. Recent clinical studies have indicated promising outcomes for novel drugs, either as single agents or in combination with traditional drugs. This review discusses the latest and the most promising novel drugs for ITP in adults.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/ejh.13319

Autoimmune thrombocytopenia: Current treatment options in adults with a focus on novel drugs.

Amyloid-beta peptide neurotoxicity in human neuronal cells is associated with modulation of insulin-like growth factor transport, lysosomal machinery and extracellular matrix receptor interactions.

Optical coherence tomography (OCT) is a non-invasive imaging technique recently used to investigate neurodegenerative disorders, such as Alzheimer’s disease, Parkinson’s disease or multiple sclerosis Over the last years it has been used in schizophrenia research due to the potential utility of its measurements as biomarkers of the disease From the first publication by Ascaso et al (Eur J Psychiat 2010) until now, a number of papers have been published regarding this topic Although the majority of them have found a reduction in the thickness or the volume of some retinal and optic nerve structures, there have also been some results with contradictory data These could be due on the one hand to methodological factors such as the use of different OCT devices or the inclusion/exclusion criteria On the other hand, there could be an important limitation due to the fact that the different stages of the disorder and their different neurobiological correlates and biomarkers were not taken into consideration Future longitudinal studies, that begin the assessments in the first psychotic episode (or even before, in ultra-high risk population) are needed in order to clarify the potential role of some OCT measures as biomarkers in schizophrenia

/pdf/usefulness-of-optical-coherence-tomography-measures-as-4l51sxgx9k.pdf

Usefulness of Optical Coherence Tomography Measures as Biomarkers in Schizophrenia

Page 11 of 13 Retinal changes in Alzheimer’s disease: Disease Mechanisms to Evaluation perspectives M Mirzaei1,2,3*, VB Gupta4, VK Gupta2 1Department of Molecular Sciences, Macquarie University, Sydney, NSW, Australia 2Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia 3Australian Proteome Analysis Facility, Macquarie University, Sydney, NSW, Australia 4School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia

/pdf/retinal-changes-in-alzheimer-s-disease-disease-mechanisms-to-3ws7jjqud3.pdf

Retinal changes in Alzheimer's disease: Disease Mechanisms to Evaluation perspectives.

Immune Thrombocytopenia: Antiplatelet Autoantibodies Inhibit Proplatelet Formation by Megakaryocytes and Impair Platelet Production in vitro

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Retinal changes in Alzheimer's disease: Disease Mechanisms to Evaluation perspectives.

Immune Thrombocytopenia: Antiplatelet Autoantibodies Inhibit Proplatelet Formation by Megakaryocytes and Impair Platelet Production in vitro