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p-glycoprotein (P-gp) is an efflux transporter of xenobiotic and endogenous compounds across the blood-brain barrier (BBB). P-gp plays an essential role by limiting passage of these compounds into the brain tissue. It is susceptible to drug-drug interactions when interactors drugs are co-administrated. The efficiency of P-gp may be affected by the aging process and the development of neurodegenerative diseases. Studying this protein in older adults is therefore highly relevant for all these reasons. Understanding P-gp activity in vivo is essential when considering the physiological, pathophysiological, and pharmacokinetic perspectives, as these aspects seem to be interconnected to some extent. In vivo exploration in humans is based on neuroimaging techniques, which have been improving over the last years. The advancement of exploration and diagnostic tools is opening up new prospects for understanding P-gp activity at the BBB.

One of the greatest challenges in neuroscience is to understand how a complex structure, such as the brain, is built. Spatial and temporal patternings of neuronal progenitors are responsible for the generation of most of the neuronal diversity observed in the brain. This review focuses on the temporal patterning of neuronal progenitors, i.e. the sequential expression of transcription factors that changes the capacity of stem cells to generate different neuronal types, and which is conserved in animals. Recent papers have offered a near complete understanding of the mechanism of temporal patterning in the developing visual system of Drosophila, and of how this contributes to the specification of diverse neuronal identities, which are then maintained by the sustained expression of downstream transcription factors. The insect visual system provides a unique model to study the evolution of neuronal cell types, as well as the evolution of neurodevelopmental mechanisms that generate them., (© 2024 médecine/sciences – Inserm.)

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Abstract: Brain microdialysis allows the exploration of brain extracellular medium. This review discusses the main contribution of brain microdialysis for the knowledge of the pathophysiology of brain ischemia and trauma. We describe fundamental principle of microdialysis, limits, and validated metabolic parameters as the lactate/pyruvate ratio or glycerol. The interest to use microdialysis for testing metabolic hypothesis and potential scientific research ways will also be discussed. [Copyright &y& Elsevier]

Abstract: Due to recent efforts in improving spatial and temporal resolution in imaging techniques, it is now possible to get relevant information about brain perfusion and metabolism in humans. This information can significantly impact on brain pathophysiology, diagnosis assessment and therapy options, particularly in patients having brain ischemia. Among these imaging and metabolism techniques are dynamic perfusion computed tomography, perfusion MRI, positron emission tomography and NMR spectroscopic imaging. The goal of this article is an overview of these four techniques, with their own technical description, advantages and drawbacks. Details are provided about brain parameters given by each technique and their clinical relevance, the accessibility of the technique in the emergency setting and the optimal window to use it during the patient''s evolution. [Copyright &y& Elsevier]

Abstract: Brain energy metabolism and signal transduction are intimely intricated. At the cellular level this is reflected by the interdependent metabolism of glutamate and glucose and the energetic compartmentalization between astrocytic glycolysis and neuronal metabolism. Astrocytes appear to have a particular importance in brain metabolism by regulating microcirculation and the repartition of energetic substrats in function of synaptic activity. The high level of O2 consumption compared to the mass of tissue confers a particular vulnerabiliy of brain to oxydative stress. The synthesis of glutathion, the main anti-oxydant of brain, appears to be dependant of the regulation of synaptic glutamate concentration by astrocytes. Deficiencies of astrocytes functions appear to play a key role in the physiopathology of brain injury. [Copyright &y& Elsevier]

Abstract: Nuclear magnetic spectroscopy (MRS) is a useful method for noninvasively studying intracerebral metabolism. Proton MRS can identify markers of the neuronal viability (N-acetyl-aspartate, NAA), of the metabolism of cellular membranes (choline), of the cellular energy metabolism (creatine, lactate). In Phosphorus MRS, the peaks most readily identified are involved in the high-energy cellular metabolism (ATP, phosphocreatine, inorganic phosphate), and intracellular pH (pHi) can be determined using this method. MRS has been used in experimental models of traumatic brain injury (TBI), primarily to study the cellular metabolism and the relation between biochemical and histological changes after trauma. In trauma patients, significant changes in NAA, choline and pHi were found in both grey and white matter comparing with controls, and these alterations correlated with injury severity. Correlations have been reported between these biochimical changes (reduction in NAA, increase in choline) measured at 1 to 6 months after TBI and the clinical outcome of the patients. However, there are methodological issues which still impede to recommend MRS as a tool for predicting neurological outcome in the clinical setting. [Copyright &y& Elsevier]

Oxytocin is a pleiotropic molecule which, in addition to its facilitating action during parturition and milk ejection, is involved in social and prosocial behaviors such as attachment. This article presents, after a brief historical review, the action of oxytocin during the milk ejection reflex. Oxytocin is indeed essential for this vital function in mammals. It is both a neurohormone released into the bloodstream by the axon terminals of the posterior pituitary and a neuromodulator released in the hypothalamus by the soma and dendrites of oxytocinergic magnocellular neurons. In addition, oxytocin is also released by the axon terminals of parvocellular neurons and axon collaterals of magnocellular neurons in the brain. Both maternal attachment in rats and ewes and attachment between sexual partners in the prairie vole, one of the few monogamous rodent species, are mediated by central oxytocin. However, neither administering oxytocin into the brain nor increasing expression of the oxytocin receptor in the nucleus accumbens using a gene transfer technique converts polygamous voles to monogamous ones. Unfortunately, translation of animal data to human remains problematic due to still unsolved difficulties in modifying the level of oxytocin in the brain., (© Société de Biologie, 2023.)

The neuropeptide oxytocin has been in the focus of scientists for decades due to its profound and pleiotropic effects on physiology, activity of neuronal circuits and behaviors. Until recently, it was believed that oxytocinergic action exclusively occurs through direct activation of neuronal oxytocin receptors. However, several studies demonstrated the existence and functional relevance of astroglial oxytocin receptors in various brain regions in the mouse and rat brain. Astrocytic signaling and activity are critical for many important physiological processes including metabolism, neurotransmitter clearance from the synaptic cleft and integrated brain functions. While it can be speculated that oxytocinergic action on astrocytes predominantly facilitates neuromodulation via the release of gliotransmitters, the precise role of astrocytic oxytocin receptors remains elusive. In this review, we discuss the latest studies on the interaction between the oxytocinergic system and astrocytes, and give details of underlying intracellular cascades., (© Société de Biologie, 2023.)

Neurodegenerative diseases such as Alzheimer's, Parkinson's or Amyotrophic Lateral Sclerosis are generally of sporadic origin, but the risk of being affected increases dramatically with age. Progress in understanding brain aging contributes to define precisely the relationships between aging associated physiological and pathological processes. Aging is induced by various stresses, which turn somatic cells to a senescent state. Senescent cells cannot divide but acquire a typical phenotype and release chemicals that trigger inflammation. In the brain, glial cells such as astrocytes or microglia as well as neurons are affected. Dendritic branching declines, resulting in a decrease of synaptic plasticity and cognitive performances, associated with brain aging. Aging alters also glymphatic washing, the process by which brain catabolites are eliminated. The neurodegenerative diseases are proteinopathies resulting from pathological conformations of physiological proteins. Normally washed by the glymphatic flux, these proteins accumulate and aggregate in its absence and then trigger neuron death., (© Société de Biologie, 2022.)

Nicotine is the specific psychoactive substance of tobacco while tetrahydrocannabinol (THC) is the specific component of cannabis. The inhalation technique of cannabis is different from that of tobacco smoking: the volume of puffs is larger, inhalation is deeper, and pulmonary retention time is longer. Cannabis addiction is difficult to evaluate, both products often being smoked concomitantly. The principle physical side effects of cannabis affect organs and functions in a similar way to tobacco: pulmonary, cardiovascular, endocrine and stomatological. Gastrointestinal complications such as cannabinoid hyperemesis are specific to cannabis. Some psychological effects of THC may be acute (altered time and space perception, sensory disability, decreased vigilance, mood and dissociative disorders, hallucinations and delirium, impaired learning and memory, impaired cognitive and motor performance, panic attacks and anxiety) or chronic (lack of motivation, disorganisation of thoughts, increase in frequency and severity of schizophrenic crises). Cannabis can also be implicated in traffic and workplace accidents. Synthetic cannabinoids have increased psychotropic and somatic effects due to a greater affinity for brain cannabinoid receptors., (Copyright © 2020. Published by Elsevier Masson SAS.)

The various roles of membrane lipids in human health has urged researchers to study their impact in neuropsychiatric diseases, especially in schizophrenia spectrum disorders and more recently in early stages of psychosis. The progress in mass spectrometry technologies now allows a more comprehensive analysis of phospholipids (PL) and their fatty acid (FA) molecular species. FA are defined by a carbon chain of variable length and are said to be unsaturated when their chain has one or more carbon-carbon double bonds. The PL are composed of a hydrophilic polar head with a phosphoric acid group and an hydrophobic part with FAs; they encompass glycerophospholipids and sphingolipids. The plasma membrane is a complex and dynamic structure consisting of a lipid bilayer composed of an outer layer and an inner layer of specific lipid composition. The permanent remodeling of membrane lipids involves phospholipases especially the phospholipase A2. Seventy percent of the brain consists of lipids from different classes and molecular species. Most of the brain lipids are composed of polyunsaturated fatty acid (PUFA)-enriched diacyl classes where omega-3 and omega-6 molecular species predominate. The balance between omega-3 and omega-6 is important for the neurodevelopment. PUFA are also involved in neurogenesis and neurotransmission. Sphingomyelin (SM) is a sphingolipid that influences inflammation, cell proliferation and lipid rafts formation. It is an important component of myelin sheaths of white matter and therefore is involved in cerebral connectivity. In rat models, deficiency in omega-3 causes abnormalities in dopaminergic neurotransmission, impacts on the functioning of some receptors (including cannabinoids CB1, glutamatergic N-methyl-D-aspartate receptor, NMDA), and increases sensitivity to hallucinogens. In contrast, omega-3 supplementation improves cognitive function and prevents psychotic-like behavior in some animal models for schizophrenia. It also reduces oxidative stress and prevents demyelination. The historical membrane hypothesis of schizophrenia has led to explore the lipids abnormality in this disorder. This hypothesis was initially based on the observation of an abnormal membrane prostaglandin production in schizophrenia caused by a membrane arachidonic acid deficiency. It has evolved emphasizing the various PUFA membrane's roles in particular regarding oxidative stress, inflammation and regulation of the NMDA receptors. In patients with mental disorders, low omega-3 index is more frequent than in the general population. This lipid abnormality could lead to myelination abnormalities and cognitive deficits observed in patients. It could also participate in oxidative stress abnormalities and inflammation reported in schizophrenia. On the other hand, low omega-3 index deficit was reported to be associated with an increased cardiovascular risk, and omega-3 supplementation may also have a positive cardiovascular impact in psychiatric patients, even more than in the general population. The presence of membrane lipid abnormalities is also found in patients during the first psychotic episode (FEP). The omega-3 supplementation improved the recovery rate and prevented the loss of gray matter in FEP. In patients at ultra-high risk to develop a psychotic disorder (UHR), omega-3 supplementation has been associated with a reduction of the rate of conversion to psychosis and with metabolic changes, such as decreased activity of phospholipase A2. However, this study has not as yet been replicated. Not all patients exhibit lipid abnormalities. Several studies, including studies from our team, have found a bimodal distribution of lipids in patients with schizophrenia. But some studies have found differences (in PUFA) in the acute phase whereas our studies (on phospholipids) are in chronic phases. It will be interesting to study in more depth the links between these two parameters. Furthermore, we identified a subgroup which was identified with a deficit in sphingomyelin and PUFA whereas others have found an increase of sphingomyelin. Individuals with this abnormal lipid cluster had more cognitive impairments and more severe clinical symptoms. Because the niacin test is an indirect reflection of arachidonic acid levels, it has been proposed to identify a subset of patients with membrane lipids anomalies. Niacin test response is influenced by several factors related to lipid metabolism, including cannabis use and phospholipase A2 activity. Despite progress, the function and impact of membrane lipids are still poorly understood in schizophrenia. They could serve as biomarkers for identifying biological subgroups among patients with schizophrenia. In UHR patients, their predictive value on the conversion to psychosis should be tested. Omega-3 supplementation could be a promising treatment thanks to its good tolerance and acceptability. It could be more appropriate for patients with PUFA anomalies in a more personalized medical approach., (Copyright © 2020 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Metabolic encephalopathies (ME) are a common cause of admission to emergency rooms, to hospitalization wards or to intensive care units. They could account for 10 to 20% of causes of comatose states in ICU and could be associated to a poor outcome especially in older patients. Nevertheless, they are often reversible and are associated with a favorable outcome when diagnosed and rapidly treated. They correspond to an altered brain functioning secondary to the deficiency of a substance that is mandatory for the normal brain functioning or to the accumulation of a substance that can be either endogenous or exogenous. It preferably occurs in co-morbid patients, complicating its diagnosis and its management. Altered brain functioning, going from mild neuropsychological impairment to coma, movement disorders especially myoclonus and the absence of any obvious differential diagnosis are highly suggestive of the diagnosis. Whereas some biological samplings and brain MRI are essential to rule out differential diagnosis, some others, such as electroencephalogram, may be able to propose important clues in favor of the diagnosis. Once simple symptomatic measures are introduced, the treatment consists mainly in the correction of the cause. Specific treatment options are only seldom available for ME; this is the case for hepatic encephalopathy and some drug-induced encephalopathies. We will successively describe in this review the main pathophysiological mechanisms, the main causes, favoring circumstances of ME, the differential diagnosis to rule out and the etiological work-up for the diagnosis. Finally, a diagnostic and therapeutic strategy for the care of patients with ME will be proposed., (Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

Alzheimer's disease (AD) is a neurodegenerative disease primarily characterized by cognitive deficits and neuropathological lesions such as Tau aggregates and amyloid plaques, but also associated with metabolic and neuroendocrine abnormalities, such as impairment of cerebral insulin. However, the origin of these symptoms and their relationship to pathology and cognitive disorders remain poorly understood. Insulin is a hormone involved in the control of peripheral and central energy homeostasis, and insulin-resistant state has been linked to increased risk of dementia. It is now well established that brain insulin resistance can exacerbate Tau lesions. Conversely, recent data indicate that Tau protein can modulate insulin signalling in the brain, creating a vicious circle precipitating the pathological AD. This review aims to highlight our current understanding of the role of insulin in the brain and its relationship with Tau protein in the context of AD and Tauopathies., (© 2018 médecine/sciences – Inserm.)

Adiponectin (ApN) is a hormone produced by adipose tissue, yet the plasma level of ApN is decreased in overweight and obese people, as well as in people with diabetes. In the periphery, this decrease in circulating levels of ApN induces the establishment of a chronic low-grade inflammatory state and is involved in the development of insulin resistance and atheromas. Conversely, "favorable" living conditions, weight loss and regular physical exercise increase ApN blood concentration. Some forms of ApN can reach the brain parenchyma through the cerebrospinal fluid. In the brain, the increase in ApN exerts powerful antidepressant and anxiolytic effects, in particular by fighting against neuroinflammation., (© 2018 médecine/sciences – Inserm.)

Nicotinic acetylcholine receptors (nAChRs) are pentameric ligand-gated ion channels widely expressed in the central nervous system and the periphery. They play an important modulatory role in learning, memory and attention, and have been implicated in various diseases such as Alzheimer's disease, Parkinson's disease, epilepsy, schizophrenia and addiction. These receptors are activated by the endogenous neurotransmitter acetylcholine, or by nicotine, the alkaloid found in tobacco leaves. Both molecules open the ion channel and cause the movement of cations across the membrane, which directly affects neuronal excitability and synaptic plasticity. nAChRs are very heterogeneous in their subunit composition (α2-10 et β2-4), in their brain distribution (cortex, midbrain, striatum…) and in their sub-cellular localization (pre- vs post-synaptic, axonal, dendritic…). This heterogeneity highly contributes to the very diverse roles these receptors have in health and disease. The ability to activate or block a specific nAChR subtype, at a defined time and space within the brain, would greatly help obtaining a clearer picture of these various functions. To this aim, we are developing novel optogenetic pharmacology strategies for optically controlling endogenous nAChR isoforms within the mouse brain. The idea is to tether a chemical photoswitch on the surface of a cysteine-modified nAChR, and use light for rapidly and reversibly turning that receptor mutant on and off. Here we will discuss the history of optogenetic pharmacology, and the recent advances for the optical control of brain nicotinic receptors in vivo., (© Société de Biologie, 2017.)

Fatty acid sensitive neurons located in hypothalamus, hippocampus or striatum are able to detect daily variations of plasma fatty acid levels. Thus, these neurons play a role to regulate energy balance by controling food intake, insulin secretion or hepatic glucose production. Molecular mechanisms that mediate fatty acid effects include receptor FAT (fatty acid transporter)/CD36. Deregulation of this brain lipid sensing may be an early event leading to further dysfunction of energy balance leading to obesity and type 2 diabetes., (© 2015 médecine/sciences – Inserm.)

Tetrahydrocannabinol, the main psychotropic component of Cannabis indica, is an addictive drug with multiple effects including both peripheral and central damages. All these effects are due to interference with endocannabinoidergic transmission. This endocannabinoid system subtly regulates many physiologicalfunctions. This regulation involves various ligands derived from arachidonic acid (anandamide, di-arachidonoylglycerol, virodhamin, noladin ether, N arachidonoyl dopamine, etc.) which stimulate two main types of receptor CB1 in the central nervous system and CB2 in the periphery. CB1 receptors are very numerous and ubiquitous in the brain. They influence various important functions (awakening, attention, delirium, hallucinations, memory, cognition, anxiety, humor stability, motor coordination, brain maturation, etc.). Far from mimicking endocannabinoids, THC caricatures their effects. It affects all brain structures, simultaneously, intensely and durably, inducing down-regulation of CB1 receptors and thereby reducing the effects of their physiological ligands. On account of its exceptional lipophilia, THC accumulates for days and even weeks in the brain. It is not a soft drug but rather a slow drug: its abuse induces long-lasting modifications and deterioration of brain function, potentially leading to various mental and psychiatric disorders.

Beyond the classically described regulation of calcium and bone metabolism, vitamin D is a neurosteroid hormone essential to neurophysiological function (regulation of neurotransmitters and neurotrophins) with anti-inflammatory and antioxidant neuroprotective action. In contrast, hypovitaminosis D, which is extremely frequent in the elderly, may result in neurological dysfunction and may explain part of the cognitive disorders in this population. Epidemiology is consistent with this notion and has repeatedly shown an association between hypovitaminosis D and cognitive decline, either in the general population or in Alzheimer's patients. Preliminary intervention trials confirm the causal relationship and quantify the cognitive effect of vitamin D supplementation in the elderly. This raises prospects for primary/secondary prevention of cognitive decline by exogenous supplies of vitamin D. In particular, although current anti-dementia drugs are only symptomatic, future treatment options could rely on drug combinations preventing several neurodegenerative mechanisms at once. As such, vitamin D enhances the efficacy of memantine in terms of neuronal protection and prevention of cognitive decline in Alzheimer's disease., (© Société de Biologie, 2014.)

Hyperhomocysteinemia is a risk factor for neurological diseases, but the underlying pathophysiology has not been adequately explained. Mild hyperhomocysteinemia, which is sometimes associated with a low plasma level of vitamin B9, B12 and folic acid, is responsible in the toxicity in neural cell by activating NMDA receptor. Indeed, even if vitamin supplementation has clearly proven its efficiency on lowering plasma levels of homocysteine, recent studies do not show any positive effect of vitamin therapy on cognitive function. The hypothesis that this therapy is inefficient has been recently reinforced by two randomized trials on the effects of vitamin supplementation. Several hypotheses still need to be explored: Mechanisms of homocysteine toxicity and that of total uselessness of vitamin supplementation; the possible need to complete the actual data with further, more powerful studies in order to prove the role of homocysteine in the development of neurodegenerative diseases and a clinical effect of vitamin therapy., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

mTOR (mammalian target of rapamycin), a protein kinase highly conserved, is the catalytic subunit of two complexes, mTORC1 and mTORC2. These complexes are regulated by amino acids availability, by insulin and growth factors signaling pathways. Thus, mTORC1 and mTORC2 complexes are essential sensors of the cellular nutrient and energy levels in living organisms. mTORC1 is sensitive to rapamycin (also known as sirolimus), a drug prescribed in case of organ transplantation (kidney) due to its immunosuppressive and anti-proliferative properties. However, some studies have shown that the rapamycin treatment can induce fertility disorders. Thus, this article reviews the mTOR involvement in the male and female reproductive axis., (© 2013 médecine/sciences – Inserm / SRMS.)

Introduction: Encephalitis is an inflammatory or infectious disease with an acute or subacute presentation. Immunological abnormalities in serum can be found but may be underdiagnosed. In several cases, a paraneoplastic origin with anti-neuron antibodies is noted. In all cases, other auto-antibodies can be found with or without any neoplastic mechanism., Objectives: The aim of our study was to describe a clinical, radiological and immunological cohort of patients with autoimmune encephalitis and suggest a diagnostic and therapeutic algorithm., Patients and Method: We performed a retrospective study in an immunological unit of neurology. All patients with autoimmune encephalitis between March 2000 and October 2009 were included. The clinical, imaging and immunological evaluations were recorded for each patient., Results: Our cohort included 16 patients (eight men and eight women), mean age 45.3±10years. All patients had acute or subacute neuropsychological or neuropsychiatric impairment and all patients but one had temporal lobe dysfunction confirmed by cerebral MRI, PET or SPECT. Epilepsy was observed in 56% of cases, extra-temporal lobe impairment in 50%, including sleep disturbances. A cancer was found in only 25% (two small-cell lung cancers, one testis seminoma, one non-small-cell lung cancer with Merckel cells cancer). Anti-neuron antibodies were noted in 56% of cases (two with anti-voltage gate potassium channel complex antibodies (ab), two with anti-NMDA-R ab, two with anti-glutamate acid decarboxylase ab, one with anti-Ma2, two with anti-Hu ab and two remained uncharacterized). Systemic antibodies were found in 50% (one anti-gangliosides, one anti-SSA and one anti-DNA and four antinuclear ab uncharacterized, two anti-TPO and two anti-phospholipids). All patients received immunomodulatory treatments, including intravenous immunoglobulins (IgIV) and cancer was treated. Five patients achieved complete recovery, partial improvement was observed in 10 patients and two patients died., Discussion: Despite clinical homogeneity at presentation, clinical outcome seems to be different between patients with antibodies against neuronal surface antigens and those with antibodies against intracellular antigens, which are more likely refractory to immunotherapy and paraneoplastic. The frequency of extra-temporal lobe impairment suggests that the term of limbic encephalitis should be changed to autoimmune encephalitis., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

DNA methylation compacts chromatin structure and represses gene transcription. It is important for numerous cellular processes, including embryonic development, X-chromosome inactivation, suppression of transposable elements, and cellular differentiation. In addition, environmental cues, including drugs, pollutants, trauma or early-life social environment, alter DNA methylation patterns in different organs. For instance, studies have unravelled a complex and dynamic interplay between environment, DNA methylation and neuron function during development and in the adult. This crosstalk is hypothesized as an essential molecular event underlying the effects of long-term memory, drug addiction, and several psychotic and behavioural disorders. In this review, we give a summary of this exciting field of research and highlight the molecular functions of DNA methylation and of proteins interacting with methylated DNA., (© Société de Biologie, 2013.)

Since its discovery at the beginning of the 20th century, the blood-brain barrier (BBB) has been considered for a long time as a "physical barrier" able to limit brain distribution of highly molecular weight and/or polar compounds. This early concept of an anatomical barrier between the blood and the brain was supported by the finding of unique tight junctions between the brain endothelial cells so that they formed a continuous wall preventing the paracellular diffusion of solutes. In the middle of the 50's, BBB has been proposed as a "biochemical barrier" able to control the supply of brain to essential nutriments. More recently, BBB was evidenced as a key element in controlling effects of central nervous system drugs, since it plays a critical role in the uptake and efflux of drugs from the blood to the brain, or vice versa, hence affecting their concentrations and effects in the central nervous system (CNS). The BBB has therefore been more recently defined as a "pharmacological barrier" since the endothelial cells were found to contain a range of metabolizing enzymes and transporters that control the rate and extent of drugs reaching the brain parenchyma via transcellular pathway. The emergence of new quantitative proteomic approaches allows quantifying these transporters and enzymes at the BBB, opening the way to identify new drugs that may be targeted to the brain., (© Société de Biologie, 2012.)

The central nervous system is a sanctuary protected by barriers, among which the blood-brain barrier (BBB). The BBB is formed by the specific nature of the endothelial cells of the brain capillaries, that allow brain access only to nutrients necessary for brain cell survival and function. These properties of the BBB result in the incapacity of therapeutic compounds, both small and large, to reach the brain at therapeutic concentrations. Various strategies are now being developed to enhance the amount and concentration of these compounds in the brain parenchyma. The development of new technologies such as peptide vectors will achieve the delivery of active agents in therapeutic concentration across the BBB to treat brain diseases such as cancer or neurodegenerative disorders. In this paper, design of new active peptides and the development of new protein, peptide, vectors for drug brain delivery using physiological approaches will be addressed. In addition to the Angiopep platform technology which is in development at Angiochem Inc. and is to date the most advanced in human clinical trials, the new Transcend technology using a protein melanotransferrin for the transport of biologics such as lysosomal enzymes and antibodies will be discussed., (© Société de Biologie, 2012.)

The blood-brain barrier (BBB), which isolates the brain from the whole body, restricts exchanges between the brain and the peripheral compartments. Several studies highlight the importance of this barrier in neurodegenerative diseases such as Alzheimer's disease (AD). This pathology is characterized by an abnormal accumulation and aggregation of Aβ peptides which contribute to the neurodegenerative processes and the BBB seems to play a key role for the brain Aβ peptides metabolism. This review focuses on recent data demonstrating the important role of the BBB in AD, suggesting that this barrier is a possible new therapeutic target in this disease., (© 2011 médecine/sciences – Inserm / SRMS.)

The identification of a Sonic Hedgehog (Shh) signaling pathway in the adult vertebrate central nervous system has paved the way to the characterization of the functional roles of Shh signals in normal and diseased brain. This morphogen is proposed to play a key role in the establishment and maintenance of adult neurogenic niches and to modulate the proliferation of neuronal or glial precursors. Consistent with its role during embryogenesis, alteration of Shh signaling is associated with tumorigenesis while its recruitment in damaged neural tissue might be part of the regenerating process. We will discuss the most recent data of the Hedgehog pathway in the adult brain and its relevance as a novel therapeutic approach for brain diseases including brain tumors., (© 2011 médecine/sciences – Inserm / SRMS.)

Introduction: Conventional MRI allows diagnostic and prognosis approaches for patients with suspected metabolic disease., Background: Bilateral and symmetrical abnormalities are the most suggestive aspects. Signal characteristics (intensity, difference of signal on various sequences), lesion extension and location provide important etiological information. Non-conventional MRI techniques are particularly interesting for pathophysiology. Different MRI modalities offer promising techniques for monitoring treatments and patient follow-up., Conclusion: Combining different MRI modalities can contribute to the diagnosis and help improve understanding of the pathogenic mechanisms of adult metabolic diseases; they offer promising options for the prognosis and treatment follow-up., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Copper is essential for many enzymatic reactions and in neurotransmitter biosynthesis. Its deficiency or its excess has consequences on many organs, especially the liver and the brain. The biochemical tests performed in case of suspicion of copper metabolism disorder are difficult to analyse. They include the measurement of serum ceruloplasmin, serum copper and 24h urinary copper excretion. The interpretation must take into account the clinical features. We distinguish mainly: (1) copper deficiency, acquired in malabsorption or in copper diet deficiency, or related to a genetic disease (Menkes disease); (2) copper overload, acquired or from a genetic origin (Wilson disease); (3) aceruloplasminemia, reducing ferroxidase activity leading to iron overload. It is important to diagnose these diseases as some of them have an effective treatment if it is started early enough., (Copyright © 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.)

Hypernatremia invariably denotes hyperosmolarity and, at least transiently, causes cellular dehydration. Because of blood brain barrier properties, cerebral tissue volume is modified by acute changes in osmolarity. An acute hyperosmolarity (by intravenous sodium or mannitol) temporally decreases intracranial pressure. This treatment is thus useful in critical situations, allowing time for diagnosis and, if possible, other treatment. But in cases of sustained hypernatremia, cellular dehydration is rapidly counterbalanced by an increase in cellular osmolarity. For the brain, it has been shown that cerebral volume is restored in a few hours during prolonged hypernatremia. Moreover, the plasmatic osmotic load induces an increase in diuresis and natriuresis. A tight control is then necessary to prevent hypovolemia and electrolytes disorders. Teams using this treatment should undertake controlled randomized studies to ascertain any beneficial effect that cannot be explained by physiology., (Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.)

This review focuses on new aspects in growth hormone (GH) biology and pathophysiology presented at the Endocrine Society's meeting, in San Diego, in June 2010. First, we will describe recent advances in the understanding of cytokine hormone signaling via STAT5 in mammary gland development, highlighting the primary role of miR193b for differentiation of mammary stem cells into alveolar progenitor cells. We will examine the potential implication of endocrine and autocrine GH for mammary gland carcinogenesis. Three novel murine models bearing tissue-specific inactivation of GH receptor or JAK2 bring new insights into the large spectrum of GH effects on energy homeostasis. We will also report new data supporting a paracrine regulation of GH secretion in women by estrogen's action in the brain. Thereafter we will question the reasons for GH abuse for doping by assessing the hormonal impact on body composition and physical performance in recreational athletes. Finally, we will discuss the controversial issue of GH replacement in acromegalic patients presenting GH deficiency after treatment of acromegaly., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

The main historical steps leading to the concept of Niemann-Pick type C disease as an intracellular lipid and more specifically a cholesterol transport disorder are summarized; the current stage of knowledge and research hypotheses regarding the function of the NPC1 and NPC2 proteins and pathogeny of the cerebral dysfunction are briefly commented. The various approaches for laboratory diagnosis of patients are finally discussed., (Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.)

Until recent years, brain applications of (31)P magnetic resonance spectroscopy were poor. Arising of clinical high field strength magnets (three Tesla) as well as dedicated brain coils (eg: bird cage), using specific and useful sequences providing appropriate spatial localisation and signal to noise ratio brought highlights on multinuclear spectroscopy. Better understanding of brain metabolism emphasizes the role of phosphoenergetic compounds and its potential issues in tumoral, metabolic and degenerative diseases. In the present paper, we report 1 year of experience and preliminary results for 40 patients as well as review of the literature. By successive in vivo determination and quantitation of numerous metabolites it allows, multinuclear spectroscopy may provide additional information to biomathematical models of brain metabolism., (Copyright 2009. Published by Elsevier Masson SAS.)