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Systematic review and meta-analysis of the prevalence of neuropathic-like pain and/or pain sensitization in people with knee and hip osteoarthritis

Zolio L, Lim KY, McKenzie JE, Yan MK, Estee M, Hussain SM, et al.

Osteoarthritis Cartilage, 2021 08;29(8):1096-1116.
PMID: 33971205 DOI: 10.1016/j.joca.2021.03.021

OBJECTIVE: To determine the prevalence of neuropathic-like pain (NP) and pain sensitization (PS) defined by self-report questionnaires in knee and hip osteoarthritis, and whether prevalence is potentially explained by disease-severity or affected joint.
DESIGN: MEDLINE, EMBASE, CINAHL were systematically searched (1990-April 2020) for studies describing the prevalence of NP and PS in knee and hip osteoarthritis using self-report questionnaires. Random-effects meta-analysis was performed. Statistical heterogeneity between studies and sub-groups (affected joint and population source as a proxy for disease severity) was assessed (I2 statistic and the Chi-squared test).
RESULTS: From 2,706 non-duplicated references, 39 studies were included (2011-2020). Thirty-six studies reported on knee pain and six on hip pain. For knee osteoarthritis, the pooled prevalence of NP was: using PainDETECT, possible NP(score ≥13) 40% (95%CI 32-48%); probable NP(score >18) 20% (95%CI 15-24%); using Self-Report Leeds Assessment of Neuropathic Symptoms and Signs, 32% (95%CI 26-38%); using Douleur Neuropathique (DN4) 41% (95% CI 24-59%). The prevalence of PS using Central Sensitization Inventory (CSI) was 36% (95% CI 12-59%). For hip osteoarthritis, the pooled prevalence of NP was: using PainDETECT, possible NP 29% (95%CI 22-37%%); probable NP 9% (95%CI 6-13%); using DN4 22% (95%CI 12-31%) in one study. The prevalence of possible NP pain was higher at the knee (40%) than the hip (29%) (difference 11% (95% CI 0-22%), P = 0.05).
CONCLUSIONS: Using self-report questionnaire tools, NP was more prevalent in knee than hip osteoarthritis. The prevalence of NP in knee and hip osteoarthritis were similar for each joint regardless of study population source or tool used. Whether defining NP using self-report questionnaires enables more effective targeted therapy in osteoarthritis requires investigation.

Matched MeSH terms: Central Nervous System Sensitization/physiology*
How Do Abnormalities in the Cerebrospinal Fluid Impact Neuropsychology with Progressing Age?

Joshi G, Ling APK, Chye SM, Koh RY

CNS Neurol Disord Drug Targets, 2023;22(3):431-440.
PMID: 35400348 DOI: 10.2174/1871527321666220408105130

The behavior of an individual changes from neonate to elderly due to the development of the central nervous system (CNS). One of the important components of the CNS is the cerebrospinal fluid (CSF), which bathes the brain and spinal cord. CSF has changing properties throughout life, including composition and volume imbalance. However, a specific age group that shows prevailing abnormality- corresponding behavior remains unclear. The objective of this article is to explore how such changes reflect on one's psychological as well as physical processing. Production of CSF could be affected by many factors, including its flow, absorption, volume, and composition. Prenatally, congenital malformations and infections hold the greatest risk of impacting the child's physical and mental growth. In adolescents, transmission of external substances like alcohol or drugs in the cerebrospinal fluid is known to impact severe mood changes that potentially result in suicide and depression. In the adult working population, the influence of stress levels on CSF composition causes anxiety and sleep disorders. Finally, the reduced production of CSF was found to be associated with memory deficits and Alzheimer's disease in the aging group. From the collected evidence, it can be observed that CSF played an important role in behavioral changes and may be associated with neurodegenerations. By linking the CSF abnormalities to the clinical symptoms at different stages of life, it may provide additional information in the diagnosis of diseases that are associated with neuropsychological changes.

Matched MeSH terms: Central Nervous System/physiology
Comparison of controlled drugs and new psychoactive substances (NPS) regulations in East and Southeast Asia

Lin OA, Chuang PJ, Tseng YJ

Regul Toxicol Pharmacol, 2023 Feb;138:105338.
PMID: 36642324 DOI: 10.1016/j.yrtph.2023.105338

New psychoactive substances (NPS) are substances of abuse that easily evade existing controlled drug regulations. This study conducted a systematic review on controlled drug regulations and analyzed the numbers of new psychoactive substances (NPS) reported in six East and Southeast Asian countries in comparison to US and UK from 2009 to 2020. Generally, more NPS were reported in the US (551) and UK (400), compared to Japan (379), China (221), Singapore (142), South Korea (99), Malaysia (41), and Taiwan (35). Legislative mechanisms including the specific listing of individual substances, generic control of a family of substances, analogue control of similar substances, temporary bans of new substances were evaluated. In this review, countries that have adopted a combination of legislative mechanisms were able to identify higher numbers of NPS for regulatory control, such as the US, UK, Japan, Singapore, and South Korea. These findings can provide references to countries like Malaysia and Taiwan, to strengthen NPS-related regulations nationally. Countries in the East and Southeast Asian region should be encouraged to collaborate more closely and to implement additional legislative approaches most relevant to the regional NPS trends to bridge the regulatory gap and to prevent the spread of emerging NPS.

Matched MeSH terms: Central Nervous System Agents*
Nipah virus infection: pathology and pathogenesis of an emerging paramyxoviral zoonosis

Wong KT, Shieh WJ, Kumar S, Norain K, Abdullah W, Guarner J, et al.

Am J Pathol, 2002 Dec;161(6):2153-67.
PMID: 12466131

In 1998, an outbreak of acute encephalitis with high mortality rates among pig handlers in Malaysia led to the discovery of a novel paramyxovirus named Nipah virus. A multidisciplinary investigation that included epidemiology, microbiology, molecular biology, and pathology was pivotal in the discovery of this new human infection. Clinical and autopsy findings were derived from a series of 32 fatal human cases of Nipah virus infection. Diagnosis was established in all cases by a combination of immunohistochemistry (IHC) and serology. Routine histological stains, IHC, and electron microscopy were used to examine autopsy tissues. The main histopathological findings included a systemic vasculitis with extensive thrombosis and parenchymal necrosis, particularly in the central nervous system. Endothelial cell damage, necrosis, and syncytial giant cell formation were seen in affected vessels. Characteristic viral inclusions were seen by light and electron microscopy. IHC analysis showed widespread presence of Nipah virus antigens in endothelial and smooth muscle cells of blood vessels. Abundant viral antigens were also seen in various parenchymal cells, particularly in neurons. Infection of endothelial cells and neurons as well as vasculitis and thrombosis seem to be critical to the pathogenesis of this new human disease.

Matched MeSH terms: Central Nervous System/pathology; Central Nervous System/virology; Central Nervous System Viral Diseases/diagnosis; Central Nervous System Viral Diseases/epidemiology; Central Nervous System Viral Diseases/pathology; Central Nervous System Viral Diseases/virology
A proposed cascade of vascular events leading to granulomatous amoebic encephalitis

Baig AM, Khan NA

Microb Pathog, 2015 Nov;88:48-51.
PMID: 26276705 DOI: 10.1016/j.micpath.2015.08.005

Granulomatous amoebic encephalitis due to Acanthamoeba is a chronic disease that almost always results in death. Hematogenous spread is a pre-requisite followed by amoebae invasion of the blood-brain barrier to enter the central nervous system. Given the systemic nature of this infection, a significant latent period of several months before the appearance of clinical manifestations is puzzling. Based on reported cases, here we propose pathogenetic mechanisms that explain the above described latency of the disease.

Matched MeSH terms: Central Nervous System
Fulltext Social drug use in the parturient: implications for the management of obstetrical anaesthesia

Kuczkowski KM

Med J Malaysia, 2003 Mar;58(1):147-54; quiz 155.
PMID: 14556345

Maternal use of social drugs in pregnancy continues to increase--worldwide. Although a great deal has been learned regarding the implications of illicit drug abuse in pregnancy (cocaine, amphetamines, hallucinogens), the use of social drug in pregnancy has received far less attention. This article reviews the consequences of the social drug use in pregnancy including ethanol, tobacco and caffeine and offers recommendation for anaesthetic management of these potentially complicated pregnancies.

Matched MeSH terms: Central Nervous System Stimulants/adverse effects*; Central Nervous System Depressants/adverse effects*
Fulltext Organotypic slice culture based on in ovo electroporation for chicken embryonic central nervous system

Yang C, Li X, Li S, Chai X, Guan L, Qiao L, et al.

J Cell Mol Med, 2019 03;23(3):1813-1826.
PMID: 30565384 DOI: 10.1111/jcmm.14080

Organotypic slice culture is a living cell research technique which blends features of both in vivo and in vitro techniques. While organotypic brain slice culture techniques have been well established in rodents, there are few reports on the study of organotypic slice culture, especially of the central nervous system (CNS), in chicken embryos. We established a combined in ovo electroporation and organotypic slice culture method to study exogenous genes functions in the CNS during chicken embryo development. We performed in ovo electroporation in the spinal cord or optic tectum prior to slice culture. When embryonic development reached a specific stage, green fluorescent protein (GFP)-positive embryos were selected and fluorescent expression sites were cut under stereo fluorescence microscopy. Selected tissues were embedded in 4% agar. Tissues were sectioned on a vibratory microtome and 300 μm thick sections were mounted on a membrane of millicell cell culture insert. The insert was placed in a 30-mm culture dish and 1 ml of slice culture media was added. We show that during serum-free medium culture, the slice loses its original structure and propensity to be strictly regulated, which are the characteristics of the CNS. However, after adding serum, the histological structure of cultured-tissue slices was able to be well maintained and neuronal axons were significantly longer than that those of serum-free medium cultured-tissue slices. As the structure of a complete single neuron can be observed from a slice culture, this is a suitable way of studying single neuronal dynamics. As such, we present an effective method to study axon formation and migration of single neurons in vitro.

Matched MeSH terms: Central Nervous System/cytology*; Central Nervous System/embryology; Central Nervous System/metabolism
Fulltext Digitalized bite mark analysis for the undergraduate dental students

Mohd Yusmiaidil Putera Mohd Yusof

Compendium of Oral Science, 2015;2(1):1-5.
MyJurnal

In legal system, the admissibility of bite mark injury has proven to give more positive impact when current tech-nologies are adapted to its analysis. The early exposure of the digitalized bite mark analysis during the under-graduate dental program is beneficial to stimulate interests and provide guidance among the professional den-tists. The step-by-step bite mark analysis partly adapted from KU Leuven, Belgium is emphasized by delivering the illustrated practical techniques using computer software Adobe Photoshop®. The overlays analysis demon-strated its practicality as easy to use and offered opportunities to learn through unconventional mode of teach-ing. The incorporation of bite mark injury analysis to the undergraduate dental learning is highly recommended

Matched MeSH terms: Central Nervous System Stimulants
Fulltext A rare case of disseminated sarcoidosis presenting with neurosarcoidosis: a case report

Noorhafini Abdul Sukur, Narisa Sulaiman Sahari, Abdul Aziz Marwan, Rosmadi Ismail

Malaysian Journal of Medicine and Health Sciences, 2020;16(108):81-83.
MyJurnal

Sarcoidosis is characterized by formation of inflammatory granulomas affecting all over the body, with pulmonary predilection (1). Neurosarcoidosis is a rare but potentially dangerous manifestation of sarcoidosis. We report a case of disseminated sarcoidosis presenting with a neurological diagnostic dilemma. Worsening mediastinal lymphade- nopathy, together formation of lung and liver nodules making a sarcoidosis diagnosis favourable. Histology from these lesions showed non-caseating granulomatous inflammation. She was treated as a rare case of disseminated sarcoidosis. To date, there is no specific or clear guideline on the management of disseminated sarcoidosis.

Matched MeSH terms: Central Nervous System Diseases
Metallic and semiconducting carbon nanotubes separation using an aqueous two-phase separation technique: a review

Tang MS, Ng EP, Juan JC, Ooi CW, Ling TC, Woon KL, et al.

Nanotechnology, 2016 Aug 19;27(33):332002.
PMID: 27396920 DOI: 10.1088/0957-4484/27/33/332002

It is known that carbon nanotubes show desirable physical and chemical properties with a wide array of potential applications. Nonetheless, their potential has been hampered by the difficulties in acquiring high purity, chiral-specific tubes. Considerable advancement has been made in terms of the purification of carbon nanotubes, for instance chemical oxidation, physical separation, and myriad combinations of physical and chemical methods. The aqueous two-phase separation technique has recently been demonstrated to be able to sort carbon nanotubes based on their chirality. The technique requires low cost polymers and salt, and is able to sort the tubes based on their diameter as well as metallicity. In this review, we aim to provide a review that could stimulate innovative thought on the progress of a carbon nanotubes sorting method using the aqueous two-phase separation method, and present possible future work and an outlook that could enhance the methodology.

Matched MeSH terms: Central Nervous System Agents
Fulltext Assessing neuroplasticity using magnetoencephalography (MEG) in patient with left-Temporo-Parietal Pilocytic Astrocytomas treated with endoscopic surgery

Hanani Abdul Manan, Zamzuri Idris, Jafri Malin Abdullah, Mohammed Faruque Reza, Hazim Omar

Jurnal Sains Kesihatan Malaysia, 2018;16(1):63-69.
MyJurnal

Neuroplasticity has been subjected to a great deal of research in the last century. Recently, significant emphasis has been
placed on the global effect of localized plastic changes throughout the central nervous system, and on how these changes
integrate in a pathological context. The present study aimed to demonstrate the functional cortical reorganization before
and after surgery using magnetoencephalography (MEG) in a participant with brain tumor. Results of Visual Evoked
Magnetic Field (VEF) based on functional MEG study revealed significantly different of MEG N100 waveforms before and
after surgery. Larger and additional new locations for visual activation areas after the surgery were found suggesting
neuroplasticity. The present study highlight a physiological plasticity in a teenage brain and the alterations regarding
neural plasticity and network remodeling described in pathological contexts in higher-order visual association areas.

Matched MeSH terms: Central Nervous System
Fulltext A rare extrapyramidal manifestation in a patient with primary central nervous system lymphoma

Tee TY, Khoo CS, Ibrahim NM, Osman SS

Neurol India, 2019 3 13;67(1):297-299.
PMID: 30860142 DOI: 10.4103/0028-3886.253620
Matched MeSH terms: Central Nervous System Neoplasms/diagnosis; Central Nervous System Neoplasms/drug therapy*; Central Nervous System Neoplasms/pathology*
Fulltext Bromophenols from Symphyocladia latiuscula (Harvey) Yamada as Novel Cholecystokinin 2 Receptor Antagonists

Paudel P, Park SE, Seong SH, Fauzi FM, Jung HA, Choi JS

J Integr Neurosci, 2023 Jan 05;22(1):10.
PMID: 36722239 DOI: 10.31083/j.jin2201010

BACKGROUND: Cholecystokinin (CCK) is one of the most abundant peptides in the central nervous system and is believed to function as a neurotransmitter as well as a gut hormone with an inverse correlation of its level to anxiety and depression. Therefore, CCK receptors (CCKRs) could be a relevant target for novel antidepressant therapy.
METHODS: In silico target prediction was first employed to predict the probability of the bromophenols interacting with key protein targets based on a model trained on known bioactivity data and chemical similarity considerations. Next, we tested the functional effect of natural bromophenols from Symphyocladia latiuscula on the CCK2 receptor followed by a molecular docking simulation to predict interactions between a compound and the binding site of the target protein.
RESULTS: Results of cell-based functional G-protein coupled receptor (GPCR) assays demonstrate that bromophenols 2,3,6-tribromo-4,5-dihydroxybenzyl alcohol (1), 2,3,6-tribromo-4,5-dihydroxybenzyl methyl ether (2), and bis-(2,3,6-tribromo-4,5-dihydroxybenzyl) ether (3) are full CCK2 antagonists. Molecular docking simulation of 1‒3 with CCK2 demonstrated strong binding by means of interaction with prime interacting residues: Arg356, Asn353, Val349, His376, Phe227, and Pro210. Simulation results predicted good binding scores and interactions with prime residues, such as the reference antagonist YM022.
CONCLUSIONS: The results of this study suggest bromophenols 1-3 are CCK2R antagonists that could be novel therapeutic agents for CCK2R-related diseases, especially anxiety and depression.

Matched MeSH terms: Central Nervous System
Nanoneuroscience: Cutting-edge Approach for Disease Management

Malhotra S, Jain N, Rathee J, Kaul S, Nagaich U, Pandey M, et al.

Recent Pat Nanotechnol, 2024;18(2):256-271.
PMID: 38197418 DOI: 10.2174/1872210517666230403105152

Neurological disorders (ND) have affected a major part of our society and have been a challenge for medical and biosciences for decades. However, many of these disorders haven't responded well to currently established treatment approaches. The fact that many active pharmaceutical ingredients can't get to their specified action site inside the body is one of the main reasons for this failure. Extracellular and intracellular central nervous system (CNS) barriers prevent the transfer of drugs from the blood circulation to the intended location of the action. Utilizing nanosized drug delivery technologies is one possible way to overcome these obstacles. These nano-drug carriers outperform conventional dosage forms in many areas, including good drug encapsulation capacity, targeted drug delivery, less toxicity, and enhanced therapeutic impact. As a result, nano-neuroscience is growing to be an intriguing area of research and a bright alternative approach for delivering medicines to their intended action site for treating different neurological and psychiatric problems. In this review, we have included a short overview of the pathophysiology of neurological diseases, a detailed discussion about the significance of nanocarriers in NDs, and a focus on its recent advances. Finally, we highlighted the patented technologies and market trends, including the predictive analysis for the years 2021-2028.

Matched MeSH terms: Central Nervous System
Blood-brain Barrier and Neurovascular Unit Dysfunction in Parkinson's Disease: From Clinical Insights to Pathogenic Mechanisms and Novel Therapeutic Approaches

Khor SLQ, Ng KY, Koh RY, Chye SM

CNS Neurol Disord Drug Targets, 2024;23(3):315-330.
PMID: 36999187 DOI: 10.2174/1871527322666230330093829

The blood-brain barrier (BBB) plays a crucial role in the central nervous system by tightly regulating the influx and efflux of biological substances between the brain parenchyma and peripheral circulation. Its restrictive nature acts as an obstacle to protect the brain from potentially noxious substances such as blood-borne toxins, immune cells, and pathogens. Thus, the maintenance of its structural and functional integrity is vital in the preservation of neuronal function and cellular homeostasis in the brain microenvironment. However, the barrier's foundation can become compromised during neurological or pathological conditions, which can result in dysregulated ionic homeostasis, impaired transport of nutrients, and accumulation of neurotoxins that eventually lead to irreversible neuronal loss. Initially, the BBB is thought to remain intact during neurodegenerative diseases, but accumulating evidence as of late has suggested the possible association of BBB dysfunction with Parkinson's disease (PD) pathology. The neurodegeneration occurring in PD is believed to stem from a myriad of pathogenic mechanisms, including tight junction alterations, abnormal angiogenesis, and dysfunctional BBB transporter mechanism, which ultimately causes altered BBB permeability. In this review, the major elements of the neurovascular unit (NVU) comprising the BBB are discussed, along with their role in the maintenance of barrier integrity and PD pathogenesis. We also elaborated on how the neuroendocrine system can influence the regulation of BBB function and PD pathogenesis. Several novel therapeutic approaches targeting the NVU components are explored to provide a fresh outlook on treatment options for PD.

Matched MeSH terms: Central Nervous System
Does long term supplementation of vitamin E cause detrimental effects on the central nervous system? Morphological and histological study in experimental male Wistar rats

Mohamad Fairuz Y, Azian A, Nursiati MT, Srijit D, Hamzaini AH, Wan Zurinah WN, et al.

Clin Ter, 2013;164(2):119-24.
PMID: 23698204 DOI: 10.7417/CT.2013.1529

Aging is attributed to neuronal loss associated with increased oxidative stress. Vitamin E, and in particular, tocotrienol are potent antioxidants, which have been shown to be neuroprotective. The main aim of the present study was to observe the effect of long term intake of vitamin E in the form of tocotrienol rich fraction (TRF) and refined, bleached, deodorized palm olein (RBDPO) on the brain of experimental rats.

Matched MeSH terms: Central Nervous System Diseases/chemically induced*; Central Nervous System Diseases/pathology*
Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcome

Jahanfar S, Sharifah H

Cochrane Database Syst Rev, 2009 April 15.
PMID: 19370665 DOI: 10.1002/14651858.CD006965.pub2

BACKGROUND: Maternal caffeine consumption during pregnancy may have adverse effects on fetal, neonatal and maternal outcomes.
OBJECTIVES: This review investigates the effects of restricting caffeine intake by mothers on fetal, neonatal and pregnancy outcomes.
SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2008), scanned bibliographies of published studies and corresponded with investigators.
SELECTION CRITERIA: Randomised controlled trials including quasi-randomised controlled trials (RCTs) investigating the effect of caffeine and/or supplementary caffeine versus restricted caffeine intake or placebo on pregnancy outcome.
DATA COLLECTION AND ANALYSIS: The two review authors independently assessed trial quality and extracted data.
MAIN RESULTS: One study met the inclusion criteria. Caffeinated instant coffee (568 women) was compared with decaffeinated instant coffee (629 women) and it was found that reducing the caffeine intake of regular coffee drinkers (3+ cups/day) during the second and third trimester by an average of 182 mg/day did not affect birthweight or length of gestation.
AUTHORS' CONCLUSIONS: There is insufficient evidence to confirm or refute the effectiveness of caffeine avoidance on birthweight or other pregnancy outcomes. There is a need to conduct high-quality, double-blinded RCTs to determine whether caffeine has any effect on pregnancy outcome.

Matched MeSH terms: Central Nervous System Stimulants/administration & dosage; Central Nervous System Stimulants/pharmacology*
Fulltext The distribution of inflammation and virus in human enterovirus 71 encephalomyelitis suggests possible viral spread by neural pathways

Wong KT, Munisamy B, Ong KC, Kojima H, Noriyo N, Chua KB, et al.

J. Neuropathol. Exp. Neurol., 2008 Feb;67(2):162-9.
PMID: 18219253 DOI: 10.1097/nen.0b013e318163a990

Previous neuropathologic studies of Enterovirus 71 encephalomyelitis have not investigated the anatomic distribution of inflammation and viral localization in the central nervous system (CNS) in detail. We analyzed CNS and non-CNS tissues from 7 autopsy cases from Malaysia and found CNS inflammation patterns to be distinct and stereotyped. Inflammation was most marked in spinal cord gray matter, brainstem, hypothalamus, and subthalamic and dentate nuclei; it was focal in the cerebrum, mainly in the motor cortex, and was rare in dorsal root ganglia. Inflammation was absent in the cerebellar cortex, thalamus, basal ganglia, peripheral nerves, and autonomic ganglia. The parenchymal inflammatory response consisted of perivascular cuffs, variable edema, neuronophagia, and microglial nodules. Inflammatory cells were predominantly CD68-positive macrophage/microglia, but there were a few CD8-positive lymphocytes. There were no viral inclusions; viral antigens and RNA were localized only in the somata and processes of small numbers of neurons and in phagocytic cells. There was no evidence of virus in other CNS cells, peripheral nerves, dorsal root autonomic ganglia, or non-CNS organs. The results indicate that Enterovirus 71 is neuronotropic, and that, although hematogenous spread cannot be excluded, viral spread into the CNS could be via neural pathways, likely the motor but not peripheral sensory or autonomic pathways. Viral spread within the CNS seems to involve motor and possibly other pathways.

Matched MeSH terms: Central Nervous System/physiopathology; Central Nervous System/virology*
Adenosine Receptors in Modulation of Central Nervous System Disorders

Choudhury H, Chellappan DK, Sengupta P, Pandey M, Gorain B

Curr Pharm Des, 2019;25(26):2808-2827.
PMID: 31309883 DOI: 10.2174/1381612825666190712181955

The ubiquitous signaling nucleoside molecule, adenosine is found in different cells of the human body to provide its numerous pharmacological role. The associated actions of endogenous adenosine are largely dependent on conformational change of the widely expressed heterodimeric G-protein-coupled A1, A2A, A2B, and A3 adenosine receptors (ARs). These receptors are well conserved on the surface of specific cells, where potent neuromodulatory properties of this bioactive molecule reflected by its easy passage through the rigid blood-brainbarrier, to simultaneously act on the central nervous system (CNS). The minimal concentration of adenosine in body fluids (30-300 nM) is adequate to exert its neuromodulatory action in the CNS, whereas the modulatory effect of adenosine on ARs is the consequence of several neurodegenerative diseases. Modulatory action concerning the activation of such receptors in the CNS could be facilitated towards neuroprotective action against such CNS disorders. Our aim herein is to discuss briefly pathophysiological roles of adenosine on ARs in the modulation of different CNS disorders, which could be focused towards the identification of potential drug targets in recovering accompanying CNS disorders. Researches with active components with AR modulatory action have been extended and already reached to the bedside of the patients through clinical research in the improvement of CNS disorders. Therefore, this review consist of recent findings in literatures concerning the impact of ARs on diverse CNS disease pathways with the possible relevance to neurodegeneration.

Matched MeSH terms: Central Nervous System; Central Nervous System Diseases/physiopathology*
Second regional plasmapheresis conference and workshop for Southeast Asia (SEA) on the immunomodulatory role of plasma exchange in central and peripheral nervous system disorders, Kuala Lumpur, Malaysia, 9th December 2017

Viswanathan S, Hung SKY, Goyal V, Apiwattanakul M, Thirugnanam UN, Abdullah S, et al.

J Clin Apher, 2018 Oct;33(5):559-568.
PMID: 29626354 DOI: 10.1002/jca.21630

In December 2017, 79 delegates attended the 2nd regional plasmapheresis conference and workshop for Southeast Asia (SEA) on the immunomodulatory role of plasma exchange in central and peripheral nervous system disorders in Kuala Lumpur, Malaysia. This meeting featured 6 plenary lectures, interactive sessions dedicated for experience sharing, case presentations, and a practical session for paramedics. Clinical experts and researchers from 7 SEA countries and India shared experience and challenges in treating autoimmune neurological disorders. While the spectrum of diseases and neurology practice remained largely similar, there was great disparities in accessibility of therapeutic plasma exchange (TPE) within SEA countries and between urban or rural settings. Costs, human resources, and healthcare policies are common challenges in providing sustainable TPE services. Novel techniques and innovative ideas in performing TPE were explored. A working consortium comprising of key opinion leaders was proposed to improve standards of TPE and enhance future research.

Matched MeSH terms: Central Nervous System Diseases/immunology; Central Nervous System Diseases/therapy

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