Joseph Charles R
Department of Internal Medicine, Liberty University College of Osteopathic Medicine, Lynchburg, VA 24502, USA.
Diagnostics (Basel). 2021 Oct 13;11(10):1888. doi: 10.3390/diagnostics11101888.
New approaches are required to successfully intervene therapeutically in neurodegenerative diseases. Addressing the earliest phases of disease, blood brain barrier (BBB) leak before the accumulation of misfolded proteins has significant potential for success. To do so, however, a reliable, noninvasive and economical test is required. There are two potential methods of identifying the BBB fluid leak that results in the accumulation of normally excluded substances which alter neuropil metabolism, protein synthesis and degradation with buildup of misfolded toxic proteins. The pros and cons of dynamic contrast imaging (DCI or DCE) and 3D TGSE PASL are discussed as potential early identifying methods. The results of prior publications of the 3D ASL technique and an overview of the associated physiologic challenges are discussed. Either method may serve well as reliable physiologic markers as novel therapeutic interventions directed at the vasculopathy of early neurodegenerative disease are developed. They may serve well in addressing other neurologic diseases associated with either vascular leak and/or reduced glymphatic flow.
需要新的方法来成功地对神经退行性疾病进行治疗干预。在疾病的最早阶段，即在错误折叠蛋白积累之前解决血脑屏障（BBB）渗漏问题，具有显著的成功潜力。然而，要做到这一点，需要一种可靠、无创且经济的检测方法。有两种潜在方法可用于识别导致通常被排除在外的物质积累的血脑屏障液体渗漏，这些物质会随着错误折叠的毒性蛋白的积累而改变神经毡代谢、蛋白质合成和降解。本文讨论了动态对比成像（DCI或DCE）和3D TGSE PASL作为潜在早期识别方法的优缺点。讨论了3D ASL技术先前发表的结果以及相关生理挑战的概述。随着针对早期神经退行性疾病血管病变的新型治疗干预措施的开发，这两种方法都可作为可靠的生理标志物发挥良好作用。它们在解决与血管渗漏和/或糖淋巴流减少相关的其他神经系统疾病方面可能也会有很好的效果。
