, 2003) or by facilitating the entry of Aβ-laden monocytes into the CNS, thereby contributing to the development of the disease and another suitable target for treatment (Deane et al., 2012). We understand now that the levels of Aβ in the brain are an equilibrium between its production and its clearance, reflected at the BBB as a balance between its entry and its exit from the CNS through the
LRP-1/RAGE tandem. These results have helped develop the hypothesis that clearing Aß in the circulation could create a vacuum that pulls the Aß from the CNS into the circulation learn more through these transporters. This so-called “sink hypothesis” warrants the targeting of the periphery to have positive effects in the CNS. One such compound is the macrophage-colony stimulating factor (M-CSF), the main growth factor for cells Carfilzomib solubility dmso of the monocytic lineage (Hume and MacDonald, 2012) (Figure 4). Injecting M-CSF to transgenic mice that spontaneously develop AD on a weekly basis prior to the appearance of learning and memory deficits prevented cognitive loss. The treatment also restored the population
of M1 monocytes in the circulation and greatly decreased Aβ levels. In addition, M-CSF treatment resulted in the stabilization of the cognitive decline state in transgenic mice that already had Aβ pathology (Boissonneault et al., 2009). In vitro, exposure of mouse microglia to M-CSF enables the acidification of their lysosomes and, subsequently, the degradation of internalized Aβ (Majumdar et al., 2007). In this regard, low levels
of M-CSF were recently measured in patients with presymptomatic AD or mild cognitive impairment, which together with low levels of other hematopoietic cytokines predicted the rapid evolution of the disease toward a dementia diagnosis 2 to 6 years later (Ray et al., 2007). This is one of the ways the hematopoietic system can be used to treat AD (Lampron et al., 2011). Multiple sclerosis is a chronic neuroinflammatory CNS disorder Megestrol Acetate with a widespread degradation of the myelin sheaths of axons. It is characterized by focal lymphocyte infiltration into CNS parenchyma, which is associated with BBB dysfunction and microglia activation (Cristante et al., 2013; Compston and Coles, 2008). During the early stages of MS pathogenesis, the insults triggered by infiltrated lymphocytes are transient and both demyelination and neurological dysfunction are reversible. This is the relapsing-remitting phase of the disease. With time, the pathogenesis evolves to reach exacerbated inflammation, irreversible demyelination, and permanent neurological dysfunctions, leading to the formation of demyelinated plaques in the CNS, the progressive stage of the disease (Compston and Coles, 2008). The early factors involved in MS pathogenesis are still largely unknown.
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