Posterior reversible encephalopathy syndrome and autoimmunity

Li, Yang; Song, Junmin; Huq, A.H.M. Mahbubul; Timilsina, Suraj; Gershwin, M. Eric

doi:10.1016/j.autrev.2022.103239

Cited by 4 publications

(3 citation statements)

References 97 publications

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“…46 Models involving a proinflammatory state would also be interesting to study the impact of different cytokines on the BBB permeability in PRES, as suggested by the eclamptic rat model of Fang et al 36 corroborated by some clinical data. 47 Models based on hyperhomocysteinemia (dietary and genetic) could also be of interest to investigate the pathogenic value of endothelial dysfunction in PRES. 48 Because anti-VEGF drugs are known to induce both preeclampsia-like syndrome and PRES, 4,20 anti-VEGF therapy could also provide an interesting model of PRES with endothelial damage.…”

Section: Perspectivesmentioning

confidence: 99%

Experimental Models of Posterior Reversible Encephalopathy Syndrome: A Review From Pathophysiology to Therapeutic Targets

Largeau,

Bergeron,

Auger

et al. 2024

Stroke

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Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity characterized by nonspecific symptomatology (eg, headache, visual disturbances, encephalopathy, and seizures) and classically cortical and subcortical vasogenic edema predominantly affecting the parietooccipital region. PRES etiologies are usually dichotomized into toxic PRES (eg, antineoplastic drugs, illicit drugs) and clinical condition-associated PRES (eg, acute hypertension, dysimmune disorders). Although the pathophysiology of PRES remains elusive, 2 main pathogenic hypotheses have been suggested: cerebral hyperperfusion due to acute hypertension and cerebral hypoperfusion related to endothelial dysfunction. Research into the pathogenesis of PRES has emerged through the development of animal models in the last decade. The motivation for developing a suitable PRES model is 2-fold: to fill in knowledge gaps of the pathophysiological mechanisms involved, and to open new perspectives for clinical assessment of pharmacological targets to improve therapeutic management of PRES. All current models of PRES have a hypertensive background, on which other triggers (acute hypertension, inflammatory, drug toxicity) have been added to address specific facets of PRES (eg, seizures). The initial model consisted in inducing a reduced uterine perfusion pressure that mimics preeclampsia, a leading cause of PRES. More recently, a model of stroke-prone spontaneously hypertensive rats on high-salt diet, originally developed for hypertensive small vessel disease and vascular cognitive impairment, has been studied in PRES. This review aims to discuss, depending on the research objective, the benefits and limitations of current experimental approaches and thus to define the desirable characteristics for studying the pathophysiology of PRES and developing new therapies.

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Section: Perspectivesmentioning

confidence: 99%

Experimental Models of Posterior Reversible Encephalopathy Syndrome: A Review From Pathophysiology to Therapeutic Targets

Largeau,

Bergeron,

Auger

et al. 2024

Stroke

View full text Add to dashboard Cite

show abstract

“…In practical terms, chronic liver disease and acute liver failure can lead to a diverse range of neuropsychiatric abnormalities, ranging from subtle cognitive impairment to severe disorientation, confusion, and coma ( Rose et al, 2020 ). Additionally, conditions like hypertension, autoimmune diseases, renal dysfunction/failure, and preeclampsia/eclampsia may precipitate acute or subacute neurological symptoms, including headache, seizure, confusion, vomiting, and visual disturbances ( Li et al, 2023 ). Severe neuropsychiatric disorders have a profound impact on the quality of life of patients, significantly complicating the process of diagnosis and treatment ( Cosci et al, 2015 ; Santos et al, 2017 ; Bengtsson et al, 2021 ; Coronel et al, 2022 ).…”

Section: Pitnets Combined With Neuropsychiatric Disordersmentioning

confidence: 99%

Research status and prospects of pituitary adenomas in conjunction with neurological and psychiatric disorders and the tumor microenvironment

Cui,

Chen,

et al. 2024

Front. Neurosci.

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Patients with pituitary neuroendocrine tumors (PitNETs) often experience neuropsychiatric disorders due to factors such as hormonal imbalances, and inadequate management of medications, surgeries, and radiation therapies. Commonly observed disorders include depression, anxiety, and cognitive dysfunction, which significantly impact patients’ quality of life and prognosis. PitNETs have a significant presence of immune cells within the tumor microenvironment (TME), predominantly macrophages and T lymphocytes. These immune cells secrete a variety of cytokines, growth factors, and chemokines, which regulate the biological behaviors of PitNETs, including tumor initiation, proliferation, migration, invasion, and angiogenesis. In addition, this review provides a pioneering summary of the close relationships between the aberrant secretion of proinflammatory cytokines within the TME of PitNETs and the occurrence of neuropsychiatric disorders, along with their potential underlying mechanisms. The cytokines produced as a result of TME dysregulation may affect various aspects of the central nervous system, including neurotransmitter metabolism, neuroendocrine function, and neurovascular plasticity, thereby leading to a higher susceptibility to neurobehavioral disorders in PitNET patients.

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“…However, this hypothesis does not explain the finding that hypertension often precedes the onset of RPLS symptoms (Rabinstein et al, 2012). Some studies have suggested that the ischemic lesions often caused by vasospasm are mostly located in the cortex or white matter near the cortex (Li et al, 2023). If not treated in time, the lesions will often progress to cytotoxic edema, that is, cerebral infarction.…”

Section: The Etiology and Pathogenesis Of Pe-related Rplsmentioning

confidence: 99%

Advances in imaging findings of preeclampsia-related reversible posterior leukoencephalopathy syndrome

et al. 2023

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Preeclampsia (PE)-related reversible posterior leukoencephalopathy syndrome (RPLS) is a common complication of hypertensive disorders of pregnancy. The syndrome usually occurs after 20 weeks of gestation and can lead to brain injury. Severe headache, seizures, disturbance of consciousness, and other neurological symptoms may occur in severe cases. PE-RPLS has high morbidity and mortality rates and seriously damages maternal and fetal health. In recent years, the continuous advancement of medical imaging technology has provided an important imaging basis for the early diagnosis and prognostic evaluation of RPLS. This article mainly details the research status of the etiology and pathogenesis of PE-RPLS and describes its characteristic imaging findings, especially MRI findings, to provide new insights into its early diagnosis, early treatment, and improvement of prognosis.

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Posterior reversible encephalopathy syndrome and autoimmunity

Cited by 4 publications

References 97 publications

Experimental Models of Posterior Reversible Encephalopathy Syndrome: A Review From Pathophysiology to Therapeutic Targets

Experimental Models of Posterior Reversible Encephalopathy Syndrome: A Review From Pathophysiology to Therapeutic Targets

Research status and prospects of pituitary adenomas in conjunction with neurological and psychiatric disorders and the tumor microenvironment

Advances in imaging findings of preeclampsia-related reversible posterior leukoencephalopathy syndrome

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