Publications by authors named "Massimo Fiandaca"

Direct putaminal infusion of adeno-associated virus vector (serotype 2) (AAV2) containing the human glial cell line-derived neurotrophic factor (GDNF) transgene was studied in a phase I clinical trial of participants with advanced Parkinson's disease (PD). Convection-enhanced delivery of AAV2-GDNF with a surrogate imaging tracer (gadoteridol) was used to track infusate distribution during real-time intraoperative magnetic resonance imaging (iMRI). Pre-, intra-, and serial postoperative (up to 5 years after infusion) MRI were analyzed in 13 participants with PD treated with bilateral putaminal co-infusions (52 infusions in total) of AAV2-GDNF and gadoteridol (infusion volume, 450 mL per putamen).

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Article Synopsis
  • Research indicates that reactivation of silent transposable elements (TEs) could lead to cognitive decline and Alzheimer's disease (AD) by affecting gene expression and causing neuroinflammation.
  • The study examines aging subjects who developed late-onset AD, comparing blood samples collected before and after their condition changed.
  • The analysis identified significant changes in the expression of 1,790 TEs, suggesting that a specific transcriptional profile of DE TEs could serve as a potential biomarker for cognitive decline and AD progression.
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Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy wherein a majority of patients present metastatic disease at diagnosis. Although the role of epithelial to mesenchymal transition (EMT), mediated by transforming growth factor beta (TGFβ), in imparting an aggressive phenotype to PDAC is well documented, the underlying biochemical pathway perturbations driving this behaviour have not been elucidated. We used high-resolution mass spectrometry (HRMS) based molecular phenotyping approach in order to delineate metabolic changes concomitant to TGFβ-induced EMT in pancreatic cancer cells.

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Background: Altered plasma levels of sphingolipids, including sphingomyelins (SM), have been found in mouse models of Alzheimer's disease (AD) and in AD patient plasma samples.

Objective: This study assesses fourteen plasma SM species in a late-onset AD (LOAD) patient cohort (n = 138).

Methods: Specimens from control, preclinical, and symptomatic subjects were analyzed using targeted mass-spectrometry-based metabolomic methods.

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Article Synopsis
  • There is a critical need for an effective, non-invasive tool for diagnosing Alzheimer's disease (AD) and assessing its severity, with metabolomics showing potential for this purpose.
  • Using artificial intelligence and machine learning, researchers aimed to determine if a specific set of plasma metabolites could serve as reliable biomarkers for mild cognitive impairment (MCI) and AD.
  • Out of 212 metabolites analyzed, five were identified as key differentiators between healthy individuals and those with MCI or AD, with models showing moderate accuracy and confirming disturbed lipid metabolism as a significant factor in dementia cases.
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Introduction: Vector-based intracerebral gene therapies are being used to treat specific neurodegenerative conditions such as Parkinson's Disease (PD). This review presents a basis for central nervous system (CNS) gene therapy treatments of neurodegenerative diseases such as PD, as well as the need for novel skill sets and health delivery strategies within the clinical neurosciences (neurology and neurosurgery) to meet future demand for such therapies.

State Of The Art: Preclinical vector-based gene therapy approaches have been translated into clinical trials for PD and other neurodegenerative conditions.

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The concept of repairing the brain with growth factors has been pursued for many years in a variety of neurodegenerative diseases including primarily Parkinson's disease (PD) using glial cell line-derived neurotrophic factor (GDNF). This neurotrophic factor was discovered in 1993 and shown to have selective effects on promoting survival and regeneration of certain populations of neurons including the dopaminergic nigrostriatal pathway. These observations led to a series of clinical trials in PD patients including using infusions or gene delivery of GDNF or the related growth factor, neurturin (NRTN).

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Objective: To develop and assess a convective delivery technique that enhances the effectiveness of drug delivery to nonspherical brain nuclei, the authors developed an occipital "infuse-as-you-go" approach to the putamen and compared it to the currently used transfrontal approach.

Methods: Eleven nonhuman primates received a bilateral putamen injection of adeno-associated virus with 2 mM gadolinium-DTPA by real-time MR-guided convective perfusion via either a transfrontal (n = 5) or occipital infuse-as-you-go (n = 6) approach.

Results: MRI provided contemporaneous assessment and monitoring of putaminal infusions for transfrontal (2 to 3 infusion deposits) and occipital infuse-as-you-go (stepwise infusions) putaminal approaches.

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Objective: Successful convection-enhanced delivery of therapeutic agents to subcortical brain structures requires accurate cannula placement. Stereotactic guiding devices have been developed to accurately target brain nuclei. However, technologies remain limited by a lack of MRI compatibility, or by devices' size, making them suboptimal for direct gene delivery to brain parenchyma.

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It is known that culture media (CM) promotes cellular growth, adhesion, and protects explanted primary brain cells from in vitro stresses. The fetal bovine serum (FBS) supplement used in most CM, however, contains significant quantities of extracellular vesicles (EVs) that confound quantitative and qualitative analyses from the EVs produced by the cultured cells. We quantitatively tested the ability of common FBS EV-depletion protocols to remove exogenous EVs from FBS-supplemented CM and evaluated the influence such methods have on primary astrocyte culture growth and viability.

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Article Synopsis
  • The causes of sporadic neurodegenerative diseases likely involve a mix of genetic factors and environmental influences, with gene-environment interactions becoming more important due to advances in understanding epigenetics.
  • A potential link between traumatic brain injury (TBI) and Parkinson's disease (PD) is highlighted, though the exact mechanisms remain unclear.
  • Preliminary findings show altered blood glutamic acid levels in subacute mild TBI subjects and PD/PDD patients, suggesting a possible connection that, if further validated, could point to excitotoxic mechanisms linking TBI with Parkinson's disease.
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  • Researchers investigated the role of microRNAs in gene expression related to neural plasticity after stroke, aiming to find similar markers in human plasma.
  • They collected plasma samples from 27 stroke participants and measured microRNA levels, identifying 6 with increased expression and 3 with decreased expression associated with recovery outcomes.
  • The findings suggest that certain microRNAs in plasma could provide insights into human neural repair after stroke and may differ from those observed in animal models.
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  • Contemporary metabolomics generates complex high-dimensional data, requiring standardized methods for effective analysis and interpretation to derive accurate biochemical and clinical insights.
  • While much attention has been given to untargeted metabolomics, targeted approaches using commercial kits lack similar methodological scrutiny, potentially leading to the incomplete replication of biomarker panels.
  • The paper identifies challenges in analyzing targeted metabolomic data, proposes solutions to enhance data preprocessing, and outlines an analytical pipeline for improving biomarker discovery and predictive model development across different experimental settings.
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Past and recent attempts at devising objective biomarkers for traumatic brain injury (TBI) in both blood and cerebrospinal fluid have focused on abundance measures of time-dependent proteins. Similar independent determinants would be most welcome in diagnosing the most common form of TBI, mild TBI (mTBI), which remains difficult to define and confirm based solely on clinical criteria. There are currently no consensus diagnostic measures that objectively define individuals as having sustained an acute mTBI.

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The complex multifactorial nature of polygenic Alzheimer's disease (AD) presents significant challenges for drug development. AD pathophysiology is progressing in a non-linear dynamic fashion across multiple systems levels - from molecules to organ systems - and through adaptation, to compensation, and decompensation to systems failure. Adaptation and compensation maintain homeostasis: a dynamic equilibrium resulting from the dynamic non-linear interaction between genome, epigenome, and environment.

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Systems healthcare is a holistic approach to health premised on systems biology and medicine. The approach integrates data from molecules, cells, organs, the individual, families, communities, and the natural and man-made environment. Both extrinsic and intrinsic influences constantly challenge the biological networks associated with wellness.

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Pancreatic cancer (PC) is an aggressive disease with high mortality rates, however, there is no blood test for early detection and diagnosis of this disease. Several research groups have reported on metabolomics based clinical investigations to identify biomarkers of PC, however there is a lack of a centralized metabolite biomarker repository that can be used for meta-analysis and biomarker validation. Furthermore, since the incidence of PC is associated with metabolic syndrome and Type 2 diabetes mellitus (T2DM), there is a need to uncouple these common metabolic dysregulations that may otherwise diminish the clinical utility of metabolomic biosignatures.

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As the world population ages, primary prevention of age-related cognitive decline and disability will become increasingly important. Prevention strategies are often developed from an understanding of disease pathobiology, but models of biological success may provide additional useful insights. Here, we studied 224 older adults, some with superior memory performance (n = 41), some with normal memory performance (n = 109), and some with mild cognitive impairment or Alzheimer's disease (AD; n = 74) to understand metabolomic differences which might inform future interventions to promote cognitive health.

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