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      Neurodegeneration-Associated Proteins in Human Olfactory Neurons Collected by Nasal Brushing

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          Abstract

          The olfactory neuroepithelium is located in the upper vault of the nasal cavity, lying on the olfactory cleft and projecting into the dorsal portion of the superior and middle turbinates beyond the mid-portion of the nasal septum. It is composed of a variety of cell types including olfactory sensory neurons, supporting glial-like cells, microvillar cells, and basal stem cells. The cells of the neuroepithelium are often intermingled with respiratory and metaplastic epithelial cells. Olfactory neurons undergo a constant self-renewal in the timespan of 2–3 months; they are directly exposed to the external environment, and thus they are vulnerable to physical and chemical injuries. The latter might induce metabolic perturbations and ultimately be the cause of cell death. However, the lifespan of olfactory neurons is biologically programmed, and for this reason, these cells have an accelerated metabolic cycle leading to an irreversible apoptosis. These characteristics make these cells suitable for research related to nerve cell degeneration and aging. Recent studies have shown that a non-invasive and painless olfactory brushing procedure allows an efficient sampling from the olfactory neuroepithelium. This approach allows to detect the pathologic prion protein in patients with sporadic Creutzfeldt–Jakob disease, using the real-time quaking-induced conversion assay. Investigating the expression of all the proteins associated to neurodegeneration in the cells of the olfactory mucosa is a novel approach toward understanding the pathogenesis of human neurodegenerative diseases. Our aim was to investigate the expression of α-synuclein, β-amyloid, tau, and TDP-43 in the olfactory neurons of normal subjects. We showed that these proteins that are involved in neurodegenerative diseases are expressed in olfactory neurons. These findings raise the question on whether a relationship exists between the mechanisms of protein aggregation that occur in the olfactory bulb during the early stage of the neurodegenerative process and the protein misfolding occurring in the olfactory neuroepithelium.

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          Most cited references44

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          Motile cilia of human airway epithelia are chemosensory.

          Cilia are microscopic projections that extend from eukaryotic cells. There are two general types of cilia; primary cilia serve as sensory organelles, whereas motile cilia exert mechanical force. The motile cilia emerging from human airway epithelial cells propel harmful inhaled material out of the lung. We found that these cells express sensory bitter taste receptors, which localized on motile cilia. Bitter compounds increased the intracellular calcium ion concentration and stimulated ciliary beat frequency. Thus, airway epithelia contain a cell-autonomous system in which motile cilia both sense noxious substances entering airways and initiate a defensive mechanical mechanism to eliminate the offending compound. Hence, like primary cilia, classical motile cilia also contain sensors to detect the external environment.
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            A test for Creutzfeldt-Jakob disease using nasal brushings.

            Definite diagnosis of sporadic Creutzfeldt-Jakob disease in living patients remains a challenge. A test that detects the specific marker for Creutzfeldt-Jakob disease, the prion protein (PrP(CJD)), by means of real-time quaking-induced conversion (RT-QuIC) testing of cerebrospinal fluid has a sensitivity of 80 to 90% for the diagnosis of sporadic Creutzfeldt-Jakob disease. We have assessed the accuracy of RT-QuIC analysis of nasal brushings from olfactory epithelium in diagnosing sporadic Creutzfeldt-Jakob disease in living patients.
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              Combining early markers strongly predicts conversion from mild cognitive impairment to Alzheimer's disease.

              The utility of combining early markers to predict conversion from mild cognitive impairment (MCI) to Alzheimer's Disease (AD) remains uncertain. Included in the study were 148 outpatients with MCI, broadly defined, followed at 6-month intervals. Hypothesized baseline predictors for follow-up conversion to AD (entire sample: 39/148 converters) were cognitive test performance, informant report of functional impairment, apolipoprotein E genotype, olfactory identification deficit, and magnetic resonance imaging (MRI) hippocampal and entorhinal cortex volumes. In the 3-year follow-up patient sample (33/126 converters), five of eight hypothesized predictors were selected by backward and stepwise logistic regression: Pfeffer Functional Activities Questionnaire (FAQ; informant report of functioning), University of Pennsylvania Smell Identification Test (UPSIT; olfactory identification), Selective Reminding Test (SRT) immediate recall (verbal memory), MRI hippocampal volume, and MRI entorhinal cortex volume. For 10% false positives (90% specificity), this five-predictor combination showed 85.2% sensitivity, combining age and Mini-Mental State Examination (MMSE) showed 39.4% sensitivity; combining age, MMSE, and the three clinical predictors (SRT immediate recall, FAQ, and UPSIT) showed 81.3% sensitivity. Area under ROC curve was greater for the five-predictor combination (.948) than age plus MMSE (.821; p = .0009) and remained high in subsamples with MMSE > or = 27/30 and amnestic MCI. The five-predictor combination strongly predicted conversion to AD and was markedly superior to combining age and MMSE. Combining the clinically administered measures also led to strong predictive accuracy. If independently replicated, the findings have potential utility for early detection of AD.
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                Author and article information

                Contributors
                Journal
                Front Neurosci
                Front Neurosci
                Front. Neurosci.
                Frontiers in Neuroscience
                Frontiers Media S.A.
                1662-4548
                1662-453X
                05 March 2020
                2020
                : 14
                : 145
                Affiliations
                [1] 1Neuropathology Section, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona , Verona, Italy
                [2] 2Otolaryngology Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona , Verona, Italy
                [3] 3Anatomy and Histology Section, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona , Verona, Italy
                [4] 4Physiology Section, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona , Verona, Italy
                [5] 5Biology and Genetics Section, Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona , Verona, Italy
                [6] 6Department of Pathology and Laboratory Medicine, Indiana University School of Medicine , Indianapolis, IN, United States
                Author notes

                Edited by: Zara M. Patel, Stanford University School of Medicine, United States

                Reviewed by: Jason C. Bartz, Creighton University, United States; Bernardo Moreno-López, University of Cádiz, Spain

                *Correspondence: Gianluigi Zanusso, gianluigi.zanusso@ 123456univr.it

                These authors have contributed equally to this work

                This article was submitted to Neurodegeneration, a section of the journal Frontiers in Neuroscience

                Article
                10.3389/fnins.2020.00145
                7066258
                32194369
                b8d0be60-76e7-498c-9e69-fae778e4bf9a
                Copyright © 2020 Brozzetti, Sacchetto, Cecchini, Avesani, Perra, Bongianni, Portioli, Scupoli, Ghetti, Monaco, Buffelli and Zanusso.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 15 November 2019
                : 05 February 2020
                Page count
                Figures: 8, Tables: 2, Equations: 0, References: 50, Pages: 12, Words: 0
                Categories
                Neuroscience
                Original Research

                Neurosciences
                olfactory neurons,olfactory neuroepithelium,olfactory brushing,neurodegenerative diseases,misfolded proteins

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