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      Neuroprotective effects of gemfibrozil in neurological disorders: Focus on inflammation and molecular mechanisms

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          Abstract

          Background

          Gemfibrozil (Gem) is a drug that has been shown to activate PPAR‐α, a nuclear receptor that plays a key role in regulating lipid metabolism. Gem is used to lower the levels of triglycerides and reduce the risk of coronary heart disease in patients. Experimental studies in vitro and in vivo have shown that Gem can prevent or slow the progression of neurological disorders (NDs), including cerebral ischemia (CI), Alzheimer's disease (AD), Parkinson's disease (PD), and multiple sclerosis (MS). Neuroinflammation is known to play a significant role in these disorders.

          Method

          The literature review for this study was conducted by searching Scopus, Science Direct, PubMed, and Google Scholar databases.

          Result

          The results of this study show that Gem has neuroprotective effects through several cellular and molecular mechanisms such as: (1) Gem has the ability to upregulate pro‐survival factors (PGC‐1α and TFAM), promoting the survival and function of mitochondria in the brain, (2) Gem strongly inhibits the activation of NF‐κB, AP‐1, and C/EBPβ in cytokine‐stimulated astroglial cells, which are known to increase the expression of iNOS and the production of NO in response to proinflammatory cytokines, (3) Gem protects dopamine neurons in the MPTP mouse model of PD by increasing the expression of PPARα, which in turn stimulates the production of GDNF in astrocytes, (4) Gem reduces amyloid plaque pathology, reduces the activity of glial cells, and improves memory, (5) Gem increases myelin genes expression (MBP and CNPase) via PPAR‐β, and (6) Gem increases hippocampal BDNF to counteract depression.

          Conclusion

          According to the study, Gem was investigated for its potential therapeutic effect in NDs. Further research is needed to fully understand the therapeutic potential of Gem in NDs.

          Abstract

          Neuroprotective effects of Gem on NDs. Gem exhibits neuroprotective properties by reducing inflammation, oxidative stress, and apoptosis in the brain. The mechanism of action involves modulating lipid metabolism, upregulating antioxidant enzymes, and inhibiting proinflammatory cytokines. Preclinical studies have shown that Gem treatment protects neurons, promotes neurite outgrowth, and improves cognitive function in animal models of neurodegenerative diseases like Alzheimer's and Parkinson's.

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          Most cited references200

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          From stress to inflammation and major depressive disorder: a social signal transduction theory of depression.

          Major life stressors, especially those involving interpersonal stress and social rejection, are among the strongest proximal risk factors for depression. In this review, we propose a biologically plausible, multilevel theory that describes neural, physiologic, molecular, and genomic mechanisms that link experiences of social-environmental stress with internal biological processes that drive depression pathogenesis. Central to this social signal transduction theory of depression is the hypothesis that experiences of social threat and adversity up-regulate components of the immune system involved in inflammation. The key mediators of this response, called proinflammatory cytokines, can in turn elicit profound changes in behavior, which include the initiation of depressive symptoms such as sad mood, anhedonia, fatigue, psychomotor retardation, and social-behavioral withdrawal. This highly conserved biological response to adversity is critical for survival during times of actual physical threat or injury. However, this response can also be activated by modern-day social, symbolic, or imagined threats, leading to an increasingly proinflammatory phenotype that may be a key phenomenon driving depression pathogenesis and recurrence, as well as the overlap of depression with several somatic conditions including asthma, rheumatoid arthritis, chronic pain, metabolic syndrome, cardiovascular disease, obesity, and neurodegeneration. Insights from this theory may thus shed light on several important questions including how depression develops, why it frequently recurs, why it is strongly predicted by early life stress, and why it often co-occurs with symptoms of anxiety and with certain physical disease conditions. This work may also suggest new opportunities for preventing and treating depression by targeting inflammation.
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            A new mechanism of nervous system plasticity: activity-dependent myelination.

            The synapse is the focus of experimental research and theory on the cellular mechanisms of nervous system plasticity and learning, but recent research is expanding the consideration of plasticity into new mechanisms beyond the synapse, notably including the possibility that conduction velocity could be modifiable through changes in myelin to optimize the timing of information transmission through neural circuits. This concept emerges from a confluence of brain imaging that reveals changes in white matter in the human brain during learning, together with cellular studies showing that the process of myelination can be influenced by action potential firing in axons. This Opinion article summarizes the new research on activity-dependent myelination, explores the possible implications of these studies and outlines the potential for new research.
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              ERK1/2 MAP kinases: structure, function, and regulation.

              ERK1 and ERK2 are related protein-serine/threonine kinases that participate in the Ras-Raf-MEK-ERK signal transduction cascade. This cascade participates in the regulation of a large variety of processes including cell adhesion, cell cycle progression, cell migration, cell survival, differentiation, metabolism, proliferation, and transcription. MEK1/2 catalyze the phosphorylation of human ERK1/2 at Tyr204/187 and then Thr202/185. The phosphorylation of both tyrosine and threonine is required for enzyme activation. Whereas the Raf kinase and MEK families have narrow substrate specificity, ERK1/2 catalyze the phosphorylation of hundreds of cytoplasmic and nuclear substrates including regulatory molecules and transcription factors. ERK1/2 are proline-directed kinases that preferentially catalyze the phosphorylation of substrates containing a Pro-Xxx-Ser/Thr-Pro sequence. Besides this primary structure requirement, many ERK1/2 substrates possess a D-docking site, an F-docking site, or both. A variety of scaffold proteins including KSR1/2, IQGAP1, MP1, β-Arrestin1/2 participate in the regulation of the ERK1/2 MAP kinase cascade. The regulatory dephosphorylation of ERK1/2 is mediated by protein-tyrosine specific phosphatases, protein-serine/threonine phosphatases, and dual specificity phosphatases. The combination of kinases and phosphatases make the overall process reversible. The ERK1/2 catalyzed phosphorylation of nuclear transcription factors including those of Ets, Elk, and c-Fos represents an important function and requires the translocation of ERK1/2 into the nucleus by active and passive processes involving the nuclear pore. These transcription factors participate in the immediate early gene response. The activity of the Ras-Raf-MEK-ERK cascade is increased in about one-third of all human cancers, and inhibition of components of this cascade by targeted inhibitors represents an important anti-tumor strategy. Thus far, however, only inhibition of mutant B-Raf (Val600Glu) has been found to be therapeutically efficacious. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                mzamaniyan66@yahoo.com
                hakimizadeh_elham@yahoo.com
                Journal
                CNS Neurosci Ther
                CNS Neurosci Ther
                10.1111/(ISSN)1755-5949
                CNS
                CNS Neuroscience & Therapeutics
                John Wiley and Sons Inc. (Hoboken )
                1755-5930
                1755-5949
                30 October 2023
                March 2024
                : 30
                : 3 ( doiID: 10.1002/cns.v30.3 )
                : e14473
                Affiliations
                [ 1 ] School of Medicine Qazvin University of Medical Sciences Qazvin Iran
                [ 2 ] Neurophysiology Research Center Hamadan University of Medical Sciences Hamadan Iran
                [ 3 ] Department of Pharmacology and Toxicology, School of Pharmacy Hamadan University of Medical Sciences Hamadan Iran
                [ 4 ] Institute of Pharmaceutical Research, GLA University Mathura India
                [ 5 ] Department of Pediatric Dentistry, Faculty of Dentistry Hasanuddin University Makassar Indonesia
                [ 6 ] Pharmaceutics and Pharmaceutical Technology Taif University Taif Saudi Arabia
                [ 7 ] Department of Medical Laboratory Sciences College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University Al‐Kharj Saudi Arabia
                [ 8 ] Universidad Continental Lima Peru
                [ 9 ] Microbiology Research Group College of Pharmacy, Al‐Ayen University Thi‐Qar Iraq
                [ 10 ] Medical Laboratory Technology Department College of Medical Technology, The Islamic University Najaf Iraq
                [ 11 ] Physiology‐Pharmacology Research Center Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences Rafsanjan Iran
                Author notes
                [*] [* ] Correspondence

                Mohammad Yasin Zamanian, Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan 6718773654, Iran.

                Email: mzamaniyan66@ 123456yahoo.com

                Elham Hakimizadeh, Physiology‐Pharmacology Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

                Email: hakimizadeh_elham@ 123456yahoo.com

                Author information
                https://orcid.org/0000-0003-0944-0320
                Article
                CNS14473 CNSNT-2023-985.R1
                10.1111/cns.14473
                10916451
                37904726
                bc5f4161-a630-482f-a981-f8de3dfdab29
                © 2023 Hamadan University of Medical Sciences. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 August 2023
                : 12 July 2023
                : 03 September 2023
                Page count
                Figures: 2, Tables: 1, Pages: 15, Words: 12133
                Categories
                Review
                Review
                Custom metadata
                2.0
                March 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.9 mode:remove_FC converted:06.03.2024

                Neurosciences
                gemfibrozil,neuroinflammation,neurological disorders,neuroprotective,ppar‐α
                Neurosciences
                gemfibrozil, neuroinflammation, neurological disorders, neuroprotective, ppar‐α

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