Cellular mechanisms involved in neurodegenera-
tion and neuroprotection are continuing to be
explored, and this paper focuses on some novel dis-
coveries that give further insight into these process-
es. Oligodendrocytes and activated astroglia are
likely generators of the pro-inflammatory
cytokines, such as the tumor necrosis factor family
and interleukin family, and these glial support cells
express adhesion receptors (e.g., VCAM) and
release intercellular adhesion molecules (ICAM)
that have a major role in neuronal apoptosis. Even
brief exposure to some substances, in ontogeny and
sometimes in adulthood, can have lasting effects on
behaviors because of their prominent toxicity (e.g.,
NMDA receptor antagonists) or because they sensi-
tize receptors (e.g., dopamine D
2
agonists), possibly
permanently, and thereby alter behavior for the
lifespan. Cell cycle genes which may be derived
from microglia, are the most-recent entry into the
neuroprotection schema. Neuroprotection afforded
by some common substances (e.g., melatonin) and
uncommon substances [e.g., nicotine, green tea
polyphenol (-)-epigallocatechin-3-gallate (EGCG),
trolox], ordinarily thought to be simple radical
scavengers, now are thought to invoke previously
unsuspected cellular mechanisms in the process of
neuroprotection. Although Alzheimer's disease
(AD) has features of a continuous spectrum of neu-
ral and functional decline, in vivo PET imaging and
and functional magnetic resonance imaging, indi-
cate that AD can be staged into an early phase
treatable by inhibitors of ß and γ secretase; and a
late phase which may be more amenable to treat-
ment by drugs that prevent or reverse tau phospho-
rylation. Neural transplantation, thought to be the
last hope for neurally injured patients (e.g.,
Parkinsonians), may be displaced by non-neural tis-
sue transplants (e.g., human umbilical cord blood;
Sertoli cells) which seem to provide similar neu-
rotrophic support and improved behavior - without
posing the major ethical dilemma of removing tis-
sue from aborted fetuses. The objective of this
paper is to invite added research into the newly dis-
covered (or postulated) novel mechanisms; and to
stimulate discovery of additional mechanisms
attending neurodegeneration and neuroprotection.
Keywords: Neurodegeneration; Neuroprotection; Cell cycle
genes; Cytokines; Non-neural transplantation; Sertoli cells;
Human umbilical cord blood; Alzheimer disease;
Oligodendrocytes; Astroglia
INTRODUCTION
Every so often it is important to 'rise above the dust'
and get into a skybox to have a better view and appre-
ciation of what is actually happening on the playing
field. This review is intended to be that view from the
skybox to see some of the new players on the opposing
teams: neurodegeneration and neuroprotection. The
new players are most likely to recruit a new audience
(i.e., new investigators) and turn the tide of the game
through their novelty (i.e., new mechanisms) which
changes the game strategy (i.e., direction of research).
There is a saying that hope springs eternal. This review
is intended to help that dream become a
reality.Therefore, we focus on what is seen as novel,
not the generally recognized aspects of these topics.
Neurodegeneration is a disabling disease that affects
F.P. Graham Publishing Co.
Neurotoxicity Research, 2003, VOL. 5(6). pp. 375-384
Novel Mechanisms and Approaches in the Study of
Neurodegeneration and Neuroprotection. A Review.
RICHARD M. KOSTRZEWA
a
and JUAN SEGURA-AGUILAR
b
a
Department of Pharmacology, Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614-
1708, USA;
b
Molecular and Clinical Pharmacology, ICBM, Faculty of Medicine, University of Chile, Casilla 70000
Santiago, Chile. kostrzew@etsu.edu
(In final form: 31 October 2003)
*Corresponding author. Tel: +1 423 439-6321; Fax: +1 423 439-8773; E-mail: kostrzew@etsu.edu
ISSN 1029 8428 print/ ISSN 1476-3524 online. © 2003 FP Graham Publishing Co., www.fpgrahamco.com