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  • Type 3 diabetes is a term that has recently been suggested to explain Alzheimer's disease resulting from resistance to insulin in the brain, thereby suggesting Alzheimer's disease as a neuroendocrine disorder. Experimental brain diabetes shares many features with Alzheimer's disease, including cognitive impairment and disturbances in acetylcholine homeostasis. In humans, impairments in brain insulin and insulin growth factor signal increase accumulation of amyloid β, hyperphosphorylated tau, reactive oxygen and nitrogen species, and pro-inflammatory and pro-apoptotic molecules in Alzheimer’s disease. Insulin resistance and defective brain energy metabolism in the development of Alzheimer's disease by using molecular imaging techniques assuming that brain insulin resistance manifests itself as reductions in the regional cerebral metabolic rate of glucose (CMRglc), the cerebral metabolic rate of oxygen (CMRo2), glycolysis, lactate, cerebral blood flow, synaptic density, with increased brain Amyloid β accumulation, and risk of developing Alzheimer's disease.

 

  • COVID-19 gives rise to widespread neurological manifestations. The signs and symptoms are associated with both central and peripheral nervous systems. COVID-19-associated coagulopathy (CAC) is increasingly recognized as a result of acute infection and is likely caused by inflammation, including inflammatory cytokine storm. Recent studies suggest that axonal transport of SARS-CoV-2 to the brain can occur from the olfactory neuroepithelium of the cribriform plate adjacent to the olfactory bulb that may lead to symptomatic anosmia. The internalization of SARS-CoV-2 is mediated by the binding of the spike glycoprotein of the virus to the angiotensin-converting enzyme 2 (ACE2) on cellular membranes, also with the aid of transmembrane protease, serine 2 (TMPRSS2), cathepsin B (CAT B), and cathepsin L (CAT L). ACE2 is expressed in several tissues including lung alveolar cells, gastrointestinal tissue, and the brain. ACE2 is encoded in astrocytes, oligodendrocytes, and neurons. It has been also found in the substantia nigra, ventricles, middle temporal gyrus, posterior cingulate cortex, and olfactory bulb. Intracerebral hemorrhage (ICH) and ischemic stroke can be seen in patients with COVID-19.

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