The Optic Nerve’s Perfusion Processes and Axonal Transport

Review Article | DOI: https://doi.org/DOI:10.31579/2692-9406/160

The Optic Nerve’s Perfusion Processes and Axonal Transport

  • Moyseyenko N.M

Associate Professor of Otorhinolaryngology and Ophthalmology with a course of head and neck surgery Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.

*Corresponding Author: Moyseyenko N. M, Associate Professor of Otorhinolaryngology and Ophthalmology with a course of head and neck surgery Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine.

Citation: Moyseyenko N.M, (2023), The Optic Nerve’s Perfusion Processes and Axonal Transport, J. Biomedical Research and Clinical Reviews. 8(4); DOI:10.31579/2692-9406/160

Copyright: © 2023, Moyseyenko N.M. this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 28 July 2023 | Accepted: 10 August 2023 | Published: 16 August 2023

Keywords: optic nerve; perfusion; axonal transport; astrocytes

Abstract

The optic nerve has a number of devices that regulate the function of axons and provide the energy needs of neurons. Although significant progress has been made in their understanding, the treatment of conditions that damage axons and lead to the death of GCS remains limited.
The purpose of the study: To investigate the patterns of perfusion processes and axonal transport of the optic nerve according to the literature.
Research methods: An analysis of 58 sources of literature.According to the literature, it is known that there are two main regulators of energy and perfusion processes in the optic nerve, which act on the anti- and retrograde pathways, which provide the movement of both nerve impulses (essentially a solution of electrolytes) and elements of the cytoskeleton and neurotransmitters, through which the retina-cerebral and cerebra-retinal effects are carried out.An important role in the regulation of perfusion and axonal transport is played by astrocytes, which under physiological conditions provide trophism of neurons, axons, as well as the exchange of neurotransmitters and other active conditions.
Conclusion: Thus, the study of processes that provide optic nerve perfusion, as well as the mechanisms of their violation is important for the study of optic neuropathies of various origins.

Introduction

The optic nerve has a number of devices that regulate the function of axons and provide the energy needs of neurons. Fluid perfusion in the optic nerve is of interest to scientists in many medical fields. It is believed that axonal transport provides the propagation of excitation from the ganglion cells of the retina (ҐKS) to the subcortical pathways, and on the way back - contribute to the imperative regulation of the brain processes of the visual system through the spread of neurotransmitters. That is why the violation of such interaction is the basis for both the development of atrophy and regeneration of the optic nerve.

Although significant progress has been made in their understanding, the treatment of conditions that damage axons and lead to the death of ҐKS remains limited 

The purpose of the study: To investigate the patterns of perfusion processes and axonal transport of the optic nerve according to the literature.

Research methods: An analysis of 56 sources of literature.

Result: According to the literature, the head of the optic nerve provides a balance of substances for the axons of ҐKS. Almost 50% of the cells of the optic nerve head are glia. Astrocytes play a crucial role in maintaining axonal homeostasis. They are interconnected by spaces and act as a syncytium to buffer changes in the extracellular environment of the axon [ 2]. Behind the sclera through the lattice axons wrapped in oligodendrocytes enter the retrolaminar part of the optic nerve.

Axons ҐKS provide communication between the eye and the brain. An axonal pathway is formed that integrates nerve impulses from the entire retina and converts them into active potential. This activity has a high energy dependence, and therefore is dependent on metabolic and ischemic processes that occur in the retina and along the nerve. Myelination of fibers allows to conduct salts during carrying out the active potential reducing energy requirement for a cell.

The relative sizes of the axon and GCS indicate their high metabolic needs. While the cell body is the main site for energy production and protein synthesis, the axon itself can provide some synthetic functions. The metabolic balance of an axon is provided in two ways. First, due to mitochondria and metabolism to meet the energy needs of the axon, and secondly due to the blood supply to the optic nerve.

Mitochondria   is   the   site   of    oxidative    generation    of adenosine triphosphate in the (ATP) as and accumulate in the area of enhanced energy needs [ 3]. Mitochondria do not have a fixed place within the axon, they can move to regions where demand is higher. During development, mitochondria move to regions where axonal growth occurs and the cone expands. When growth is complete, mitochondria are redistributed throughout the neuron [4]. Mitochondria are crucial for the survival of ҐKS in diseases such as Lieber’s optic neuropathy or autosomal dominant neuropathy, where mitochondrial dysfunction occurs retinal cell death and persistent vision loss [5].

According to the metabolic requirements of axons, goal and VC and optic nerve multiway and on vascular plexus and thin capillaries. Anastomosis insufficiency is thought to underlie conditions such as anterior ischemic optic neuropathy, in which high visual function may persist due to the peculiarities of blood circulation in the optic nerve basin, and compensation by choroidal arterioles [ 6]. Ensuring a stable supply of oxygen is essential to maintain the metabolic needs of the axons of the optic nerve head. This is done under conditions of fluctuations in intraocular (IOP) and systemic blood pressure. The property of the choroid to balance pressure fluctuations while maintaining optic nerve perfusion is shown. However, the dynamic range for this autoregulation is limited, with IOP above 45 mm. rt. Art. perfusion decreases sharply. D feisty autoregulation can occur regionally within the optic nerve head. It is known that oxygen levels in the optic nerve sashayed be constant during periods of hypoxia -induced systemic the hypotensive you [ 7]. Autoregulation ensures the preservation of perfusion in excess of blood pressure, preventing ischemia of the optic nerve head. Deep nocturnal hypotension and decreased perfusion of the optic nerve head, resulting from systemic shock leads to the development of glaucomatous excavation [8]. Multiple studies have shown that there are no precapillary sphincters within the capillary bed of the optic nerve head. At the same time, capillary pericytes have contractile properties, which allows you to change the pressure inside the capillary bed and thus regulate stable perfusion. It is known that inside the head of the optic nerve pericytes react by narrowing with a decrease in oxygen or acidity [9].

Adenosine is a strong relaxing factor for pericytes, which provides increased blood flow in areas with high metabolic demand and high ATP intake [10]. Such mechanisms regulate the balance of potassium ions and carbon dioxide. Angiotensin II regulates the sensitivity to carbon dioxide inside the head of the optic nerve [11].

Endothelial cells play an important role in controlling the tone of the vessels of the optic nerve head through the production of nitric oxide, increasing permeability to blood. Violation of this mechanism plays a pathogenetic role in the formation of glaucoma, diabetic retinopathy and compression neuropathy [12]. Regulation is also carried out through the production of endothelin 1, which affects the hemodynamics of DZN, and its disorders contribute to the death of GCS. In particular, in ischemic neuropathy, an increase in the concentration of endothelin-1 in plasma has been determined [13, 14].

In addition, endothelin receptors are found in astrocytes, which has a control over their proliferation and a direct effect on axon function. Elevated endothelin levels reduce anterograde mitochondrial transport, thereby impairing local ATP supply [15, 16].

In addition to its primary function in conducting action potentials, the axon allows the body of the neuron to make metabolic contact through its endings with targets in the lateral cranked nucleus and upper humps in the quadrupedal body. These processes are important for the survival of neurons in disease.

This interaction between the structures ensures the transport of molecules, vesicles and organelles in both directions. The anterograde pathway is ascending, directed from the body ҐKS to the brain. Retrograde path - descending, from the lateral geniculate body. Disruption of this transport process as a result of focal damage to the optic nerve, or damage to the population of cells in contact with the nerve ending of the axon, can lead to the death of ҐKS. In experimental glaucoma, for example, a decrease in the level of neurotoxic factor (BDNF), which is retrogradely transported to the body ҐKS leads to their increased death. On the other hand, exogenous BDNF protection protects these cells from such damage [17, 18].

Axonal (anterograde and retrograde) transport of molecules, subcellular organelles and metabolic products occurs along the optic nerve, is energy-dependent and requires a high concentration of oxygen, and therefore is disrupted by ischemic, inflammatory and compression processed

Anterograde axonal transport system is divided into slow, medium and high-speed parts. Rapid transport is trans synoptically through vesicles located at the presynaptic ends of the axon. In this way, proteins are transported, and the process is potentiated by enzymes called neurotransmitters.

Slow antirad transport provides the movement of proteins synthesized in the nerve cell, which include components of the cytoskeleton and protein complexes that are delivered to the axon and its ends. Slow anterograde transport is divided into two components: slow A transport in relation to the distribution of triplet proteins of neurofilaments, such as tubulin and spectrum, as well as tau proteins; slow B transport is faster and involves the transfer of microfilaments, actin and proteins of supramolecular complexes of the cytosolic matrix [ 19, 20 ].

High binding affinity leads to continuous and faster transport. Under other conditions, it is mediated by components of low affinity, and therefore is slower. Microtubules themselves are highly polarized structures of alpha and beta-tubulin. Under certain conditions, they are grouped. The "minus" end is close to the cell body and the "positive" end is close to the end of the axon, usually more unstable and associated with the growing end of the axon.

Molecular control for anterograde transport is provided by kinesin molecules belonging to the family of specialized motor proteins. Kinesins have a motor domain that hydrolyzes ATP to move microtubules down the axon. Kinesins are synthesized in the cell body and stored in soluble form in the cytoplasm. Kinesin control is activated by binding to the "cargo" molecule, which is then traced along the microtubules of the axon to the end (Fig. 1).

Figure 1:  Scheme of axonal transport in the optic nerve

Designation: fast transport (Fc), due to the connections between the kinesin complex of the molecule and the axon microtubule for fast antegrade axoplasmic transport from the negative end (Minus end) to the positive end (Plus end)). Slow transport (Scab) through the microtubule (b) or (Sc.B.) using spectrum (Actin filament) and cytosolic proteins (crosslinked proteins) (c). Retrograde transport using the driver molecule dynein (Dynein), which is carried out through the microtubule of the axon to the cell body (Cell body) (d) [ 21].

There are different types of kinesin that provide different modes of transport. Axonal myosin is involved in the delivery of the cargo molecule at the end of the axon and can also modulate the rate of anterograde axonal transport [22, 23].

Retrograde transport is classified as fast. It is controlled by mediators contained in endosomes and lysosomes and absorbed by membrane receptors. The molecules are transported towards the body of neurons. As a mediator, dynein is used [ 24 ], which is first synthesized in the cell body, and then spreads along the axon to the "positive end" through both anti- and retrograde transport systems and activates retrograde transport towards the neuron body [ 25 ]. For slow transport, the actin-spectrum system within the axon is also used more often than through microtubules.

Under normal conditions, astrocytes establish contact with retinal neurons, ensuring the metabolic stability of nerve tissue [2 6]. Physiological studies 

have identified important functions that these cells perform in the optic nerve and other parts of the CNS. Thus, they are responsible for storing glycogen by supplying glucose to neurons. R halutz the level of extracellular potassium, important in the regulation and metabolism of neurotransmitters such as GABA. They help in the removal of CO2 from the retina. Contribute to the maintenance of water homeostasis in the retina [27, 28].

Astrocytes (Fig. 2) also provides the barrier function of the retina [29, 30]. At the level of the optic nerve, astrocytes are responsible for the secretion by axons of BDNF and associated neurotrophies produced by ҐKS. They also interact with specific transmembrane receptors of cells, which decrease in size after ligand binding and are included in vesicles for retrograde transport into the body of the neuron [[31].

Obstruction of rapid transport leads to a violation of the integrity of the distal axon. Thus, in glaucoma in violation of axonal transport is considered the basis of the pathogenesis of axonal damage GKS as a result of increased IOP. Under such conditions, the axonal cytoskeleton is disturbed, there is disengagement and edema of neurofilaments. Thus, there is a mechanical blocking of axonal transport at the earliest time [32]. Loss ҐKS under such conditions as disorders accompanied by active transport and passive diffusion in a klykayuchy Valerenes degenerates distal axons of place lesions [ 33, 34 ].

Thus, it has been shown that the exchange of molecules and organelles within the neural network makes neurons disrupted in many diseases [ 35].

Figure 2:  Organization of axonal transport

Symbols: (A) Axton blockage in experimental glaucoma: СCS indicated by red arrow, with neurofilaments blocked in the cytoplasm, astrocytes indicated by green arrow. Retinal immunofluorescence. (B) Scheme of astrocyte function in the optic nerve [56]. (C) The microglia are indicated by an arrow. Optic nerve immunofluorescence [36]

The speed of slow axonal transport involves the transport of molecules over long distances. Some axons take several years for the molecules to reach their nerve endings. Therefore, axons have the property of their own synthesis [ 37] due to peri axonal ribosomes [38].

An important component of fluid perfusion in the optic nerve is the pressure gradient within the lattice plate, which is created by the difference between ocular (IOP), cranial, and orbital pressures [39, 40]. Violation of the dynamics of cerebrospinal fluid can cause normotensive in hakim in [41, 42].

It is known that cerebrospinal fluid circulates in the subarachnoid space of the optic nerve, as well as in the perivascular spaces of blood vessels that penetrate the nerve in the apex, and between the processes of astrocytes. Under such conditions, the cerebrospinal fluid (CSF) that surrounds the nerve provides buoyancy, nutrient delivery and cleanses of breakdown products [ 43]. On the other hand, for the optic nerve, the CSF surrounding nerve fibers is a source of proteins and peptides, such as neurotrophic factor and growth factor [44, 45].

In the brain, a glymphatic pathway is described in which the CSF flows into and out of the parenchyma through the spaces formed between the blood vessels and the palatine layer of the astrocytic benefit. The lymphatic pathway consists of perivascular inflow of CSF into the brain parenchyma, purification of fluid and solutes in the extracellular space.

The course of cerebrospinal fluid in the optic nerve may be similar to the glymphatic system of the brain, which consists of par arterial inflow into the brain parenchyma and perivenous outflow of intercellular fluid and solutes [ 4 6]. The glymphatic system cleanses the brain of harmful metabolites through the water channel and aquaporin-4 at the astrocytic end. Such a perivascular pathway also facilitates the penetration of CSF into the optic nerve [47].

However, differences in the vascular anatomy of the optic nerve compared to the brain call into question whether there is a glymphatic system in the optic nerve. It is known that the retrolaminar optic nerve of the mouse consists only of capillaries with intussusception of the soft membrane, while 

the brain has large penetrating arteries with thick walls surrounded by both soft shell and glia [48]. It is possible that the flow of CSF through the optic nerve along the perivascular pathways occurs on the principle of simple diffusion or a combination of diffusion and pulsation [49].

Aquaporin-4 is an integral membrane protein found on the astrocytic endophyte (growth stimulator), which promotes the permeability of water to cell membranes and the perivascular space of the optic nerve. Aquaporin-4 thus facilitates the transport of cerebrospinal fluid and perivascular fluid [[50]. In optic neuromyelitis, the formation of anti-Aquaporin-4 antibodies has been detected, which block the flow of perivascular fluid, which leads to demyelination of nerve fibers [51, 52].

Sometimes neurodegenerative diseases occur due to an imbalance between the production and purification of neurotoxic substances in the optic nerve. Under such conditions, the accumulation of amyloid substances has been described, for example in glaucoma [53, 54].

Glum, which covers the gratings around the disk, is also important for CSF penetration. Thus, the CSF cleanses the laminar and retrolaminar parts of the optic nerve head of neurotoxins. It is disorders of current regulation of CSF and glial water and solutions that serve as a pathogenetic element of glaucoma [55] and traumatic fragmentation of the optic nerve [56].

The enzyme Rho kinase, a low IOP inhibitor that enhances intraocular outflow, has also been described. Rho kinase activation has a beneficial effect on neurons in traumatic injuries [ 57, 58].

Conclusion

Thus, according to the literature, we know that Mr. enteritis I and redistribution of ATP serving a count done in mitochondria Yahya who migrate to areas of greatest growth and activity. The redistribution of nutrients within the axons and in the perineural space is ensured by capillary hemodynamics, which also has a self-regulatory system, due to active substances such as adenosine and endothelin 1. This is due to the survival of ҐKS and their axons in critical conditions for the general organism.

There are two main regulators of energy and perfusion processes in the optic nerve, which act on the anti- and retrograde pathways, which provide the movement of both the nerve impulse (which is essentially dissolved electrolytes) and elements of the cytoskeleton and neurotransmitters through which retina-cerebral and cerebra-retinal effects.

Rapid antirad transport is carried out transapically, through vesicles and by means of mediators (neurotransmitters). Slow antirad transport provides the movement of protein synthesized in the nerve cell, cytoskeleton components and protein complexes. It is carried out due to proteins of neurofilaments and supramolecular complexes of the cytosolic matrix. Retrograde transport - the mediator dynein is used.

An important role in the regulation of perfusion and axonal transport is played by astrocytes, which under physiological conditions provide trophism of neurons, axons, as well as the exchange of neurotransmitters and other active conditions.

 

Conclusion

Thus, the study of processes that provide perfusion of the optic nerve, as well as the pathogenetic mechanisms of their violation is important for the study of forms of optic neuropathy

References

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

img

Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

img

Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

img

Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

img

Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

img

Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

img

Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

img

Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

img

Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

img

Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

img

Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

img

Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

img

Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

img

Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

img

Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

img

Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

img

Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

img

Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

img

Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

img

Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

img

Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

img

Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

img

Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

img

Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

img

Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

img

S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

img

Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

img

George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

img

Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

img

Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

img

Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

img

Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

img

Maria Dolores Gomez Barriga