Loading

Journal of Neurological Disorders and Stroke

A Possible Link between Microglial Process Dysfunction and Neuropsychiatric Disorders

Review Article | Open Access | Volume 2 | Issue 3

  • 1. Department of Aging Science and Pharmacology, Kyushu University, Japan
  • 2. Japan Science and Technology Agency, Core Research for Evolutional Science and Technology, Japan
+ Show More - Show Less
Corresponding Authors
Hiroshi Nakanishi, Department of Aging Science and Pharmacology, Faculty of Dental Sciences, Kyushu University, Fukuoka, 812-8582, Japan, Tel: +81-92 642 6413; Fax: +81-92 642 6415
ABSTRACT

Pío del Río Hortega first discovered microglia by histological staining with silver carbonate. He thought that microglia with highly branched fine processes in the healthy brain were quiescent and called these cells as resting microglia. After brain injury, microglia changes their morphology into activated type, which has phagocytic activity at the sites of neuronal damage and inflammation. At 90 years after the discovery of microglia, resting microglia in the healthy brain were found to be very dynamic, much more than any other cells in a live mouse brain using the two-photon scanning laser microscope. Beyond the roles as brain-resident macrophages, many lines of evidence have revealed that microglia have essential roles in the maturation and maintenance of neuronal circuits in the brain through both elimination and formation of dendritic spines through their processes. Furthermore, length and structural complexity of highly branched fine processes are regulated by microglial intrinsic molecular clock. Dysfunction of dendritic spine and disturbance of circadian clock system are widely accepted characteristic abnormalities in neuropsychiatric disorders. Therefore, the growing understanding of movement and functions of microglial processes may aid in the development of novel pharmacological interventions against neuropsychiatric disorders, which are associated with synapse loss and aberrant neuronal connectivity.

CITATION

Hayashi Y, Wu Z, Nakanishi H (2014) A Possible Link between Microglial Process Dysfunction and Neuropsychiatric Disorders. J Neurol Disord Stroke 2(3): 1060.

KEYWORDS

•    Microglia
•    Microglial processe
•    Dendritic spine
•    Neuronal circuit
•    Molecular clock
•    Neuropsychiatric disorders

ABBREVIATIONS

CX3 CR1: Fractalkine Receptor; IDO: Indoleamine 2,3-Dioxygenase; NMDA: N-methyl-D-aspartate

INTRODUCTION

One hundred years ago, Santiago Ramón y Cajal proposed that the brain consists of three elements, the first element is neuron, the second element is astrocyte and the third element is a group of adendritic cells that seemed devoid of processes. In 1920, however, Pío del Río Hortega, a student of Cajal, found processes in third element by histological staining with silver carbonate. Furthermore, he divided the third element into two different cell types, microglia and oligodendrocytes, based on the number and feature of their processes. He published these findings without his teacher’s permission. So, there was a long debate about the processes of Cajal’s third element. Finally, Hortega’s findings turned to be right, whereas existence of microglia in the brain was not widely accepted until the development of anti F4/80 antibody [1], because of a poor reproducibility of histological staining with silver carbonate.

Hortega called microglia with highly branched fine processes in the healthy brain as resting microglia. After brain injury, resting microglia change their morphology into activated type, which has phagocytic activity at the sites of neuronal damage and inflammation. At 90 years after the discovery of microglia, Axel Nimmerjahn tried to see microglia in a live mouse brain using the two-photon scanning laser microscope. He found that resting microglia are very dynamic, much more than any other cell in the adult brain [2]. Microglia are now being considered more active players in the normal healthy brain [2,3]. Furthermore, microglia with highly branched fine processes are associated with regulation of synapse functions [4-9]. Now, much attention has been paid on the movement and functions of microglial processes. It is considered that synapse loss and aberrant neuronal connectivity are important causative factors in neuropsychiatric disorders. Therefore, a possible link between microglial dysfunction and neuropsychiatric disorders is now one of most exciting topics of microglial research.

Synaptic stripping

Blinzinger and Kreuzberg first reported the involvement of microglia in synaptic functions. In response to facial nerve injury, microglia accumulate to spread on injured facial motoneurons to physically displace afferent synapses from cell bodies and dendrites through insertion of their processes [10]. This phenomenon is referred to “synaptic stripping” and considered to play important roles in regeneration of facial nerve and synapse reorganization. Recently, we have proposed a new interpretation of synaptic stripping following nerve injury of motoneurons [11]. At an early phase after nerve injury, extracellular nucleotides including ATP and adenosine transiently inhibit the synaptic inputs through the activation of P2Y and A1 receptors localized on the presynaptic terminals before the opposition of microglia. In contrast, microglia spread on the surface of the injured motoneurons inhibit synaptic inputs through detachment of axon terminals at a later phase after nerve injury. Therefore, microglia induce blockade of synaptic transmission following nerve injury through two mechanisms: chemical blocking at an early phase and physical blocking at a later phase.

Synaptic pruning

During developmental stage of the brain, excess numbers of synapses are formed and then unnecessary synapses are eliminated. This phenomenon is referred to “synaptic pruning”, because pruning is a horticultural practice involving the selective removal of parts of a plant, such as branches, buds, or roots. Synaptic pruning is a characteristic series of developmental events required for the formation of proper neural circuit. A recent study provides evidence the involvement of microglia in synaptic pruning during the postnatal developmental stage. Microglia eliminate synapses through fractalkine receptor (CX3 CR1), a microglia specific chemokine receptor, at P13-16 in the hippocampus [4]. Furthermore, CX3 CR1 deficient mice exhibit delayed maturation of thalamocortical synapse [12]. The importance of synaptic pruning for mature neuronal circuits is also demonstrated in the dorsal lateral geniculate nucleus of the thalamus. During the pruning period, microglia eliminate synapses with low synaptic activities in the retinal ganglion cells through recognition of complement component C3 [5]. Furthermore, the elimination of synapses by microglia is also regulated by the tumor growth factor-β signaling [8]. Not only postnatal developmental stage but also post-maturity, microglia are associated with synapse regulation. Constant darkness, shut off the visual information, initiated the elevation of synaptic element in the inclusions within the microglia [6].

Synaptic formation Microglia have been reported to promote dendritic spine formation. Interleukin-10 from microglia promotes synapse formation through its receptor in hippocampal neurons [13]. However, the expression of interleukin-10 receptors in hippocampal neurons is limited in early developmental stage. More recently, the role of microglia in synapse formation has been demonstrated in young adult mice. During the late postnatal period or young adulthood, microglial depletion, which was accomplished by administration of diphtheria toxin in CX3 CR1CreER/+:R26iDTR/+ mice, caused the reduction of basal level of spine formation and elimination over 4 days in the motor cortex. Furthermore, microglia-depleted mice showed impairment of motor performance due to the reduction of motor-learningrelated spine formation. Microglial depletion also causes the reduction of synaptic proteins, such as GluN2B and vGlut1, and miniature excitatory postsynaptic currents. These changes caused by microglial depletion were also observed in mice that are manipulated microglia-specific removable of brain-derived neurotrophic factor, which increases neuronal tropomyosinrelated kinase receptor phosphorylation, a key mediator of synaptic plasticity [14]. Therefore, it is considered that microglia serves important physiological functions in learning and memory by promoting learning-related synapse formation. These observations further support the notion that microglia are active players in the healthy brain.

Circadian rythmicity

The sleep-wake cycle plays an important role in the determination of synaptic strength. Waking results in high synaptic density and strength, whereas sleep results in low synaptic density and strength. Although the sleep-wake cycle dependent synaptic strength is very important for the brain function, the precise mechanism remains unclear. Cajal proposed a possible role of astrocytes in the sleep-wake cycle. During sleep, astrocytes extend and insert their processes between axons and dendrites and disconnect synapses as a circuit breaker [15]. On the other hand, during awaking, astrocytes retract their processes, so axons can connect with dendrites.

Recently, we have found that microglia, instead of astrocytes, regulate sleep-wake cycle dependent changes in strength through extension and retraction of their processes [16]. We first noticed that the morphology of microglia is quite different between day and night. In both phase, microglia have highly branched morphology. However, total length of microglial processes was significantly longer and branch point of them was larger at night. Microglial represented highly complicated morphology at night. Interestingly, the contact ratio of microglial process and dendritic spine are higher at night. Microglia exhibited circadian rhythmicity, oscillating expression patterns of clock genes, which orchestrate the expression of P2Y12 receptors. Inhibition of P2Y12 receptors disrupted the rhythmic patterns of synaptic strength or spine density [16]. Upregulated P2Y12 receptors in the microglia at night triggers the contact with dendritic spine sequentially initiate the reduction of synaptic strength or spine density at daytime. We could not detect phagocytic activity of microglia. Proteolysis or modulation of extracellular matrix with tissue-plasminogen activator or matrix metalloprotease 9 have critical role in the regulation of dendritic spine [17,18]. Among secreted proteases from microglia [19], cathepsin S, a microglia specific protease in the brain, is only regulated by clock genes. More interestingly, cathepsin S-deficient mice exhibit disrupted circadian oscillation patterns of synaptic strength and spine density. These mice exhibit higher locomotor activity and reduced sleep level [7].

Without microglia-synapse interactions, the synaptic strength may be kept at the high level. Decrease in the synaptic strength by microglia-synapse interactions may be necessary for the resetting the neuronal capacity for information processing. Therefore, microglia-synapse interactions regulated by the microglial molecular clock are important for the synaptic homeostasis in the healthy brain. Furthermore, dysfunction of microglial molecular clock may play a causative role in neuropsychiatric disorders including depression and cognitive deficits [20].

Synaptic transmission

After cellular activation, microglia secrete several molecules including low molecular mass (<500Da), glutamate, neurotrophic factor, and cytokine [21,22]. These molecules can regulate N-methyl-D-aspartate (NMDA) receptors, thus microglia involve synaptic plasticity. Actually, microglia-releasing factor enhance the formation of long-term potentiation in CA1 region. The factor was identified as glycine [23]. In contrast, excessive activation of NMDA receptor results in the neuronal death. Quinolinic acid is an endogenous modulator with agonistic properties on NMDA receptor, which was observed in microglia in the anterior cingulate gyrus of severely depressed and suicidal patients [24]. Interestingly, Indoleamine 2,3-Dioxygenase (IDO) and kynurenine monooxygenase, quinolinic acid biosynthesis enzyme, were increased in microglia from CX3 CR1 deficient mice [25]. Furthermore, blocking of IDO significantly inhibited the development of depressive-like behavior in CX3 CR1 deficient mice [26]. It indicated that dysfunction of microglia lead to abnormal neuronal activity. Abnormality in microglia has also proposed in the schizophrenia using positron emission tomography. The binding of (R)-[11C]PK11195 to translocator protein, expressed in activated microglia, was increased in gray matter and hippocampus in the patient [27,28]. Interleukin1β, an inflammatory cytokine, from activated microglia might possible candidate to cause abnormal neurotransmission in depression or schizophrenia.

Behavioral abnormality

Disruption of synaptic pruning by microglia might lead to neuropsychiatric disorders because of the positive correlation with abnormality of dendritic spine [29]. Besides the synapse dysfunction, aberrant behavior was observed by microglial dysfunction. Hoxb8 mutant microglia results in the induction of excessive grooming behavior [30]. This behavior has similarity in obsessive-compulsive disorder, which is an anxiety disorder characterized by unreasonable thoughts and fears that lead you to do repetitive behaviors. Transplantation of wild-type bone marrow into Hoxb8 mutant mice ameliorated pathological grooming in 4 weeks. It is considered that monocyte within transplanted bone marrow cell migrated into central nerves system and then differentiated into microglia [31]. Hoxb8 is also found in the lamina I and II of spinal cord and dorsal root ganglia [32]. Further study using microglia specific mutation of Hoxb8 is desirable to understand significance of microglia in pathological grooming. Microglia are also involved in Rett syndrome, which is a devastating neurological developmental disorder that is seen in infancy and occurs almost exclusively in females. It is usually caused by a mutation of the MECP2 gene on the X chromosome. Transplantation of wild-type bone marrow into Mecp2-mutant mice ameliorates Rett syndrome-like behaviors. In addition, pharmacologically inhibition of microglial phagocytosis by annexin V cancels the improvement of aberrant behavior with bone marrow transplantation [33]. More recently, positron emission tomography analyses have revealed that the number of microglia is increased in the autism patient [34]. These observations suggest that dysfunction of microglial functions including phagocytic elimination of synapses impairs normal maturation of the neuronal circuit, which in turn leads to neuropsychiatric disorders.

CONCLUSION

Beyond the roles as brain-resident macrophages, microglia have an essential function in the maturation and maintenance of neuronal circuits in the brain through elimination and formation of dendritic spines through their processes. However, the detailed underlying molecular mechanisms have not yet fully clarified. On the other hand, abnormalities in dendritic spine such as spine morphology and imbalance in spine formation and elimination are associated with neuropsychiatric disorders. Interestingly, these changes show layer-specific patterns in the cerebral cortex [29]. Although a link between microglial dysfunction and neuropsychiatric disorders remains hypothetical, the growing understanding of movement and functions of microglial processes may aid in the development of novel pharmacological interventions against neuropsychiatric disorders.

REFERENCES

1. Perry VH, Hume DA, Gordon S. Immunohistochemical localization of macrophages and microglia in the adult and developing mouse brain. Neuroscience. 1985; 15: 313-326.

2. Nimmerjahn A, Kirchhoff F, Helmchen F. Resting microglial cells are highly dynamic surveillants of brain parenchyma in vivo. Science. 2005; 308: 1314-1318.

3. Davalos D, Grutzendler J, Yang G, Kim JV, Zuo Y, Jung S, et al. ATP mediates rapid microglial response to local brain injury in vivo. Nat Neurosci. 2005; 8: 752-758.

4. Paolicelli RC, Bolasco G, Pagani F, Maggi L, Scianni M, Panzanelli P, et al. Synaptic pruning by microglia is necessary for normal brain development. Science. 2011; 333: 1456-1458.

5. Schafer DP, Lehrman EK, Kautzman AG, Koyama R, Mardinly AR, Yamasaki R, et al. Microglia sculpt postnatal neural circuits in an activity and complement-dependent manner. Neuron. 2012; 74: 691- 705.

6. Tremblay MÈ, Lowery RL, Majewska AK. Microglial interactions with synapses are modulated by visual experience. PLoS Biol. 2010; 8: e1000527.

7. Hayashi Y, Koyanagi S, Kusunose N, Okada R, Wu Z, Tozaki-Saitoh H, et al. The intrinsic microglial molecular clock controls synaptic strength via the circadian expression of cathepsin S. Sci Rep. 2013; 3: 2744.

8. Bialas AR, Stevens B. TGF-β signaling regulates neuronal C1q expression and developmental synaptic refinement. Nat Neurosci. 2013; 16: 1773-1782.

9. Hoshiko M, Arnoux I, Avignone E, Yamamoto N, Audinat E. Deficiency of the microglial receptor CX3CR1 impairs postnatal functional development of thalamocortical synapses in the barrel cortex. J Neurosci. 2012; 32: 15106-15111.

10. Blinzinger K, Kreutzberg G. Displacement of synaptic terminals from regenerating motoneurons by microglial cells. Z Zellforsch Mikrosk Anat. 1968; 85: 145-157.

11. Yamada J, Hayashi Y, Jinno S, Wu Z, Inoue K, Kohsaka S, et al. Reduced synaptic activity precedes synaptic stripping in vagal motoneurons after axotomy. Glia. 2008; 56: 1448-1462.

12. Gambrill AC, Barria A. NMDA receptor subunit composition controls synaptogenesis and synapse stabilization. Proc Natl Acad Sci U S A. 2011; 108: 5855-5860.

13. Lim SH, Park E, You B, Jung Y, Park AR, Park SG, et al. Neuronal synapse formation induced by microglia and interleukin 10. PLoS One. 2013; 8: e81218.

14. Parkhurst CN, Yang G, Ninan I, Savas JN, Yates JR, Lafaille JJ, et al. Microglia Promote Learning-Dependent Synapse Formation through Brain-Derived Neurotrophic Factor. Cell. 2013; 155: 1596-1609.

15. García-Marín V, García-López P, Freire M. Cajal’s contributions to the study of Alzheimer’s disease. J Alzheimers Dis. 2007; 12: 161-174.

16. Hayashi Y, Koyanagi S, Kusunose N, Takayama F, Okada R, Wu Z, et al. Diurnal Spatial Rearrangement of Microglial Processes through the Rhythmic Expression of P2Y12 Receptors. J Neurol Disord. 2013; 120.

17. Mataga N, Mizuguchi Y, Hensch TK. Experience-dependent pruning of dendritic spines in visual cortex by tissue plasminogen activator. Neuron. 2004; 44: 1031-1041.

18. Wang XB, Bozdagi O, Nikitczuk JS, Zhai ZW, Zhou Q, Huntley GW. Extracellular proteolysis by matrix metalloproteinase-9 drives dendritic spine enlargement and long-term potentiation coordinately. Proc Natl Acad Sci U S A. 2008; 105: 19520-19525.

19. Nakanishi H. Microglial functions and proteases. Mol Neurobiol. 2003; 27: 163-176.

20. Bhattacharjee Y. Psychiatric research. Is internal timing key to mental health? Science. 2007; 317: 1488-1490.

21. Kettenmann H, Hanisch UK, Noda M, Verkhratsky A. Physiology of microglia. Physiol Rev. 2011; 91: 461-553.

22. Hayashi Y, Kawaji K, Sun L, Zhang X, Koyano K, Yokoyama T, et al. Microglial Ca(2+)-activated K(+) channels are possible molecular targets for the analgesic effects of S-ketamine on neuropathic pain. J Neurosci. 2011; 31: 17370-17382.

23. Hayashi Y, Ishibashi H, Hashimoto K, Nakanishi H. Potentiation of the NMDA receptor-mediated responses through the activation of the glycine site by microglia secreting soluble factors. Glia. 2006; 53: 660- 668.

24. Steiner J, Walter M, Gos T, Guillemin GJ, Bernstein HG, Sarnyai Z, et al. Severe depression is associated with increased microglial quinolinic acid in subregions of the anterior cingulate gyrus: evidence for an immune-modulated glutamatergic neurotransmission? J Neuroinflammation. 2011; 8: 94.

25. Corona AW, Huang Y, O’Connor JC, Dantzer R, Kelley KW, Popovich PG, et al. Fractalkine receptor (CX3CR1) deficiency sensitizes mice to the behavioral changes induced by lipopolysaccharide. J Neuroinflammation. 2010; 7: 93.

26. Corona AW, Norden DM, Skendelas JP, Huang Y, O’Connor JC, Lawson M, et al. Indoleamine 2,3-dioxygenase inhibition attenuates lipopolysaccharide induced persistent microglial activation and depressive-like complications in fractalkine receptor (CX3CR1)- deficient mice. Brain Behav Immun. 2013; 31: 134-142.

27. van Berckel BN, Bossong MG, Boellaard R, Kloet R, Schuitemaker A, Caspers E, et al. Microglia activation in recent-onset schizophrenia: a quantitative (R)-[11C]PK11195 positron emission tomography study. Biol Psychiatry. 2008; 64: 820-822.

28. Doorduin J, de Vries EF, Willemsen AT, de Groot JC, Dierckx RA, Klein HC. Neuroinflammation in schizophrenia-related psychosis: a PET study. J Nucl Med. 2009; 50: 1801-1807.

29. Penzes P, Cahill ME, Jones KA, VanLeeuwen JE, Woolfrey KM. Dendritic spine pathology in neuropsychiatric disorders. Nat Neurosci. 2011; 14: 285-293.

30. Chen SK, Tvrdik P, Peden E, Cho S, Wu S, Spangrude G, et al. Hematopoietic origin of pathological grooming in Hoxb8 mutant mice. Cell. 2010; 141: 775-785.

31. Priller J, Flugel A, Wehner T, Boentert M, Haas CA, Prinz M, et al. Targeting gene-modified hematopoietic cells to the central nervous system: use of green fluorescent protein uncovers microglial engraftment. Nat Med. 2001; 7: 1356-1361.

32. Holstege JC, de Graaff W, Hossaini M, Cardona Cano S, Jaarsma D, van den Akker E, et al. Loss of Hoxb8 alters spinal dorsal laminae and sensory responses in mice. Proc Natl Acad Sci U S A. 2008; 105: 6338- 6343.

33. Derecki NC, Cronk JC, Lu Z, Xu E, Abbott SB, Guyenet PG, et al. Wildtype microglia arrest pathology in a mouse model of Rett syndrome. Nature. 2012; 484: 105-109.

34. Suzuki K, Sugihara G, Ouchi Y, Nakamura K, Futatsubashi M, Takebayashi K, et al. Microglial activation in young adults with autism spectrum disorder. JAMA Psychiatry. 2013; 70: 49-58.

Hayashi Y, Wu Z, Nakanishi H (2014) A Possible Link between Microglial Process Dysfunction and Neuropsychiatric Disorders. J Neurol Disord Stroke 2(3): 1060.

Received : 27 Jan 2014
Accepted : 03 Mar 2014
Published : 10 Mar 2014
Journals
Annals of Otolaryngology and Rhinology
ISSN : 2379-948X
Launched : 2014
JSM Schizophrenia
Launched : 2016
Journal of Nausea
Launched : 2020
JSM Internal Medicine
Launched : 2016
JSM Hepatitis
Launched : 2016
JSM Oro Facial Surgeries
ISSN : 2578-3211
Launched : 2016
Journal of Human Nutrition and Food Science
ISSN : 2333-6706
Launched : 2013
JSM Regenerative Medicine and Bioengineering
ISSN : 2379-0490
Launched : 2013
JSM Spine
ISSN : 2578-3181
Launched : 2016
Archives of Palliative Care
ISSN : 2573-1165
Launched : 2016
JSM Nutritional Disorders
ISSN : 2578-3203
Launched : 2017
Annals of Neurodegenerative Disorders
ISSN : 2476-2032
Launched : 2016
Journal of Fever
ISSN : 2641-7782
Launched : 2017
JSM Bone Marrow Research
ISSN : 2578-3351
Launched : 2016
JSM Mathematics and Statistics
ISSN : 2578-3173
Launched : 2014
Journal of Autoimmunity and Research
ISSN : 2573-1173
Launched : 2014
JSM Arthritis
ISSN : 2475-9155
Launched : 2016
JSM Head and Neck Cancer-Cases and Reviews
ISSN : 2573-1610
Launched : 2016
JSM General Surgery Cases and Images
ISSN : 2573-1564
Launched : 2016
JSM Anatomy and Physiology
ISSN : 2573-1262
Launched : 2016
JSM Dental Surgery
ISSN : 2573-1548
Launched : 2016
Annals of Emergency Surgery
ISSN : 2573-1017
Launched : 2016
Annals of Mens Health and Wellness
ISSN : 2641-7707
Launched : 2017
Journal of Preventive Medicine and Health Care
ISSN : 2576-0084
Launched : 2018
Journal of Chronic Diseases and Management
ISSN : 2573-1300
Launched : 2016
Annals of Vaccines and Immunization
ISSN : 2378-9379
Launched : 2014
JSM Heart Surgery Cases and Images
ISSN : 2578-3157
Launched : 2016
Annals of Reproductive Medicine and Treatment
ISSN : 2573-1092
Launched : 2016
JSM Brain Science
ISSN : 2573-1289
Launched : 2016
JSM Biomarkers
ISSN : 2578-3815
Launched : 2014
JSM Biology
ISSN : 2475-9392
Launched : 2016
Archives of Stem Cell and Research
ISSN : 2578-3580
Launched : 2014
Annals of Clinical and Medical Microbiology
ISSN : 2578-3629
Launched : 2014
JSM Pediatric Surgery
ISSN : 2578-3149
Launched : 2017
Journal of Memory Disorder and Rehabilitation
ISSN : 2578-319X
Launched : 2016
JSM Tropical Medicine and Research
ISSN : 2578-3165
Launched : 2016
JSM Head and Face Medicine
ISSN : 2578-3793
Launched : 2016
JSM Cardiothoracic Surgery
ISSN : 2573-1297
Launched : 2016
JSM Bone and Joint Diseases
ISSN : 2578-3351
Launched : 2017
JSM Bioavailability and Bioequivalence
ISSN : 2641-7812
Launched : 2017
JSM Atherosclerosis
ISSN : 2573-1270
Launched : 2016
Journal of Genitourinary Disorders
ISSN : 2641-7790
Launched : 2017
Journal of Fractures and Sprains
ISSN : 2578-3831
Launched : 2016
Journal of Autism and Epilepsy
ISSN : 2641-7774
Launched : 2016
Annals of Marine Biology and Research
ISSN : 2573-105X
Launched : 2014
JSM Health Education & Primary Health Care
ISSN : 2578-3777
Launched : 2016
JSM Communication Disorders
ISSN : 2578-3807
Launched : 2016
Annals of Musculoskeletal Disorders
ISSN : 2578-3599
Launched : 2016
Annals of Virology and Research
ISSN : 2573-1122
Launched : 2014
JSM Renal Medicine
ISSN : 2573-1637
Launched : 2016
Journal of Muscle Health
ISSN : 2578-3823
Launched : 2016
JSM Genetics and Genomics
ISSN : 2334-1823
Launched : 2013
JSM Anxiety and Depression
ISSN : 2475-9139
Launched : 2016
Clinical Journal of Heart Diseases
ISSN : 2641-7766
Launched : 2016
Annals of Medicinal Chemistry and Research
ISSN : 2378-9336
Launched : 2014
JSM Pain and Management
ISSN : 2578-3378
Launched : 2016
JSM Women's Health
ISSN : 2578-3696
Launched : 2016
Clinical Research in HIV or AIDS
ISSN : 2374-0094
Launched : 2013
Journal of Endocrinology, Diabetes and Obesity
ISSN : 2333-6692
Launched : 2013
Journal of Substance Abuse and Alcoholism
ISSN : 2373-9363
Launched : 2013
JSM Neurosurgery and Spine
ISSN : 2373-9479
Launched : 2013
Journal of Liver and Clinical Research
ISSN : 2379-0830
Launched : 2014
Journal of Drug Design and Research
ISSN : 2379-089X
Launched : 2014
JSM Clinical Oncology and Research
ISSN : 2373-938X
Launched : 2013
JSM Bioinformatics, Genomics and Proteomics
ISSN : 2576-1102
Launched : 2014
JSM Chemistry
ISSN : 2334-1831
Launched : 2013
Journal of Trauma and Care
ISSN : 2573-1246
Launched : 2014
JSM Surgical Oncology and Research
ISSN : 2578-3688
Launched : 2016
Annals of Food Processing and Preservation
ISSN : 2573-1033
Launched : 2016
Journal of Radiology and Radiation Therapy
ISSN : 2333-7095
Launched : 2013
JSM Physical Medicine and Rehabilitation
ISSN : 2578-3572
Launched : 2016
Annals of Clinical Pathology
ISSN : 2373-9282
Launched : 2013
Annals of Cardiovascular Diseases
ISSN : 2641-7731
Launched : 2016
Journal of Behavior
ISSN : 2576-0076
Launched : 2016
Annals of Clinical and Experimental Metabolism
ISSN : 2572-2492
Launched : 2016
Clinical Research in Infectious Diseases
ISSN : 2379-0636
Launched : 2013
JSM Microbiology
ISSN : 2333-6455
Launched : 2013
Journal of Urology and Research
ISSN : 2379-951X
Launched : 2014
Journal of Family Medicine and Community Health
ISSN : 2379-0547
Launched : 2013
Annals of Pregnancy and Care
ISSN : 2578-336X
Launched : 2017
JSM Cell and Developmental Biology
ISSN : 2379-061X
Launched : 2013
Annals of Aquaculture and Research
ISSN : 2379-0881
Launched : 2014
Clinical Research in Pulmonology
ISSN : 2333-6625
Launched : 2013
Journal of Immunology and Clinical Research
ISSN : 2333-6714
Launched : 2013
Annals of Forensic Research and Analysis
ISSN : 2378-9476
Launched : 2014
JSM Biochemistry and Molecular Biology
ISSN : 2333-7109
Launched : 2013
Annals of Breast Cancer Research
ISSN : 2641-7685
Launched : 2016
Annals of Gerontology and Geriatric Research
ISSN : 2378-9409
Launched : 2014
Journal of Sleep Medicine and Disorders
ISSN : 2379-0822
Launched : 2014
JSM Burns and Trauma
ISSN : 2475-9406
Launched : 2016
Chemical Engineering and Process Techniques
ISSN : 2333-6633
Launched : 2013
Annals of Clinical Cytology and Pathology
ISSN : 2475-9430
Launched : 2014
JSM Allergy and Asthma
ISSN : 2573-1254
Launched : 2016
Annals of Sports Medicine and Research
ISSN : 2379-0571
Launched : 2014
JSM Sexual Medicine
ISSN : 2578-3718
Launched : 2016
Annals of Vascular Medicine and Research
ISSN : 2378-9344
Launched : 2014
JSM Biotechnology and Biomedical Engineering
ISSN : 2333-7117
Launched : 2013
Journal of Hematology and Transfusion
ISSN : 2333-6684
Launched : 2013
JSM Environmental Science and Ecology
ISSN : 2333-7141
Launched : 2013
Journal of Cardiology and Clinical Research
ISSN : 2333-6676
Launched : 2013
JSM Nanotechnology and Nanomedicine
ISSN : 2334-1815
Launched : 2013
Journal of Ear, Nose and Throat Disorders
ISSN : 2475-9473
Launched : 2016
JSM Ophthalmology
ISSN : 2333-6447
Launched : 2013
Journal of Pharmacology and Clinical Toxicology
ISSN : 2333-7079
Launched : 2013
Annals of Psychiatry and Mental Health
ISSN : 2374-0124
Launched : 2013
Medical Journal of Obstetrics and Gynecology
ISSN : 2333-6439
Launched : 2013
Annals of Pediatrics and Child Health
ISSN : 2373-9312
Launched : 2013
JSM Clinical Pharmaceutics
ISSN : 2379-9498
Launched : 2014
JSM Foot and Ankle
ISSN : 2475-9112
Launched : 2016
JSM Alzheimer's Disease and Related Dementia
ISSN : 2378-9565
Launched : 2014
Journal of Addiction Medicine and Therapy
ISSN : 2333-665X
Launched : 2013
Journal of Veterinary Medicine and Research
ISSN : 2378-931X
Launched : 2013
Annals of Public Health and Research
ISSN : 2378-9328
Launched : 2014
Annals of Orthopedics and Rheumatology
ISSN : 2373-9290
Launched : 2013
Journal of Clinical Nephrology and Research
ISSN : 2379-0652
Launched : 2014
Annals of Community Medicine and Practice
ISSN : 2475-9465
Launched : 2014
Annals of Biometrics and Biostatistics
ISSN : 2374-0116
Launched : 2013
JSM Clinical Case Reports
ISSN : 2373-9819
Launched : 2013
Journal of Cancer Biology and Research
ISSN : 2373-9436
Launched : 2013
Journal of Surgery and Transplantation Science
ISSN : 2379-0911
Launched : 2013
Journal of Dermatology and Clinical Research
ISSN : 2373-9371
Launched : 2013
JSM Gastroenterology and Hepatology
ISSN : 2373-9487
Launched : 2013
Annals of Nursing and Practice
ISSN : 2379-9501
Launched : 2014
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
Author Information X