Aldehyde dehydrogenase

醛脱氢酶
  • 文章类型: Journal Article
    这项开放标签和比较研究旨在测试含有醛脱氢酶的酵母发酵粉末的发酵大米提取物基物质的功效和安全性(KisLip®,PicoEntech,大韩民国)在健康的男性个体中。健康男性受试者(n=20)在其第一次访问时消耗90g酒精。在第二次访问时,参与者饮用90克酒精或低剂量KISLip®酒精(2000毫克,KL-L),然后添加90g酒精或高剂量KISLip®酒精(3000mg,KL-H)在第三次访问中。KISLip®的功效取决于与酒精代谢相关的重要基因的突变状态,包括乙醇脱氢酶(ADH1B),细胞色素P4502E1(CYP2E1(5B)和CYP2E1(6)),和醛脱氢酶(ALDH2)。与仅酒精组相比,KISLip®以剂量依赖性方式显著降低酒精的最高水平(Cmax)和乙醛的总体水平。观察到KISLip®对酒精代谢的这些显著影响独立于四个基因中的突变。此外,KISLip®治疗组的宿醉症状显著减轻.在研究期间,参与者在摄入KISLip®后未出现任何不良事件.这项临床研究表明,补充KISLip®对酒精代谢具有有益作用,并可能改善宿醉的严重程度,而不会发生任何不良事件。
    This open-labeled and comparative study aimed to test the efficacy and safety of a fermented rice extract-based substance containing yeast-fermented powder having aldehyde dehydrogenase (KisLip®, Pico Entech, Republic of Korea) in healthy male individuals. Healthy male subjects (n = 20) consumed 90 g of alcohol at their first visit. At the second visit, participants consumed 90 g of alcohol or alcohol with a low dose of KISLip® (2000 mg, KL-L) and then 90 g of alcohol or alcohol with a high dose of KISLip® (3000 mg, KL-H) at the third visit. The efficacy of KISLip® depends on the mutational status of important genes related to alcohol metabolism, including alcohol dehydrogenase (ADH1B), cytochrome P4502E1 (CYP2E1 (5B) and CYP2E1 (6)), and aldehyde dehydrogenase (ALDH2). KISLip® significantly reduced the highest level (Cmax) of alcohol and overall levels of acetaldehyde compared to the alcohol-only group in a dose-dependent manner. These significant effects of KISLip® on alcohol metabolism were observed independent of mutations in the four genes. In addition, hangover symptoms were significantly decreased in the KISLip® treated groups. During the study, the participants did not show any adverse events after KISLip® intake. This clinical study suggested that supplementation of KISLip® had beneficial effects on alcohol metabolism and might ameliorate the severity of hangovers without any adverse events.
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  • 文章类型: Journal Article
    背景:REDUCE-IT(使用Icosapent乙基干预试验减少心血管事件)显示,二十碳素乙基(IPE)可将主要不良心血管事件减少25%。由于这些好处的潜在机制尚未完全理解,IPE预防CardioLink-14试验(ClinicalTrials.gov:NCT04562467)旨在确定IPE是否调节轻度至中度高甘油三酯血症患者的血管再生(VR)细胞含量.
    方法:将70名用他汀类药物治疗的甘油三酯≥1.50和<5.6mmol/L、动脉粥样硬化性心血管疾病或有其他心血管危险因素的2型糖尿病患者随机分配至IPE(4g/天)或常规治疗。从基线和3个月就诊时收集的血液中分离具有高醛脱氢酶活性(ALDHhi)的VR细胞,并用谱系特异性细胞表面标记物表征。主要终点是前血管ALDHhiside散射(SSC)低CD133+祖细胞频率的变化。ALDHhiSSCmid单核细胞和ALDHhiSSChi粒细胞前体亚群的频率变化,活性氧的产生,血清生物标志物,和ω-3水平也进行了评估。
    结果:基线特征,心血管危险因素,两组之间的药物平衡。与常规护理相比,IPE增加了ALDHhiSSClowCD133+细胞的平均频率(-1.00%±2.45%vs.+7.79%±1.70%;p=0.02),尽管总体ALDHhissc降低了细胞频率。IPE分配还降低了ALDHhiSSChi祖细胞的氧化应激,并增加了ALDHhiSSChi粒细胞前体细胞含量。
    结论:IPE预防CardioLink-14提供了IPE可以调节VR细胞含量的第一个翻译证据,并提出了一种新机制,可能是IPE在REDUCE-IT中观察到的心脏保护作用的基础。
    背景:HLSTherapeutics以实物形式提供了IPE,在研究设计中没有作用,行为,分析,或解释。
    BACKGROUND: REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) showed that icosapent ethyl (IPE) reduced major adverse cardiovascular events by 25%. Since the underlying mechanisms for these benefits are not fully understood, the IPE-PREVENTION CardioLink-14 trial (ClinicalTrials.gov: NCT04562467) sought to determine if IPE regulates vascular regenerative (VR) cell content in people with mild to moderate hypertriglyceridemia.
    METHODS: Seventy statin-treated individuals with triglycerides ≥1.50 and <5.6 mmol/L and either atherosclerotic cardiovascular disease or type 2 diabetes with additional cardiovascular risk factors were randomized to IPE (4 g/day) or usual care. VR cells with high aldehyde dehydrogenase activity (ALDHhi) were isolated from blood collected at the baseline and 3-month visits and characterized with lineage-specific cell surface markers. The primary endpoint was the change in frequency of pro-vascular ALDHhiside scatter (SSC)lowCD133+ progenitor cells. Change in frequencies of ALDHhiSSCmid monocyte and ALDHhiSSChi granulocyte precursor subsets, reactive oxygen species production, serum biomarkers, and omega-3 levels were also evaluated.
    RESULTS: Baseline characteristics, cardiovascular risk factors, and medications were balanced between the groups. Compared to usual care, IPE increased the mean frequency of ALDHhiSSClowCD133+ cells (-1.00% ± 2.45% vs. +7.79% ± 1.70%; p = 0.02), despite decreasing overall ALDHhiSSClow cell frequency. IPE assignment also reduced oxidative stress in ALDHhiSSClow progenitors and increased ALDHhiSSChi granulocyte precursor cell content.
    CONCLUSIONS: IPE-PREVENTION CardioLink-14 provides the first translational evidence that IPE can modulate VR cell content and suggests a novel mechanism that may underlie the cardioprotective effects observed with IPE in REDUCE-IT.
    BACKGROUND: HLS Therapeutics provided the IPE in kind and had no role in the study design, conduct, analyses, or interpretation.
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  • 文章类型: Journal Article
    背景:异环磷酰胺是具有众所周知的肾毒性的儿童的主要抗癌药物。了解这种毒性的潜在机制可以帮助识别毒性风险增加的儿童。
    方法:IFOS01研究包括接受以异环磷酰胺为基础的Ewing肉瘤或横纹肌肉瘤化疗的儿童。在化疗期间和之后对肾功能进行了全面评估。质子核磁共振(NMR)和常规生物化学用于检测异环磷酰胺诱导的肾小管病的早期症状。在外周血淋巴细胞中测量醛脱氢酶(ALDH)的酶活性,作为异环磷酰胺衍生的氯乙醛解毒能力的标志。定量异环磷酰胺和去氯乙基化代谢物的血浆和尿液浓度。
    结果:15名参与者接受的异环磷酰胺总剂量中位数为59g/m2(范围:24-102),在7个周期的中位数上给出(范围:4-14)。所有儿童在化疗期间都有急性近端肾小管毒性,这是可逆的,用常规测定法和NMR都可以看到。经过31个月的中位随访,8/13儿童呈现总体慢性毒性,其中7例肾小球滤过率降低。ALDH酶活性在整个循环中显示出很高的个体间和个体内差异,尽管随后出现慢性肾毒性的儿童的总体活动看起来较低。所有儿童的异环磷酰胺和代谢物浓度相似。
    结论:急性肾毒性在化疗期间是常见的,并且不能确定有长期毒性风险的儿童。ALDH在晚期肾功能不全中的作用是可能的,因此应鼓励进一步探索其酶活性和多态性,以增进对异环磷酰胺诱导的肾毒性的理解。
    BACKGROUND: Ifosfamide is a major anti-cancer drug in children with well-known renal toxicity. Understanding the mechanisms underlying this toxicity could help identify children at increased risk of toxicity.
    METHODS: The IFOS01 study included children undergoing ifosfamide-based chemotherapy for Ewing sarcoma or rhabdomyosarcoma. A fully evaluation of renal function was performed during and after chemotherapy. Proton nuclear magnetic resonance (NMR) and conventional biochemistry were used to detect early signs of ifosfamide-induced tubulopathy. The enzymatic activity of aldehyde dehydrogenase (ALDH) was measured in the peripheral blood lymphocytes as a marker of ifosfamide-derived chloroacetaldehyde detoxification capacity. Plasma and urine concentrations of ifosfamide and dechloroethylated metabolites were quantified.
    RESULTS: The 15 participants received a median total ifosfamide dose of 59 g/m2 (range: 24-102), given over a median of 7 cycles (range: 4-14). All children had acute proximal tubular toxicity during chemotherapy that was reversible post-cycle, seen with both conventional assays and NMR. After a median follow-up of 31 months, 8/13 children presented overall chronic toxicity among which 7 had decreased glomerular filtration rate. ALDH enzymatic activity showed high inter- and intra-individual variations across cycles, though overall activity looked lower in children who subsequently developed chronic nephrotoxicity. Concentrations of ifosfamide and metabolites were similar in all children.
    CONCLUSIONS: Acute renal toxicity was frequent during chemotherapy and did not allow identification of children at risk for long-term toxicity. A role of ALDH in late renal dysfunction is possible so further exploration of its enzymatic activity and polymorphism should be encouraged to improve the understanding of ifosfamide-induced nephrotoxicity.
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  • 文章类型: Journal Article
    生物催化氧化是发展绿色和可持续生物制造过程中最重要和不可或缺的有机反应之一。NAD(P)依赖性醛脱氢酶(ALDH)催化醛氧化为羧酸。这里,两个ALDHs,SpALDH1和SpALDH2是从Sphingobiumsp。SYK-6.它们属于不同的ALDH家族,并且仅共享32.30%的氨基酸同一性。有趣的是,SpALDH1和SpALDH2表现出显著不同的酶学性质和底物谱。SpALDH2比SpALDH1具有更好的热稳定性。SpALDH1是一种金属酶,被钾离子激活,而SpALDH2不依赖金属。与SpALDH1相比,SpALDH2具有相对较宽的芳香醛底物谱。基于同源性建模和分子对接分析,阐明了ALDHs底物特异性的潜在机制。对于两个ALDHs,基质结合袋的疏水性对于催化性能很重要,特别是底物特异性。值得注意的是,柔性回路444-457的优化可改革吡啶底物和SpALDH1之间的氢键,从而提高催化活性。最后,构建了ALDHs和NOX催化的偶联反应,以高效生产芳香羧酸。
    Biocatalytic oxidation is one of the most important and indispensable organic reactions for the development of green and sustainable biomanufacturing processes. NAD(P)+-dependent aldehyde dehydrogenase (ALDH) catalyzes the oxidation of aldehydes to carboxylic acids. Here, two ALDHs, SpALDH1 and SpALDH2, were identified from Sphingobium sp. SYK-6. They belong to different ALDH families and share only 32.30% amino acid identity. Interestingly, SpALDH1 and SpALDH2 exhibit significantly different enzymatic properties and substrate profiles. SpALDH2 has better thermostability than SpALDH1. SpALDH1 is a metalloenzyme and is activated by potassium ions, while SpALDH2 is not metallic-dependent. Compared with SpALDH1, SpALDH2 has a relatively broad substrate spectrum toward aromatic aldehydes. Based on homology modeling and molecular docking analysis, mechanisms underlying the substrate specificity of ALDHs were elucidated. For both ALDHs, hydrophobicity of substrate binding pockets is important for the catalytic properties, especially substrate specificity. Notably, optimization of the flexible loop 444-457 reforms a hydrogen bond between pyridine substrates and SpALDH1, contributing to the high catalytic activity. Finally, a coupling reaction catalyzed by ALDHs and NOX was constructed for efficient production of aromatic carboxylic acids.
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  • 文章类型: Journal Article
    已知BNTA对膝骨关节炎和炎性破骨细胞生成具有治疗作用。然而,BNTA对颞下颌关节骨关节炎(TMJOA)的保护作用及其潜在机制和生理靶点仍不清楚。在本研究中,BNTA改善了体内碘乙酸钠(MIA)诱导的TMJOA中的软骨降解和炎症反应。在IL-1β诱导的髁突软骨细胞中,BNTA可防止氧化应激,炎症反应和通过激活核因子E2相关因子2(NRF2)信号增加软骨细胞外基质的合成。NRF2信号传导的抑制消除了BNTA在TMJOA中的保护作用。值得注意的是,BNTA可以直接与ALDH3A1结合并充当稳定剂,正如药物亲和力响应靶标稳定性测定(DARTS)所证明的那样,细胞热转移测定(CETSA)和分子对接结果。对潜在分子和细胞机制的进一步研究推断ALDH3A1调节NRF2信号传导的正相关。总之,BNTA可以通过ALDH3A1/NRF2轴减弱TMJOA进展,推断BNTA是治疗颞下颌下颌关节骨关节炎的治疗靶点。
    BNTA is known to have a therapeutic effect on knee osteoarthritis and inflammatory osteoclastogenesis. However, the protective effect of BNTA regarding temporomandibular mandibular joint osteoarthritis (TMJOA) and its underlying mechanism and physiological target remains unclear. In the present study, BNTA ameliorated cartilage degradation and inflammation responses in monosodium iodoacetate (MIA)-induced TMJOA in vivo. In IL-1β-induced condylar chondrocytes, BNTA prevents oxidative stress, inflammatory responses and increasing synthesis of cartilage extracellular matrix through activating nuclear factor-E2-related factor 2 (NRF2) signaling. Suppression of NRF2 signaling abolishes the protective effect of BNTA in TMJOA. Notably, BNTA may bind directly to ALDH3A1 and act as a stabilizer, as evidenced by drug affinity responsive target stability assay (DARTS), cellular thermal shift assay (CETSA) and molecular docking results. Further investigation of the underlying molecular and cellular mechanism infers a positive correlation of ALDH3A1 regulating NRF2 signaling. In conclusion, BNTA may attenuate TMJOA progression via the ALDH3A1/NRF2 axis, inferring that BNTA is a therapeutic target for treating temporomandibular mandibular joint osteoarthritis.
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  • 文章类型: Journal Article
    背景:摄入的酒精主要被乙醇脱氢酶1B(ADH1B)氧化为乙醛,乙醛主要被醛脱氢酶2(ALDH2)进一步氧化为乙酸盐。尽管饮酒是食管癌的一个令人信服的危险因素,ADH1Brs1229984(His48Arg)的作用,与酒精代谢缓慢相关的单核苷酸多态性,在食管癌的发展尚不清楚。因为这种单核苷酸多态性与食道癌风险增加和饮酒强度有关,它与食道癌的关联可能通过独立于饮酒强度的直接途径起作用,通过饮酒强度介导的间接途径,或者两者兼而有之。
    方法:为了解开这些不同的途径,我们通过将ADH1BArg等位基因和饮酒定义为暴露和介质,将中介分析应用于食管癌病例对照研究(600例和865例对照)。分别,并将ADH1BArg等位基因的总效应比值比分解为直接效应和间接效应比值比。
    结果:ADH1BArg等位基因通过饮酒强度变化以外的途径与食道癌风险相关(直接效应比值比,2.03;95%置信区间,1.41-2.92),除了饮酒强度介导的间接途径(间接效应比值比,1.27;95%置信区间,1.05-1.53)。通过对ALDH2rs671(Glu504Lys)的基因型进行分层进一步分析,强烈减弱酶活性的功能性单核苷酸多态性,在每个层内显示出显著的直接效应优势比。
    结论:这些结果表明,ADH1BArg等位基因通过减缓酒精分解而导致食道癌风险,除了它对酒精消耗量的影响。
    BACKGROUND: Ingested alcohol is predominantly oxidized to acetaldehyde by alcohol dehydrogenase 1B (ADH1B), and acetaldehyde is further oxidized to acetate mainly by aldehyde dehydrogenase 2 (ALDH2). Although alcohol consumption is a convincing risk factor for oesophageal cancer, the role of ADH1B rs1229984 (His48Arg), the single-nucleotide polymorphism associated with slow alcohol metabolism, in oesophageal cancer development is unclear. Because this single-nucleotide polymorphism is associated with both increased risk of oesophageal cancer and drinking intensity, its association with oesophageal cancer might operate either through a direct pathway independently of drinking intensity, via an indirect pathway mediated by drinking intensity, or both.
    METHODS: To disentangle these different pathways, we applied a mediation analysis to an oesophageal cancer case-control study (600 cases and 865 controls) by defining the ADH1B Arg allele and alcohol consumption as exposure and mediator, respectively, and decomposed the total-effect odds ratio of the ADH1B Arg allele into direct- and indirect-effect odds ratio.
    RESULTS: The ADH1B Arg allele was associated with oesophageal cancer risk through pathways other than change in drinking intensity (direct-effect odds ratio, 2.03; 95% confidence interval, 1.41-2.92), in addition to the indirect pathway mediated by drinking intensity (indirect-effect odds ratio, 1.27; 95% confidence interval, 1.05-1.53). Further analyses by stratifying genotypes of ALDH2 rs671 (Glu504Lys), the functional single-nucleotide polymorphism that strongly attenuates the enzymatic activity, showed significant direct-effect odds ratio within each stratum.
    CONCLUSIONS: These results indicate that ADH1B Arg allele contributes to oesophageal cancer risk by slowing alcohol breakdown, in addition to its effect on the amount of alcohol consumed.
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  • 文章类型: Comparative Study
    转移性肿瘤是由受控氧化还原微环境中的转移性种子(癌症干细胞“CSC”)引发的。因此,通过消除CSC破坏氧化还原平衡的有效疗法至关重要.二乙基二硫代氨基甲酸酯(DE)是自由基解毒酶(醛脱氢酶“ALDH”1A)的有效抑制剂,可有效根除CSC。通过用绿色合成的氧化铜(Cu4O3)纳米颗粒(NPs)和氧化锌NPs进行纳米配制,增强了这种DE效应,并且更具选择性。形成CDNP和ZDNP的新型纳米复合物,分别。这些纳米复合物表现出最高的凋亡,反移民,和在M.D.Anderson-转移性乳腺(MDA-MB)231细胞中的ALDH1A抑制潜能。重要的是,使用乳腺肿瘤肝转移动物模型,这些纳米复合物显示出比氟尿嘧啶更高的选择性氧化活性,因为它们仅在肿瘤组织(乳腺和肝脏)中升高活性氧并消耗谷胱甘肽。由于CDNP比ZDNP具有更高的肿瘤摄取和更强的氧化活性,CDNPs更有可能诱导细胞凋亡,抑制缺氧诱导因子基因,并通过下调其干性来消除CD44+CSCs,化学抗性,和转移基因和减少的肝肿瘤标志物(甲胎蛋白)。这些电位解释了最高的肿瘤大小减少,并完全根除了CDNP中肿瘤向肝脏的转移。因此,CD纳米复合物显示出最高的治疗潜力,代表了一种安全且有前途的纳米药物来对抗乳腺癌的转移阶段。
    Metastatic tumor is initiated by metastatic seeds (cancer stem cells \"CSCs\") in a controlled redox microenvironment. Hence, an effective therapy that disrupts redox balance with eliminating CSCs is critical. Diethyldithiocarbamate (DE) is potent inhibitor of radical detoxifying enzyme (aldehyde dehydrogenase \"ALDH\"1A) causing effective eradication of CSCs. This DE effect was augmented and more selective by its nanoformulating with green synthesized copper oxide (Cu4O3) nanoparticles (NPs) and zinc oxide NPs, forming novel nanocomplexes of CD NPs and ZD NPs, respectively. These nanocomplexes exhibited the highest apoptotic, anti-migration, and ALDH1A inhibition potentials in M.D. Anderson-metastatic breast (MDA-MB) 231 cells. Importantly, these nanocomplexes revealed more selective oxidant activity than fluorouracil by elevating reactive oxygen species with depleting glutathione in only tumor tissues (mammary and liver) using mammary tumor liver metastasis animal model. Due to higher tumoral uptake and stronger oxidant activity of CD NPs than ZD NPs, CD NPs had more potential to induce apoptosis, suppress hypoxia-inducing factor gene, and eliminate CD44+CSCs with downregulating their stemness, chemoresistance, and metastatic genes and diminishing hepatic tumor marker (α-fetoprotein). These potentials interpreted the highest tumor size reduction with complete eradicating tumor metastasis to liver in CD NPs. Consequently, CD nanocomplex revealed the highest therapeutic potential representing a safe and promising nanomedicine against the metastatic stage of breast cancer.
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  • 文章类型: Randomized Controlled Trial
    持续接触乙醛,乙醇的主要代谢产物,可能会影响精神运动的表现,即使在酒精消耗后数小时的呼吸乙醇水平显着下降。我们研究了服用低剂量(0.33g/kg)大麦烧酒后精神运动功能与呼出乙醇和乙醛浓度变化之间的关系,一种传统的日本蒸馏酒精饮料,当呼出的乙醇浓度降到十亿分之78,000(0.15mg/L)以下时,在日本,酒精影响下驾驶的标准门槛。我们评估了ALDH2的rs671G/G纯合(*1/*1)和G/A杂合(*1/*2)的遗传多态性如何影响呼出空气和精神运动动力学中乙醇和乙醛的动力学使用数字符号替代测试(DSST),临界闪烁融合测试(CFFT),和视觉模拟量表(VAS),直到烧酒或饮水后12小时。不同基因型的DSST和CFFT评分无显著差异;然而,ALDH2*1/*2组比*1/*1组DSST达到饮酒前水平所需的时间更长。在VAS测试中,烧酒消费后,*1/*2组面部潮红和情绪升高倾向更高。情绪升高和面部潮红的VAS评分与呼出气中的乙醛浓度相关。这些结果表明,即使暴露于低剂量的酒精,ALDH2*1/*2组的DSST恢复也趋于较慢,情绪升高更高。
    Sustained exposure to acetaldehyde, the major metabolite of ethanol, may influence psychomotor performance even after the breath ethanol level significantly drops several hours following ethanol consumption. We examined the relationship between psychomotor function and changes in exhaled ethanol and acetaldehyde concentrations after consuming a low dose (0.33 g/kg) of barley shochu, a traditional Japanese distilled alcohol beverage, at the point when the exhaled ethanol concentrations dropped below 78,000 parts per billion (0.15 mg/L), the standard threshold for driving under the influence of alcohol in Japan. We assessed how the genetic polymorphisms of rs671 G/G homozygous (*1/*1) and G/A heterozygous (*1/*2) of ALDH2 influenced the kinetics of ethanol and acetaldehyde in exhaled air and psychomotor dynamics using the Digit Symbol Substitution Test (DSST), Critical Flicker Fusion Test (CFFT), and visual analogue scale (VAS) up to 12 h after shochu or water intake. There was no significant difference in DSST and CFFT scores depending on genotype; however, the time required for the DSST to attain the level prior to drinking was longer in the ALDH2 *1/*2 group than in the *1/*1 group. In the VAS test, facial flushing and mood elevation tended to be higher in the *1/*2 group after shochu consumption. VAS scores for mood elevation and facial flushing correlated with acetaldehyde concentration in exhaled breath. These results indicate that DSST recovery tends to be slower and mood elevation higher in the ALDH2 *1/*2 group even when exposed to a low dose of alcohol.
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  • 文章类型: Observational Study
    背景:吡哆醇依赖性癫痫(PDE)是一种罕见的癫痫发作,通常表现为新生儿癫痫。大多数病例是由双等位基因致病性ALDH7A1变体引起的。虽然抗癫痫药物无效,吡哆醇能控制癫痫发作,和饮食干预可能是有益的。由于青春期之后的自然史没有得到充分的探索,我们的研究旨在评估挪威不同年龄段的PDE谱.
    方法:通过联系所有挪威儿科来确定患者,神经学,以及神经康复部门和相关专业协会。收集和审查医疗记录。
    结果:我们确定了15例接受PDE治疗的患者;13例患有ALDH7A1变体(PDE-ALDH7A1),一个人患有PNPO缺乏症,在一个,病因仍然模糊。在PDE-ALDH7A1患者中,12人在研究时还活着;5人>18岁,6人<4岁。中位年龄为10岁(范围2个月-53岁)。估计儿童最低患病率为6.3/百万,成人最低患病率为1.2百万。十个人在生命的第一天就癫痫发作。围产期并发症和神经放射学异常提示几名患者有其他癫痫发作病因。吡哆醇在六个人中立即起效,而6人延迟(>1小时)或不确定的效果。从第一次发作到连续治疗的中位延迟为11天(范围0-42)。9人经历了并发疾病或由于吡哆醇停药而引起的突破性癫痫发作。认知结果从正常到严重的智力障碍不等。这种情况在成人生活中似乎保持稳定。
    结论:我们发现儿童中PDE-ALDH7A1的患病率远高于成人,提示以前的诊断不足和早期死亡率。围产期并发症很常见,可延迟诊断和吡哆醇治疗的开始。用吡哆醇终身持续治疗势在必行。由于更好的诊断和生存,预计成年患者人数将上升。
    Pyridoxine-dependent epilepsy (PDE) is a rare seizure disorder usually presenting with neonatal seizures. Most cases are caused by biallelic pathogenic ALDH7A1variants. While anti-seizure medications are ineffective, pyridoxine provides seizure control, and dietary interventions may be of benefit. As the natural history beyond adolescence is insufficiently explored, our study aimed to assess the spectrum of PDE at various ages in Norway.
    Patients were ascertained by contacting all Norwegian paediatric, neurological, and neurohabilitation departments and relevant professional societies. Medical records were collected and reviewed.
    We identified 15 patients treated for PDE; 13 had ALDH7A1 variants (PDE-ALDH7A1), one had PNPO deficiency, and in one, aetiology remained obscure. Of those with PDE-ALDH7A1, 12 were alive at time of study; five were > 18 years old and six were < 4 years. Median age was 10 years (range 2 months-53 years). Estimated minimum prevalence was 6.3/million among children and 1.2/million among adults. Ten had seizure onset on the first day of life. Perinatal complications and neuroradiological abnormalities suggested additional seizure aetiologies in several patients. Pyridoxine had immediate effect in six, while six had delayed (>1 h) or uncertain effect. Median delay from first seizure to continuous treatment was 11 days (range 0-42). Nine experienced breakthrough seizures with intercurrent disease or due to pyridoxine discontinuation. Cognitive outcomes ranged from normal to severe intellectual disability. The condition appeared to remain stable in adult life.
    We found a much higher prevalence of PDE-ALDH7A1 in children relative to adults, suggesting previous underdiagnosis and early mortality. Perinatal complications are common and can delay diagnosis and initiation of pyridoxine treatment. Lifelong and continuous treatment with pyridoxine is imperative. Due to better diagnostics and survival, the number of adult patients is expected to rise.
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  • 文章类型: Journal Article
    迟发性阿尔茨海默病(LOAD)是一种复杂的疾病,神经炎症在其中发挥重要的病理生理作用,和暴露于神经毒性底物如醛可能有贡献。神经炎症相关基因的血液mRNA表达水平似乎是LOAD的潜在生物学标志物。已经提出了ALDH2和LOAD之间的关系。
    我们的目的是检查日本LOAD患者的血液ALDH2表达,进行遗传关联研究,并为亚洲人口的扩展荟萃分析增加新的研究。
    血液表达研究(45名AD受试者,54个对照),其中从整个外周血样品中分离总RNA,并进行ALDH2表达测量。此外,遗传关联研究(271名AD受试者,492对照)使用来自全外周血样品的基因组DNA进行。最后,一项荟萃分析研究了ALDH2*2频率与LOAD风险之间的关系.
    ALDH2mRNA表达在LOAD中明显高于对照组,并且有负载的男性也高于有负载的女性(p=0.043)。两个分类组中的基因型和等位基因频率在AD和对照受试者之间显着不同。荟萃分析显示ALDH2*2等位基因有显著差异,AD风险增加(OR=1.38;95%CI=1.02-1.85;p=0.0348,I2=81.1%)。
    血液ALDH2表达显著增加,以及与LOAD中ALDH2*2的遗传关联。ALDH2可能在亚洲人群LOAD的发病机制中起重要作用。
    Late-onset Alzheimer\'s disease (LOAD) is a complex disease in which neuroinflammation plays an important pathophysiological role, and exposure to neurotoxic substrates such as aldehydes may contribute. Blood mRNA expression levels of neuroinflammation-related genes appear to be potential biological markers of LOAD. A relationship between ALDH2 and LOAD has been suggested.
    Our objective was to examine blood ALDH2 expression in Japanese LOAD patients, conduct a genetic association study, and add new studies to an extended meta-analysis of the Asian population.
    A blood expression study (45 AD subjects, 54 controls) in which total RNA was isolated from whole peripheral blood samples and ALDH2 expression measured was conducted. In addition, a genetic association study (271 AD subjects, 492 controls) using genomic DNA from whole peripheral blood samples was conducted. Finally, a meta-analysis examined the relationship between ALDH2*2 frequency and the risk of LOAD.
    ALDH2 mRNA expression was significantly higher in LOAD than in controls, and also higher in men with LOAD than in women with LOAD (p = 0.043). The genotypes in the two classified groups and the allele frequency were significantly different between AD and control subjects. The meta-analysis showed a significant difference in the ALDH2*2 allele, with an increased AD risk (OR = 1.38; 95% CI = 1.02-1.85; p = 0.0348, I2 = 81.1%).
    There was a significant increase in blood ALDH2 expression, and a genetic association with ALDH2*2 in LOAD. ALDH2 may have significant roles in the pathogenesis of LOAD in the Asian population.
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