Lysine

赖氨酸
  • 文章类型: Journal Article
    结核病(TB)仍然是全球健康威胁,需要创新的控制和预防战略。这篇全面的综述探讨了结核分枝杆菌赖氨酸转运蛋白(LysE)基因,揭示其在控制和预防结核病(TB)方面的多方面作用和潜在用途。作为消除过量L-赖氨酸和L-精氨酸的关键角色,LysE有助于结核分枝杆菌的存活和毒力。这篇综述综合了来自不同电子数据库的发现,包括13项针对结核分枝杆菌LysE的研究。这项研究揭示了LysE可以成为潜在的药物靶标,结核病的诊断标记,和疫苗开发的有希望的候选人。广泛使用的BCG疫苗中不存在LysE强调了其独特性,并将其定位为结核病预防的新领域。总之,这篇综述强调了LysE在结核病发病机制中的重要性及其作为药物靶标的潜力,诊断标记,和候选疫苗。LysE的多面性使其处于抗击结核病的创新方法的最前沿,呼吁持续的研究努力,以充分发挥其在全球抗击这种传染病的潜力。
    Tuberculosis (TB) remains a global health threat, necessitating innovative strategies for control and prevention. This comprehensive review explores the Mycobacterium tuberculosis Lysine Exporter (LysE) gene, unveiling its multifaceted roles and potential uses in controlling and preventing tuberculosis (TB). As a pivotal player in eliminating excess L-lysine and L-arginine, LysE contributes to the survival and virulence of M. tuberculosis. This review synthesizes findings from different electronic databases and includes 13 studies focused on the LysE of M. tuberculosis. The research unveils that LysE can be a potential drug target, a diagnostic marker for TB, and a promising candidate for vaccine development. The absence of LysE in the widely used BCG vaccine underscores its uniqueness and positions it as a novel area for TB prevention. In conclusion, this review underscores the significance of LysE in TB pathogenesis and its potential as a drug target, diagnostic marker, and vaccine candidate. The multifaceted nature of LysE positions it at the forefront of innovative approaches to combat TB, calling for sustained research efforts to harness its full potential in the global fight against this infectious disease.
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  • 文章类型: Journal Article
    组蛋白赖氨酸乳酸化(Kla)已成为一种独特的表观遗传修饰,通过将乳酰基独特地添加到赖氨酸残基上,与已建立的酰化修饰显着不同。这种修饰不仅改变核小体结构,而且显著影响染色质动力学和基因表达。因此在细胞代谢中起着至关重要的作用,炎症反应,和胚胎发育。组蛋白Kla与各种代谢过程的关联,特别是糖酵解和谷氨酰胺代谢,强调了它在代谢重编程中的关键作用,包括在癌组织中,它有助于肿瘤发生,免疫逃避,和血管生成。此外,组蛋白Kla参与各种疾病的发病机制,特别是几种癌症和神经退行性疾病。组蛋白Kla的鉴定为靶向特定Kla位点的治疗干预开辟了新的途径。在这次审查中,我们总结了组蛋白Kla修饰和其他酰化修饰之间的差异,讨论组蛋白Kla在疾病中的作用和机制,最后描述了现有的药物和潜在的目标。这项研究为将组蛋白Kla与疾病联系起来的机制以及新药物和靶标的发现提供了新的见解。
    Histone lysine lactylation (Kla) has emerged as a distinct epigenetic modification that differs markedly from established acylation modifications through the unique addition of a lactyl group to a lysine residue. Such modifications not only alter nucleosome structure but also significantly impact chromatin dynamics and gene expression, thus playing a crucial role in cellular metabolism, inflammatory responses, and embryonic development. The association of histone Kla with various metabolic processes, particularly glycolysis and glutamine metabolism, underscores its pivotal role in metabolic reprogramming, including in cancerous tissues, where it contributes to tumorigenesis, immune evasion, and angiogenesis. In addition, histone Kla is involved in the pathogenesis of various diseases, particularly several cancers and neurodegenerative diseases. The identification of histone Kla opens new avenues for therapeutic interventions targeting specific Kla sites. In this review, we summarize the differences between histone Kla modifications and other acylation modifications, discuss the mechanisms and roles of histone Kla in disease, and conclude by describing existing drugs and potential targets. This study provides new insights into the mechanisms linking histone Kla to diseases and into the discovery of new drugs and targets.
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  • 文章类型: Journal Article
    赖氨酸特异性脱甲基酶1(LSD1/KDM1A)已成为治疗各种癌症(如乳腺癌,肝癌,等。)和其他疾病(血液病、心血管疾病,等。),由于其观察到的过度表达,从而为药物开发提供了重大机遇。自2004年发现以来,人们对LSD1抑制剂进行了广泛的研究,计算方法的显著贡献。这篇综述系统地总结了自2010年以来通过计算机辅助药物设计(CADD)技术研究的LSD1抑制剂,展示了各种化学支架,包括苯乙嗪衍生物,tranylcypromine(缩写为TCP或2-PCPA)衍生物,含氮杂环(吡啶,嘧啶,唑,噻吩并[3,2-b]吡咯,吲哚,喹啉和苯并恶唑)衍生物,天然产物(包括血根碱,酚类化合物和白藜芦醇衍生物,类黄酮和其他天然产物)和其他(包括硫脲化合物,非诺多泮和雷洛昔芬,(4-氰基苯基)甘氨酸衍生物,通过AI技术发现的炔丙胺和苯甲酰肼衍生物和抑制剂)。计算技术,比如虚拟筛选,分子对接和3D-QSAR模型,在阐明这些抑制剂与LSD1之间的相互作用方面发挥了关键作用。此外,人工智能等尖端技术的整合有望促进新型LSD1抑制剂的发现.这篇综述中提出的全面见解旨在为推进LSD1抑制剂的进一步研究提供有价值的信息。
    Lysine-specific demethylase 1 (LSD1/KDM1A) has emerged as a promising therapeutic target for treating various cancers (such as breast cancer, liver cancer, etc.) and other diseases (blood diseases, cardiovascular diseases, etc.), owing to its observed overexpression, thereby presenting significant opportunities in drug development. Since its discovery in 2004, extensive research has been conducted on LSD1 inhibitors, with notable contributions from computational approaches. This review systematically summarizes LSD1 inhibitors investigated through computer-aided drug design (CADD) technologies since 2010, showcasing a diverse range of chemical scaffolds, including phenelzine derivatives, tranylcypromine (abbreviated as TCP or 2-PCPA) derivatives, nitrogen-containing heterocyclic (pyridine, pyrimidine, azole, thieno[3,2-b]pyrrole, indole, quinoline and benzoxazole) derivatives, natural products (including sanguinarine, phenolic compounds and resveratrol derivatives, flavonoids and other natural products) and others (including thiourea compounds, Fenoldopam and Raloxifene, (4-cyanophenyl)glycine derivatives, propargylamine and benzohydrazide derivatives and inhibitors discovered through AI techniques). Computational techniques, such as virtual screening, molecular docking and 3D-QSAR models, have played a pivotal role in elucidating the interactions between these inhibitors and LSD1. Moreover, the integration of cutting-edge technologies such as artificial intelligence holds promise in facilitating the discovery of novel LSD1 inhibitors. The comprehensive insights presented in this review aim to provide valuable information for advancing further research on LSD1 inhibitors.
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  • 文章类型: Journal Article
    翻译后修饰作为用于调节不同细胞过程的关键分子调节机制发生。蛋白质的丙二基化,赖氨酸/k残基的可逆翻译后修饰,与多种生物学功能有关,如细胞调节和发病机制。这种修饰在代谢途径中起着至关重要的作用,线粒体功能,脂肪酸氧化和其他生命过程。然而,准确识别丙二酸位点对于理解丙二酸的分子机制至关重要,而实验鉴定可能是一项具有挑战性且成本高昂的任务。最近,基于机器学习(ML)的方法已经被提出来解决这个问题。已经证明,这些程序提高了准确性,同时降低成本和时间限制。然而,这些方法也有具体的缺点,包括从蛋白质序列中提取不适当的特征,高维特征和低效的底层分类器。因此,迫切需要有效的预测因子和计算方法。在这项研究中,我们对现有的预测模型进行了全面的分析和回顾,用于预测蛋白质序列中丙二酰位点的工具和基准数据集,然后进行比较研究。审查包括基准数据集的规格,解释特征和编码方法,预测方法的描述及其嵌入ML或深度学习模型,以及该领域现有工具的描述和比较。为了评估和比较工具的预测能力,根据最新的数据库提取了一组新的数据,并根据提取的数据评估了工具。最后,提出了一种由多个分类器组成的混合架构,包括经典ML模型和深度学习模型,以整合预测结果。与本研究中包含的所有预测工具相比,这种方法显示出更好的性能(本手稿中提供的模型的源代码可在https://github.com/Malonylation中找到)。数据库URL:https://github.com/A-Golshan/Malonylation。
    The post-translational modifications occur as crucial molecular regulatory mechanisms utilized to regulate diverse cellular processes. Malonylation of proteins, a reversible post-translational modification of lysine/k residues, is linked to a variety of biological functions, such as cellular regulation and pathogenesis. This modification plays a crucial role in metabolic pathways, mitochondrial functions, fatty acid oxidation and other life processes. However, accurately identifying malonylation sites is crucial to understand the molecular mechanism of malonylation, and the experimental identification can be a challenging and costly task. Recently, approaches based on machine learning (ML) have been suggested to address this issue. It has been demonstrated that these procedures improve accuracy while lowering costs and time constraints. However, these approaches also have specific shortcomings, including inappropriate feature extraction out of protein sequences, high-dimensional features and inefficient underlying classifiers. As a result, there is an urgent need for effective predictors and calculation methods. In this study, we provide a comprehensive analysis and review of existing prediction models, tools and benchmark datasets for predicting malonylation sites in protein sequences followed by a comparison study. The review consists of the specifications of benchmark datasets, explanation of features and encoding methods, descriptions of the predictions approaches and their embedding ML or deep learning models and the description and comparison of the existing tools in this domain. To evaluate and compare the prediction capability of the tools, a new bunch of data has been extracted based on the most updated database and the tools have been assessed based on the extracted data. Finally, a hybrid architecture consisting of several classifiers including classical ML models and a deep learning model has been proposed to ensemble the prediction results. This approach demonstrates the better performance in comparison with all prediction tools included in this study (the source codes of the models presented in this manuscript are available in https://github.com/Malonylation). Database URL: https://github.com/A-Golshan/Malonylation.
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  • 文章类型: Journal Article
    蛋白质在各种生物系统中作为关键调节因子发挥着关键作用。影响基因表达等关键过程,细胞周期进程,和细胞增殖。然而,蛋白质的功能可以通过翻译后修饰(PTM)进一步修饰,它们扩大了它们的作用,并在失调时导致疾病进展。在这次审查中,我们深入研究了用于表征PTM的方法,揭示用于帮助解开其复杂性的技术和工具。此外,我们探讨了不同类型PTM之间发生的串扰和竞争的普遍性,特别关注组蛋白和非组蛋白。不同修饰之间的复杂相互作用为蛋白质功能和细胞过程增加了额外的调节层。为了深入了解各种修饰之间赖氨酸残基的竞争,已经开发了诸如MethylSight之类的计算系统,允许对修改景观进行全面分析。此外,我们概述了针对PTM的抑制剂或药物领域令人兴奋的发展,强调他们在抗击流行疾病方面的潜力。调节PTM的药物的发现和开发为治疗干预提供了有希望的途径。提供解决复杂疾病的新策略。随着这个快速发展的领域的研究进展,我们预计我们对PTM及其在健康和疾病中的作用的理解会取得显著进展,最终为创新的治疗方法铺平道路。
    Proteins play a critical role as key regulators in various biological systems, influencing crucial processes such as gene expression, cell cycle progression, and cellular proliferation. However, the functions of proteins can be further modified through post-translational modifications (PTMs), which expand their roles and contribute to disease progression when dysregulated. In this review, we delve into the methodologies employed for the characterization of PTMs, shedding light on the techniques and tools utilized to help unravel their complexity. Furthermore, we explore the prevalence of crosstalk and competition that occurs between different types of PTMs, specifically focusing on both histone and non-histone proteins. The intricate interplay between different modifications adds an additional layer of regulation to protein function and cellular processes. To gain insights into the competition for lysine residues among various modifications, computational systems such as MethylSight have been developed, allowing for a comprehensive analysis of the modification landscape. Additionally, we provide an overview of the exciting developments in the field of inhibitors or drugs targeting PTMs, highlighting their potential in combatting prevalent diseases. The discovery and development of drugs that modulate PTMs present promising avenues for therapeutic interventions, offering new strategies to address complex diseases. As research progresses in this rapidly evolving field, we anticipate remarkable advancements in our understanding of PTMs and their roles in health and disease, ultimately paving the way for innovative treatment approaches.
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  • 文章类型: Journal Article
    单纯疱疹病毒-1(HSV-1)和-2(HSV-2)很大,球形,与智人共进化超过30万年的双链DNA病毒,已经开发了许多免疫规避机制来在人类宿主的一生中存活。尽管在持续缺乏可接受的预防性和治疗性疫苗的情况下,批准的药理学(例如,核苷类似物)对病毒爆发有好处,而抗性和毒性限制了它们的普遍应用。针对这些缺点,有一个长期的历史证明和未经证实的家庭疗法。随着所谓替代疗法的广泛性,如果没有适当的信息,患者会面临伤害的风险。这里,我们研究了目前的黄金标准HSV疗法的缺点,阿昔洛韦,并描述了几种天然产物在控制HSV感染方面表现出了希望,包括柠檬香脂,赖氨酸,蜂胶,维生素E,还有锌,而精氨酸,大麻,和许多其他娱乐性药物是有害的。基于这些文献,我们提供了有关此类天然产品的使用及其进一步调查的建议。
    Herpes simplex virus-1 (HSV-1) and -2 (HSV-2) are large, spherically shaped, double-stranded DNA viruses that coevolved with Homo sapiens for over 300,000 years, having developed numerous immunoevasive mechanisms to survive the lifetime of their human host. Although in the continued absence of an acceptable prophylactic and therapeutic vaccine, approved pharmacologics (e.g., nucleoside analogs) hold benefit against viral outbreaks, while resistance and toxicity limit their universal application. Against these shortcomings, there is a long history of proven and unproven home remedies. With the breadth of purported alternative therapies, patients are exposed to risk of harm without proper information. Here, we examined the shortcomings of the current gold standard HSV therapy, acyclovir, and described several natural products that demonstrated promise in controlling HSV infection, including lemon balm, lysine, propolis, vitamin E, and zinc, while arginine, cannabis, and many other recreational drugs are detrimental. Based on this literature, we offered recommendations regarding the use of such natural products and their further investigation.
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  • 文章类型: Journal Article
    由于各种感知和真正的健康益处,单个氨基酸作为补充剂广泛流行。目前,由于缺乏良好的人体剂量反应试验,国家卫生机构没有针对氨基酸的可耐受高摄入量(UL)提出建议。在过去的十年中,在国际氨基酸科学理事会(ICAAS)的倡议下,非营利组织,进行了一系列UL人体临床研究。这篇叙述性综述的目的是总结对6种必需氨基酸(亮氨酸,色氨酸,蛋氨酸,赖氨酸,组氨酸,苯丙氨酸),两种非必需氨基酸(精氨酸,丝氨酸)和两个非蛋白质氨基酸(鸟氨酸,瓜氨酸)并提供第一组UL。UL的膳食参考摄入量(DRI)框架的概念的简要背景,氨基酸UL的概念,并提供了结果的观点。数据表明,在相对健康的成人个体中,所测试的氨基酸具有良好的耐受性,和ULs,或未观察到的不良反应水平(NOAEL),可以确定最低观察到的不良反应水平(LOAEL)。ULs用于亮氨酸青年(35g/d),色氨酸(4.5g/d)和亮氨酸老年(30g/d);蛋氨酸的NOAEL和LOAEL为3.2和6.4g/d,精氨酸的NOAEL(30g/d);赖氨酸的NOAEL和LOAEL分别为6和7.5g/d,组氨酸的NOAEL和LOAEL分别为8和12g/d,分别为苯丙氨酸(12g/d)和NOAEL,丝氨酸(12g/d),鸟氨酸(12g/d)和瓜氨酸(24g/d)。这些第一组人类UL数据希望帮助国家和国际机构制定补充氨基酸的安全标准。
    Individual amino acids are widely popular as supplements because of various perceived and real health benefits. However, currently, there are no recommendations set by national health agencies for tolerable upper intake levels (UL) for amino acids because of a lack of well-conducted human dose-response trials. In the past decade, under the initiative of the International Council on Amino Acid Science, a nonprofit organization, a series of UL human clinical studies were conducted. The goal of this narrative review is to summarize the studies on 6 essential amino acids (leucine, tryptophan, methionine, lysine, histidine, and phenylalanine), 2 nonessential amino acids (arginine and serine), and 2 nonproteinogenic amino acids (ornithine and citrulline) and provide the first set of ULs. A brief background of the concept of the DRI framework of UL, the concept of UL for amino acids, and a perspective of the results are also provided. The data suggest that in relatively healthy adult individuals, the tested amino acids are well tolerated, and ULs, or the no-observed-adverse-effect-level (NOAEL), lowest-observed-adverse-effect-level (LOAEL), can be determined. The ULs were for leucine-young (35 g/d), tryptophan (4.5 g/d), and leucine-elderly (30 g/d); NOAEL and LOAEL for methionine at 3.2 and 6.4 g/d, respectively; NOAEL for arginine (30 g/d); NOAEL and LOAEL for lysine at 6 and 7.5 g/d, respectively; NOAEL and LOAEL for histidine at 8 and 12 g/d, respectively; and NOAEL for phenylalanine (12 g/d), serine (12 g/d), ornithine (12 g/d) and citrulline (24 g/d). This first set of human UL data are hoped to help national and international agencies set safety standards for supplemental amino acids.
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  • 文章类型: Journal Article
    暴露于有机磷毒物的急性影响可以通过抑制乙酰胆碱酯酶活性来解释。然而,解释与有机磷暴露相关的长期疾病的机制仍在研究中。我们发现有机磷神经毒剂和有机磷农药不仅在乙酰胆碱酯酶的丝氨酸上产生共价加合物,还有酪氨酸,赖氨酸,谷氨酸,来自多种蛋白质的丝氨酸和苏氨酸。几乎任何蛋白质都可以被高剂量的有机磷毒物修饰。在人神经母细胞瘤SH-SY5Y细胞的无血清培养基中加入低剂量的10μM毒死rifoxon,导致从细胞裂解物中免疫纯化的48种蛋白质上的酪氨酸加合物。我们在用兔抗二乙氧基磷酸酪氨酸单克隆抗体免疫净化修饰的蛋白质后,通过质谱鉴定了加合的蛋白质,该抗体使这项研究偏向于酪氨酸加合物。在培养的细胞中,主要的有机磷酸酯目标是丰富的蛋白质。有机磷酸酯修饰的蛋白质可能会破坏生理过程。在单独的实验中,我们鉴定了赖氨酸上的有机磷酸酯加合物。有机磷酸化激活赖氨酸用于蛋白质交联。活化的赖氨酸与谷氨酸或天冬氨酸蛋白质侧链反应,在蛋白质之间形成异肽键,产生高分子量的交联蛋白。交联的蛋白质形成不溶性聚集体,可能导致神经退行性疾病。
    The acute effects of exposure to organophosphorus toxicants are explained by inhibition of acetylcholinesterase activity. However, the mechanisms that explain long term illness associated with organophosphorus exposure are still under investigation. We find that organophosphorus nerve agents and organophosphorus pesticides make covalent adducts not only on the serine from acetylcholinesterase, but also on tyrosine, lysine, glutamate, serine and threonine from a variety of proteins. Almost any protein can be modified by a high dose of organophosphorus toxicant. A low dose of 10 μM chlorpyrifos oxon added to the serum-free culture medium of human neuroblastoma SH-SY5Y cells resulted in tyrosine adducts on 48 proteins immunopurified from the cell lysate. We identified the adducted proteins by mass spectrometry after immunopurifying modified proteins with a rabbit anti-diethoxyphospho-tyrosine monoclonal antibody which biased this study for tyrosine adducts. In cultured cells, the primary organophosphate targets are abundant proteins. Organophosphate-modified proteins may disrupt physiological processes. In separate experiments we identified organophosphate adducts on lysine. Organophosphylation activates the lysine for protein crosslinking. The activated lysine reacts with glutamic acid or aspartic acid protein side chains to form an isopeptide bond between proteins, resulting in high molecular weight crosslinked proteins. Crosslinked proteins form insoluble aggregates that may lead to neurogenerative disease.
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  • 文章类型: Journal Article
    这篇综述的目的是提请注意烘焙产品中的Nε-(羧甲基)赖氨酸(CML)含量,包括烘焙过程中的形成及其对健康的影响。添加到烘焙产品中的配方中的酚类组分显著减少了CML的形成。在酚类成分中,阿魏酸对CML的降低作用最为显著。在模型饼干系统中测试的黄烷酮中,二氢杨梅素表现出最强的CML降低作用。脂肪的添加-,sugar-,烘焙产品配方中富含蛋白质的成分通常会增加这些产品中的CML含量。此外,添加具有降低水分活度作用的成分,比如膳食纤维,烘烤中的高温也增加了CML的形成。因此,食品行业也应注重优化食品生产,以最大限度地减少CML的形成,同时保持烘焙产品的安全性和感官特性。实际应用:食物中的CML水平可能会随着烹饪温度的升高而增加200倍。向烘焙产品配方中添加蛋白质和脂肪可以增加CML的形成。在蛋糕中添加葡萄糖可以比果糖产生更高水平的CML,精制蔗糖,或未精制的蔗糖。酚类化合物对烘焙产品中的CML形成具有降低作用。
    The purpose of this review is to draw attention to the Nϵ -(carboxymethyl)lysine (CML) content of bakery products with respect to their formation during baking and their health effects. Phenolic components added to the formulation in bakery products significantly reduce the formation of CML. Among the phenolic components, ferulic acid showed the most significant lowering effect on CML. Among the flavanones tested in the model cookie system, dihydromyricetin exhibited the strongest CML-reducing effect. The addition of fat-, sugar-, and protein-rich ingredients to the formulations of bakery products generally increases the CML content in these products. In addition, the addition of components that have a water activity-reducing effect, such as dietary fiber, and the high temperature in baking also increase the formation of CML. Therefore, the food industry should also focus on optimizing food production to minimize CML formation while maintaining the safety and organoleptic properties of bakery products. PRACTICAL APPLICATION: The CML level in foods is likely to increase 200 times with an increase in cooking temperature. The addition of protein and fat to bakery product formulations can increase CML formation. The addition of glucose in cakes can produce higher levels of CML than fructose, refined sucrose, or unrefined sucrose. Phenolic compounds have a reducing effect on CML formation in bakery products.
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  • 文章类型: Meta-Analysis
    背景:儿童厌食症可导致营养不良,免疫力低,生长迟缓,和各种继发感染,给社会带来了巨大的负担。在东亚,Chuna手法疗法已广泛用于儿童厌食症的治疗。我们旨在全面评估Chuna手法治疗儿童厌食症的效果。
    方法:从成立到2022年9月13日,对12个数据库进行了全面搜索。仅包括评估Chuna手动疗法治疗儿童厌食症的随机对照试验。使用Cochrane偏倚风险工具评估纳入研究的方法学质量。每个主要结果的证据质量都使用建议评估的分级进行评估,发展,和评价方法。进行了荟萃分析,汇总数据以二分结局的风险比(RR)和95%置信区间(CI)表示.
    结果:纳入了25个RCT,涉及2230名参与者。meta分析显示,基于厌食症状的Chuna手法治疗总有效率(TER)高于赖氨酸肌醇和维生素B12(RR:1.53,95%CI:1.28-1.84),多酶和多维生素(RR:1.21,95%CI:1.11-1.33),和葡萄糖酸钙锌(RR:1.22,95%CI:1.06-1.39)。Chuna手法治疗与葡萄糖酸锌加赖氨酸治疗的总有效率差异无统计学意义。未报告与Chuna手动治疗相关的不良事件。总的来说,纳入的研究有不清楚的偏倚风险,证据质量一般为中低。
    结论:目前的证据表明,春娜手法治疗对改善厌食症症状可能是有效和安全的,特别是与赖氨酸肌醇和维生素B12相比,多酶加多维生素,和葡萄糖酸钙锌.然而,由于纳入研究的方法学质量较低,更严格,在这个主题上需要高质量的RCT。
    BACKGROUND: Anorexia in children can cause malnutrition, low immunity, growth retardation, and various secondary infections, resulting in a huge burden on society. In East Asia, Chuna manual therapy has been widely used for the treatment of childhood anorexia. We aimed to comprehensively evaluate the effects of Chuna manual therapy for treating childhood anorexia.
    METHODS: Twelve databases were comprehensively searched from their inception to September 13, 2022. Only randomized controlled trials assessing Chuna manual therapy for the treatment of childhood anorexia were included. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. The quality of evidence for each main outcome was evaluated using the grading of recommendations assessment, development, and evaluation approach. A meta-analysis was performed, and the pooled data were presented as risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous outcomes.
    RESULTS: Twenty-five RCTs involving 2230 participants were included. The meta-analysis showed that Chuna manual therapy had a higher total effective rate (TER) based on anorexia symptoms than that of lysine inositol and vitamin B12 (RR: 1.53, 95% CI: 1.28-1.84), multi-enzyme and multi-vitamin (RR: 1.21, 95% CI: 1.11-1.33), and zinc calcium gluconate (RR: 1.22, 95% CI: 1.06-1.39). There was no significant difference in total effective rate between Chuna manual therapy and zinc gluconate plus lysine. No adverse events associated with Chuna manual therapy were reported. Overall, the included studies had an unclear risk of bias, and the quality of evidence was generally moderate to low.
    CONCLUSIONS: Current evidence showed that Chuna manual therapy may be effective and safe for improving anorexia symptoms, especially compared with lysine inositol and vitamin B12, multi-enzyme plus multi-vitamin, and zinc calcium gluconate. However, owing to the low methodological quality of the included studies, more rigorous, high-quality RCTs are required on this topic.
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