animal model

动物模型
  • 文章类型: Journal Article
    背景:在肩袖损伤的临床和动物研究中,功能评估对于评估治疗结果至关重要。虽然步态分析通常用于评估肩袖撕裂的动物模型,它与人类患者的相关性较小,因为人类肩部通常是在非负重状态下评估的。本研究介绍了熟练的触角测试作为大鼠肩部功能评估工具,这允许评估没有承重。
    方法:在对照组中,8只雄性Sprague-Dawley大鼠接受了无修复的肩袖撕裂手术。在肩袖修复组中,20只大鼠在肩袖撕裂后4周接受肩袖修复。对于熟练的触达测试,训练大鼠伸展前肢以获取食物颗粒,以及试验的数量,记录了尝试次数和成功率。在基线时进行步态分析和熟练到达测试,撕裂后4周,修复后1、2、4和8周。重复测量方差分析用于评估时间对肩关节功能的影响。显著性水平设定为0.05。
    结果:熟练的测试需要216小时才能进行,而步态分析需要44小时。在肩袖修复组中,步态表现在修复后1周显著恶化,在修复后4周恢复至撕裂后4周水平。关于熟练的触达测试,尝试的次数,修复后1周的试验数量和成功率下降.随后,修复后2周观察到性能短暂反弹,随后,尝试和试验的数量持续下降。修复后8周,只有成功率恢复到与撕裂后4周相似的水平.
    结论:熟练的伸手测试可以检测肩袖撕裂和修复后的功能缺陷,虽然它需要很高的时间和劳动力成本。
    BACKGROUND: Functional assessments are crucial to evaluate treatment outcomes in clinical and animal studies on rotator cuff injuries. While gait analysis is commonly used to assess animal models of rotator cuff tears, it is less relevant for human patients as the human shoulder is typically assessed in a non-weight-bearing condition. The present study introduces the skilled reaching test as a shoulder functional assessment tool for rats, which allows for evaluation without weight bearing.
    METHODS: In the control group, 8 male Sprague-Dawley rats received rotator cuff tear surgery without repair. In the rotator cuff repair group, 20 rats received rotator cuff repair at 4 weeks post rotator cuff tear. For the skilled reaching test, rats were trained to extend their forelimbs to fetch food pellets, and the number of trials, number of attempts and the success rate were recorded. The gait analysis and skilled reaching test were performed at baseline, 4 weeks post-tear, 1, 2, 4, and 8 weeks post-repair. The repeated measures analysis of variance was used to evaluate the effects of time on the shoulder function. The significance level was set at 0.05.
    RESULTS: The skilled reaching test required 216 h to conduct, while the gait analysis took 44 h. In the rotator cuff repair group, gait performance significantly deteriorated at 1 week post-repair and restored to 4 weeks post-tear levels at 4 weeks post-repair. Regarding the skilled reaching test, the number of attempts, number of trials and the success rate decreased at 1 week post-repair. Subsequently, there was a brief rebound in performance observed at 2 weeks post-repair, followed by a continued decline in the number of attempts and trials. By 8 weeks post-repair, only the success rate had restored to levels similar to those observed at 4 weeks post-tear.
    CONCLUSIONS: The skilled reaching test can detect functional deficiencies following rotator cuff tear and repair, while it requires high time and labour costs.
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  • 文章类型: Journal Article
    目的:这项研究的目的是评估使用具有特定温度-时间间隔的二极管激光器是否可以对骨整合植入物进行热植入物去除。
    方法:首先,在10头猪的上颌骨和下颌骨两侧进行了前三个前磨牙的拔牙。三个月后,将植入物插入10头猪的上下颚。再过三个月,骨整合植入物用激光设备加热至50°C的温度1分钟。14天后,植入物稳定性商(ISQ),扭矩输出值,使用共振频率分析评估骨与植入物接触(BIC)比率。
    结果:ISQ值显示各组内或对照组与试验组之间无显著差异。此外,扭矩输出和BIC值测量结果在两组之间无显著差异.
    结论:在50°C时,BIC值的变化明显较小;然而,这些差异并不显著。未来的研究应该以更高的温度或更长的时间间隔评估相同的程序。
    结论:仅在50°C下持续1分钟,牙种植体将无法预测地脱整合。
    OBJECTIVE: The aim of this study was to evaluate whether thermal implant removal of osseointegrated implants is possible using a diode laser with an specific temperature-time interval.
    METHODS: First, tooth extraction of the first three premolars was performed in the maxilla and mandible on both sides of 10 pig. After 3 months, implants were inserted into the upper and lower jaws of 10 pigs. After 3 more months, osseointegrated implants were heated with a laser device to a temperature of 50 °C for 1 min. After 14 days, the implant stability quotient (ISQ), torque-out values, and bone-to-implant contact (BIC) ratio were assessed using resonance frequency analysis.
    RESULTS: ISQ values showed no significant differences within each group or between the control and test groups. Furthermore, torque-out and BIC value measurements presented no significant differences between the groups.
    CONCLUSIONS: At 50°C, changes in the BIC values were noticeably smaller; however, these differences were not significant. Future studies should evaluate the same procedures at either a higher temperature or longer intervals.
    CONCLUSIONS: With only 50 °C for 1 min, a dental implant will not de-integrate predictably.
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  • 文章类型: Journal Article
    背景:兔子通常用作胎儿生长受限(FGR)的自然模型;然而,没有研究证实兔子有FGR。本研究旨在使用扩散加权MRI和体视学来表征健康妊娠兔的胎儿胎盘单位(FPU)。该研究的次要目的是描述扩散加权MRI(DW-MRI)发现之间的关联。胎儿体重测量和胎盘组织学分析。
    方法:孕兔在妊娠28天全麻下进行DW-MRI检查。在3.0T时进行MR成像。计算胎儿脑的表观扩散系数(ADC)值,肝脏,和胎盘。通过体视学分析胎盘(滋养细胞的体积密度,母体血液空间和胎儿血管)。对每个胎儿和胎盘称重。根据子宫角中的位置定义两组胎儿(子宫颈组与卵巢组)。
    结果:我们分析了5只孕兔的20个FPU。子宫颈组的胎儿和胎盘明显轻于卵巢组(34.7±3.7gvs.40.2±5.4g;p=0.02)。体积密度分析显示胎儿血管的百分比,胎儿在子宫角中的位置对母体的血液空间和滋养细胞没有显着影响。根据胎儿在子宫角中的位置,ADC值没有差异,ADC值与胎儿体重无相关性。
    结论:在FGR兔模型中对胎盘进行多模态评估的结果表明,这不是胎儿生长受限的自然模型。
    BACKGROUND: Rabbits are routinely used as a natural model of fetal growth restriction (FGR); however, no studies have confirmed that rabbits have FGR. This study aimed to characterize the fetoplacental unit (FPU) in healthy pregnant rabbits using diffusion-weighted MRI and stereology. A secondary objective of the study was to describe the associations among findings from diffusion-weighted MRI (DW-MRI), fetal weight measurement and histological analysis of the placenta.
    METHODS: Pregnant rabbits underwent DW-MRI under general anesthesia on embryonic day 28 of pregnancy. MR imaging was performed at 3.0 T. The apparent diffusion coefficient (ADC) values were calculated for the fetal brain, liver, and placenta. The placenta was analyzed by stereology (volume density of trophoblasts, the maternal blood space and fetal vessels). Each fetus and placenta were weighed. Two groups of fetuses were defined according to the position in the uterine horn (Cervix group versus Ovary group).
    RESULTS: We analyzed 20 FPUs from 5 pregnant rabbits. Fetuses and placentas were significantly lighter in the Cervix group than in the Ovary group (34.7 ± 3.7 g vs. 40.2 ± 5.4 g; p = 0.02). Volume density analysis revealed that the percentage of fetal vessels, the maternal blood space and trophoblasts was not significantly affected by the position of the fetus in the uterine horn. There was no difference in ADC values according to the position of the fetus in the uterine horn, and there was no correlation between ADC values and fetal weight.
    CONCLUSIONS: The findings of a multimodal evaluation of the placenta in a rabbit model of FGR suggested is not a natural model of fetal growth restriction.
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  • 文章类型: Journal Article
    背景:有关皮肤填充剂的丰盈作用的信息对于医师了解产品特征和在临床实践中的审慎决策至关重要。对于材料工程师来说,开发和优化新的真皮填充物非常重要,特别是当比较新产品的理化性质与世界范围内使用的现有填料的理化性质时。
    目的:本研究旨在建立一种可靠的,用于体内定量评估填充效果的非侵入性方法,以预测填充剂注射后可能的有效性并评估随时间的降解趋势。
    方法:建立兔耳部注射真皮填充剂模型。将透明质酸(HA)填充剂注射到兔耳朵的皮下层,导致稳定的皮肤隆起。超声检查用于无创测量皮肤凸起以进行体积计算;定期分析体积变化,直到38周。病理检查,黄金标准,进行以确认降解。
    结果:在宏观上观察到HA填充剂注射的即时增容效果为局部皮肤隆起。超声波能够精确检测填充物的形状并计算长度,宽度,和每个时间点的皮肤凸起的高度。病理评价中的隆起程度和残留样本数量与使用超声进行形态学观察的结果一致。
    结论:通过兔耳注射模型评估评估真皮填充物的体积影响,可以在材料开发的早期进行材料科学评估,具有一定的临床参考价值。
    方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
    BACKGROUND: Information about the volumizing effects of dermal fillers is critical for physicians\' understanding of product features and prudent decision-making in clinical practice. It is important for material engineers to develop and optimize new dermal fillers, especially when comparing the physiochemical properties of a new product with those of existing fillers that are used worldwide.
    OBJECTIVE: This study aimed to establish a reliable, noninvasive method for in vivo quantitative evaluation of the filling effect in order to predict possible effectiveness after filler injection and to evaluate the degradation trend over time.
    METHODS: A rabbit model of ear injection with dermal fillers was established. Hyaluronic acid (HA) filler was injected into the subcutaneous layer of rabbit ears, resulting in a stable skin bulge. Ultrasonography was used to noninvasively measure the skin bulge for volume calculation; the volume change was analyzed periodically until 38 weeks. Pathological examination, the gold standard, was performed to confirm degradation.
    RESULTS: The immediate volumizing effect of HA filler injection was macroscopically observed as a local skin bulge. Ultrasound was able to precisely detect the shape of the filler and calculate the length, width, and height of the skin bulge at each time point. The degree of uplift and amount of residual samples in the pathological evaluation were consistent with the results of morphological observation using ultrasound.
    CONCLUSIONS: Evaluation of the volume impact of dermal filler through the rabbit ear injection model evaluation enables material science evaluation in the early stage of material development, and has certain clinical reference value.
    METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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  • 文章类型: Journal Article
    口腔扁平苔藓(OLP)是一种常见的口腔黏膜疾病,病因不明,发病机制复杂。患有OLP的患者忍受以交替的非侵蚀性和侵蚀性病变为特征的慢性病程。目前尚无明确的治疗方法。特别具有挑战性的是治疗顽固性侵蚀性OLP,强调迫切需要针对特定致病途径的疗法。在像OLP这样的疾病中,病因错综复杂,难以捉摸,动物模型对于假设检验和阐明疾病机制是必不可少的。迄今为止,文献中只报道了三种用于口腔苔藓样病变的动物模型。这篇透视论文评估了这些现有的模型,以及在第三届国际口腔粘膜免疫和微生物组会议上介绍的新型OLP小鼠模型。这些模型的有效性受到严格评估,讨论了它们在促进我们对OLP的理解方面的潜在未来应用。
    Oral lichen planus (OLP) is a prevalent oral mucosal disease characterized by an unknown etiology and a complex pathogenesis. Patients with OLP endure a chronic course marked by alternating non-erosive and erosive lesions, with no definitive cure currently available. Particularly challenging is the treatment of recalcitrant erosive OLP, highlighting an urgent need for therapies targeting specific pathogenic pathways. In diseases like OLP, where the etiopathogenesis is intricate and elusive, animal models are indispensable for hypothesis testing and elucidating disease mechanisms. To date, only three animal models for oral lichenoid lesions have been reported in the literature. This Perspective paper evaluates these existing models, along with a novel OLP mouse model introduced at the 3rd International Conference on Oral Mucosal Immunity and Microbiome. The validity of these models is critically assessed, and their potential future applications in advancing our understanding of OLP are discussed.
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  • 文章类型: Journal Article
    目的:从组织学上比较新引入的锥形,骨整合和牙髓骨愈合。在完全愈合的部位进行自切骨水平测试植入物和锥形骨水平控制植入物。
    方法:66个植入物(33个测试,将33个对照)置于小型猪模型中,并在浸没愈合3、6和12周后进行定性组织学和定量组织学分析。主要和次要结果是骨与植入物接触(BIC)和首次骨与植入物接触(fBIC)。对测试植入物和对照植入物之间的结果进行统计学比较。
    结果:测试植入物的BIC值在所研究的时间点上是可比的且不劣质的,除了12周时间点显示与对照植入物(80.88±7.51%)相比,测试的BIC值(88.07±5.35%)在统计学上显着更高(p=.010)。fBIC值同样具有可比性和非劣性,除了6周的结果,与对照植入物(-75.7±100.59μm)相比,该测试显示出统计学上更高的值(-546.5±450.80μm)。测试植入物的fBIC结果在质量上更稳定并且在测试时间点之间一致。
    结论:新型自切骨水平测试植入物在愈合的脊骨经过12周的愈合后,与常规骨水平植入物相比,显示出较好的骨整合和相似的骨水平。
    OBJECTIVE: To histologically compare osseointegration and crestal bone healing between newly introduced tapered, self-cutting bone-level test implants and tapered bone-level control implants in sites with fully healed sites.
    METHODS: Sixty-six implants (33 test, 33 control) were placed 1 mm subcrestally in a minipig model and underwent qualitative histologic and quantitative histometric analyses after 3, 6 and 12 weeks of submerged healing. The primary and secondary outcomes were the bone-to-implant contact (BIC) and first bone-to-implant contact (fBIC). Outcomes between the test and control implants were statistically compared.
    RESULTS: The BIC values of the test implants were comparable and non-inferior over the time points studied, except for the 12 weeks time point which showed statistically significantly higher BIC values of the test (88.07 ± 5.35%) compared to the control implants (80.88 ± 7.51%) (p = .010). Similarly comparable and non-inferior were the fBIC values, except for the 6-week outcome, which showed statistically higher values for the test (-546.5 ± 450.80 μm) compared to the control implants (-75.7 ± 100.59 μm). fBIC results for the test implants were qualitatively more stable and consistent between test time points.
    CONCLUSIONS: Novel self-cutting bone-level test implants demonstrated superior osseointegration and similar bone levels compared to conventional bone-level implants after a healing period of 12 weeks in healed ridges.
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  • 文章类型: Journal Article
    背景:急性肺栓塞(PE)引起通气-灌注不匹配和缺氧,并增加肺压和右心室(RV)后负荷,在短时间内可能导致致命的RV故障。心肺因素可能对增加的血凝块负担有不同的反应。我们旨在阐明猪模型中连续PE发作期间的即时心肺反应。
    方法:这是一个随机的,控制,重复测量的盲法研究。每15分钟随机分配12只猪接受假手术或连续PE,直到平均肺压加倍。在每次PE后1、2、5和13分钟使用压力-容量环进行心肺评估。侵入性压力,以及动脉和混合静脉血气分析。应用方差分析和混合模型统计分析。
    结果:初次PE给药后肺压升高(p<0.0001),与以下PE后观察到的压力变化相比,肺压变化更高。相反,第一次PE后,RV动脉弹性和肺血管阻力没有增加,但在三次PE后观察到增加(分别为p=0.0103和p=0.0015)。RV扩张发生在初始PE之后,而RV射血分数在第三次PE后下降(p=0.004)。RV耦合表现出从第一次PE(p=0.095)下降的趋势,尽管增加了机械功(p=0.003)。换气变量随着连续的PE显示出更多的增量变化。
    结论:在连续PE的实验模型中,第三次PE后表现为RV后负荷升高和功能障碍,与第一次PE后肺压升高相反。通气变量与凝块负荷表现出更直接的关联。
    BACKGROUND: Acute pulmonary embolism (PE) induces ventilation-perfusion mismatch and hypoxia and increases pulmonary pressure and right ventricular (RV) afterload, entailing potentially fatal RV failure within a short timeframe. Cardiopulmonary factors may respond differently to increased clot burden. We aimed to elucidate immediate cardiopulmonary responses during successive PE episodes in a porcine model.
    METHODS: This was a randomized, controlled, blinded study of repeated measurements. Twelve pigs were randomly assigned to receive sham procedures or consecutive PEs every 15 min until doubling of mean pulmonary pressure. Cardiopulmonary assessments were conducted at 1, 2, 5, and 13 min after each PE using pressure-volume loops, invasive pressures, and arterial and mixed venous blood gas analyses. ANOVA and mixed-model statistical analyses were applied.
    RESULTS: Pulmonary pressures increased after the initial PE administration (p < 0.0001), with a higher pulmonary pressure change compared to pressure change observed after the following PEs. Conversely, RV arterial elastance and pulmonary vascular resistance was not increased after the first PE, but after three PEs an increase was observed (p = 0.0103 and p = 0.0015, respectively). RV dilatation occurred following initial PEs, while RV ejection fraction declined after the third PE (p = 0.004). RV coupling exhibited a decreasing trend from the first PE (p = 0.095), despite increased mechanical work (p = 0.003). Ventilatory variables displayed more incremental changes with successive PEs.
    CONCLUSIONS: In an experimental model of consecutive PE, RV afterload elevation and dysfunction manifested after the third PE, in contrast to pulmonary pressure that increased after the first PE. Ventilatory variables exhibited a more direct association with clot burden.
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  • 文章类型: Journal Article
    目的:这项研究的目的是1)研究上皮下结缔组织移植物(SCTG)和体积稳定的胶原基质(VCMX)对立即植入物植入方案中软组织体积增加的影响,和2)以确定聚脱氧核糖核苷酸(PDRN)是否可以增强VCMX的作用。
    方法:在拔除其第三和第四下颌前磨牙的远根后,立即将牙科植入物放置在4只杂种犬中。植入物和颊骨板之间的间隙填充有合成骨替代颗粒。口腔应用以下软组织增强方式:1)对照(无增强),2)SCTG,3)VCMX,和4)VCMX/PDRN。4个月后,进行了组织形态计量学分析.使用叠加的标准镶嵌语言(STL)文件评估组织变化。
    结果:在超过一半的测试组中发现伤口裂开,但两组均成功实现二次伤口愈合。从组织形态上看,在植入平台水平(IP)或以上的SCTG组中,组织厚度较好,SCTG组和VCMX组的IP以下组织厚度相似。然而,各组间厚度的差异很小.VCMX/PDRN组的角化组织高度大于SCTG和VCMX组。叠加STL文件显示所有组的软组织体积减少。
    结论:软组织体积增大后的伤口裂开可能不利于获得预期的结果。PDRN似乎对软组织体积增加没有积极影响。
    OBJECTIVE: The aims of this study were 1) to investigate the effects of a subepithelial connective tissue graft (SCTG) and a volume-stable collagen matrix (VCMX) on soft-tissue volume gain in the immediate implant placement protocol, and 2) to determine whether polydeoxyribonucleotide (PDRN) can enhance the effects of a VCMX.
    METHODS: Dental implants were placed in 4 mongrel dogs immediately after extracting the distal roots of their third and fourth mandibular premolars. The gap between the implant and the buccal bone plate was filled with synthetic bone substitute particles. The following soft-tissue augmentation modalities were applied buccally: 1) control (no augmentation), 2) SCTG, 3) VCMX, and 4) VCMX/PDRN. After 4 months, histomorphometric analysis was performed. Tissue changes were evaluated using superimposed standard tessellation language (STL) files.
    RESULTS: Wound dehiscence was found in more than half of the test groups, but secondary wound healing was successfully achieved in all groups. Histomorphometrically, tissue thickness was favored in group SCTG at or above the implant platform level (IP), and group SCTG and the groups with VCMX presented similar tissue thickness below the IP. However, the differences in such thickness among the groups were minor. The keratinized tissue height was greater in group VCMX/PDRN than in groups SCTG and VCMX. Superimposing the STL files revealed a decrease in soft-tissue volume in all groups.
    CONCLUSIONS: Wound dehiscence after soft-tissue volume augmentation might be detrimental to obtaining the expected outcomes. PDRN appears not to have a positive effect on the soft-tissue volume gain.
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  • 文章类型: Journal Article
    近年来抗生素的过度使用越来越多,导致抗生素成为儿科患者处方最多的药物,新生儿重症监护病房72%的病人接受抗生素治疗。抗生素使用的一个影响是微生物群的改变,这与代谢紊乱有关,包括肥胖.
    这项新生大鼠的实验研究比较了每12小时100/10μg/g的氨苄西林/美罗培南(访问/观察组)的给药,头孢噻肟每24小时200μg/g(观察组),每24小时服用阿米卡星15μg/g(进入组),以盐溶液为对照。每种抗生素根据体重调整到所需的剂量,每天对10-14只新生雄性大鼠进行腹膜内给药,持续5天。使用ANOVA对第28天记录的形态测量和生化参数进行比较。
    阿米卡星对形态测量的影响最大,低密度脂蛋白胆固醇,头孢噻肟对葡萄糖和甘油三酯的影响最大,而氨苄青霉素/美罗培南对测量参数的影响最弱。
    在新生期施用抗生素会影响大鼠的身体成分以及脂质和碳水化合物血清水平。未来的研究应评估抗生素在未成熟新生儿器官中的毒性,并可能有助于改善治疗决策并防止新生儿不合理使用抗生素,从而减少代谢后果。
    UNASSIGNED: The increasing overuse of antibiotics in recent years has led to antibiotics being the most prescribed drugs for pediatric patients, and 72% of patients in the neonatal intensive care unit are treated with antibiotics. One effect of antibiotic use is the alteration of the microbiota, which is associated with metabolic disorders, including obesity.
    UNASSIGNED: This experimental study in newborn rats compared the administration of ampicillin/meropenem (Access/Watch groups) at 100/10 μg/g every 12 h, cefotaxime 200 μg/g every 24 h (Watch group), and amikacin 15 μg/g every 24 h (Access group) versus saline solution as the control. Each antibiotic was adjusted to the required dosages based on weight, and the doses were administered intraperitoneally daily for 5 days to 10-14 newborn male rats per group. A comparison of the morphometric and biochemical parameters registered on day 28 was performed using ANOVA.
    UNASSIGNED: Amikacin had the largest effect on morphometric measurements, and low-density lipoprotein cholesterol, while cefotaxime had the largest effect on glucose and triglycerides, whereas ampicillin/meropenem produced the weakest effect on the measured parameters.
    UNASSIGNED: The administration of antibiotics in the neonatal stage can affect the body composition of rats as well as the lipid and carbohydrate serum levels. Future studies should evaluate the toxicity of antibiotics in immature neonatal organs and could help to improve therapeutic decisions and prevent the unjustified use of antibiotics in newborns, thereby reducing metabolic consequences.
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  • 文章类型: Journal Article
    背景:诊断由阿尔茨海默病(AD)或可能的轻度AD痴呆引起的轻度认知障碍(MCI)的主要标准部分依赖于认知评估和淀粉样斑块的存在。尽管这些标准在认知障碍患者中预测AD方面表现出很高的敏感性,它们的特异性仍然有限。值得注意的是,高达25%的非痴呆淀粉样斑块患者可能因AD而误诊为MCI,事实上,他们患有不同的大脑疾病。抗淀粉样蛋白抗体的引入使这种情况复杂化。医生必须优先考虑哪些淀粉样蛋白阳性MCI患者接受这些治疗,因为并非所有人都是合适的候选人。具体来说,患有非AD淀粉样蛋白病理的患者不是淀粉样蛋白修饰疗法的主要目标。因此,对于可以准确检测痴呆前AD的高度特异性血液生物标志物,从而优化淀粉样蛋白抗体处方。
    目的:本研究的目的是评估基于外周生物标志物的预测模型,以识别MCI和轻度痴呆患者,这些患者将在认知障碍人群中以高特异性出现AD痴呆症状。
    方法:在基于基因转移的AD动物模型中鉴定外周生物标志物,然后在回顾性多中心临床研究中进行验证。
    方法:来自7个回顾性队列的参与者(美国,欧盟和澳大利亚)。
    方法:这项研究追踪了345名认知障碍个体,长达13年,包括193名MCI患者和152名轻度痴呆症患者,从他们最初的访问开始。最后的诊断,在他们上次评估中建立的,将249名参与者分类为AD患者,96名为非AD脑部疾病,根据每种疾病亚型的具体诊断标准。淀粉样蛋白状态,在基线评估,82.9%的参与者可以使用,61.9%的淀粉样蛋白检测呈阳性。每个临床组中都有淀粉样蛋白阳性和阴性个体。一些AD患者有合并症,如代谢紊乱,慢性疾病,或心血管疾病。
    方法:我们开发了81种血液生物标志物的靶向质谱检测方法,包括先前在AAV-AD大鼠中鉴定的45种蛋白质和36种代谢物。
    方法:我们分析了研究参与者的血液样本中的81种生物标志物。B-HEALED测试,基于机器学习的诊断工具,被开发来区分AD患者,包括123例前驱性AD和126例轻度AD痴呆,来自96名患有非AD脑部疾病的个体。该模型使用70%的数据进行了训练,选择相关的生物标志物,校准算法,并建立截止值。剩余的30%用作外部测试数据集,用于预测准确性的盲验证。
    结果:整合了19种血液生物标志物和参与者年龄的组合,B-HEALED模型成功区分了将发展为AD痴呆症状的参与者(82名患有前驱AD,83名患有AD痴呆)与非AD受试者(71名个体)的特异性为93.0%,敏感性为65.4%(AUROC=81.9%,p<0.001)在内部验证期间。当淀粉样蛋白状态(来自CSF或PET扫描)和B-HEALED模型联合应用时,如果两个测试都呈阳性,则将个人归类为AD,我们实现了100%的特异性和52.8%的敏感性.这种性能在盲外部验证中是一致的,在独立数据集上强调模型的可靠性。
    结论:B-HEALED测试,利用基于血液的生物标志物,在识别认知障碍人群中的AD患者方面表现出高预测特异性,尽量减少误报。当与淀粉样蛋白筛查一起使用时,它有效地识别了一个几乎纯的前驱AD队列。这些结果对完善临床试验纳入标准具有重要意义。促进药物开发和验证,并准确识别将从疾病改善性AD治疗中受益最大的患者。
    The primary criteria for diagnosing mild cognitive impairment (MCI) due to Alzheimer\'s Disease (AD) or probable mild AD dementia rely partly on cognitive assessments and the presence of amyloid plaques. Although these criteria exhibit high sensitivity in predicting AD among cognitively impaired patients, their specificity remains limited. Notably, up to 25% of non-demented patients with amyloid plaques may be misdiagnosed with MCI due to AD, when in fact they suffer from a different brain disorder. The introduction of anti-amyloid antibodies complicates this scenario. Physicians must prioritize which amyloid-positive MCI patients receive these treatments, as not all are suitable candidates. Specifically, those with non-AD amyloid pathologies are not primary targets for amyloid-modifying therapies. Consequently, there is an escalating medical necessity for highly specific blood biomarkers that can accurately detect pre-dementia AD, thus optimizing amyloid antibody prescription.
    The objective of this study was to evaluate a predictive model based on peripheral biomarkers to identify MCI and mild dementia patients who will develop AD dementia symptoms in cognitively impaired population with high specificity.
    Peripheral biomarkers were identified in a gene transfer-based animal model of AD and then validated during a retrospective multi-center clinical study.
    Participants from 7 retrospective cohorts (US, EU and Australia).
    This study followed 345 cognitively impaired individuals over up to 13 years, including 193 with MCI and 152 with mild dementia, starting from their initial visits. The final diagnoses, established during their last assessments, classified 249 participants as AD patients and 96 as having non-AD brain disorders, based on the specific diagnostic criteria for each disorder subtype. Amyloid status, assessed at baseline, was available for 82.9% of the participants, with 61.9% testing positive for amyloid. Both amyloid-positive and negative individuals were represented in each clinical group. Some of the AD patients had co-morbidities such as metabolic disorders, chronic diseases, or cardiovascular pathologies.
    We developed targeted mass spectrometry assays for 81 blood-based biomarkers, encompassing 45 proteins and 36 metabolites previously identified in AAV-AD rats.
    We analyzed blood samples from study participants for the 81 biomarkers. The B-HEALED test, a machine learning-based diagnostic tool, was developed to differentiate AD patients, including 123 with Prodromal AD and 126 with mild AD dementia, from 96 individuals with non-AD brain disorders. The model was trained using 70% of the data, selecting relevant biomarkers, calibrating the algorithm, and establishing cutoff values. The remaining 30% served as an external test dataset for blind validation of the predictive accuracy.
    Integrating a combination of 19 blood biomarkers and participant age, the B-HEALED model successfully distinguished participants that will develop AD dementia symptoms (82 with Prodromal AD and 83 with AD dementia) from non-AD subjects (71 individuals) with a specificity of 93.0% and sensitivity of 65.4% (AUROC=81.9%, p<0.001) during internal validation. When the amyloid status (derived from CSF or PET scans) and the B-HEALED model were applied in association, with individuals being categorized as AD if they tested positive in both tests, we achieved 100% specificity and 52.8% sensitivity. This performance was consistent in blind external validation, underscoring the model\'s reliability on independent datasets.
    The B-HEALED test, utilizing multiomics blood-based biomarkers, demonstrates high predictive specificity in identifying AD patients within the cognitively impaired population, minimizing false positives. When used alongside amyloid screening, it effectively identifies a nearly pure prodromal AD cohort. These results bear significant implications for refining clinical trial inclusion criteria, facilitating drug development and validation, and accurately identifying patients who will benefit the most from disease-modifying AD treatments.
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