inflammatory mediators

炎症介质
  • 文章类型: Journal Article
    变应性鼻炎(AR)是一种常见的鼻黏膜炎症性疾病,由过敏原暴露引发,并以打喷嚏等症状为特征,鼻塞,瘙痒,还有鼻漏.这篇全面的综述旨在解开支撑AR的分子机制,探索从过敏原识别到慢性炎症和组织重塑的发病机制。该疾病的核心是免疫球蛋白E(IgE)介导的超敏反应,涉及关键的炎症介质和细胞参与者,如肥大细胞,嗜酸性粒细胞,和T细胞。遗传易感性和环境因素在易感性和疾病进展中也起着重要作用。AR的治疗策略多种多样,从通过抗组胺药和鼻用糖皮质激素缓解症状到更有针对性的方法,如过敏原特异性免疫疗法。新兴的治疗集中在新的分子途径,越来越重视个性化医疗以优化患者预后。尽管取得了进步,在充分理解AR的异质性和开发普遍有效的治疗方法方面仍然存在挑战。这篇综述综合了当前的知识,强调对AR的分子基础及其对临床实践的意义的关键见解。它强调了整合的必要性,多学科方法来提高治疗效果,并呼吁正在进行的研究,以解决尚未解决的问题,并探索AR管理的新领域。通过这种全面的综合,这篇综述旨在为未来的研究和临床策略提供信息和启发,最终改善受AR影响的个体的生活质量。
    Allergic rhinitis (AR) is a prevalent inflammatory disorder of the nasal mucosa, triggered by allergen exposure and characterized by symptoms such as sneezing, nasal congestion, itching, and rhinorrhea. This comprehensive review aims to unravel the molecular mechanisms underpinning AR, exploring the pathogenesis from allergen recognition to chronic inflammation and tissue remodelling. Central to the disease are immunoglobulin E (IgE)-mediated hypersensitivity reactions, involving key inflammatory mediators and cellular players such as mast cells, eosinophils, and T cells. Genetic predisposition and environmental factors also play significant roles in susceptibility and disease progression. Therapeutic strategies for AR are varied, ranging from symptomatic relief through antihistamines and nasal corticosteroids to more targeted approaches like allergen-specific immunotherapy. Emerging treatments focus on novel molecular pathways, with a growing emphasis on personalized medicine to optimize patient outcomes. Despite advancements, challenges remain in fully understanding the heterogeneity of AR and developing universally effective treatments. This review synthesizes current knowledge, highlighting critical insights into the molecular basis of AR and their implications for clinical practice. It underscores the need for integrated, multidisciplinary approaches to enhance therapeutic efficacy and calls for ongoing research to address unresolved questions and explore new frontiers in AR management. Through this comprehensive synthesis, the review aims to inform and inspire future research and clinical strategies, ultimately improving the quality of life for individuals affected by AR.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    本研究旨在探讨循环炎症因子CRP水平,基于IL-6、IL-10和TNF-α的文献综述。这项研究还使用荟萃分析研究了单核苷酸多态性(SNP)位点对腹主动脉瘤(AAA)易感性的影响,并旨在提供有关AAA研究发病机理的其他信息。
    系统搜索了包括PubMed和WebofScience在内的电子数据库,以收集有关AAA的信息,炎症因子,如CRP,用于数据提取的IL-6、IL-10、TNF-α和SNP位点。总共评估了四个基因中的六个SNP(rs3091244,CRP;rs1800947,CRP;rs1205,CRP;rs1800795,IL-6;rs1800896,IL-10;和rs1800629,TNF)。
    本研究共纳入41项相关调查,涉及9,007例AAA患者进行荟萃分析。根据汇总分析,循环CRP和IL-6水平显示与AAA相关,而血浆IL-10和TNF-α水平与AAA无关。循环CRP水平标准均差(SMD)为0.30(95%置信区间(CI):0.17-0.43),IL-6水平SMD为0.34(95%CI:0.20-0.49),IL-10水平SMD为-0.01(95%CI:-0.09-0.06),TNF-α水平SMD为0.09(95%CI:0.00-0.19)。同样,rs3091244(CRP)在隐性基因模型下的比值比(OR)为1.70(95%CI:1.13-2.57)。此外,在rs3091244位点具有A和T突变基因的个体可能比具有C等位基因的个体具有更高的AAA易感性趋势。连续,等位基因模型中rs1800795(IL-6)基因座的OR为0.91(95%CI:0.51-0.97),与具有C等位基因的个体相比,在rs1800795(IL-6)基因座具有G突变基因的个体对AAA的敏感性较低。同时,rs1800896(IL-10)位点在五个统计模型下呈正相关,并且在rs1800896位点具有A突变基因的个体对AAA的易感性可能高于具有G等位基因的个体。然而,rs1800947(CRP),rs1205(CRP),和rs1800629(TNF)位点在5个统计模型下不存在正相关,没有统计学意义。结果表明,rs1800629,rs1800947和rs1205位点的基因多态性与AAA易感性无关。
    某些已知的与AAA易感性相关的炎症介质中的基因多态性可能作为临床应用的潜在预测生物标志物。此外,与腹主动脉瘤形成和进展相关的炎症介质的SNP需要广泛的研究来证实这些结果。
    UNASSIGNED: This study aimed to explore the levels of circulating inflammatory factors CRP, IL-6, IL-10 and TNF- α based on the literature review. This study also examined the influence of single nucleotide polymorphism (SNP) sites on the susceptibility of abdominal aortic aneurysm (AAA) using meta-analysis and intended to provide additional information on pathogenesis of AAA research.
    UNASSIGNED: Electronic databases including PubMed and Web of Science were systemically searched to collect the information on AAA, inflammatory factors such as CRP, IL-6, IL-10, TNF- α and the SNP sites for data extraction. Altogether six SNPs in four genes (rs3091244, CRP; rs1800947, CRP; rs1205, CRP; rs1800795, IL-6; rs1800896, IL-10; and rs1800629, TNF) were assessed.
    UNASSIGNED: This study enrolled altogether 41 relevant investigations involving 9,007 AAA patients to carry out meta-analysis. According to pooled analysis, circulating CRP and IL-6 levels were shown to be related to the AAA, while plasma IL-10 and TNF- α levels were not associated with AAA. The circulating CRP level standard mean difference (SMD) was 0.30 (95% confidence interval (CI): 0.17-0.43), the IL-6 level SMD was 0.34 (95% CI: 0.20-0.49), the IL-10 level SMD was -0.01 (95% CI: -0.09-0.06), and the TNF- α level SMD was 0.09 (95% CI: 0.00-0.19). Similarly, the odds ratio (OR) of rs3091244 (CRP) under the recessive gene model was 1.70 (95% CI: 1.13-2.57). In addition, individuals with A and T mutant genes at locus rs3091244 might have a higher tendency of AAA susceptibility than those with C allele. Consecutively, the OR was 0.91 (95% CI: 0.51-0.97) for rs1800795 (IL-6) locus in the allele model, and individuals with G mutant gene at locus rs1800795 (IL-6) might be less susceptible to AAA than those with C allele. Meanwhile, the rs1800896 (IL-10) locus had a positive association under the five statistical models, and individuals with A mutant gene at locus rs1800896 might have a higher susceptibility to AAA than those with G allele. Nevertheless, the rs1800947 (CRP), rs1205 (CRP), and rs1800629 (TNF) loci did not have positive correlation under the five statistical models, with no statistical significance. The results indicate that the gene polymorphisms at rs1800629, rs1800947, and rs1205 loci were not related to the AAA susceptibility.
    UNASSIGNED: Gene polymorphisms in certain known inflammatory mediators related to AAA susceptibility might serve as potential predictive biomarkers for clinical applications. Moreover, SNP of inflammatory mediators relevant to abdominal aortic aneurysmal formation and progression need extensive investigations to confirm these results.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    钩藤(威尔德。前Schult.)DC。(Rubiaceae)传统上被亚马逊土著群体用来治疗炎症性疾病。迄今为止,目前还没有系统评价和荟萃分析,以支持有关该物种的传统知识,对使用绒毛膜孢菌控制动物炎症进行研究.进行这项研究是为了评估毛霉素提取物在调节炎症介质中的作用,并确定该物种可以治疗哪种类型的炎性疾病。
    我们对2023年7月26日之前发表的临床前研究进行了系统评价和荟萃分析,Embase,还有Scopus.四名独立审稿人提取了数据并评估了偏见的风险。从研究中提取了绒毛膜下对炎性疾病的影响以及所涉及的炎症介质。估计结果的标准化平均差异(SMD)和95%置信区间(95CI)。荟萃分析使用RevMan5.4(CochraneCollaboration)进行。该协议在PROSPERO(CRD42023450869)中注册。
    纳入了523项研究中的24项。绒毛乳杆菌提取物降低细胞因子白细胞介素(IL)-6(SMD:-0.72,95CI:-1.15,-0.29,p=0.001)和转录因子核因子κB(NF-κB)(SMD:-1.19,95CI:-1.89,-0.48,p=0.001)。然而,提取物没有显著改变IL-1(SMD:-0.16,95CI:-0.87,+0.56,p=0.67),IL-10(SMD:-0.05,95CI:-0.35,0.45,p=0.80),或肿瘤坏死因子-α(TNF-α)水平(SMD:0.18,95CI:-0.25,0.62,p=0.41)。
    许多茎皮提取物,根,和毛霉的叶子,主要是水性和乙醇,表现出抗炎和/或免疫调节活性和低毒性。提取物降低NF-κB和IL-6。这些发现表明,该物种具有治疗这些标志物增加的炎症性疾病的潜力,根据民族药理学使用。这些活性与特定类别的化合物无关。
    系统审查注册:https://www。crd.约克。AC.uk/prospro/display_record.php?RecordID=450869,标识符CRD42023450869。
    UNASSIGNED: Uncaria tomentosa (Willd. ex Schult.) DC. (Rubiaceae) is traditionally used by Amazonian indigenous groups to treat inflammatory diseases. To date, there are no systematic reviews and meta-analyses on the use of U. tomentosa for inflammation control in animals supporting the traditional knowledge about this species. This study was conducted to evaluate the effect of U. tomentosa extracts in modulating inflammatory mediators and to determine which types of inflammatory diseases can be treated by this species.
    UNASSIGNED: We conducted a systematic review and meta-analysis of preclinical studies published before 26 July 2023, identified in PubMed, Embase, and Scopus. Four independent reviewers extracted the data and assessed the risks of bias. The effects of U. tomentosa on inflammatory diseases and the inflammatory mediators involved were extracted from the studies. Standardized mean differences (SMD) and 95% confidence intervals (95%CI) of the outcomes were estimated. The meta-analyses were conducted using RevMan 5.4 (Cochrane Collaboration). This protocol was registered in PROSPERO (CRD42023450869).
    UNASSIGNED: Twenty-four of 523 studies were included. U. tomentosa extracts decreased the cytokines interleukin (IL)-6 (SMD: -0.72, 95%CI: -1.15, -0.29, p = 0.001) and transcription factor nuclear factor kappa-B (NF-κB) (SMD: -1.19, 95%CI: -1.89, -0.48, p = 0.001). However, the extracts did not significantly alter IL-1 (SMD: -0.16, 95%CI: -0.87, +0.56, p = 0.67), IL-10 (SMD: -0.05, 95%CI:-0.35, 0.45, p = 0.80), or tumor necrosis factor-alpha (TNF-α) levels (SMD: 0.18, 95%CI: -0.25, 0.62, p = 0.41).
    UNASSIGNED: Many extracts of stem bark, roots, and leaves of U. tomentosa, mostly aqueous and hydroethanolic, exhibited anti-inflammatory and/or immunomodulatory activities and low toxicity. The extracts decreased NF-κB and IL-6. These findings suggest that this species has the potential to treat inflammatory diseases in which these markers are increased, according to the ethnopharmacological use. These activities are not related to a specific class of compounds.
    Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=450869, Identifier CRD42023450869.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    皮质播散性抑制(CSD)是与偏头痛密切相关的皮质去极化慢波,具有先兆。以前,人们认为CSD去极化主要由神经元驱动,伴有神经元肿胀的特征性变化,细胞外钾(K)和谷氨酸增加。然而,星形胶质细胞的作用,神经血管单元的成员,最近,CSD在偏头痛中受到越来越多的关注。在CSD的早期阶段,星形胶质细胞为神经元提供能量支持,并从突触间隙清除K+和谷氨酸。然而,在CSD的后期,当能量需求超过星形胶质细胞的代偿能力时,星形胶质细胞释放大量乳酸加剧缺氧。星形胶质细胞性足肿胀是CSD的特征,和神经元没有类似的改变。它主要是由于K+流入和异常活性钙(Ca2+)信号传导。水通道蛋白4(AQP-4)仅介导钾流入,几乎没有水通道蛋白的作用。星形胶质细胞足内膜肿胀导致血管周围间隙闭合,减缓淋巴系统的流动并加剧神经炎症,导致持续的CSD。星形胶质细胞是CSD偏头痛的双刃剑,可能是CSD干预的潜在目标。
    Cortical spreading depression (CSD) is a slow wave of cortical depolarization closely associated with migraines with an aura. Previously, it was thought that CSD depolarization was mainly driven by neurons, with characteristic changes in neuronal swelling and increased extracellular potassium (K+) and glutamate. However, the role of astrocytes, a member of the neurovascular unit, in migraine with CSD has recently received increasing attention. In the early stages of CSD, astrocytes provide neurons with energy support and clear K+ and glutamate from synaptic gaps. However, in the late stages of CSD, astrocytes release large amounts of lactic acid to exacerbate hypoxia when the energy demand exceeds the astrocytes\' compensatory capacity. Astrocyte endfoot swelling is a characteristic of CSD, and neurons are not similarly altered. It is primarily due to K+ influx and abnormally active calcium (Ca2+) signaling. Aquaporin 4 (AQP-4) only mediates K+ influx and has little role as an aquaporin. Astrocytes endfoot swelling causes perivascular space closure, slowing the glymphatic system flow and exacerbating neuroinflammation, leading to persistent CSD. Astrocytes are double-edged swords in migraine with CSD and may be potential targets for CSD interventions.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    炎症是一种可能由微生物引起的机体的保护性反应,病毒,或真菌感染,组织损伤,甚至自身免疫反应。炎症的主要症状是免疫学的后果,生物化学,以及在损伤部位局部引发促炎化学介质释放的生理变化,增加血流量,血管通透性,和白细胞募集。这项研究的目的是对炎症过程进行概述,专注于化学介质。文献综述是基于对2009年至2023年之间发表的期刊的搜索,关于主要化学介质在炎症过程中的作用以及目前在发病机理中的研究。诊断,和治疗。炎症病理及其介质研究中的一些最新贡献,包括细胞因子和趋化因子,Kinin系统,自由基,一氧化氮,组胺,细胞粘附分子,白三烯,前列腺素和补体系统及其在人类健康和慢性疾病中的作用。
    Inflammation is a protective response of the body potentially caused by microbial, viral, or fungal infections, tissue damage, or even autoimmune reactions. The cardinal signs of inflammation are consequences of immunological, biochemical, and physiological changes that trigger the release of pro-inflammatory chemical mediators at the local of the injured site thus, increasing blood flow, vascular permeability, and leukocyte recruitment. The aim of this study is to give an overview of the inflammatory process, focusing on chemical mediators. The literature review was based on a search of journals published between the years 2009 and 2023, regarding the role of major chemical mediators in the inflammatory process and current studies in pathogenesis, diagnosis, and therapy. Some of the recent contributions in the study of inflammatory pathologies and their mediators, including cytokines and chemokines, the kinin system, free radicals, nitric oxide, histamine, cell adhesion molecules, leukotrienes, prostaglandins and the complement system and their role in human health and chronic diseases.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    由于多重耐药微生物的出现,开发新型抗微生物剂来代替抗生素已变得紧迫。抗菌肽(AMP),广泛分布在生活的各个王国,对各种细菌具有很强的抗菌活性,真菌,寄生虫,和病毒。AMP作为抗生素的新替代品的潜力已逐渐引起相当大的兴趣。此外,AMP具有很强的抗癌潜力以及抗炎和免疫调节活性。许多研究提供了证据,表明AMP可以招募和激活免疫细胞,控制炎症。这篇综述重点介绍了有关免疫细胞中不同AMP抗炎机制的证据的科学文献。包括巨噬细胞,单核细胞,淋巴细胞,肥大细胞,树突状细胞,中性粒细胞,和嗜酸性粒细胞.多种免疫调节特性,包括激活和分化免疫细胞的能力,改变炎症介质的含量和表达,并调节特定的细胞功能和炎症相关的信号通路,进行了详细的总结和讨论。本综述有助于更好地了解AMPs在免疫系统调节中的作用,并为AMPs作为新型抗炎药物用于治疗各种炎症性疾病提供参考。
    The development of novel antimicrobial agents to replace antibiotics has become urgent due to the emergence of multidrug-resistant microorganisms. Antimicrobial peptides (AMPs), widely distributed in all kingdoms of life, present strong antimicrobial activity against a variety of bacteria, fungi, parasites, and viruses. The potential of AMPs as new alternatives to antibiotics has gradually attracted considerable interest. In addition, AMPs exhibit strong anticancer potential as well as anti-inflammatory and immunomodulatory activity. Many studies have provided evidence that AMPs can recruit and activate immune cells, controlling inflammation. This review highlights the scientific literature focusing on evidence for the anti-inflammatory mechanisms of different AMPs in immune cells, including macrophages, monocytes, lymphocytes, mast cells, dendritic cells, neutrophils, and eosinophils. A variety of immunomodulatory characteristics, including the abilities to activate and differentiate immune cells, change the content and expression of inflammatory mediators, and regulate specific cellular functions and inflammation-related signaling pathways, are summarized and discussed in detail. This comprehensive review contributes to a better understanding of the role of AMPs in the regulation of the immune system and provides a reference for the use of AMPs as novel anti-inflammatory drugs for the treatment of various inflammatory diseases.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    肿瘤不是与生物体分离存在的;它们的生长,扩散,运动性,免疫抑制反应与肿瘤的微环境密切相关。随着肿瘤细胞和微环境共同进化,炎症微环境随之而来,推动炎症-癌症转化现象-现代医学提出的想法。这篇综述旨在囊括肿瘤炎症微环境中的一系列代表性因素,如白细胞介素(IL-6,IL-10,IL-17,IL-1β),转化生长因子-β(TGF-β),干扰素-γ(IFN-γ),肿瘤坏死因子-α(TNF-α),血管内皮生长因子(VEGF),和基质金属蛋白酶(MMPs)。此外,借鉴中医和药理学研究,我们探索了这些因素与肿瘤相关炎症细胞之间的微妙相互作用:肿瘤相关巨噬细胞(TAMs),骨髓来源的抑制细胞(MDSCs),肿瘤相关中性粒细胞(TAN)和树突状细胞(DC)。通过分析这些实体的肿瘤促进作用,我们深入研究了童小林院士的“状态-目标分化”新模型的内涵及其在肿瘤诊断和治疗中的应用。我们的目标是在临床实践中提高肿瘤治疗的准确性和针对性。通过现代医学的视角,深入研究我们对肿瘤发病机理的理解,我们在肿瘤的整个发育阶段发现了关键的病因和发病机制,揭示了中医(CM)的进化模式:热态→痰态→停滞态→虚态。在这个基础上,我们设计了一个状态调节公式。同时,借鉴中药药理研究,我们精心鉴定了一系列有效调节上述肿瘤相关介质的靶向药物.这种综合策略——国家认同的和谐整合,目标识别,同时调节-旨在提高临床疗效。中医与西医在肿瘤治疗中的融合为中医在临床实践中的精确和精细应用引入了新的维度。
    Tumours do not exist in isolation from the organism; their growth, proliferation, motility, and immunosuppressive response are intricately connected to the tumour\'s microenvironment. As tumour cells and the microenvironment coevolve, an inflammatory microenvironment ensues, propelling the phenomenon of inflammation-cancer transformation-an idea proposed by modern medicine. This review aims to encapsulate the array of representative factors within the tumour\'s inflammatory microenvironment, such as interleukins (IL-6, IL-10, IL-17, IL-1β), transforming growth factor-beta (TGF-β), interferon-gamma (IFN-γ), tumour necrosis factor-alpha (TNF-α), vascular endothelial growth factor (VEGF), and matrix metalloproteinases (MMPs). Moreover, drawing upon research in traditional Chinese medicine (TCM) and pharmacology, we explore the delicate interplay between these factors and tumour-associated inflammatory cells: tumour-associated macrophages (TAMs), myeloid-derived suppressor cells (MDSCs), tumour-associated neutrophils (TANs) and dendritic cells (DCs). By analyzing the tumour-promoting effects of these entities, we delve into the connotations of Academician Tong Xiao-lin\'s novel model of \"state-target differentiation\" and its application in the diagnosis and treatment of tumours. Our aim is to enhance the precision and targeting of tumour treatment in clinical practice. Delving deeper into our understanding of tumour pathogenesis through the lens of modern medicine, we discern the key etiology and pathogenesis throughout the entire developmental stage of tumours, unveiling the evolutionary patterns of Chinese Medicine (CM) states: heat state → phlegm state → stagnation state → deficiency state. Building upon this foundation, we devised a state-regulating formula. Simultaneously, drawing on pharmacological research in traditional Chinese medicine (TCM), we meticulously identified a range of targeted drugs that effectively modulate the aforementioned tumour-related mediators. This comprehensive strategy-a harmonious integration of state identification, target recognition, and simultaneous regulation-aims to elevate clinical efficacy. The fusion of TCM with Western medicine in tumour treatment introduces novel dimensions to the precise and refined application of TCM in clinical practice.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    牙周病是牙齿支撑装置的多微生物感染,表现为临床附着丧失和牙槽骨丧失。由于牙周病的慢性炎症状态,文献中已经提出了牙周病与全身性疾病之间的关联。不良妊娠结局也不例外.由于牙周病原体的入侵,可能会发生一系列影响胎儿胎盘单元安全性的全身性炎症和免疫事件.怀孕期间的生理激素和代谢波动可能会进一步加剧这种情况。这不仅会对妊娠期产生负面影响,从而导致早产低体重,而且还会通过先兆子痫和妊娠糖尿病使妊娠复杂化。这篇叙述性综述文章旨在提供与牙周病之间关系相关的现有证据的摘要。相关的牙周病原体和由促炎细胞因子和前列腺素介导的毒力机制,和不良妊娠结局。此外,本文重点介绍了一些有关牙周治疗干预和妊娠结局影响的文献.
    Periodontal disease is a multi-microbial infection of the teeth-supporting apparatus that manifests as clinical attachment loss and alveolar bone loss. The association between periodontal disease and systemic diseases has been proposed in the literature owing to the former\'s chronic state of inflammation, and adverse pregnancy outcomes are no exception. As a result of periodontal pathogen invasion, a series of systemic inflammatory and immunologic events affecting the safety of the fetoplacental unit may unfold. This may be further exaggerated by physiologic hormonal and metabolic fluctuations during pregnancy. This can not only negatively affect the gestation period and consequently cause preterm low weight but also complicate the pregnancy via preeclampsia and gestational diabetes. This narrative review article aims to provide a summary of relevant available evidence pertinent to the relationship between periodontal diseases, associated periodontal pathogens and virulence mechanisms mediated by pro-inflammatory cytokines and prostaglandins, and adverse pregnancy outcomes. Furthermore, this article highlights some of the literature addressing the impact of periodontal therapy interventions and pregnancy outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    由于其难以捉摸的病理生理机制和新变体的不断涌现,COVID-19已经前所未有地影响了世界,并将继续广泛流行。患有COVID-19的重症患者通常与细胞因子风暴有关,多器官功能障碍,和高死亡率。迄今为止,越来越多的证据表明,体外血液吸附可以通过调节免疫稳态来发挥其对护理标准的辅助作用,减少病毒血症,并降低重症COVID-19患者的内毒素活性。然而,各种血液过滤器的选择,开始和终止血液吸收疗法的时机,体外回路的抗凝管理,目标亚组的识别,最终的生存利益仍然存在争议。这篇叙述性综述的目的是全面总结COVID-19危重患者使用血液吸附的基本原理,并收集该领域的最新临床证据。
    COVID-19 has been affecting the world unprecedentedly and will remain widely prevalent due to its elusive pathophysiological mechanism and the continuous emergence of new variants. Critically ill patients with COVID-19 are commonly associated with cytokine storm, multiple organ dysfunction, and high mortality. To date, growing evidence has shown that extracorporeal hemoadsorption can exert its adjuvant effect to standard of care by regulating immune homeostasis, reducing viremia, and decreasing endotoxin activity in critically ill COVID-19 cases. However, the selection of various hemofilters, timing of initiation and termination of hemoadsorption therapy, anticoagulation management of extracorporeal circuits, identification of target subgroups, and ultimate survival benefit remain controversial. The purpose of this narrative review is to comprehensively summarize the rationale for the use of hemoadsorption in critically ill patients with COVID-19 and to gather the latest clinical evidence in this field.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    类风湿性关节炎(RA)是一种慢性炎症性关节病,可引起软骨和骨骼损伤以及残疾。各种细胞因子在疾病形成中起重要作用,如肿瘤坏死因子(TNF)-α,白细胞介素(IL)-1,IL-6,IL-17和巨噬细胞;破骨细胞也被细胞因子激活,导致骨骼退化。早期诊断是最佳治疗成功的关键,特别是在具有良好特征的不良预后风险因素的患者中,例如高疾病活动度,自身抗体的存在,和早期关节损伤。治疗算法涉及用综合指数测量疾病活动,应用治疗对目标的策略,使用常规的,生物,和新的非生物疾病缓解抗风湿药。在维持严格缓解(或至少低疾病活动性)的治疗目标后,应尝试减少剂量。尽管现在大多数患者的前景都很好,许多人仍然对目前的治疗没有反应。在过去的几十年里,生物制剂改变了疾病的进展,如TNF-α抑制剂(英夫利昔单抗,依那西普,阿达木单抗,戈利木单抗,certolizumab),IL-1抑制剂(anakinra),IL-6抑制剂(托珠单抗),CD20抑制剂(利妥昔单抗),和细胞毒性T淋巴细胞相关抗原(CTLA)-4抑制剂(abatacept)。在生物制剂治疗中,在强化生物治疗后持续缓解的患者中,“无生物”缓解是否可能鲜为人知。英夫利昔单抗和依那西普,从长远来看,开发药物抗体。本文综述了细胞因子对关节的作用以及生物药物在阻断细胞因子降解作用中的作用,生物制剂的好处,以及长期和短期的不利影响。它们单独或与其他药物组合也有效。
    Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that can cause cartilage and bone damage as well as a disability. Various cytokines play an essential role in disease formation such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-1, IL-6, IL-17, and macrophages; osteoclast is also activated by the cytokines, which cause bone degradation. Early diagnosis is key to optimal therapeutic success, particularly in patients with well-characterized risk factors for poor outcomes such as high disease activity, presence of autoantibodies, and early joint damage. Treatment algorithms involve measuring disease activity with composite indices, applying a treatment-to-target strategy, and using conventional, biological, and new non-biological disease-modifying antirheumatic drugs. After the treatment target of stringent remission (or at least low disease activity) is maintained, dose reduction should be attempted. Although the prospects for most patients are now favorable, many still do not respond to current therapies. The biologics have changed the disease progression over the past few decades, such as TNF-alpha inhibitors (infliximab, etanercept, adalimumab, golimumab, certolizumab), IL-1 inhibitors (anakinra), IL-6 inhibitors (tocilizumab), CD20 inhibitors (rituximab), and cytotoxic T-lymphocyte associated antigen (CTLA)-4 inhibitors (abatacept). In treatment with biologics, only little is known if \"biologic-free\" remission is possible in patients with sustained remission following intensive biological therapy. Infliximab and etanercept, in the long run, develop the drug antibody. This article has reviewed the action of the cytokine on joints and biological drug\'s action in blocking the cytokine degradation effect, benefits of biologics, and adverse effects in the long and short term. They are also effective alone or in combination with other drugs.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号