neurodegenerative disorders

神经退行性疾病
  • 文章类型: Journal Article
    各种形式的神经退行性疾病为当代医疗保健提供了相当大的挑战。人工智能的出现从根本上改变了诊断图景,提供了识别这些严重疾病的有效和早期手段。作为计算智能的一个子集,机器学习算法已经成为分析包括遗传在内的大型数据集的非常有效的工具,成像,和临床数据。此外,多模态数据集成,其中包括来自大脑成像的信息(MRI,PET扫描),遗传概况,和临床评估,通过计算智能变得更容易。通过这种合并方法,可以全面了解疾病的过程,这也有助于创建早期医学评估和结果预测的预测模型。此外,使用人工智能进行神经影像分析已经显示出很大的希望。复杂的图像处理方法与机器学习算法相结合,可以识别大脑中的功能和结构异常,它通常是神经退行性疾病的早期指标。本章探讨了计算智能如何在改善神经退行性疾病如帕金森氏症的诊断中发挥关键作用。老年痴呆症,等。总而言之,计算智能为改善神经退行性疾病的识别提供了一种革命性的方法。在与这些困难疾病的斗争中,接受和改进这些计算技术肯定会为更个性化的治疗和更多成功的治疗铺平道路。
    The numerous and varied forms of neurodegenerative illnesses provide a considerable challenge to contemporary healthcare. The emergence of artificial intelligence has fundamentally changed the diagnostic picture by providing effective and early means of identifying these crippling illnesses. As a subset of computational intelligence, machine-learning algorithms have become very effective tools for the analysis of large datasets that include genetic, imaging, and clinical data. Moreover, multi-modal data integration, which includes information from brain imaging (MRI, PET scans), genetic profiles, and clinical evaluations, is made easier by computational intelligence. A thorough knowledge of the course of the illness is made possible by this consolidative method, which also facilitates the creation of predictive models for early medical evaluation and outcome prediction. Furthermore, there has been a great deal of promise shown by the use of artificial intelligence to neuroimaging analysis. Sophisticated image processing methods combined with machine learning algorithms make it possible to identify functional and structural anomalies in the brain, which often act as early indicators of neurodegenerative diseases. This chapter examines how computational intelligence plays a critical role in improving the diagnosis of neurodegenerative diseases such as Parkinson\'s, Alzheimer\'s, etc. To sum up, computational intelligence provides a revolutionary approach for improving the identification of neurodegenerative illnesses. In the battle against these difficult disorders, embracing and improving these computational techniques will surely pave the path for more individualized therapy and more therapies that are successful.
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  • 文章类型: Journal Article
    背景:髓系细胞上表达的触发受体2蛋白(TREM2)在各种生物学过程中起着至关重要的作用,包括破骨细胞分化,和疾病相关的小胶质细胞(DAM)激活来调节神经炎症,和大脑中的吞噬作用。TREM2的遗传变异与神经退行性疾病有关,例如Nasu-hakola病(NHD),以骨病变为特征,神经精神疾病,和早发性痴呆.
    方法:我们研究了3名疑似NHD的兄弟姐妹。对先证者进行全外显子组测序以确定可能的遗传原因,并通过Sanger测序以验证另外两个受影响的兄弟姐妹中已识别的变体。一个健康的妹妹,还有父母.
    结果:我们在TREM2中鉴定了新的纯合缺失(c.549del;p.(Leu184Serfs*5))。我们的文献综述揭示了16个TREM2突变导致早发性痴呆和骨病变。
    结论:这些发现,除了先前的研究,阐明TREM2相关疾病的临床谱,帮助准确的诊断和病人护理。这些知识对于理解TREM2依赖性DAM及其参与神经发育障碍的发病机理至关重要,这可以帮助开发靶向治疗并改善受TREM2影响的个体的结果。
    BACKGROUND: The Triggering Receptor Expressed on Myeloid Cells 2 protein (TREM2) plays a crucial role in various biological processes, including osteoclast differentiation, and disease-associated microglia (DAM) activation to regulate neuroinflammation, and phagocytosis in the brain. Genetic variations in TREM2 are implicated in neurodegenerative disorders, such as Nasu-hakola disease (NHD), characterized by bone lesions, neuropsychiatric disorders, and early-onset dementia.
    METHODS: We studied 3 siblings with suspected NHD. Whole-exome sequencing was conducted on the proband to identify the possible genetic cause(s) and by Sanger sequencing to validate the identified variants in the two other affected siblings, a healthy sister, and the parents.
    RESULTS: We identified a novel homozygous deletion (c.549del; p.(Leu184Serfs*5)) in TREM2. Our literature review reveals 16 TREM2 mutations causing early-onset dementia and bone lesions.
    CONCLUSIONS: These findings, alongside previous research, elucidate the clinical spectrum of TREM2-related diseases, aiding accurate diagnosis and patient care. This knowledge is vital for understanding TREM2-dependent DAM and its involvement in the pathogenesis of neurodevelopmental disorders which can help to develop targeted therapies and improve outcomes for TREM2-affected individuals.
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  • 文章类型: Journal Article
    脊髓小脑共济失调(SCAs)是一种罕见的常染色体显性神经退行性疾病。迄今为止,已经表征了大约50种不同的SCA亚型。SCA的流行类型通常是PolyQ起源的,其中疾病病理是多个谷氨酰胺残基被编码到疾病蛋白上的结果,导致扩张。SCAs2和3是最常见的诊断亚型,其中受影响的患者表现出某些特征性的生理表现,如步态共济失调和构音障碍。然而,其他临床体征是这些亚型所独有的.最近,已经开发了多种分子诊断方法来鉴定和表征这些亚型。尽管取得了这些进步,SCAs的分子病理学仍然未知。为了进一步理解神经退行性SCAs2和3的机制,基于患者来源的诱导多能干细胞(iPSC)的建模是一个引人注目的途径。我们涵盖了以下基于iPSC的SCA亚型2和3的体外疾病建模的现状,连同创建的细胞系列表,以及研究结果与个性化自体治疗的相关性。
    Spinocerebellar ataxias (SCAs) are a rare autosomal dominant neurodegenerative disorder. To date, approximately 50 different subtypes of SCAs have been characterized. The prevalent types of SCAs are usually of PolyQ origin, wherein the disease pathology is a consequence of multiple glutamine residues being encoded onto the disease proteins, causing expansions. SCAs 2 and 3 are the most frequently diagnosed subtypes, wherein affected patients exhibit certain characteristic physiological manifestations, such as gait ataxia and dysarthria. Nevertheless, other clinical signs were exclusive to these subtypes. Recently, multiple molecular diagnostic methods have been developed to identify and characterize these subtypes. Despite these advancements, the molecular pathology of SCAs remains unknown. To further understand the mechanisms involved in neurodegenerative SCAs 2 and 3, patient-derived induced pluripotent stem cell (iPSC)-based modelling is a compelling avenue to pursue. We cover the present state of iPSC-based in-vitro illness modelling of SCA subtypes 2 and 3 below, along with a list of cell lines created, and the relevance of research outcomes to personalized autologous therapy.
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  • 文章类型: Journal Article
    针对肠道微生物组的干预措施,如粪便移植,益生元,益生菌,合生元,据推测,抗生素肠道耗竭通过在肠-脑轴的背景下重新平衡肠道微生物组,可用于延迟帕金森病的发作和进展。我们的研究旨在组织最近关于帕金森病动物模型中这些干预措施的发现,以确定它们如何影响神经炎症和运动结果。在PubMed中进行了系统的文献检索,WebofScience,Embase,和SCOPUS用于针对肠道微生物组的非饮食干预。通过使用体内鼠PD模型来追踪多巴胺能细胞损失,研究了肠道靶向干预措施,电机测试,和神经炎性标志物作为结局被认为是合格的.数据库中总共确定了1335项研究,其中29人被认定符合资格。对所得数据进行了叙述系统化,并表示了结果的影响方向。还使用SYRCLE偏倚风险工具进行质量评估。在29项符合条件的研究中,我们发现,绝大多数报告说干预减少了多巴胺能细胞的损失(82.76%,95%CI[64.23%,94.15%])诱导产生的疾病模型。此外,大多数研究报告小胶质细胞减少(87.5%,95%CI[61.65%,98.45%])和星形细胞活化(84,62%,95%CI[54.55%,98.08%])引起的疾病模型的诱导。这些结果也反映在大多数人身上(96.4%95%CI[81.65%,99.91%])的研究报告行为运动测试的表现有所提高。该研究的一个重要局限性是,在研究中发现的信息不足以评估偏倚风险的具体原因。这些结果表明,在急性帕金森病动物模型中,非饮食肠道微生物组靶向干预可以改善神经炎症和运动结果。需要进一步的研究来澄清这些益处是否转移到疾病的长期发病机制中,这一点还没有完全理解。这项研究没有资金来源,并且该协议已在PROSPERO数据库中注册,ID号为CRD42023461495。
    Gut microbiome-targeted interventions such as fecal transplant, prebiotics, probiotics, synbiotics, and antibiotic gut depletion are speculated to be of potential use in delaying the onset and progression of Parkinson\'s disease by rebalancing the gut microbiome in the context of the gut-brain axis. Our study aims to organize recent findings regarding these interventions in Parkinson\'s disease animal models to identify how they affect neuroinflammation and motor outcomes. A systematic literature search was applied in PubMed, Web of Science, Embase, and SCOPUS for gut microbiome-targeted non-dietary interventions. Studies that investigated gut-targeted interventions by using in vivo murine PD models to follow dopaminergic cell loss, motor tests, and neuroinflammatory markers as outcomes were considered to be eligible. A total of 1335 studies were identified in the databases, out of which 29 were found to be eligible. A narrative systematization of the resulting data was performed, and the effect direction for the outcomes was represented. Quality assessment using the SYRCLE risk of bias tool was also performed. Out of the 29 eligible studies, we found that a significant majority report that the intervention reduced the dopaminergic cell loss (82.76%, 95% CI [64.23%, 94.15%]) produced by the induction of the disease model. Also, most studies reported a reduction in microglial (87.5%, 95% CI [61.65%, 98.45%]) and astrocytic activation (84,62%, 95% CI [54.55%, 98.08%]) caused by the induction of the disease model. These results were also mirrored in the majority (96.4% 95% CI [81.65%, 99.91%]) of the studies reporting an increase in performance in behavioral motor tests. A significant limitation of the study was that insufficient information was found in the studies to assess specific causes of the risk of bias. These results show that non-dietary gut microbiome-targeted interventions can improve neuroinflammatory and motor outcomes in acute Parkinson\'s disease animal models. Further studies are needed to clarify if these benefits transfer to the long-term pathogenesis of the disease, which is not yet fully understood. The study had no funding source, and the protocol was registered in the PROSPERO database with the ID number CRD42023461495.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)是一种以认知功能下降为特征的进行性神经退行性疾病,记忆丧失,和日常功能受损。虽然目前没有治愈AD的方法,已经探索了几种药物治疗目标和管理策略。此外,传统药用植物因其在AD管理中的潜在作用而受到关注。AD的药物治疗靶标包括淀粉样β(Aβ)聚集,tau蛋白过度磷酸化,神经炎症,氧化应激,和胆碱能功能障碍。传统药用植物,比如银杏叶,锯缘石杉,姜黄(姜黄),还有人参,已经证明了通过其生物活性化合物调节这些靶标的能力。银杏,例如,含有类黄酮和萜类化合物,通过减少Aβ沉积和增强脑血流量而表现出神经保护作用。锯缘石杉,石杉碱A的天然来源,具有抑制乙酰胆碱酯酶的特性,从而改善胆碱能功能。姜黄,富含姜黄素,具有抗炎和抗氧化作用,可能减轻神经炎症和氧化应激。人参的人参皂苷具有神经保护和抗淀粉样生成特性。调查传统药用植物作为AD管理的补充方法提供了几个优点,包括较低的不良反应风险和潜在的多靶点相互作用。此外,这些植物的文化知识和利用为开发新疗法提供了丰富的信息来源。然而,需要进一步的研究来阐明确切的作用机制,标准化制剂,并评估这些自然疗法的安全性和有效性。将传统的基于药用植物的疗法与现代药物疗法相结合可能是更全面和有效的AD治疗方法的关键。本文旨在探讨AD的药物治疗靶点,并评估传统药用植物在其管理中的潜力。
    Alzheimer\'s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and impaired daily functioning. While there is currently no cure for AD, several pharmacotherapeutic targets and management strategies have been explored. Additionally, traditional medicinal plants have gained attention for their potential role in AD management. Pharmacotherapeutic targets in AD include amyloid-beta (Aβ) aggregation, tau protein hyperphosphorylation, neuroinflammation, oxidative stress, and cholinergic dysfunction. Traditional medicinal plants, such as Ginkgo biloba, Huperzia serrata, Curcuma longa (turmeric), and Panax ginseng, have demonstrated the ability to modulate these targets through their bioactive compounds. Ginkgo biloba, for instance, contains flavonoids and terpenoids that exhibit neuroprotective effects by reducing Aβ deposition and enhancing cerebral blood flow. Huperzia serrata, a natural source of huperzine A, has acetylcholinesterase-inhibiting properties, thus improving cholinergic function. Curcuma longa, enriched with curcumin, exhibits anti-inflammatory and antioxidant effects, potentially mitigating neuroinflammation and oxidative stress. Panax ginseng\'s ginsenosides have shown neuroprotective and anti-amyloidogenic properties. The investigation of traditional medicinal plants as a complementary approach to AD management offers several advantages, including a lower risk of adverse effects and potential multi-target interactions. Furthermore, the cultural knowledge and utilization of these plants provide a rich source of information for the development of new therapies. However, further research is necessary to elucidate the precise mechanisms of action, standardize preparations, and assess the safety and efficacy of these natural remedies. Integrating traditional medicinal-plant-based therapies with modern pharmacotherapies may hold the key to a more comprehensive and effective approach to AD treatment. This review aims to explore the pharmacotherapeutic targets in AD and assess the potential of traditional medicinal plants in its management.
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  • 文章类型: Journal Article
    我们的系统评价和荟萃分析旨在揭示UPFs摄入与神经退行性疾病之间的关系,包括多发性硬化症(MS),帕金森病(PD),阿尔茨海默病(AD),认知障碍,和痴呆症。
    使用Scopus进行了系统搜索,PubMed/MEDLINE,和ISIWebofScience数据库没有任何限制,直到2023年6月24日。使用随机效应模型汇集相对风险(RR)和95%置信区间(CI),虽然经过验证的方法通过纽卡斯尔-渥太华量表检查了质量和发表偏倚,艾格的回归不对称性,和Begg的等级相关测试,分别。
    来自28项研究的分析表明,较高的UPFs摄入量与MS风险增加显着相关(RR=1.15;95%CI:1.00,1.33;I2=37.5%;p=0.050;n=14),PD(RR=1.56;95%CI:1.21,2.02;I2=64.1%;p=0.001;n=15),和认知障碍(RR=1.17;95%CI:1.06,1.30;I2=74.1%;p=0.003;n=17),虽然不是AD或痴呆。我们观察到,UPFs摄入量增加25g与MS风险增加4%相关(RR=1.04;95%CI:1.01,1.06;I2=0.0%;p=0.013;n=7),但不是警局.非线性剂量反应关系表明UPF摄入量与MS风险之间存在正非线性关联(P非线性=0.031,P剂量反应=0.002)。PD的风险没有观察到这种关联(P非线性=0.431,P剂量反应=0.231)。
    这些发现表明,持续过度消费UPFs可能对神经退行性疾病产生不利影响,随着年龄的增长,可能导致生活质量下降和独立性下降。
    UNASSIGNED: Our systematic review and meta-analysis aimed to uncover the relationship between UPFs intake and neurodegenerative disorders, including multiple sclerosis (MS), Parkinson\'s disease (PD), Alzheimer\'s disease (AD), cognitive impairment, and dementia.
    UNASSIGNED: A systematic search was conducted using the Scopus, PubMed/MEDLINE, and ISI Web of Science databases without any limitation until June 24, 2023. Relative risk (RR) and 95% confidence interval (CI) were pooled by using a random-effects model, while validated methods examined quality and publication bias via Newcastle-Ottawa Scale, Egger\'s regression asymmetry, and Begg\'s rank correlation tests, respectively.
    UNASSIGNED: Analysis from 28 studies indicated that a higher UPFs intake was significantly related to an enhanced risk of MS (RR = 1.15; 95% CI: 1.00, 1.33; I2 = 37.5%; p = 0.050; n = 14), PD (RR = 1.56; 95% CI: 1.21, 2.02; I2 = 64.1%; p = 0.001; n = 15), and cognitive impairment (RR = 1.17; 95% CI: 1.06, 1.30; I2 = 74.1%; p = 0.003; n = 17), although not AD or dementia. We observed that a 25 g increment in UPFs intake was related to a 4% higher risk of MS (RR = 1.04; 95% CI: 1.01, 1.06; I2 = 0.0%; p = 0.013; n = 7), but not PD. The non-linear dose-response relationship indicated a positive non-linear association between UPF intake and the risk of MS (Pnonlinearity = 0.031, Pdose-response = 0.002). This association was not observed for the risk of PD (Pnonlinearity = 0.431, Pdose-response = 0.231).
    UNASSIGNED: These findings indicate that persistent overconsumption of UPFs may have an adverse impact on neurodegenerative conditions, potentially leading to a decline in quality of life and reduced independence as individuals age.
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  • 文章类型: Journal Article
    帕金森病是一种以运动和非运动症状为特征的进行性神经退行性疾病,包括幻觉.使用抗精神病药物是治疗与帕金森病精神病(PDP)相关的幻觉的常用策略。然而,由于与可用治疗方案相关的潜在风险,在选择最合适的药物时需要仔细考虑。非典型抗精神病药(AAP),如匹马色林和氯氮平,有效控制PDP症状。相反,对喹硫平应用的支持不如其他抗精神病药物那么重要,因为专门调查喹硫平应用的研究仍在兴起,而且相对较新.AAP的广泛作用机制,涉及多巴胺和5-羟色胺受体,与典型的抗精神病药物相比,提供改善的结果和更少的副作用。相反,其他抗精神病药物,包括利培酮,奥氮平,阿立哌唑,齐拉西酮,还有Lurasidone,已发现加重运动症状,通常不推荐用于PDP。虽然AAP提供有利的好处,它们与特定的不良反应有关。锥体外系症状,嗜睡,低血压,便秘,使用AAP时通常观察到认知障碍。氯氮平,特别是,有粒细胞缺乏症的风险,需要密切监测血细胞计数。匹马色林,一种选择性的5-羟色胺反向激动剂,避免了受体相关的副作用,但与校正的QT(QTc)间期延长有关,而喹硫平被报道与死亡风险增加有关.这篇综述旨在分析收益,风险,以及抗精神病药物的作用机制,以帮助临床医生做出明智的决定并加强患者护理。
    Parkinson\'s disease is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, including hallucinations. The use of antipsychotic medications is a common strategy to manage hallucinations associated with Parkinson\'s disease psychosis (PDP). However, careful consideration is necessary when selecting the most appropriate drug due to the potential risks associated with the available treatment options. Atypical antipsychotics (AAPs), such as Pimavanserin and Clozapine, have effectively controlled PDP symptoms. On the contrary, the support for utilizing quetiapine is not as substantial as other antipsychotics because research studies specifically investigating its application are still emerging and relatively recent. The broad mechanisms of action of AAPs, involving dopamine and serotonin receptors, provide improved outcomes and fewer side effects than typical antipsychotics. Conversely, other antipsychotics, including risperidone, olanzapine, aripiprazole, ziprasidone, and lurasidone, have been found to worsen motor symptoms and are generally not recommended for PDP. While AAPs offer favorable benefits, they are associated with specific adverse effects. Extrapyramidal symptoms, somnolence, hypotension, constipation, and cognitive impairment are commonly observed with AAP use. Clozapine, in particular, carries a risk of agranulocytosis, necessitating close monitoring of blood counts. Pimavanserin, a selective serotonin inverse agonist, avoids receptor-related side effects but has been linked to corrected QT (QTc) interval prolongation, while quetiapine has been reported to be associated with an increased risk of mortality. This review aims to analyze the benefits, risks, and mechanisms of action of antipsychotic medications to assist clinicians in making informed decisions and enhance patient care.
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  • 文章类型: Review
    <br><b>简介:</b>痴呆的早期发现和诊断在治疗中至关重要,减缓疾病进展,或抑制症状。关于早期检测阿尔茨海默病(AD)的潜在标志物,考虑了嗅觉变化的可能作用。</br><br><b>材料和方法:</b>使用电子数据库PubMed进行了文献检索,Scopus,和WebofScience在2022年5月30日至2022年8月2日之间。使用与嗅觉相关的关键字组合搜索术语“痴呆”。</br><br><b>结果:</b>通过数据库搜索共识别出1,288条记录。在这些文章中,49人最终被包括在分析中。结果显示嗅觉变化作为早期检测AD的潜在生物标志物的潜在作用。多项研究表明,AD患者可能会出现嗅觉障碍,PD,MCI或其他类型的痴呆症。即使嗅觉测试能够检测神经退行性疾病引起的嗅觉丧失,他们不能可靠地区分某些疾病。</br><br><b>结论:嗅觉评估一再被报道用于早期诊断,但不是为了鉴别诊断.</br>.
    <br><b>Introduction:</b> The early detection and diagnosis of dementia are of key importance in treatment, slowing disease progression, or suppressing symptoms. The possible role of changes in the sense of smell is considered with regard to potential markers for early detection of Alzheimer\'s disease (AD).</br> <br><b>Materials and methods:</b> A literature search was conducted using the electronic databases PubMed, Scopus, and Web of Science between May 30, 2022 and August 2, 2022. The term \"dementia\" was searched with keyword combinations related to olfaction.</br> <br><b>Results:</b> A total of 1,288 records were identified through the database search. Of these articles, 49 were ultimately included in the analysis. The results showed the potential role of changes in the sense of smell as potential biomarkers for early detection of AD. Multiple studies have shown that olfactory impairment may be observed in patients with AD, PD, MCI, or other types of dementia. Even though smell tests are able to detect olfactory loss caused by neurodegenerative diseases, they cannot reliably distinguish between certain diseases.</br> <br><b>Conclusions:</b> In individuals with cognitive impairment or neurodegenerative diseases, olfactory assessment has repeatedly been reported to be used for early diagnosis, but not for differential diagnosis.</br>.
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  • 文章类型: Journal Article
    神经退行性疾病,其中包括阿尔茨海默病(AD),帕金森病(PD),亨廷顿病(HD),和肌萎缩侧索硬化症(ALS),代表了一个重大和日益增长的全球卫生挑战。目前的治疗主要集中在症状管理,而不是改变疾病进展。在这次审查中,我们讨论了这些疾病的主要治疗策略,强调其局限性。对于AD,主要治疗方法是胆碱酯酶抑制剂和N-甲基-D-天冬氨酸(NMDA)受体拮抗剂.对于PD,多巴胺替代疗法,包括左旋多巴,是常用的。HD主要通过对症治疗来管理,和可重复使用的延长生存在ALS。然而,这些疗法都不能阻止或显著减缓神经变性过程。相比之下,这篇综述重点介绍了生物活性肽作为潜在治疗药物的新兴研究。这些天然存在或合成设计的分子可以与特定的细胞靶标相互作用,潜在的调节疾病过程。临床前研究表明,生物活性肽可以减轻氧化应激,炎症,和蛋白质错误折叠,这是神经退行性疾病的常见病理特征。使用生物活性肽进行神经变性的临床试验有限,但显示了有希望的初步结果。例如,半缩醛,γ-分泌酶抑制剂肽,通过减少淀粉样蛋白β的产生显示出在AD中的潜力,尽管由于副作用而停止了开发。尽管取得了这些进步,许多挑战依然存在,包括确定最佳的肽,确认他们的行动机制,并克服与它们传递到大脑有关的障碍。未来的研究应优先发现和开发新的生物活性肽,并提高我们对其药代动力学和药效学的理解。最终,这种方法可能会导致更有效的治疗神经退行性疾病,超越症状管理,有可能改变这些毁灭性疾病的进程。
    Neurodegenerative disorders, which include Alzheimer\'s disease (AD), Parkinson\'s disease (PD), Huntington\'s disease (HD), and amyotrophic lateral sclerosis (ALS), represent a significant and growing global health challenge. Current therapies predominantly focus on symptom management rather than altering disease progression. In this review, we discuss the major therapeutic strategies in practice for these disorders, highlighting their limitations. For AD, the mainstay treatments are cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists. For PD, dopamine replacement therapies, including levodopa, are commonly used. HD is managed primarily with symptomatic treatments, and reusable extends survival in ALS. However, none of these therapies halts or substantially slows the neurodegenerative process. In contrast, this review highlights emerging research into bioactive peptides as potential therapeutic agents. These naturally occurring or synthetically designed molecules can interact with specific cellular targets, potentially modulating disease processes. Preclinical studies suggest that bioactive peptides may mitigate oxidative stress, inflammation, and protein misfolding, which are common pathological features in neurodegenerative diseases. Clinical trials using bioactive peptides for neurodegeneration are limited but show promising initial results. For instance, hemiacetal, a γ-secretase inhibitor peptide, has shown potential in AD by reducing amyloid-beta production, though its development was discontinued due to side effects. Despite these advancements, many challenges remain, including identifying optimal peptides, confirming their mechanisms of action, and overcoming obstacles related to their delivery to the brain. Future research should prioritize the discovery and development of novel bioactive peptides and improve our understanding of their pharmacokinetics and pharmacodynamics. Ultimately, this approach may lead to more effective therapies for neurodegenerative disorders, moving beyond symptom management to potentially modify the course of these devastating diseases.
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  • 文章类型: Journal Article
    背景:血脑屏障(BBB)调节大脑物质进入,对治疗脑部疾病构成挑战。传统方法面临局限性,导致非侵入性鼻内给药的探索。这种方法利用了鼻子到大脑的直接连接,克服BBB限制。鼻内给药增强了药物的生物利用度,减少剂量,并最大限度地减少全身副作用。值得注意的是,脂质纳米粒,如固体脂质纳米粒和纳米结构脂质载体,提供改善的稳定性和控制释放等优点。它们的纳米级尺寸有助于有效的药物装载,提高溶解度和生物利用度。量身定制的脂质组合物能够实现最佳药物释放,这对慢性脑部疾病至关重要。这篇综述评估了脂质纳米颗粒在治疗神经肿瘤和神经退行性疾病中的作用,为有效的鼻-脑药物输送提供见解。
    方法:在主要医学数据库中进行了系统搜索(PubMed,OvidMEDLINE,和Scopus)至2024年1月6日。搜索策略利用了与“脂质纳米颗粒”相关的相关医学主题标题(MeSH)术语和关键词,“鼻内给药”,“神经肿瘤疾病”,和“神经退行性疾病”。这篇综述包括体外研究,在体内,或离体鼻内施用用于治疗脑疾病的基于脂质的纳米载体。
    结果:在最初的891篇论文中,经过严格分析,有26篇文章符合资格标准。排除360篇文章是由于不相关等原因,未报告的选定结果,本文是系统的文献综述或荟萃分析,缺乏方法/结果细节。这篇系统的文献综述,专注于通过基于脂质的纳米载体用于神经肿瘤学的鼻-脑药物递送,神经退行性疾病,和其他脑部疾病,包括60项研究。时间分布分析表明,2018年至2020年的研究兴趣达到顶峰(28.3%),随着时间的推移稳步增长。关于药物类别,阿尔茨海默病突出(26.7%),其次是抗肿瘤药物(25.0%)。在调查的65种药物中,Rivastigmine,阿霉素,卡莫司汀是研究最多的(5.0%),展示了神经系统疾病的多样化方法。值得注意的是,固体脂质纳米粒(SLN)占主导地位(65.0%),其次是纳米结构脂质载体(NLCs)(28.3%),突出了它们在鼻内给药中的功效。使用了各种脂质,单硬脂酸甘油酯突出(20.0%),表明配方中的偏好。性能评估试验是平衡的,体内研究优先(43.3%),强调将研究结果转化为复杂的生物系统,以实现潜在的临床应用。
    结论:本系统综述揭示了鼻内脂质纳米粒治疗脑疾病的转化潜力,克服BBB积极成果突出了SLN和NLC的有效性,这是从AD到中风和神经胶质瘤的疾病的有希望的新方法。在庆祝进步的同时,解决纳米粒子毒性等挑战也至关重要。
    BACKGROUND: The blood-brain barrier (BBB) regulates brain substance entry, posing challenges for treating brain diseases. Traditional methods face limitations, leading to the exploration of non-invasive intranasal drug delivery. This approach exploits the direct nose-to-brain connection, overcoming BBB restrictions. Intranasal delivery enhances drug bioavailability, reduces dosage, and minimizes systemic side effects. Notably, lipid nanoparticles, such as solid lipid nanoparticles and nanostructured lipid carriers, offer advantages like improved stability and controlled release. Their nanoscale size facilitates efficient drug loading, enhancing solubility and bioavailability. Tailored lipid compositions enable optimal drug release, which is crucial for chronic brain diseases. This review assesses lipid nanoparticles in treating neuro-oncological and neurodegenerative conditions, providing insights for effective nose-to-brain drug delivery.
    METHODS: A systematic search was conducted across major medical databases (PubMed, Ovid MEDLINE, and Scopus) up to 6 January 2024. The search strategy utilized relevant Medical Subject Heading (MeSH) terms and keywords related to \"lipid nanoparticles\", \"intranasal administration\", \"neuro-oncological diseases\", and \"neurodegenerative disorders\". This review consists of studies in vitro, in vivo, or ex vivo on the intranasal administration of lipid-based nanocarriers for the treatment of brain diseases.
    RESULTS: Out of the initial 891 papers identified, 26 articles met the eligibility criteria after a rigorous analysis. The exclusion of 360 articles was due to reasons such as irrelevance, non-reporting selected outcomes, the article being a systematic literature review or meta-analysis, and lack of method/results details. This systematic literature review, focusing on nose-to-brain drug delivery via lipid-based nanocarriers for neuro-oncological, neurodegenerative, and other brain diseases, encompassed 60 studies. A temporal distribution analysis indicated a peak in research interest between 2018 and 2020 (28.3%), with a steady increase over time. Regarding drug categories, Alzheimer\'s disease was prominent (26.7%), followed by antiblastic drugs (25.0%). Among the 65 drugs investigated, Rivastigmine, Doxorubicin, and Carmustine were the most studied (5.0%), showcasing a diverse approach to neurological disorders. Notably, solid lipid nanoparticles (SLNs) were predominant (65.0%), followed by nanostructured lipid carriers (NLCs) (28.3%), highlighting their efficacy in intranasal drug delivery. Various lipids were employed, with glyceryl monostearate being prominent (20.0%), indicating preferences in formulation. Performance assessment assays were balanced, with in vivo studies taking precedence (43.3%), emphasizing the translation of findings to complex biological systems for potential clinical applications.
    CONCLUSIONS: This systematic review reveals the transformative potential of intranasal lipid nanoparticles in treating brain diseases, overcoming the BBB. Positive outcomes highlight the effectiveness of SLNs and NLCs, which are promising new approaches for ailments from AD to stroke and gliomas. While celebrating progress, addressing challenges like nanoparticle toxicity is also crucial.
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