MS, Multiple sclerosis

MS,多发性硬化
  • 文章类型: Journal Article
    神经退行性疾病,以神经元的结构或功能逐渐丧失为特征,目前被认为是无法治愈的。运动障碍,如震颤和姿势不稳,认知或行为障碍,如记忆障碍是最常见的症状,越来越多的神经退行性疾病患者对公共健康构成严重威胁,对经济发展构成负担。因此,预防疾病的发生和延缓其进展至关重要。维生素D可以在体内转化为具有基因组和非基因组作用的激素,发挥不同的生理作用。累积证据表明,维生素D可以通过调节相关分子和信号通路来改善神经变性,包括维持Ca2+稳态。减少氧化应激,抑制炎症,抑制致病蛋白的形成和聚集,等。本文综述了维生素D在包括阿尔茨海默病在内的神经退行性疾病中的生物学功能的分子机制的最新发现。帕金森病,多发性硬化症,和血管性痴呆.还总结了研究补充维生素D对神经退行性疾病患者的影响的临床试验。合成的信息可能会激发人们对维生素D在神经系统中的神经保护作用的理解,并为将来的神经退行性疾病患者提供治疗选择。
    Neurodegenerative diseases, featured by progressive loss of structure or function of neurons, are considered incurable at present. Movement disorders like tremor and postural instability, cognitive or behavioral disorders such as memory impairment are the most common symptoms of them and the growing patient population of neurodegenerative diseases poses a serious threat to public health and a burden on economic development. Hence, it is vital to prevent the occurrence of the diseases and delay their progress. Vitamin D can be transformed into a hormone in vivo with both genomic and non-genomic actions, exerting diverse physiological effects. Cumulative evidence indicates that vitamin D can ameliorate neurodegeneration by regulating pertinent molecules and signaling pathways including maintaining Ca2+ homeostasis, reducing oxidative stress, inhibiting inflammation, suppressing the formation and aggregation of the pathogenic protein, etc. This review updates discoveries of molecular mechanisms underlying biological functions of vitamin D in neurodegenerative diseases including Alzheimer\'s disease, Parkinson\'s disease, multiple sclerosis, and vascular dementia. Clinical trials investigating the influence of vitamin D supplementation in patients with neurodegenerative diseases are also summarized. The synthesized information will probably provoke an enhanced understanding of the neuroprotective roles of vitamin D in the nervous system and provide therapeutic options for patients with neurodegenerative diseases in the future.
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  • 文章类型: Case Reports
    抗髓磷脂少突胶质细胞糖蛋白(MOG)-免疫球蛋白G(IgG)相关疾病(MOGAD)是一种免疫介导的中枢神经系统(CNS)炎性脱髓鞘疾病,近年来已被广泛认可。它不同于多发性硬化症(MS)和视神经脊髓炎谱系障碍(NMOSD),它们是独立的疾病谱。在这里,我们报道了一个5岁男孩因发烧入院3天的案例,头痛,和呕吐。磁共振成像显示左丘脑异常高强度和肺炎支原体血清IgM阳性。阿奇霉素治疗后,头痛逐渐消失,但在入院后第6天出现瘫痪和尿潴留。MRI复检显示左丘脑原始异常信号明显减弱,但是大脑和脑脊髓出现了新的异常信号,血清MOG-IgG阳性。治疗后,孩子已经完全康复,仍在接受后续护理。我们认为,这是一例MOGAD的儿童,具有继发于肺炎支原体感染的双相ADEM表型,这对阐明MOGAD的病理生理学具有潜在价值。
    Anti-myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG) associated disorder (MOGAD) is an immune-mediated central nervous system (CNS) inflammatory demyelinating disorder that has been widely recognized in recent years. It is distinct from multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), which are separate disease spectrums. Here we report the case of a 5-year-old boy who was admitted for 3 days with fever, headache, and vomiting. Magnetic resonance imaging revealed abnormal hyperintensity in the left thalamus and positive serum IgM for M. pneumoniae. After treatment with azithromycin, the headache gradually disappeared, but paralysis and urinary retention occurred on the 6th day after admission. MRI re-examination showed that the original abnormal signal in the left thalamus was significantly weakened, but new abnormal signals appeared in the brain and cerebrospinal cord, and the serum MOG-IgG was positive. After treatment, the child has fully recovered and is still receiving follow-up care. We believe that this is a case of MOGAD in a child with a biphasic ADEM phenotype secondary to M. pneumoniae infection, which has potential value in elucidating the pathophysiology of MOGAD.
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  • 文章类型: Journal Article
    神经系统疾病(NSD)的治疗因其发病机制的复杂性一直是困扰研究者的难题。随着老龄化社会的到来,寻找NSD的有效治疗方法已成为热门话题。人参多糖(GP),作为人参中的主要生物活性物质,在免疫调节中具有各种生物学特性,抗氧化剂,抗炎等.考虑到GP的作用与神经系统疾病的发病机制之间的关联,近年来已经进行了许多相关的实验。在本文中,我们回顾了以往关于GP对神经系统相关疾病的影响和机制的研究。我们发现GP通过调节免疫系统对NSD发挥改善作用,炎症反应,氧化损伤和信号通路。并对构效关系进行了讨论和总结。此外,我们为GP作为有前途的神经保护剂的进一步开发和利用提供了新的见解。
    The treatments of nervous system diseases (NSDs) have long been difficult issues for researchers because of their complexity of pathogenesis. With the advent of aging society, searching for effective treatments of NSDs has become a hot topic. Ginseng polysaccharides (GP), as the main biologically active substance in ginseng, has various biological properties in immune-regulation, anti-oxidant, anti-inflammation and etc. Considering the association between the effects of GP and the pathogenesis of neurological disorders, many related experiments have been conducted in recent years. In this paper, we reviewed previous studies about the effects and mechanisms of GP on diseases related to nervous system. We found GP play an ameliorative role on NSDs through the regulation of immune system, inflammatory response, oxidative damage and signaling pathway. Structure-activity relationship was also discussed and summarized. In addition, we provided new insights into GP as promising neuroprotective agent for its further development and utilization.
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  • 文章类型: Journal Article
    18kDa转运蛋白(TSPO),以前被称为外周苯二氮卓受体,主要定位于类固醇生成细胞的线粒体外膜。在生理条件下脑TSPO表达相对较低,但响应神经胶质细胞激活而上调。作为神经炎症的主要指标,TSPO与许多神经精神疾病和神经退行性疾病的发病机制和进展有关。包括阿尔茨海默病(AD),肌萎缩侧索硬化(ALS),帕金森病(PD),多发性硬化症(MS),重度抑郁症(MDD)和强迫症(OCD)。在这种情况下,已经开发了许多TSPO靶向的正电子发射断层扫描(PET)示踪剂。其中,几种放射性配体已进入临床研究。在这次审查中,我们将概述TSPOPET示踪剂的最新发展,专注于放射性配体设计,放射性同位素标记,药代动力学,和PET成像评价。此外,我们会考虑目前的限制,以及TSPO放射性药物未来应用的翻译潜力。这篇综述旨在不仅提出当前TSPOPET成像中的挑战,同时也为TSPO靶向PET示踪剂的发现工作提供了新的视角。应对这些挑战将促进TSPO在与中枢神经系统疾病相关的神经炎症的临床研究中的翻译。
    The 18 kDa translocator protein (TSPO), previously known as the peripheral benzodiazepine receptor, is predominately localized to the outer mitochondrial membrane in steroidogenic cells. Brain TSPO expression is relatively low under physiological conditions, but is upregulated in response to glial cell activation. As the primary index of neuroinflammation, TSPO is implicated in the pathogenesis and progression of numerous neuropsychiatric disorders and neurodegenerative diseases, including Alzheimer\'s disease (AD), amyotrophic lateral sclerosis (ALS), Parkinson\'s disease (PD), multiple sclerosis (MS), major depressive disorder (MDD) and obsessive compulsive disorder (OCD). In this context, numerous TSPO-targeted positron emission tomography (PET) tracers have been developed. Among them, several radioligands have advanced to clinical research studies. In this review, we will overview the recent development of TSPO PET tracers, focusing on the radioligand design, radioisotope labeling, pharmacokinetics, and PET imaging evaluation. Additionally, we will consider current limitations, as well as translational potential for future application of TSPO radiopharmaceuticals. This review aims to not only present the challenges in current TSPO PET imaging, but to also provide a new perspective on TSPO targeted PET tracer discovery efforts. Addressing these challenges will facilitate the translation of TSPO in clinical studies of neuroinflammation associated with central nervous system diseases.
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  • 文章类型: Journal Article
    人类二氢乳清酸脱氢酶(DHODH)是开发治疗癌症和免疫性疾病的治疗剂的可行靶标,如类风湿性关节炎(RA),牛皮癣和多发性硬化症(MS)。在这里,设计并合成了一系列基于丙烯酰胺的新型DHODH抑制剂作为潜在的RA治疗剂。2-丙烯酰胺苯甲酸类似物11被确定为结构-活性关系(SAR)研究的先导化合物。用萘基部分取代苯基将抑制活性显著提高到两位数纳摩尔范围。进一步的结构优化表明,丙烯酰胺具有小的疏水基团(Me,2位的Cl或Br)是优选的。此外,在苯甲酸的5位添加氟原子增强了效力。优化工作导致有效的化合物42和53-55,IC50值为41、44、32和42nmol/L,分别。最有效的化合物54还以剂量依赖性方式显示出有利的药代动力学(PK)谱和令人鼓舞的体内抗关节炎作用。
    Human dihydroorotate dehydrogenase (DHODH) is a viable target for the development of therapeutics to treat cancer and immunological diseases, such as rheumatoid arthritis (RA), psoriasis and multiple sclerosis (MS). Herein, a series of acrylamide-based novel DHODH inhibitors as potential RA treatment agents were designed and synthesized. 2-Acrylamidobenzoic acid analog 11 was identified as the lead compound for structure-activity relationship (SAR) studies. The replacement of the phenyl group with naphthyl moieties improved inhibitory activity significantly to double-digit nanomolar range. Further structure optimization revealed that an acrylamide with small hydrophobic groups (Me, Cl or Br) at the 2-position was preferred. Moreover, adding a fluoro atom at the 5-position of the benzoic acid enhanced the potency. The optimization efforts led to potent compounds 42 and 53‒55 with IC50 values of 41, 44, 32, and 42 nmol/L, respectively. The most potent compound 54 also displayed favorable pharmacokinetic (PK) profiles and encouraging in vivo anti-arthritic effects in a dose-dependent manner.
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  • 文章类型: Journal Article
    单酰基甘油脂肪酶(MAGL)是一种丝氨酸水解酶,在催化甘油单酯水解为甘油和脂肪酸中起着至关重要的作用。它通过将丰富的内源性大麻素2-花生四烯酸甘油降解为花生四烯酸,将内源性大麻素和二十烷酸系统连接在一起,前列腺素和其他炎症介质的前体。MAGL抑制剂被认为是许多治疗领域的重要药物。包括抗伤害性,抗焦虑药,抗炎,甚至抗癌。目前,ABX-1431,MAGL的一流抑制剂,正在进入神经系统疾病和其他疾病的临床2期研究。这篇综述总结了MAGL的多种(病理)生理作用,并将对MAGL抑制剂的发展进行概述。尽管已经报道了大量的MAGL抑制剂,仍然需要新的抑制剂,特别是可逆的。
    Monoacylglycerol lipase (MAGL) is a serine hydrolase that plays a crucial role catalysing the hydrolysis of monoglycerides into glycerol and fatty acids. It links the endocannabinoid and eicosanoid systems together by degradation of the abundant endocannabinoid 2-arachidaoylglycerol into arachidonic acid, the precursor of prostaglandins and other inflammatory mediators. MAGL inhibitors have been considered as important agents in many therapeutic fields, including anti-nociceptive, anxiolytic, anti-inflammatory, and even anti-cancer. Currently, ABX-1431, a first-in-class inhibitor of MAGL, is entering clinical phase 2 studies for neurological disorders and other diseases. This review summarizes the diverse (patho)physiological roles of MAGL and will provide an overview on the development of MAGL inhibitors. Although a large number of MAGL inhibitors have been reported, novel inhibitors are still required, particularly reversible ones.
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  • 文章类型: Journal Article
    溶质载体(SLC)转运蛋白冥想许多基本的生理功能,包括营养吸收,离子流入/流出,和废物处理。在对抗肿瘤和感染的保护作用中,哺乳动物免疫系统协调复杂的信号来支持增殖,分化,和单个细胞亚群的效应子功能。最近在这一领域的研究已经产生了令人惊讶的发现溶质载体转运蛋白的作用,它们被发现调节淋巴细胞信号并控制其分化,函数,和命运通过调节不同的代谢途径和不同代谢物的平衡水平。在这次审查中,我们目前的信息主要是关于葡萄糖转运蛋白,氨基酸转运蛋白,和金属离子输送器,这对于在许多不同的病理条件下介导免疫细胞稳态至关重要。
    Solute carrier (SLC) transporters meditate many essential physiological functions, including nutrient uptake, ion influx/efflux, and waste disposal. In its protective role against tumors and infections, the mammalian immune system coordinates complex signals to support the proliferation, differentiation, and effector function of individual cell subsets. Recent research in this area has yielded surprising findings on the roles of solute carrier transporters, which were discovered to regulate lymphocyte signaling and control their differentiation, function, and fate by modulating diverse metabolic pathways and balanced levels of different metabolites. In this review, we present current information mainly on glucose transporters, amino-acid transporters, and metal ion transporters, which are critically important for mediating immune cell homeostasis in many different pathological conditions.
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  • 文章类型: Journal Article
    探讨临床孤立综合征(CIS)和多发性硬化(MS)的富俱乐部组织,并描述其与身体残疾和认知障碍的关系。
    我们在41CIS中构建了高分辨率白质(WM)结构网络,使用扩散MRI和确定性纤维束成像的32个MS和35个健康对照(HC)。富人俱乐部组织中的群体差异,研究了全球和本地网络指标。改变后的网络度量之间的关系,脑损伤和临床变量,包括EDSS,MMSE,PASAT,计算疾病持续时间。此外,使用不同的分割方案进行可重复性分析.
    与HC相比,MS患者在所有类型的连接中表现出强度降低(富球杆:p<0.0001;喂食器:p=0.0004;和局部:p=0.0026)。CIS患者在MS患者和HC之间显示出中间值,并且在喂食器和局部连接中显示出强度降低(喂食器:p=0.019;局部:p=0.031),但在丰富的俱乐部连接中没有。与CIS患者相比,MS患者的富俱乐部连接显着减少(p=0.0004)。在MS组中,丰富的俱乐部和饲养者连接的强度降低与认知障碍相关。这些结果与病变分布无关,并且在不同的脑分割方案中可重复。
    富人俱乐部组织在MS患者中被破坏,在CIS.MS的富俱乐部连通性中断与认知障碍相关。这些发现表明,受损的富俱乐部连通性是渐进结构网络破坏的基本特征,预示着MS临床残疾的发展。
    To investigate the rich-club organization in clinically isolated syndrome (CIS) and multiple sclerosis (MS), and to characterize its relationships with physical disabilities and cognitive impairments.
    We constructed high-resolution white matter (WM) structural networks in 41 CIS, 32 MS and 35 healthy controls (HCs) using diffusion MRI and deterministic tractography. Group differences in rich-club organization, global and local network metrics were investigated. The relationship between the altered network metrics, brain lesions and clinical variables including EDSS, MMSE, PASAT, disease duration were calculated. Additionally, reproducibility analysis was performed using different parcellation schemes.
    Compared with HCs, MS patients exhibited a decreased strength in all types of connections (rich-club: p < 0.0001; feeder: p = 0.0004; and local: p = 0.0026). CIS patients showed intermediate values between MS patients and HCs and exhibited a decreased strength in feeder and local connections (feeder: p = 0.019; and local: p = 0.031) but not in rich-club connections. Compared with CIS patients, MS patients showed significant reductions in rich-club connections (p = 0.0004). The reduced strength of rich-club and feeder connections was correlated with cognitive impairments in the MS group. These results were independent of lesion distribution and reproducible across different brain parcellation schemes.
    The rich-club organization was disrupted in MS patients and relatively preserved in CIS. The disrupted rich-club connectivity was correlated with cognitive impairment in MS. These findings suggest that impaired rich-club connectivity is an essential feature of progressive structural network disruption, heralding the development of clinical disability in MS.
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  • 文章类型: Case Reports
    目前尚无狂犬病疫苗和免疫球蛋白联合使用导致急性播散性脑脊髓炎(ADEM)的报道。该报告描述了一名老人在服用纯化的Vero细胞狂犬病疫苗(PVRV)和人狂犬病免疫球蛋白(HRIG)后获得了ADEM。然后给他静脉注射和口服糖皮质激素。同时,用纯化的鸡胚细胞疫苗(PCECV)代替PVRV继续狂犬病疫苗接种。此外,我们分析了狂犬病疫苗接种后不同时间点患者血液中的狂犬病病毒中和抗体(RVNA)水平。总的来说,我们观察到PCECV疫苗接种不影响ADEM的预后,糖皮质激素是关键和有效的,对PCECV的疗效无明显影响。
    It has not been reported that administration of combining rabies vaccines and immunoglobulin resulted in acute disseminated encephalomyelitis (ADEM) yet. This report described that an old man acquired ADEM after being administrated with purified Vero cell rabies vaccine (PVRV) and Human Rabies Immunoglobulin (HRIG). Then he was given intravenous and oral glucocorticoids. Simultaneously, rabies vaccination was continued with purified Chick embryo cell vaccines (PCECV) instead of PVRV. Furthermore, we analyzed the rabies virus neutralizing antibodies (RVNA) levels in the patient\'s blood at different time points after rabies vaccination. Collectively, we observed that PCECV vaccination did not affect the prognosis of ADEM, and glucocorticoid was crucial and effective, which had no significant influence on efficacy of PCECV.
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