Neuropeptides

神经肽
  • 文章类型: Journal Article
    B1类G蛋白偶联受体(GPCRs)是临床相关药物靶标的重要家族,难以通过高通量筛选和动物模型进行研究。这里,我们设计了PAClight1P78A,一种基于B1类GPCR(人类PAC1受体,hmPAC1R)具有高动态范围(ΔF/F0=1100%),优异的配体选择性,和快速活化动力学(τON=1.15s)。为了展示该工具在体外应用的实用性,我们彻底表征和比较了它的表达,PAClight1P78A转染和稳定表达细胞之间的亮度和性能。证明其在动物模型中的用途,我们显示了强大的表达和荧光反应的外源配体应用离体和体内小鼠,以及斑马鱼幼虫。因此,这种基于GPCR的新型传感器可用于生命科学领域的广泛应用,为基础研究和药物开发工作提供了动力。
    Class-B1 G-protein-coupled receptors (GPCRs) are an important family of clinically relevant drug targets that remain difficult to investigate via high-throughput screening and in animal models. Here, we engineered PAClight1P78A, a novel genetically encoded sensor based on a class-B1 GPCR (the human PAC1 receptor, hmPAC1R) endowed with high dynamic range (ΔF/F0 = 1100%), excellent ligand selectivity, and rapid activation kinetics (τON = 1.15 s). To showcase the utility of this tool for in vitro applications, we thoroughly characterized and compared its expression, brightness and performance between PAClight1P78A-transfected and stably expressing cells. Demonstrating its use in animal models, we show robust expression and fluorescence responses upon exogenous ligand application ex vivo and in vivo in mice, as well as in living zebrafish larvae. Thus, the new GPCR-based sensor can be used for a wide range of applications across the life sciences empowering both basic research and drug development efforts.
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  • 文章类型: Journal Article
    在C.elegans机制中,外周器官将内部状态信息传递给神经系统仍然未知,尽管强有力的证据表明这种信号确实存在。在这里,我们报告了一种称为INS-7的祖先胰岛素超家族的肽的发现,该肽充当肠内分泌肽,并由肠道的特化细胞分泌。INS-7分泌受到食物戒断的刺激,在禁食期间增加,并作为真正的肠-脑肽,减弱神经肽的释放,该神经肽驱动外周脂肪损失。因此,INS-7作为来自肠道的稳态信号起作用,在食物短缺期间控制神经元驱动以刺激脂肪损失。机械上,INS-7作为典型DAF-2受体的拮抗剂起作用,并通过ASI神经元中的FOXO和AMPK信号传导起作用。系统发育分析表明,与常规哺乳动物胰岛素和IGF肽相比,INS-7与广泛的胰岛素/松弛素超家族成员具有更大的相似性。由具有肠内分泌功能的特化肠细胞分泌的内源性胰岛素拮抗剂的发现表明肠的意想不到的和重要的特性及其在指导神经元功能中的作用。
    In C. elegans mechanisms by which peripheral organs relay internal state information to the nervous system remain unknown, although strong evidence suggests that such signals do exist. Here we report the discovery of a peptide of the ancestral insulin superfamily called INS-7 that functions as an enteroendocrine peptide and is secreted from specialized cells of the intestine. INS-7 secretion is stimulated by food withdrawal, increases during fasting and acts as a bona fide gut-to-brain peptide that attenuates the release of a neuropeptide that drives fat loss in the periphery. Thus, INS-7 functions as a homeostatic signal from the intestine that gates the neuronal drive to stimulate fat loss during food shortage. Mechanistically, INS-7 functions as an antagonist at the canonical DAF-2 receptor and functions via FOXO and AMPK signaling in ASI neurons. Phylogenetic analysis suggests that INS-7 bears greater resemblance to members of the broad insulin/relaxin superfamily than to conventional mammalian insulin and IGF peptides. The discovery of an endogenous insulin antagonist secreted by specialized intestinal cells with enteroendocrine functions suggests unexpected and important properties of the intestine and its role in directing neuronal functions.
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  • 文章类型: Journal Article
    偏头痛,一种原发性头痛症,其机制尚不完全清楚,在攻击期间似乎涉及三叉神经血管系统(TS)的激活。研究表明,免疫系统介导的炎症过程可能在偏头痛的病理生理中起作用。神经炎症通常与偏头痛发作有关,细胞因子在这个过程中充当关键的介质。促炎细胞因子水平升高,如白细胞介素-1β(IL-1β),白细胞介素-6(IL-6),和肿瘤坏死因子-α(TNF-α),在经历偏头痛发作的个体的血液和脑脊液中观察到。这些细胞因子具有使大脑中的疼痛通路敏感的能力,从而增加对疼痛刺激的敏感性。这种现象,被称为中央敏化,被认为有助于偏头痛的强度和持久性。Kynurenines,谷氨酸能机制的内源性介质,可以显着影响原发性头痛疾病的病理生理学。犬尿氨酸系统统称为犬尿氨酸途径(KP),可以作用于多种受体,比如谷氨酸受体,芳烃受体(AhRs),G蛋白偶联受体35(GPR35),和α-7烟碱乙酰胆碱(α7nACh)受体。这些受体也存在于免疫系统的各种细胞上,因此,KP在原发性头痛的病理机制中的作用也可能是通过它们介导的。在这次审查中,我们的目标是在炎症和偏头痛的背景下显示KP受体与免疫系统之间可能的联系.近年来偏头痛的研究主要集中在神经肽,如降钙素基因相关肽(CGRP)和垂体腺苷酸环化酶激活多肽(PACAP)作为潜在的致病因子和可能的治疗方法。这些肽在其特征和作用方面具有许多相似性。例如,它们表现出强大的血管舒张功能,发生在外周和中枢神经系统,并在传递伤害感受和神经源性炎症中发挥作用。上述神经肽与犬尿氨酸途径之间潜在联系的研究可能在揭示偏头痛的发病机制和确定新的候选药物方面发挥重要作用。
    Migraine, a primary headache disorder whose mechanism remains incompletely understood, appears to involve the activation of the trigeminovascular system (TS) during attacks. Research suggests that inflammatory processes mediated by the immune system may play a role in migraine pathophysiology. Neuroinflammation is often associated with migraine attacks, with cytokines serving as crucial mediators in the process. Elevated levels of pro-inflammatory cytokines, such as interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), have been observed in the blood and cerebrospinal fluid of individuals experiencing migraine attacks. These cytokines have the capacity to sensitize pain pathways in the brain, thereby increasing sensitivity to pain stimuli. This phenomenon, known as central sensitization, is believed to contribute to the intensity and persistence of migraine pain. Kynurenines, endogenous mediators of glutamatergic mechanisms, can significantly influence the pathophysiology of primary headache disorders. The kynurenine system is collectively known as the kynurenine pathway (KP), which can act on multiple receptors, such as glutamate receptors, aryl hydrocarbon receptors (AhRs), G protein-coupled receptors 35 (GPR35), and α-7 nicotinic acetylcholine (α7 nACh) receptors. These receptors are also found on various cells of the immune system, so the role of the KP in the pathomechanism of primary headaches may also be mediated through them. In this review, our goal is to show a possible link between the receptors of the KP and immune system in the context of inflammation and migraine. Migraine research in recent years has focused on neuropeptides, such as calcitonin gene-related peptide (CGRP) and pituitary adenylate cyclase-activating polypeptide (PACAP) as potential pathogenic factors and possible therapeutic approaches. These peptides share many similarities in their characteristics and roles. For instance, they exhibit potent vasodilation, occur in both the peripheral and central nervous systems, and play a role in transmitting nociception and neurogenic inflammation. The investigation of potential connections between the aforementioned neuropeptides and the kynurenine pathway could play a significant role in uncovering the pathomechanism of migraine and identifying new drug candidates.
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  • 文章类型: Journal Article
    由于下丘脑中的kisspeptin(KISS1)受到强啡肽的抑制作用的影响,它提出了关于有和没有多囊卵巢综合征(PCOS)的女性中这2种神经肽的受控平衡的问题。
    本研究比较了KISS1、强啡肽、神经激肽B,瘦素,和神经肽-Y在有和没有PCOS的女性中。
    在这项横断面研究中,20名PCOS女性和20名非PCOS女性的外周血样本转诊至YaminKencana诊所,CiptoMangunkusumo医院,雅加达,印度尼西亚从2022年8月至12月注册。与PCOS相关的中枢因子相关基因的mRNA相对表达,比如瘦素,神经肽Y,KISS1,速激肽-3和强啡肽(PDYN),在PCOS和非PCOS人群中进行了检查。通过定量聚合酶链反应方法进行基因定量。
    PCOS组的KISS1/PDYN比值明显高于对照组(p=0.02),PCOS组PDYN低于对照组(p<0.001)。此外,PCOS组KISS1与KISS1/PDYN比值之间的正相关性明显强于对照组(R=0.93;p<0.001vs.R=0.66,p<0.001)。
    我们的结果表明,PCOS女性KISS1/PDYN比值增加与强啡肽表达减少有关。编码强啡肽的基因的低表达和高KISS1/PDYN比率对PCOS具有高度特异性。
    UNASSIGNED: Since kisspeptin (KISS1) in the hypothalamus is affected by the inhibitory effect of dynorphin, it raises questions about the controlled balance of these 2 neuropeptides in women with and without polycystic ovary syndrome (PCOS).
    UNASSIGNED: This study compares the expression levels of KISS1, dynorphin, neurokinin-B, leptin, and neuropeptide-Y in women with and without PCOS.
    UNASSIGNED: In this cross-sectional study, the peripheral blood samples of 20 women with PCOS and 20 women without PCOS who referred to Yamin Kencana Clinic, Cipto Mangunkusumo hospital, Jakarta, Indonesia were enrolled from August-December 2022. mRNA relative expression of genes related to the central factors associated with PCOS, such as leptin, neuropeptide-Y, KISS1, tachykinin-3, and prodynorphin (PDYN), in PCOS and non-PCOS populations were examined. Gene quantification was carried out by the quantitative polymerase chain reaction method.
    UNASSIGNED: The KISS1/PDYN ratio was significantly higher in the PCOS group than in the control group (p = 0.02), and the PDYN was lower in the PCOS group than the control group (p < 0.001). Moreover, the positive correlation between KISS1 and the KISS1/PDYN ratio was significantly stronger in the PCOS group than in the control group (R = 0.93; p < 0.001 vs. R = 0.66, p < 0.001).
    UNASSIGNED: Our results suggest that an increased KISS1/PDYN ratio in PCOS women is related to diminished dynorphin expression. Low expression of the gene encoding dynorphin and a high KISS1/PDYN ratio is highly specific to PCOS.
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  • 文章类型: Journal Article
    II型甲壳类高血糖激素(CHH)神经肽在甲壳类动物中起着不同的作用。在雌雄同体的虾Lysmatavittata中,II型CHHs(蜕皮抑制激素/性腺抑制激素,MIH/GIH1和MIH/GIH2)通过转录组测序鉴定,MIH/GIH1因其对卵巢发育的抑制作用而被命名为Lvit-GIH1。基于MIH/GIH2与Lvit-GIH1的高度相似性,我们暂时将MIH/GIH2命名为Lvit-GIH2,并探讨了Lvit-GIH2在卵巢发育中的作用。Lvit-GIH2的开放阅读框(ORF)长度为333bp,编码由32-aa信号肽和78-aa成熟肽组成的前体,与甲壳类动物的II型亚家族肽具有高度的序列相似性。值得注意的是,Lvit-GIH2在多种组织中广泛表达。qRT-PCR结果表明,Lvit-GIH2的表达从雄性期到雌雄同体期呈上升趋势。RNA干扰和添加GIH2重组蛋白(rGIH2)实验均显示Lvit-GIH2抑制肝胰腺中的Lvit-Vg表达和卵巢中的Lvit-VgR表达。为了进一步研究Lvit-GIH2在卵巢发育中的作用,RNA序列分析用于检测添加rGIH2后卵巢的变化.结果表明,这些途径(半胱氨酸和蛋氨酸代谢,凋亡-多种物种,等。)和基因(17bHSD8,IGFR,CHH,等。)与卵巢发育有关的rGIH2负调控。简而言之,Lvit-GIH2可能抑制维塔塔乳杆菌的卵巢发育。
    Type II crustacean hyperglycemic hormone (CHH) neuropeptides play diverse roles in crustaceans. In the hermaphrodite shrimp Lysmata vittata, two transcripts of type II CHHs (molt-inhibiting hormone/gonad-inhibiting hormone, MIH/GIH1 and MIH/GIH2) were identified by transcriptome sequencing, and MIH/GIH1 was later named Lvit-GIH1 for its inhibitory effect on ovarian development. Based on the high similarity of MIH/GIH2 to Lvit-GIH1, we named tentatively MIH/GIH2 as Lvit-GIH2 and explored the role of Lvit-GIH2 in ovarian development. The open reading frame (ORF) of Lvit-GIH2 was 333 bp in length, encoding a precursor consisted of a 32-aa signal peptide and a 78-aa mature peptide, which shared high sequence similarity with the type II subfamily peptides in crustaceans. Notably, Lvit-GIH2 was widely expressed in multiple tissues. The qRT-PCR findings indicated a rising trend in the expression of Lvit-GIH2 from the male phase to the euhermaphrodite phase. Both RNA interference and addition of GIH2 recombinant proteins (rGIH2) experiments showed that Lvit-GIH2 suppressed Lvit-Vg expression in hepatopancreas and Lvit-VgR expression in ovary. To further investigate the role of Lvit-GIH2 in ovarian development, the RNA-sequence analysis was performed to examine the changes in ovary after addition of rGIH2. The results showed that the pathways (Cysteine and methionine metabolism, Apoptosis-multiple species, etc.) and the genes (17bHSD8, IGFR, CHH, etc.) related to ovarian development were negatively regulated by rGIH2. In brief, Lvit-GIH2 might inhibit the ovarian development in L. vittata.
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  • 文章类型: Journal Article
    小型GTPases的Ras超家族中研究最广泛的成员之一,Rac1是一种细胞内信号转导,可重塑肌动蛋白和磷酸化信号网络。先前的研究表明,Rac1介导的信号与海马依赖性工作记忆以及长期形式的学习和记忆有关,并且Rac1可以调节突触前和突触后可塑性的形式。Rac1介导的这些不同的认知功能和可塑性形式是如何联系在一起的,然而,不清楚。这里,我们表明,在突触前末端表达基因编码的Rac1抑制剂后,小鼠的空间工作记忆受到选择性损害,而长期认知过程受到突触后部位Rac1抑制的影响。为了研究这种突触前过程的调节机制,我们利用质谱的新进展来鉴定突触前Rac1信号的蛋白质组学和翻译后景观。我们鉴定了富含活性Rac1的丝氨酸/苏氨酸激酶和磷酸化细胞骨架信号和突触小泡蛋白。这些蛋白质中的磷酸化位点位于可能对突触小泡具有调节作用的位置。与此一致,我们还报告了突触前Rac1抑制后突触小泡的分布和形态以及突触后超微结构的变化。总的来说,这项研究揭示了Rac1信号在认知过程中的突触前作用,并提供了对其潜在调节机制的见解.
    One of the most extensively studied members of the Ras superfamily of small GTPases, Rac1 is an intracellular signal transducer that remodels actin and phosphorylation signaling networks. Previous studies have shown that Rac1-mediated signaling is associated with hippocampal-dependent working memory and longer-term forms of learning and memory and that Rac1 can modulate forms of both pre- and postsynaptic plasticity. How these different cognitive functions and forms of plasticity mediated by Rac1 are linked, however, is unclear. Here, we show that spatial working memory in mice is selectively impaired following the expression of a genetically encoded Rac1 inhibitor at presynaptic terminals, while longer-term cognitive processes are affected by Rac1 inhibition at postsynaptic sites. To investigate the regulatory mechanisms of this presynaptic process, we leveraged new advances in mass spectrometry to identify the proteomic and post-translational landscape of presynaptic Rac1 signaling. We identified serine/threonine kinases and phosphorylated cytoskeletal signaling and synaptic vesicle proteins enriched with active Rac1. The phosphorylated sites in these proteins are at positions likely to have regulatory effects on synaptic vesicles. Consistent with this, we also report changes in the distribution and morphology of synaptic vesicles and in postsynaptic ultrastructure following presynaptic Rac1 inhibition. Overall, this study reveals a previously unrecognized presynaptic role of Rac1 signaling in cognitive processes and provides insights into its potential regulatory mechanisms.
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  • 文章类型: Journal Article
    感觉神经元专门检测各种环境刺激的存在并发出信号。神经元损伤或疾病可能会破坏这种信号,减少关键信息的可用性。动物能区分不存在的刺激和一开始就感觉不到刺激吗?为了解决这个问题,我们研究了秀丽隐杆线虫蠕虫,由于遗传机械感受器功能障碍而缺乏温和的身体触感。我们之前表明,蠕虫可以通过增强嗅觉来弥补触觉的丧失,通过FLP-20神经肽途径。这里,我们发现缺乏触觉的蠕虫表现出来,除了感官补偿,也有谨慎的行为,好像先发制人地避免潜在的不可检测的危险。有趣的是,当触摸神经元被移除时,这些行为调整被废除,这表明触摸神经元是触摸信息不可用的信号,除了他们的常规信号触摸刺激的作用。此外,我们发现ASE味觉神经元,类似于触摸神经元,表达FLP-20神经肽,以触摸依赖的方式表现出改变的FLP-20表达水平,从而与触摸电路配合。这些结果暗示了一种新形式的神经元信号,使C.elegans能够区分缺乏触摸刺激和触觉丧失。产生适应性行为调整,可以克服无法检测潜在威胁。
    Sensory neurons specialize in detecting and signaling the presence of diverse environmental stimuli. Neuronal injury or disease may undermine such signaling, diminishing the availability of crucial information. Can animals distinguish between a stimulus not being present and the inability to sense that stimulus in the first place? To address this question, we studied Caenorhabditis elegans nematode worms that lack gentle body touch sensation due to genetic mechanoreceptor dysfunction. We previously showed that worms can compensate for the loss of touch by enhancing their sense of smell, via an FLP-20 neuropeptide pathway. Here, we find that touch-deficient worms exhibit, in addition to sensory compensation, also cautious-like behavior, as if preemptively avoiding potential undetectable hazards. Intriguingly, these behavioral adjustments are abolished when the touch neurons are removed, suggesting that touch neurons are required for signaling the unavailability of touch information, in addition to their conventional role of signaling touch stimulation. Furthermore, we found that the ASE taste neurons, which similarly to the touch neurons, express the FLP-20 neuropeptide, exhibit altered FLP-20 expression levels in a touch-dependent manner, thus cooperating with the touch circuit. These results imply a novel form of neuronal signaling that enables C. elegans to distinguish between lack of touch stimulation and loss of touch sensation, producing adaptive behavioral adjustments that could overcome the inability to detect potential threats.
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  • 文章类型: Journal Article
    胸壁附近肺部肿瘤的立体定向放射治疗通常会导致严重的胸壁疼痛(CWP)。对患者生活质量产生负面影响。SBRT诱导的CWP背后的机制尚不清楚,可能涉及多种因素。我们研究了辐射激活的破骨细胞和感觉神经元之间的潜在串扰,关注CWP中破骨细胞衍生因子。使用鼠前破骨细胞系Raw264.7,我们用RANKL诱导分化,其次是10Gyγ辐照。来自这些照射的破骨细胞的条件培养基用于处理来自小鼠背根神经节的感觉神经元培养物。神经元培养物也直接暴露于10Gy辐射,有和没有破骨细胞共培养。使用RT-qPCR和组织化学染色进行破骨细胞标志物和疼痛相关神经肽的分析。使用骨保护素和利塞膦酸盐抑制破骨细胞分化和活性。结果表明,高剂量辐射显着增加破骨细胞的大小,再吸收凹坑大小,和活性生物标志物。用CM处理的神经元从照射的破骨细胞显示疼痛相关神经肽CGRP和P物质的表达增加,通过骨保护素和利塞膦酸盐减轻。这项研究表明,高剂量辐射增强破骨细胞活性,上调感觉神经元中疼痛相关神经肽,骨保护素和利塞膦酸盐等抑制剂可能为管理辐射引起的疼痛提供治疗策略。
    Stereotactic Body Radiation Therapy for lung tumors near the chest wall often causes significant chest wall pain (CWP), negatively impacting patients\' quality of life. The mechanisms behind SBRT-induced CWP remain unclear and may involve multiple factors. We investigated the potential crosstalk between radiation-activated osteoclasts and sensory neurons, focusing on osteoclast-derived factors in CWP. Using the murine pre-osteoclast cell line Raw264.7, we induced differentiation with RANKL, followed by 10Gy gamma-irradiation. Conditioned media from these irradiated osteoclasts was used to treat sensory neuronal cultures from mouse dorsal root ganglia. Neuronal cultures were also directly exposed to 10Gy radiation, with and without osteoclast co-culture. Analysis of osteoclast markers and pain-associated neuropeptides was conducted using RT-qPCR and histochemical staining. Osteoclast differentiation and activity were inhibited using Osteoprotegerin and risedronate. Results showed that high-dose radiation significantly increased osteoclast size, resorption pit size, and activity biomarkers. Neurons treated with CM from irradiated osteoclasts showed increased expression of pain-associated neuropeptides CGRP and Substance P, which was mitigated by osteoprotegerin and risedronate. This study suggests that high-dose radiation enhances osteoclast activity, upregulating pain-associated neuropeptides in sensory neurons, and that inhibitors like osteoprotegerin and risedronate may offer therapeutic strategies for managing radiation-induced pain.
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  • 文章类型: Journal Article
    神经肽(NPs)及其同源受体是多种生理过程和行为的关键效应物。我们最近报道了果蝇葡萄糖-6-磷酸酶(G6P)基因在中枢神经系统神经分泌细胞亚群中的非规范功能,该功能控制着食物剥夺果蝇的全身葡萄糖稳态。这里,我们显示表达G6P的神经元定义了六组NP分泌细胞,四个在大脑两个在胸神经节.使用葡萄糖稳态表型作为筛选工具,我们发现位于胸神经节中表达FMRFamideNP的神经元(FMRFaG6P神经元)对于维持饥饿果蝇的全身葡萄糖稳态是必要且足够的。我们进一步表明,G6P在FMRFaG6P神经元中对于获得突出的高尔基体和有效分泌NP是必不可少的。最后,我们确定,G6P依赖性FMRFa信号传导对于表达FMRFamides受体的跳跃肌肉中糖原储存的积累至关重要。我们提出了一个通用模型,其中G6P的主要作用是抵消肽能神经元中的糖酵解,以优化最适合高尔基体扩张的细胞内环境。增强NP的释放并增强对表达同源受体的相应靶组织的信号传导。
    Neuropeptides (NPs) and their cognate receptors are critical effectors of diverse physiological processes and behaviors. We recently reported of a noncanonical function of the Drosophila Glucose-6-Phosphatase (G6P) gene in a subset of neurosecretory cells in the central nervous system that governs systemic glucose homeostasis in food-deprived flies. Here, we show that G6P-expressing neurons define six groups of NP-secreting cells, four in the brain and two in the thoracic ganglion. Using the glucose homeostasis phenotype as a screening tool, we find that neurons located in the thoracic ganglion expressing FMRFamide NPs (FMRFaG6P neurons) are necessary and sufficient to maintain systemic glucose homeostasis in starved flies. We further show that G6P is essential in FMRFaG6P neurons for attaining a prominent Golgi apparatus and secreting NPs efficiently. Finally, we establish that G6P-dependent FMRFa signaling is essential for the build-up of glycogen stores in the jump muscle which expresses the receptor for FMRFamides. We propose a general model in which the main role of G6P is to counteract glycolysis in peptidergic neurons for the purpose of optimizing the intracellular environment best suited for the expansion of the Golgi apparatus, boosting release of NPs and enhancing signaling to respective target tissues expressing cognate receptors.
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  • 文章类型: Journal Article
    目的:神经分泌素可能具有脑保护作用。我们的目的是发现脑出血(ICH)后血清分泌神经元蛋白水平与严重程度和神经系统预后之间的关系。
    方法:在这项前瞻性队列研究中,在110例ICH患者和110例健康对照者中测定了血清分泌神经元蛋白水平.采用格拉斯哥昏迷量表(GCS)和血肿量评估卒中严重程度。预后不良定义为ICH后90天的格拉斯哥预后量表(GOS)评分为1-3分。建立多因素logistic回归模型以确定血清分泌神经元素水平与严重程度和不良预后的独立相关性。在接收器工作特性(ROC)曲线下,评估血清分泌神经元蛋白水平的预后能力。限制性三次样条(RCS)模型和亚组分析用于发现血清分泌素水平与不良预后风险的关联。评价校准曲线和判定曲线以确认列线图的性能。
    结果:患者血清分泌神经元素水平明显高于健康对照组。患者血清分泌神经元蛋白水平与GCS评分和血肿体积独立相关。有42例患者在ICH后90天预后不良。预后不良的患者的血清分泌神经元蛋白水平明显高于预后良好的患者。在ROC曲线下,血清分泌神经元蛋白水平显着区分不良结局。血清分泌神经元素水平≥22.8ng/mL的患者在90天有预后不良的风险,敏感性为66.2%,特异性为81.0%。此外,血清分泌神经元蛋白水平独立预测90天预后不良。亚组分析显示血清分泌神经元素水平与其他变量无显著交互作用。列线图,包括独立的预后预测因子,使用校准曲线和决策曲线显示出可靠的预后能力。预测模型的曲线下面积明显高于GCS评分和血肿体积。
    结论:血清分泌神经元蛋白水平与ICH后90天的ICH严重程度和不良预后密切相关。因此,血清分泌神经元蛋白可能是ICH中一个有前景的预后生物标志物.
    OBJECTIVE: Secretoneurin may play a brain-protective role. We aim to discover the relationship between serum secretoneurin levels and severity plus neurological outcome after intracerebral hemorrhage (ICH).
    METHODS: In this prospective cohort study, serum secretoneurin levels were measured in 110 ICH patients and 110 healthy controls. Glasgow Coma Scale (GCS) and hematoma volume were used to assess stroke severity. Poor prognosis was defined as Glasgow Outcome Scale (GOS) scores of 1-3 at 90 days after ICH. A multivariate logistic regression model was constructed to determine independent correlation of serum secretoneurin levels with severity and poor prognosis. Under receiver operating characteristic (ROC) curve, prognostic ability of serum secretoneurin levels was assessed. Restricted cubic spline (RCS) model and subgroups analysis were used for discovering association of serum secretoneurin levels with risk of poor prognosis. Calibration curve and decision curve were evaluated to confirm performance of nomogram.
    RESULTS: Serum secretoneurin levels of patients were significantly higher than those of healthy controls. Serum secretoneurin levels of patients were independently correlated with GCS scores and hematoma volume. There were 42 patients with poor prognosis at 90 days following ICH. Serum secretoneurin levels were significantly higher in patients with poor outcome than in those with good outcome. Under the ROC curve, serum secretoneurin levels significantly differentiated poor outcome. Serum secretoneurin levels ≥ 22.8 ng/mL distinguished patients at risk of poor prognosis at 90 days with a sensitivity of 66.2% and a specificity of 81.0%. Besides, serum secretoneurin levels independently predicted a 90-day poor prognosis. Subgroup analysis showed that serum secretoneurin levels had non-significant interactions with other variables. The nomogram, including independent prognostic predictors, showed reliable prognosis capability using calibration curve and decision curve. Area under the curve of the predictive model was significantly higher than those of GCS scores and hematoma volume.
    CONCLUSIONS: Serum secretoneurin levels are strongly related to ICH severity and poor prognosis at 90 days after ICH. Thus, serum secretoneurin may be a promising prognostic biomarker in ICH.
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