Neurotoxicity

神经毒性
  • 文章类型: Journal Article
    重金属在自然界中遇到,并用于多种人类活动,包括牙齿填充物。众所周知,金属的安全性取决于它们的化学形态,以及生物系统暴露于它们的剂量和途径。这里,我们使用Nauphoetacinerea模型来检查牙科填充物中使用的重金属盐-银和汞-发挥其神经毒性的机制。若虫暴露在重金属中,由于花费更多时间不动,因此运动和探索能力降低,尤其是在一个新物体的外围,与对照若虫相比,覆盖的距离更短。暴露于AgNO3和HgCl2也加剧了氧化应激标志物(MDA和ROS)和神经递质调节因子-AChE和MAO的水平,同时减少抗氧化活性标志物,在生物化学(硫醇和GST)和RT-qPCR(TRX,GST,SOD,过氧化氢酶)检查,蟑螂的神经组织。观察到的神经运动控制中断,突触传递和氧化还原平衡解释了重金属盐如何使生物体易患神经系统疾病。
    Heavy metals are encountered in nature, and are used in several human endeavors, including in dental fillings. It is well known that the safety of metals depends on their chemical form, as well as the dose and route through which biological systems are exposed to them. Here, we used the Nauphoeta cinerea model to examine the mechanism by which salts of the heavy metals used in dental fillings - silver and mercury - exert their neurotoxicity. Nymphs exposed to heavy metals presented with reduced motor and exploratory abilities as they spent more time immobile, especially in the periphery of a novel object, and covered less distance compared with control nymphs. Exposure to AgNO3 and HgCl2 also exacerbated levels of oxidative stress markers (MDA & ROS) and the neurotransmitter regulators - AChE and MAO, while reducing antioxidant activity markers, both in biochemical (thiol & GST) and RT-qPCR (TRX, GST, SOD, Catalase) examinations, in neural tissues of the cockroach. The observed disruptions in neurolocomotor control, synaptic transmission and redox balance explain how heavy metal salts may predispose organisms to neurological disorders.
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  • 文章类型: Journal Article
    纳米技术已经显示出显著的进步,人们越来越担心NPs暴露可能引起的神经毒性和神经退行性作用。各种毒理学和流行病学研究报道,大脑是超细颗粒的主要目标。脑炎症被认为是可能的机制,可以参与神经毒性和神经退行性作用。纳米颗粒(NPs)是否会产生神经毒性并促进神经退行性变,目前尚无研究。本研究是为了调查鼻内和腹膜内暴露于氧化铈纳米颗粒(CeO2NP,通过进行一些行为测试,纳米氧化铈(NC))可能会导致脑组织中的神经毒性和神经退行性变化,生化评价,脑海马和基因表达的组织病理学检查。
    将15只小鼠分成3个相等的组。在组(I)“控制组”中,小鼠口服蒸馏水作为对照组。组(II)“NCI/P组”中的小鼠以40mg/kgb.wt,每周两次,共3周。在组(III)中,“NCI/N组”小鼠鼻内接受纳米铈(40mg/kgb.wt),每周两次,共3周。
    暴露于nanceria导致脑组织氧化损伤,丙二醛(MDA)和乙酰胆碱酯酶(AchE)水平显着增加,还原型谷胱甘肽(GSH)浓度显着降低,凋亡相关基因的上调(c-Jun:c-JunN末端激酶(JNKs),c-Fos:Fos原癌基因,AP-1转录因子亚基,c-Myc:c-骨髓细胞瘤癌基因产物或MYC原癌基因,bHLH转录因子),小鼠的运动能力和认知障碍,但腹膜内施用纳米铈后效果更明显。
    当腹膜内给予纳米二氧化铈比鼻内给予纳米二氧化铈时,纳米二氧化铈在小鼠脑组织中引起氧化损伤。
    UNASSIGNED: Nanotechnology has shown a remarkable progress nevertheless, there is a growing concern about probable neurotoxic and neurodegenerative effects due to NPs exposure. Various toxicological and epidemiological studies reported that the brain is a main target for ultrafine particles. Brain inflammation is considered as a possible mechanism that can participate to neurotoxic and neurodegenerative effects. Whether nanoparticles (NPs) may produce neurotoxicity and promote neurodegenerative is largely unstudied. The present study was done to investigate whether intranasal and intra-peritoneal exposure to cerium oxide nanoparticles (CeO2NPs, nanoceria (NC)) could cause neurotoxicity and neurodegenerative changes in the brain tissue through conducting some behavioral tests, biochemical evaluation, histopathological examinations of brain hippocampus and gene expressions.
    UNASSIGNED: Fifteen mice were separated into 3 equal groups. In group (I) \"control group\", mice were received distilled water orally and kept as a control group. Mice in the group (II) \"NC I/P group\" were injected i.p with cerium oxide nanoparticles at a dose of 40 mg/kg b.wt, twice weekly for 3 weeks. In group (III) \"NC I/N group\" mice were received nanoceria intranasally (40 mg/kg b.wt), twice weekly for 3 weeks.
    UNASSIGNED: Exposure to nanceria resulted in oxidative damage in brain tissue, a significant increase in malondialdehyde (MDA) and acetylcholinestrase (AchE) levels, significant decrease in reduced glutathione (GSH) concentration, upregulation in the apoptosis-related genes (c-Jun: c-Jun N-terminal kinases (JNKs), c-Fos: Fos protooncogene, AP-1 transcription factor subunit, c-Myc: c-myelocytomatosis oncogene product or MYC protooncogene, bHLH transcription factor), locomotor and cognitive impairment in mice but the effect was more obvious when nanoceria adminstred intraperitoneally.
    UNASSIGNED: Nanoceria cause oxidative damage in brain tissue of mice when adminstred nanoceria intraperitoneally more than those received nanoceria intranasal.
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  • 文章类型: Journal Article
    免疫检查点抑制剂(ICIs)已经改变了癌症治疗,改善许多患者的预后。然而,称为免疫相关不良事件(irAEs)的毒性是这些革命性治疗的局限性.这些irAE可能会随着治疗或ICI停止(急性)而解决,或在治疗停止后持续数月(慢性)。急性irAE是第一个被识别的,因此得到了更充分的研究。然而,近年来,慢性irAE已被重点关注,并且正成为更深入研究的主题.已注意到这些慢性irAE会影响许多不同的器官系统,包括内分泌,风湿病,胃肠,皮肤病学,神经学,和心血管系统。在这次审查中,我们讨论围绕频率的当前知识,时间进程,以及与影响各种器官系统的慢性IRAE相关的危险因素,治疗方法,和未来的方向。
    Immune checkpoint inhibitors (ICIs) have transformed cancer treatment, improving outcomes for many patients. However, toxicities termed immune-related adverse events (irAEs) are limitations of these revolutionary treatments. These irAEs may resolve with treatment or ICI cessation (acute) or persist many months beyond therapy cessation (chronic). Acute irAEs were the first to be recognized and are thus more well studied. However, chronic irAEs have been highlighted in recent years and are becoming a topic of more intensive investigation. These chronic irAEs have been noted to affect many different organ systems, including endocrine, rheumatologic, gastrointestinal, dermatologic, neurologic, and cardiovascular systems. In this review, we discuss current knowledge surrounding the frequency, time course, and risk factors associated with chronic irAEs affecting various organ systems, treatment approaches, and future directions.
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  • 文章类型: Journal Article
    丙烯酰胺(ACR)是一种神经毒性剂,其损害可以通过抗氧化剂的施用来减轻。藏红花素是一种藏红花衍生的抗氧化剂,具有神经保护作用。本研究评估了反式-克罗西汀钠(TSC)及其水溶性衍生物的保护作用,双-N-(N-甲基吡嗪基)色胺酸盐(BMPC)抗ACR神经毒性。
    用TSC和BMPC(1.95、3.9、7.81、15.62、31.25、62.5、125、250、500和1000μM)处理PC12细胞24小时。然后加入浓度为6.5mM(IC50)的ACR,通过3-(4,5-二甲基噻唑-2-基)-2,5-二苯基四唑溴化物评估细胞活力。在体内研究中,雄性Wistar大鼠用ACR治疗(50mg/kg,腹膜内(i.p.)单独或与TSC和BMPC(2.5、5和10mg/kg,i.p.)或维生素E(200IU/kg,i.p.)。然后评估运动障碍。取大鼠大脑皮层进行丙二醛(MDA)和谷胱甘肽(GSH)水平测定。
    体外研究表明,浓度为7.81μM的TSC和浓度为3.9、7.81和15.62μM的BMPC在丙烯酰胺施用中表现出最低的毒性。在体内研究中,用2.5、5和10mg/kg的TSC预处理可改善行为障碍,但是BMPC不能减弱它们。GSH和MDA被2.5、5和10mg/kgTSC和2.5mg/kgBMPC改善。
    TSC和BMPC给药通过减少MDA和提高大脑皮层中GSH含量来改善暴露于ACR的Wistar大鼠的行为指数和氧化应激损伤。
    UNASSIGNED: Acrylamide (ACR) is a neurotoxic agent whose damage could be attenuated by antioxidants administration. Crocetin is a saffron-derived antioxidant that has neuroprotective effects. This study evaluates the protective effects of trans-sodium crocetinate (TSC) and its water-soluble derivative, Bis-N-(N-methylpyprazinyl) crocetinate (BMPC) against ACR neurotoxicity.
    UNASSIGNED: PC12 cells were treated with TSC and BMPC (1.95, 3.9, 7.81, 15.62, 31.25, 62.5, 125, 250, 500, and 1000 μM) for 24 hr. ACR was then added at a concentration of 6.5 mM (IC50), and cell viability was assessed by 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide. In the in vivo study, male Wistar rats were treated with ACR (50 mg/kg, intraperitoneal (i.p.)) for 11 days alone or in combination with TSC and BMPC (2.5, 5, and 10 mg/kg, i.p.) or vitamin E (200 IU/kg, i.p.). Motor impairments were then evaluated. The cerebral cortex of sacrificed rats was taken for the malondialdehyde (MDA) and glutathione (GSH) levels measurement.
    UNASSIGNED: In vitro studies showed that TSC at a concentration of 7.81 μM and BMPC at concentrations of 3.9, 7.81, and 15.62 μM exhibited the lowest toxicity in acrylamide administration. In the in vivo study, pretreatment with 2.5, 5, and 10 mg/kg of TSC ameliorated behavioral impairments, but BMPC could not attenuate them. GSH and MDA were improved by 2.5, 5, and 10 mg/kg TSC and 2.5 mg/kg BMPC.
    UNASSIGNED: TSC and BMPC administration improved behavioral index and oxidative stress injuries in Wistar rats exposed to ACR through MDA reduction and GSH content enhancement in the cerebral cortex.
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  • 文章类型: Journal Article
    背景:中乌头碱(MA),从草药乌头中提取的二酯-二萜生物碱,通常用于治疗各种疾病。先前的研究表明,尽管乌头具有药理活性,但其具有强大的毒性,对其对神经系统和潜在机制的影响了解有限。方法:用HT22细胞和斑马鱼研究MA在体外和体内的神经毒性作用。采用多组学技术探索潜在的毒性机制。结果:我们的结果表明,用MA处理可诱导斑马鱼和HT22细胞的神经毒性。随后的分析表明,MA诱导氧化应激,以及HT22细胞中线粒体的结构和功能损伤,伴随着与自噬和溶酶体途径相关的mRNA和蛋白质表达的上调。此外,甲基化RNA免疫沉淀测序(MeRIP-seq)显示自噬相关基因的表达与MA处理后的N6-甲基腺苷(m6A)修饰之间存在相关性。此外,我们确定METTL14是暴露于MA后HT22细胞中m6A甲基化的潜在调节因子。结论:我们的研究有助于对MA引起的神经毒性作用进行彻底的机制阐明,为临床上优化含乌头中药配方的合理使用提供了有价值的见解。
    Background: Mesaconitine (MA), a diester-diterpenoid alkaloid extracted from the medicinal herb Aconitum carmichaelii, is commonly used to treat various diseases. Previous studies have indicated the potent toxicity of aconitum despite its pharmacological activities, with limited understanding of its effects on the nervous system and the underlying mechanisms. Methods: HT22 cells and zebrafish were used to investigate the neurotoxic effects of MA both in vitro and in vivo, employing multi-omics techniques to explore the potential mechanisms of toxicity. Results: Our results demonstrated that treatment with MA induces neurotoxicity in zebrafish and HT22 cells. Subsequent analysis revealed that MA induced oxidative stress, as well as structural and functional damage to mitochondria in HT22 cells, accompanied by an upregulation of mRNA and protein expression related to autophagic and lysosomal pathways. Furthermore, methylated RNA immunoprecipitation sequencing (MeRIP-seq) showed a correlation between the expression of autophagy-related genes and N6-methyladenosine (m6A) modification following MA treatment. In addition, we identified METTL14 as a potential regulator of m6A methylation in HT22 cells after exposure to MA. Conclusion: Our study has contributed to a thorough mechanistic elucidation of the neurotoxic effects caused by MA, and has provided valuable insights for optimizing the rational utilization of traditional Chinese medicine formulations containing aconitum in clinical practice.
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  • 文章类型: Journal Article
    在含有利奈唑胺的方案中,神经性不良事件经常发生,其中一些在停药后仍然不可逆转。
    我们旨在鉴定和验证一种基于宿主RNA的生物标志物,该生物标志物可以在耐多药/利福平耐药结核病(MDR/RR-TB)治疗开始前预测利奈唑胺相关神经病变,并鉴定与利奈唑胺相关神经病变相关的基因和通路。
    在德国,开始接受包括利奈唑胺在内的MDR/RR-TB治疗的成年患者被前瞻性纳入3个独立队列。收集临床数据和用于转录组学分析的全血RNA。主要结果是利奈唑胺相关的视神经和/或周围神经病变。将随机森林算法用于生物标志物鉴定。该生物标志物在来自罗马尼亚的另一个第四组MDR/RR-TB患者中得到验证。
    来自3个识别队列的总共52名患者接受了利奈唑胺治疗。其中,24(46.2%)在利奈唑胺治疗期间发生了外周和/或视神经病变。大多数(59.3%)的发作是中度(2级)严重程度。总的来说,1,479个基因的表达在治疗基线时存在显著差异.Suprabasin(SBSN)被确定为预测利奈唑胺相关神经病变的潜在生物标志物。在验证队列中,42例患者中有10例(23.8%)出现≥3级神经病变。用于生物标志物算法预测≥3级神经病变的曲线下面积为0.63(差;95%置信区间:0.42-0.84)。
    我们确定并初步验证了一种潜在的临床生物标志物,用于在开始MDR/RR-TB治疗之前预测利奈唑胺相关的神经病变。有必要在更多样化的人群中对SBSN生物标志物进行更大规模的研究。
    UNASSIGNED: Neuropathic adverse events occur frequently in linezolid-containing regimens, some of which remain irreversible after drug discontinuation.
    UNASSIGNED: We aimed to identify and validate a host RNA-based biomarker that can predict linezolid-associated neuropathy before multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) treatment initiation and to identify genes and pathways that are associated with linezolid-associated neuropathy.
    UNASSIGNED: Adult patients initiating MDR/RR-TB treatment including linezolid were prospectively enrolled in 3 independent cohorts in Germany. Clinical data and whole blood RNA for transcriptomic analysis were collected. The primary outcome was linezolid-associated optic and/or peripheral neuropathy. A random forest algorithm was used for biomarker identification. The biomarker was validated in an additional fourth cohort of patients with MDR/RR-TB from Romania.
    UNASSIGNED: A total of 52 patients from the 3 identification cohorts received linezolid treatment. Of those, 24 (46.2%) developed peripheral and/or optic neuropathies during linezolid treatment. The majority (59.3%) of the episodes were of moderate (grade 2) severity. In total, the expression of 1,479 genes differed significantly at baseline of treatment. Suprabasin (SBSN) was identified as a potential biomarker to predict linezolid-associated neuropathy. In the validation cohort, 10 of 42 (23.8%) patients developed grade ≥3 neuropathies. The area under the curve for the biomarker algorithm prediction of grade ≥3 neuropathies was 0.63 (poor; 95% confidence interval: 0.42 - 0.84).
    UNASSIGNED: We identified and preliminarily validated a potential clinical biomarker to predict linezolid-associated neuropathies before the initiation of MDR/RR-TB therapy. Larger studies of the SBSN biomarker in more diverse populations are warranted.
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  • 文章类型: Journal Article
    缺氧(OD)是一种危重症,可导致脑损伤甚至死亡。目前的缺氧管理方法的有效性有限。积雪草(CA),以其神经保护特性而闻名,为OD治疗提供了潜在的替代方案。
    本研究旨在研究缺氧条件下CA对斑马鱼幼虫脑源性神经营养因子(BDNF)和囊泡谷氨酸转运蛋白1(VGLUT1)表达的神经保护作用。
    斑马鱼胚胎接受低氧水平(1.5mg/l)受精后0-2小时(hpf),直到受精后3天(dpf),模拟OD的早期阶段。随后的治疗涉及不同浓度的CA(1.25-5µg/ml),直至受精后9天。使用PCR方法测量BDNF和VGLUT1的表达水平。使用双向方差分析进行统计分析,以评估CA对在缺氧条件下3和9dpf的斑马鱼幼虫中BDNF和VGLUT1表达的影响。
    CA显著影响OD下BDNF和VGLUT1的表达(p<0.001)。在经历OD并用CA处理的斑马鱼幼虫中观察到BDNF表达的增加(p<0.001)和VGLUT1的减少(p<0.01)。在3dpf和9dpf的斑马鱼幼虫中,BDNF和VGLUT1表达在年龄变化中在治疗组中没有显着差异(p>0.05)。2.5µg/ml的CA浓度可有效增强BDNF并降低3-9dpf斑马鱼幼虫的VGLUT1。
    CA显示出作为神经保护剂的潜力,在OD条件下调节增加的BDNF表达和降低的VGLUT1。这些发现为进一步开发缺氧疗法奠定了基础。
    UNASSIGNED: Oxygen deprivation (OD) is a critical condition that can lead to brain damage and even death. Current hypoxia management approaches are limited in effectiveness. Centella asiatica (CA), known for its neuroprotective properties, offers a potential alternative for OD treatment.
    UNASSIGNED: This study aims to investigate the neuroprotective effects of CA on the expression of brain-derived neurotrophic factor (BDNF) and vesicular glutamate transporter 1 (VGLUT1) in zebrafish larvae under oxygen-deficient conditions.
    UNASSIGNED: Zebrafish embryos were subjected to low oxygen levels (1.5 mg/l) 0-2 hours post-fertilization (hpf) until 3 days post-fertilization (dpf), simulating the early stages of OD. Subsequent treatment involved varying concentrations of CA (1.25-5 µg/ml) up to 9 days post-fertilization. The expression levels of BDNF and VGLUT1 were measured using PCR methods. Statistical analysis was conducted using a two-way analysis of variance to evaluate the impact of CA on the expression of BDNF and VGLUT1 in zebrafish larvae aged 3 and 9 dpf in oxygen-deprived conditions.
    UNASSIGNED: CA significantly influenced the expression of BDNF and VGLUT1 under OD (p < 0.001). An increase in BDNF expression (p < 0.001) and a decrease in VGLUT1 (p < 0.01) were observed in zebrafish larvae experiencing OD and treated with CA. There was no significant difference in BDNF and VGLUT1 expression across age variations in zebrafish larvae at 3 dpf and 9 dpf in the treatment groups (p > 0.05). CA concentration of 2.5 µg/ml effectively enhanced BDNF and reduced VGLUT1 in 3-9 dpf zebrafish larvae.
    UNASSIGNED: CA demonstrates potential as a neuroprotective agent, modulating increased BDNF expression and reduced VGLUT1 under OD conditions. These findings lay a foundation for further research in developing therapies for oxygen deficiency.
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  • 文章类型: Journal Article
    烟草和酒精已被确定为与重大不利健康后果相关的健康危险行为,在十大死亡原因和残疾调整寿命年(DALY)中排名。烟草的燃烧导致丙烯酰胺(ACR)的形成,以其神经毒性作用而闻名。同样,饮酒也因其神经毒性作用而被广泛认可。这两种物质都可以通过各种途径影响神经元和神经胶质细胞。这项研究旨在检查ACR和间歇性获取乙醇(IAE)消耗在一个月的时间内共同施用的影响。实验组服用20mg/kg的ACR,口服给药,伴随着持续24小时的20%乙醇的IAE,每周三次。使用高架迷宫(EPM)评估认知结果,它被用作评估学习和记忆能力的一种手段,新颖的物体识别(NOR)测试,用于评估识别记忆,还有Y迷宫,用于探索新环境和导航。此外,进行ELISA测定以检查潜在的机制,包括与炎症相关的标志物(NF-κB,PGE2和TNF-α),凋亡(Bcl2,Bax,和Caspase-3),和氧化应激(MDA,过氧化氢酶,和GSH)。作为研究的一部分,在脑匀浆中评估这些标记物。此外,进行了组织病理学研究。研究结果表明,与单独的ACR或单独的IAE组相比,在ACR和IAE组(ACR+IAE)的组合中NF-κB水平显著增加。然而,观察到TNF-α的平行变化,PGE2,Bax,Bcl-2,Caspase-3,GSH,当比较ACR+IAE组与单独ACR组时,CAT水平。在TNF-α中,ACRIAE治疗与IAE单独治疗组之间的变化相当,Bcl-2,MDA,GSH,CAT水平。此外,组织病理学分析显示,ACR+IAE组和ACR-或IAE-单独组之间发生显著变化.关于使用包括EPM在内的测试评估的内存参数,NOR,和Y迷宫,与对照组相比,在所有治疗组中观察到相当大的变化.令人惊讶的是,单独治疗和联合治疗之间的NOR和Y迷宫任务没有显着差异。进一步的研究是必要的,以探讨共同管理ACR和IAE对行为的长期变化,记忆,和神经毒性相关机制,以便更清楚地阐明它们的综合作用。
    Tobacco and alcohol have been identified as health risk behaviors associated with significant unfavorable health consequences, ranking within the list of the top ten causes of mortality and disability-adjusted life years (DALY). The combustion of tobacco leads to the formation of acrylamide (ACR), which is well known for its neurotoxic effects. Similarly, alcohol consumption has also been widely recognized for its neurotoxic effects. Both substances can affect neurons and neuroglia cells through various pathways. This study sought to examine the impacts of co-administration of ACR and intermittent-access ethanol (IAE) consumption over a period of one month. The experimental group received 20 mg/kg of ACR, administered orally, along with IAE of 20% ethanol sessions lasting 24 h, three times per week. The cognitive outcomes were assessed utilizing the elevated plus maze (EPM), which was employed as a means of assessing the capability to learn and remember, the novel object recognition (NOR) test, which was employed to assess recognition memory, and the Y-maze, which was used to explore a new environment and navigate. Additionally, ELISA assays were performed to examine underlying mechanisms, including markers associated with inflammation (NF-κB, PGE2, and TNF-α), apoptosis (Bcl2, Bax, and Caspase-3), and oxidative stress (MDA, catalase, and GSH). These markers were assessed in the brain homogenate as part of the investigation. Furthermore, a histopathological study was conducted. The findings indicated that NF-κB levels increased significantly in the combination of ACR and IAE groups (ACR + IAE) compared to either the ACR-alone or IAE-alone groups. However, parallel changes were observed in TNF-α, PGE2, Bax, Bcl-2, Caspase-3, GSH, and CAT levels when comparing the ACR + IAE group to the ACR-alone group. Comparable alterations were noted between the ACR + IAE treatment and IAE-alone groups in TNF-α, Bcl-2, MDA, GSH, and CAT levels. Moreover, the histopathological analysis revealed significant changes between the ACR + IAE and the ACR- or IAE-alone groups. Regarding memory parameters assessed using tests including EPM, NOR, and Y-maze, considerable changes were observed across all treatment groups as opposed to the control. Surprisingly, there were no notable differences in the NOR and Y-maze tasks between the alone and combination treatment. Further study is necessary to explore the long-term alteration of co-administering ACR and IAE on behavior, memory, and neurotoxicity-related mechanisms, in order to elucidate their combined effects more clearly.
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  • 文章类型: Journal Article
    使用免疫检查点抑制剂(ICIs)治疗各种晚期和侵袭性恶性肿瘤,显着提高了生存率和长期缓解率。ICI阻断免疫系统的关键抑制途径,以引发针对肿瘤的加重的免疫反应。然而,这种增强的免疫激活导致许多免疫相关不良事件(irAE)的发展,这可能会影响任何系统。尽管严重的神经系统irAE相对罕见,他们承担着很高的残疾负担,它们可能会危及生命。因此,当接受ICIs的患者出现新发神经系统症状时,临床医生必须保持警惕并迅速采取行动.在这篇叙述性评论中,我们已经收集了所有现有的流行病学数据,发病机制,临床表现,诊断,以及ICI后神经系统iRAE的治疗。这篇综述旨在提高医生的认识,丰富他们关于疾病发病机理的知识,并指导他们诊断和管理ICI后神经系统iRAE。
    The use of immune checkpoint inhibitors (ICIs) for the treatment of various advanced and aggressive types of malignancy has significantly increased both survival and long-term remission rates. ICIs block crucial inhibitory pathways of the immune system, in order to trigger an aggravated immune response against the tumor. However, this enhanced immune activation leads to the development of numerous immune-related adverse events (irAEs), which may affect any system. Although severe neurological irAEs are relatively rare, they carry a high disability burden, and they can be potentially life-threatening. Therefore, clinicians must be alert and act promptly when individuals receiving ICIs present with new-onset neurological symptoms. In this narrative review, we have collected all the currently available data regarding the epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of post-ICI neurological irAEs. This review aims to raise physicians\' awareness, enrich their knowledge regarding disease pathogenesis, and guide them through the diagnosis and management of post-ICI neurological irAEs.
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  • 文章类型: Journal Article
    遗传多态性可能影响汞(Hg)毒性。这项研究的目的是评估个体因素,例如GSTP1rs1695多态性的存在,与长期暴露于汞的巴西亚马逊土著居民的内部汞剂量和儿童神经发育有关。对82名土著儿童进行了临床评估,测量头发汞,并对GSTP1rs1695多态性进行基因分型。平均年龄是4.8岁,汞中位数为5.5微克/克,93.8%的儿童超过安全限值(2.0微克/克)。鱼类消耗与汞含量相关(p=0.03)。GSTP1rs1695A>G多态性处于Hardy-Weinberg平衡,在SawréAboy中发现GSTP1AA基因型的患病率最高(80%),在研究的村庄中,汞含量最高(10微克/克)。多年来,男性和GSTP1AA基因型携带者的汞水平趋于增加(0.69µg/g和0.86µg/g,分别)。九个孩子神经发育测试不及格,所有这些人的汞含量都>2.0微克/克,88.9%携带GSTP1AA或AG基因型,以前与最高的内部汞剂量和神经认知障碍有关。该人群的遗传咨询对于确定长期汞暴露导致神经发育障碍风险更大的个体非常重要。
    Genetic polymorphisms may influence mercury (Hg) toxicity. The aims of this study were to evaluate individual factors, such as the presence of the GSTP1 rs1695 polymorphism, associated with internal Hg dose and child neurodevelopment in indigenous people from the Brazilian Amazon chronically exposed to Hg. Eighty-two indigenous children were clinically evaluated, hair Hg was measured, and the GSTP1 rs1695 polymorphism was genotyped. The mean age was 4.8 years, the median Hg was 5.5 µg/g, and 93.8% of children exceeded the safe limit (2.0 µg/g). Fish consumption was associated with Hg levels (p = 0.03). The GSTP1 rs1695 A>G polymorphism was in the Hardy-Weinberg equilibrium and the highest prevalence of the GSTP1 AA genotype (80%) was found in Sawré Aboy, which had the highest Hg levels (10 µg/g) among the studied villages. The Hg levels tended to increase over the years in males and in carriers of the GSTP1 AA genotype (0.69 µg/g and 0.86 µg/g, respectively). Nine children failed the neurodevelopmental test, all of whom had Hg > 2.0 µg/g, and 88.9% carried the GSTP1 AA or AG genotypes, previously associated with the highest internal Hg doses and neurocognitive disorders. The genetic counseling of this population is important to identify the individuals at greater risk for neurodevelopmental disorders resulting from chronic Hg exposure.
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