Therapeutic approaches

治疗方法
  • 文章类型: Journal Article
    阿尔茨海默病(AD)是一种严重的进行性神经退行性疾病,与神经元损伤和认知功能降低有关,主要影响全球老年人。虽然越来越多的证据表明线粒体功能障碍是导致AD的最重要因素之一,其准确的病理生物学仍不清楚。线粒体生物能学和体内平衡在AD发病过程中受损和缺陷。然而,已经考虑到编码线粒体成分的核或线粒体DNA中的突变可能导致线粒体功能障碍,因为它是AD早期阶段通常受损的细胞内过程之一。此外,电子传递链功能障碍和线粒体病理蛋白相互作用与AD的线粒体功能障碍有关。许多线粒体参数在衰老过程中下降,导致活性氧(ROS)产生不平衡,导致年龄相关性AD的氧化应激。此外,神经炎症是AD相关线粒体功能障碍的另一个潜在致病因素。虽然针对线粒体功能障碍的几种治疗方法已经进行了临床前研究,很少有人在临床试验中取得成功。因此,这篇综述讨论了纠正AD线粒体功能障碍的分子机制和不同的治疗方法,有可能促进基于新型药物的AD干预措施的未来发展。
    Alzheimer\'s disease (AD) is a severe progressive neurodegenerative condition associated with neuronal damage and reduced cognitive function that primarily affects the aged worldwide. While there is increasing evidence suggesting that mitochondrial dysfunction is one of the most significant factors contributing to AD, its accurate pathobiology remains unclear. Mitochondrial bioenergetics and homeostasis are impaired and defected during AD pathogenesis. However, the potential of mutations in nuclear or mitochondrial DNA encoding mitochondrial constituents to cause mitochondrial dysfunction has been considered since it is one of the intracellular processes commonly compromised in early AD stages. Additionally, electron transport chain dysfunction and mitochondrial pathological protein interactions are related to mitochondrial dysfunction in AD. Many mitochondrial parameters decline during aging, causing an imbalance in reactive oxygen species (ROS) production, leading to oxidative stress in age-related AD. Moreover, neuroinflammation is another potential causative factor in AD-associated mitochondrial dysfunction. While several treatments targeting mitochondrial dysfunction have undergone preclinical studies, few have been successful in clinical trials. Therefore, this review discusses the molecular mechanisms and different therapeutic approaches for correcting mitochondrial dysfunction in AD, which have the potential to advance the future development of novel drug-based AD interventions.
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  • 文章类型: Systematic Review
    帕金森病(PD)是一种以运动和非运动症状为特征的常见神经退行性疾病。新的证据表明肠道微生物群的改变,特别涉及短链脂肪酸(SCFA),如丁酸,可能影响PD的发病机制和症状学。本系统综述旨在综合目前关于丁酸盐在调节运动症状中的作用及其在PD中的神经保护作用的研究。提供潜在治疗方法的见解。2024年4月,在数据库中进行了系统的文献检索,包括ScienceDirect,Scopus,威利,和WebofScience,对于2000年至2024年之间发表的研究。使用的关键词是“神经保护作用和丁酸和(帕金森病或运动症状)”。四位作者独立筛选了标题,摘要,和全文,应用纳入标准,重点研究丁酸调节和PD运动症状。共确定了1377篇文章,其中40项被选中进行全文审查,14项研究符合纳入标准。对研究人群进行数据提取,PD模型,方法论,干预细节,和结果。使用SYRCLERoB工具进行的质量评估突出了研究质量的变异性,在分配隐藏和致盲中注意到一些偏见。研究结果表明,丁酸调节对改善运动症状有显著影响,并在PD模型中提供神经保护益处。肠道微生物群的治疗调节以提高丁酸水平为PD症状管理提供了有希望的策略。
    Parkinson\'s Disease (PD) is a prevalent neurodegenerative disorder characterized by motor and non-motor symptoms. Emerging evidence suggests that gut microbiota alterations, specifically involving short-chain fatty acids (SCFAs) like butyrate, may influence PD pathogenesis and symptomatology. This Systematic Review aims to synthesize current research on the role of butyrate in modulating motor symptoms and its neuroprotective effects in PD, providing insights into potential therapeutic approaches. A systematic literature search was conducted in April 2024 across databases, including ScienceDirect, Scopus, Wiley, and Web of Science, for studies published between 2000 and 2024. Keywords used were \"neuroprotective effects AND butyrate AND (Parkinson disease OR motor symptoms)\". Four authors independently screened titles, abstracts, and full texts, applying inclusion criteria focused on studies investigating butyrate regulation and PD motor symptoms. A total of 1377 articles were identified, with 40 selected for full-text review and 14 studies meeting the inclusion criteria. Data extraction was performed on the study population, PD models, methodology, intervention details, and outcomes. Quality assessment using the SYRCLE RoB tool highlighted variability in study quality, with some biases noted in allocation concealment and blinding. Findings indicate that butyrate regulation has a significant impact on improving motor symptoms and offers neuroprotective benefits in PD models. The therapeutic modulation of gut microbiota to enhance butyrate levels presents a promising strategy for PD symptom management.
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  • 文章类型: Journal Article
    体液免疫是肺移植(LT)受体中慢性同种异体移植功能障碍的主要途径。尽管同种异体免疫和抗体介导的排斥(AMR)是众所周知的实体,一些诊断差距需要解决。形态学分析可以通过数字病理学和基于人工智能的配套工具来增强。移植物转录组学可以帮助鉴定移植物失败表型或基因型。正在评估供体来源的无细胞DNA,以进行移植物丢失风险分层和量身定制的监测。预防性治疗应根据风险进行调整。对于HLA致敏的候选人,可以扩大供体库,结合血浆置换的策略,静脉注射免疫球蛋白和免疫细胞耗竭,或新兴或创新的疗法,如imlifidase或免疫吸附。在移植前脱敏不足的情况下,抗体对同种异体移植物的影响可以通过靶向补体级联来预防,尽管LT中这种策略的证据有限。在具有体液反应的LT受体中,策略相结合,包括免疫细胞的消耗(血浆置换或免疫吸附),抑制免疫途径,或炎症级联的调节,这可以实现与光脱。总之,这些创新技术为LT接受者提供了有希望的观点,并塑造了21世纪对抗AMR的武器库。
    Humoral immunity is a major waypoint towards chronic allograft dysfunction in lung transplantation (LT) recipients. Though allo-immunization and antibody-mediated rejection (AMR) are well-known entities, some diagnostic gaps need to be addressed. Morphological analysis could be enhanced by digital pathology and artificial intelligence-based companion tools. Graft transcriptomics can help to identify graft failure phenotypes or endotypes. Donor-derived cell free DNA is being evaluated for graft-loss risk stratification and tailored surveillance. Preventative therapies should be tailored according to risk. The donor pool can be enlarged for candidates with HLA sensitization, with strategies combining plasma exchange, intravenous immunoglobulin and immune cell depletion, or with emerging or innovative therapies such as imlifidase or immunoadsorption. In cases of insufficient pre-transplant desensitization, the effects of antibodies on the allograft can be prevented by targeting the complement cascade, although evidence for this strategy in LT is limited. In LT recipients with a humoral response, strategies are combined, including depletion of immune cells (plasmapheresis or immunoadsorption), inhibition of immune pathways, or modulation of the inflammatory cascade, which can be achieved with photopheresis. Altogether, these innovative techniques offer promising perspectives for LT recipients and shape the 21st century\'s armamentarium against AMR.
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  • 文章类型: Journal Article
    胃肠道(GI)癌症代表了重大的全球健康挑战,推动不懈的努力,以确定创新的诊断和治疗方法。微生物组研究的最新进展揭示了以前被低估的癌症进展维度,该维度围绕胃肠道癌症和宿主肠道微生物群之间复杂的代谢相互作用。这篇综述旨在全面概述这些新兴的代谢相互作用及其在胃肠道癌症的精确诊断和治疗突破中催化范式转变的潜力。本文通过深入研究宿主代谢与肠道微生物群之间的共生关系,强调了微生物组研究对肿瘤学的开创性影响。它提供了为个体患者量身定制治疗策略的宝贵见解,从而超越了传统的一刀切的方法。这篇综述还揭示了新的诊断方法,可以改变胃肠道癌症的早期检测。可能导致更有利的患者结果。总之,探索宿主肠道微生物群和胃肠道癌症之间的代谢相互作用,展示了在对抗这些强大疾病的持续斗争中一个有希望的前沿.通过理解和利用微生物组的影响,对胃肠道癌症的精准诊断和治疗创新的未来似乎更加乐观,为量身定制的治疗方法和提高诊断精度打开门。
    Gastrointestinal (GI) cancers represent a significant global health challenge, driving relentless efforts to identify innovative diagnostic and therapeutic approaches. Recent strides in microbiome research have unveiled a previously underestimated dimension of cancer progression that revolves around the intricate metabolic interplay between GI cancers and the host\'s gut microbiota. This review aims to provide a comprehensive overview of these emerging metabolic interactions and their potential to catalyze a paradigm shift in precision diagnosis and therapeutic breakthroughs in GI cancers. The article underscores the groundbreaking impact of microbiome research on oncology by delving into the symbiotic connection between host metabolism and the gut microbiota. It offers valuable insights into tailoring treatment strategies to individual patients, thus moving beyond the traditional one-size-fits-all approach. This review also sheds light on novel diagnostic methodologies that could transform the early detection of GI cancers, potentially leading to more favorable patient outcomes. In conclusion, exploring the metabolic interactions between host gut microbiota and GI cancers showcases a promising frontier in the ongoing battle against these formidable diseases. By comprehending and harnessing the microbiome\'s influence, the future of precision diagnosis and therapeutic innovation for GI cancers appears more optimistic, opening doors to tailored treatments and enhanced diagnostic precision.
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  • 文章类型: Journal Article
    急性髓系白血病(AML),造血干细胞的侵袭性恶性肿瘤,以细胞分化阻断为特征,不受控制的扩散,和细胞扩增会损害健康的造血功能,并导致全血细胞减少和感染易感性。几种遗传和染色体畸变在AML中起作用并影响患者预后。TP53是参与多种细胞特征的关键抑癌基因,如细胞周期调节,基因组稳定性,扩散,分化,干细胞稳态,凋亡,新陈代谢,衰老,以及响应细胞应激的DNA损伤修复。在AML中,TP53改变发生在5%-12%的新生AML病例中。这些突变形成了一个重要的分子亚群,在AML患者中,具有这些突变的患者预后最差,总生存期最短,即使接受了积极的化疗和同种异体干细胞移植。TP53突变频率在复发性和复发性AML中增加,并与化疗耐药相关。AML遗传学和生物学的进展带来了新疗法,然而,对于TP53突变导致疾病的患者,这些药物的临床获益在很大程度上仍未被探索.本文综述了TP53突变疾病的分子特征;TP53对白血病的某些标志的影响。特别是代谢重组和免疫逃避,TP53突变的临床重要性;以及治疗TP53突变疾病的临床前和临床治疗策略的当前进展。
    Acute myeloid leukemia (AML), an aggressive malignancy of hematopoietic stem cells, is characterized by the blockade of cell differentiation, uncontrolled proliferation, and cell expansion that impairs healthy hematopoiesis and results in pancytopenia and susceptibility to infections. Several genetic and chromosomal aberrations play a role in AML and influence patient outcomes. TP53 is a key tumor suppressor gene involved in a variety of cell features, such as cell-cycle regulation, genome stability, proliferation, differentiation, stem-cell homeostasis, apoptosis, metabolism, senescence, and the repair of DNA damage in response to cellular stress. In AML, TP53 alterations occur in 5%-12% of de novo AML cases. These mutations form an important molecular subgroup, and patients with these mutations have the worst prognosis and shortest overall survival among patients with AML, even when treated with aggressive chemotherapy and allogeneic stem cell transplant. The frequency of TP53-mutations increases in relapsed and recurrent AML and is associated with chemoresistance. Progress in AML genetics and biology has brought the novel therapies, however, the clinical benefit of these agents for patients whose disease is driven by TP53 mutations remains largely unexplored. This review focuses on the molecular characteristics of TP53-mutated disease; the impact of TP53 on selected hallmarks of leukemia, particularly metabolic rewiring and immune evasion, the clinical importance of TP53 mutations; and the current progress in the development of preclinical and clinical therapeutic strategies to treat TP53-mutated disease.
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  • 文章类型: Journal Article
    糖尿病心肌病(DbCM)是2型糖尿病(T2DM)患者的常见并发症,其确切的发病机制仍有争议。假设慢性高血糖症和胰岛素抵抗激活了关键的细胞途径,这些途径负责心脏中的许多功能和解剖扰动。间质性炎症,氧化应激,心肌细胞凋亡,线粒体功能障碍,心脏代谢缺陷,心脏重塑,肥大和纤维化以及随之而来的收缩力受损是最常见的机制。表观遗传变化在这些关键途径的调节中也具有新兴作用。这篇综述的目的是强调对DbCM分子机制和靶向特定途径的新疗法的日益深入的了解。
    Diabetic cardiomyopathy (DbCM) is a common complication in individuals with type 2 diabetes mellitus (T2DM), and its exact pathogenesis is still debated. It was hypothesized that chronic hyperglycemia and insulin resistance activate critical cellular pathways that are responsible for numerous functional and anatomical perturbations in the heart. Interstitial inflammation, oxidative stress, myocardial apoptosis, mitochondria dysfunction, defective cardiac metabolism, cardiac remodeling, hypertrophy and fibrosis with consequent impaired contractility are the most common mechanisms implicated. Epigenetic changes also have an emerging role in the regulation of these crucial pathways. The aim of this review was to highlight the increasing knowledge on the molecular mechanisms of DbCM and the new therapies targeting specific pathways.
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  • 文章类型: Journal Article
    本文就血管生成在乳腺癌进展和治疗中的关键作用作一综述。它涵盖了生物标志物,成像技术,治疗方法,抵抗机制,和临床意义。关键主题包括血管内皮生长因子,血管生成素,microRNA签名,循环内皮细胞作为生物标志物,随着磁共振成像,CT血管造影,超声波,和正电子发射断层扫描成像。靶向VEGF的治疗策略,酪氨酸激酶抑制剂,并讨论了血管生成与免疫治疗的交叉。解决了诸如抗性机制和个性化医疗方法等挑战。临床意义,预后价值,并强调了血管生成靶向治疗的未来方向。本文最后对理解血管生成的转化潜力进行了思考。
    This review explores the pivotal role of angiogenesis in breast cancer progression and treatment. It covers biomarkers, imaging techniques, therapeutic approaches, resistance mechanisms, and clinical implications. Key topics include Vascular Endothelial Growth Factors, angiopoietins, microRNA signatures, and circulating endothelial cells as biomarkers, along with Magnetic Resonance Imaging, Computed Tomography Angiography, Ultrasound, and Positron Emission Tomography for imaging. Therapeutic strategies targeting VEGF, tyrosine kinase inhibitors, and the intersection of angiogenesis with immunotherapy are discussed. Challenges such as resistance mechanisms and personalized medicine approaches are addressed. Clinical implications, prognostic value, and the future direction of angiogenesis-targeted therapies are highlighted. The article concludes with reflections on the transformative potential of understanding angiogenesis.
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  • 文章类型: Journal Article
    传统药物和替代疗法长期以来一直用于治疗乳腺癌。当前治疗的主要问题之一是由于突变等遗传差异,癌细胞的耐药性增加。表观遗传变化和miRNA(microRNA)变化,如miR-1246,miR-298,miR-27b和miR-33a,随着表观遗传修饰,例如组蛋白3乙酰化和CCCTC-结合因子(CTCF)超甲基化在乳腺癌细胞系中的耐药性。某些形式的常规耐药性与基因的遗传变化有关,例如ABCB1,AKT,S100A8/A9,TAGLN2和NPM。这篇综述旨在探索当前对抗乳腺癌的方法,作用机制,以及赋予潜在耐药性的新型治疗方法。对新型治疗方法的研究揭示了耐药现象,包括影响不同形式的雌激素受体(ER)癌症的遗传变异。遗传变化,表观遗传学报告的耐药性及其在患者中的鉴定。乳腺癌的长期有效治疗包括选择性雌激素受体调节剂,选择性雌激素受体降解和遗传变异,比如核基因的突变,靶蛋白中的表观遗传修饰和miRNA改变。针对包括美登素在内的组合疗法的新研究,光动力疗法,guajadiol,talazoparib,已经开发了COX2抑制剂和miRNA1246抑制剂以提高患者存活率。
    Traditional medication and alternative therapies have long been used to treat breast cancer. One of the main problems with current treatments is that there is an increase in drug resistance in the cancer cells owing to genetic differences such as mutational changes, epigenetic changes and miRNA (microRNA) alterations such as miR-1246, miR-298, miR-27b and miR-33a, along with epigenetic modifications, such as Histone3 acetylation and CCCTC-Binding Factor (CTCF) hypermethylation for drug resistance in breast cancer cell lines. Certain forms of conventional drug resistance have been linked to genetic changes in genes such as ABCB1, AKT, S100A8/A9, TAGLN2 and NPM. This review aims to explore the current approaches to counter breast cancer, the action mechanism, along with novel therapeutic methods endowing potential drug resistance. The investigation of novel therapeutic approaches sheds light on the phenomenon of drug resistance including genetic variations that impact distinct forms of oestrogen receptor (ER) cancer, genetic changes, epigenetics-reported resistance and their identification in patients. Long-term effective therapy for breast cancer includes selective oestrogen receptor modulators, selective oestrogen receptor degraders and genetic variations, such as mutations in nuclear genes, epigenetic modifications and miRNA alterations in target proteins. Novel research addressing combinational therapies including maytansine, photodynamic therapy, guajadiol, talazoparib, COX2 inhibitors and miRNA 1246 inhibitors have been developed to improve patient survival rates.
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  • 文章类型: Journal Article
    脊髓损伤(SCI)代表中枢神经系统(CNS)内的复杂病理,导致严重的感觉和运动障碍。它激活各种信号通路,特别是丝裂原活化蛋白激酶(MAPK)途径。目前的治疗方法主要集中在症状缓解,缺乏解决潜在病理生理机制的功效。新兴的研究强调了MAPK通路在神经元分化中的意义,增长,生存,轴突再生,和SCI后的炎症反应。在损伤后调节这一途径已显示出减轻炎症的希望,最小化细胞凋亡,缓解神经性疼痛,促进神经再生。鉴于其关键作用,MAPK通路成为SCI治疗的潜在治疗靶点.这篇综述综合了当前关于SCI病理学的知识,描绘了MAPK通路的特征,并探讨其在SCI病理学和治疗干预中的双重作用。此外,它解决了SCI背景下MAPK研究中的现有挑战,提出了克服这些障碍的解决方案。我们的目的是为未来MAPK通路和SCI的研究提供全面的参考,为有针对性的治疗策略奠定基础。
    Spinal cord injury (SCI) represents a complex pathology within the central nervous system (CNS), leading to severe sensory and motor impairments. It activates various signaling pathways, notably the mitogen-activated protein kinase (MAPK) pathway. Present treatment approaches primarily focus on symptomatic relief, lacking efficacy in addressing the underlying pathophysiological mechanisms. Emerging research underscores the significance of the MAPK pathway in neuronal differentiation, growth, survival, axonal regeneration, and inflammatory responses post-SCI. Modulating this pathway post-injury has shown promise in attenuating inflammation, minimizing apoptosis, alleviating neuropathic pain, and fostering neural regeneration. Given its pivotal role, the MAPK pathway emerges as a potential therapeutic target in SCI management. This review synthesizes current knowledge on SCI pathology, delineates the MAPK pathway\'s characteristics, and explores its dual roles in SCI pathology and therapeutic interventions. Furthermore, it addresses the existing challenges in MAPK research in the context of SCI, proposing solutions to overcome these hurdles. Our aim is to offer a comprehensive reference for future research on the MAPK pathway and SCI, laying the groundwork for targeted therapeutic strategies.
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  • 文章类型: Journal Article
    表皮葡萄球菌和其他凝固酶阴性葡萄球菌在皮肤和粘膜上的普遍存在长期以来一直是对这些生物体对医疗机构中的脆弱患者造成的感染风险的随意忽视。在确认生物膜是表皮葡萄球菌的重要毒力决定因素之前,诊断标本中这种微生物的分离通常被忽略,因为临床上微不足道,可能会延迟诊断和适当治疗的开始。有助于建立慢性感染和增加发病率或死亡率。虽然我们在理解这种重要的机会病原体的生物膜机制方面取得了令人印象深刻的进展,对其他毒力决定子的研究滞后于金黄色葡萄球菌。在这次审查中,包括生物膜在内的表皮葡萄球菌的更广泛的毒力潜力,毒素,蛋白酶,免疫逃避策略和抗生素耐药机制进行了调查,以及当前和未来改善治疗干预措施的方法。
    The pervasive presence of Staphylococcus epidermidis and other coagulase-negative staphylococci on the skin and mucous membranes has long underpinned a casual disregard for the infection risk that these organisms pose to vulnerable patients in healthcare settings. Prior to the recognition of biofilm as an important virulence determinant in S. epidermidis, isolation of this microorganism in diagnostic specimens was often overlooked as clinically insignificant with potential delays in diagnosis and onset of appropriate treatment, contributing to the establishment of chronic infection and increased morbidity or mortality. While impressive progress has been made in our understanding of biofilm mechanisms in this important opportunistic pathogen, research into other virulence determinants has lagged S. aureus. In this review, the broader virulence potential of S. epidermidis including biofilm, toxins, proteases, immune evasion strategies and antibiotic resistance mechanisms is surveyed, together with current and future approaches for improved therapeutic interventions.
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