pathomechanism

病理机制
  • 文章类型: Journal Article
    细胞因子调节免疫反应,对MS发病机制至关重要。该研究评估了与健康对照相比的从头诊断的RRMS患者的CSF中的促炎和抗炎细胞因子浓度。我们评估了118名从头诊断的RRMS患者和112名对照的CSF中的细胞因子水平,分析从症状发作到诊断与时间的关系,MRI病变,和血清维生素D水平.IL-2,IL-4,IL-6,IL-13,FGF-碱性,和GM-CSF,和较低水平的IL-1β,IL-1RA,IL-5、IL-7、IL-9、IL-10、IL-12p70、IL-15、G-CSF、PDGF-bb,与对照组相比,在RRMS患者中观察到VEGF。IL-2,IL-4,IL-12p70,PDGF,G-CSF,GM-CSF,FGF基础水平随着时间的推移而增加,而IL-10下降。IL-1β,IL-1RA,IL-6,TNF-α,PDGF-bb水平与血清维生素D呈负相关。TNF-α水平与对比增强后的脑损伤呈正相关。C-脊柱MRI中IL-15水平与T2和Gd(+)病变呈负相关,而TNF-α,PDGF-bb,在C脊柱MRI中,FGF-basic与T2病变呈正相关。在Th脊柱MRI中,IL-6水平与对比增强后的病变呈正相关。从头诊断的MS患者的CSF中不同的细胞因子谱提供了对MS发病机理的见解并指导免疫调节治疗策略。
    Cytokines regulate immune responses and are crucial to MS pathogenesis. This study evaluated pro-inflammatory and anti-inflammatory cytokine concentrations in the CSF of de novo diagnosed RRMS patients compared to healthy controls. We assessed cytokine levels in the CSF of 118 de novo diagnosed RRMS patients and 112 controls, analyzing relationships with time from symptom onset to diagnosis, MRI lesions, and serum vitamin D levels. Elevated levels of IL-2, IL-4, IL-6, IL-13, FGF-basic, and GM-CSF, and lower levels of IL-1β, IL-1RA, IL-5, IL-7, IL-9, IL-10, IL-12p70, IL-15, G-CSF, PDGF-bb, and VEGF were observed in RRMS patients compared to controls. IL-2, IL-4, IL-12p70, PDGF, G-CSF, GM-CSF, and FGF-basic levels increased over time, while IL-10 decreased. IL-1β, IL-1RA, IL-6, TNF-α, and PDGF-bb levels negatively correlated with serum vitamin D. TNF-α levels positively correlated with post-contrast-enhancing brain lesions. IL-15 levels negatively correlated with T2 and Gd(+) lesions in C-spine MRI, while TNF-α, PDGF-bb, and FGF-basic correlated positively with T2 lesions in C-spine MRI. IL-6 levels positively correlated with post-contrast-enhancing lesions in Th-spine MRI. Distinct cytokine profiles in the CSF of de novo diagnosed MS patients provide insights into MS pathogenesis and guide immunomodulatory therapy strategies.
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  • 文章类型: Journal Article
    已知在偏头痛患者中会发生皮层电参数异常和视觉刺激后残影的持续存在。对偏头痛患者的或有阴性变化(CNV)和余像持久性的研究结果表明,这两种现象之间存在联系,并且与偏头痛的发病机制有关。
    到目前为止,没有研究调查了同一受试者的残像持续时间和CNV参数。这项研究的目的是调查偏头痛患者的CNV(iCNV)的早期成分与残像持续时间之间的关系。
    来自罗斯托克大学医学中心头痛中心的67名偏头痛患者接受了iCNV振幅检查,iCNV习惯化和残像持续时间。受试者还完成了为本研究开发的问卷和MIDAS(偏头痛残疾评估)问卷。
    在iCNV振幅和余像持续时间之间以及在习惯能力和余像持续时间之间发现了关联。习惯能力不足与残像持续时间明显延长有关。iCNV振幅的增加和余像持续时间的延长也显着相关。
    从这项研究的结果可以得出关于偏头痛的病理生理学的结论。结果支持皮质过度兴奋的假设,作为一个低的预激活水平的结果,这可能是偏头痛的一个可能的原因。此外,它们允许评估残像检查,这比CNV检查更容易和更快地执行,可以用作诊断工具或参数来监测偏头痛患者的治疗过程。
    UNASSIGNED: Abnormalities in electrocortical parameters and persistence of afterimage after visual stimulation are known to occur in migraine patients. The results of studies on Contingent Negative Variation (CNV) and afterimage persistence in migraine patients suggest a link between these two phenomena and a connection to the pathomechanism of migraine.
    UNASSIGNED: To date, no studies have investigated both afterimage duration and CNV parameters in the same subjects. The aim of this study was to investigate the relationship between the early component of CNV (iCNV) and the duration of the afterimage in migraine patients.
    UNASSIGNED: Sixty seven migraine patients from the headache center of the University of Rostock Medical Center were examined for iCNV amplitude, iCNV habituation and afterimage duration. The subjects also completed questionnaires developed for this study and the MIDAS (Migraine Disability Assessment) questionnaire.
    UNASSIGNED: Associations were found between iCNV amplitude and afterimage duration and between habituation capacity and afterimage duration. A deficit in habituation capacity correlated with a significantly prolonged afterimage duration. Increased iCNV amplitude and prolonged afterimage duration were also significantly correlated.
    UNASSIGNED: Conclusions about the pathophysiology of migraine can be drawn from the results of this study. The results support the hypothesis of cortical hyperexcitability as a consequence of a low pre-activation level, which may be a possible contributory cause of migraine. Furthermore, they allow assessment of whether the afterimage examination, which is easier and quicker to perform than the CNV examination, can be used as a diagnostic tool or as a parameter to monitor the course of therapy in people with migraine.
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  • 文章类型: Journal Article
    自身免疫性炎症是由对特异性自身抗原的耐受性丧失引起的,并且可导致器官特异性或全身性病症。系统性自身免疫性疾病影响了很大一部分人群,发病率越来越高,这意味着必须有有效的治疗方法来控制这些慢性疾病。不幸的是,一些全身性自身免疫性疾病患者对现有的常规合成疾病缓解抗风湿药和靶向治疗没有反应或只是部分反应.然而,在过去的几年里,一些新的药物已被批准,可用于现实生活中的临床环境。同时,出现了几个新的候选药物,并且可以在未来提供有希望的新的治疗选择.这里,我们总结了治疗系统性红斑狼疮的新药物和最令人鼓舞的候选药物,类风湿性关节炎,Sjögren病,系统性硬化症,全身性血管炎,和自身免疫性肌炎.
    Autoimmune inflammation is caused by the loss of tolerance to specific self-antigens and can result in organ-specific or systemic disorders. Systemic autoimmune diseases affect a significant portion of the population with an increasing rate of incidence, which means that is essential to have effective therapies to control these chronic disorders. Unfortunately, several patients with systemic autoimmune diseases do not respond at all or just partially respond to available conventional synthetic disease-modifying antirheumatic drugs and targeted therapies. However, during the past few years, some new medications have been approved and can be used in real-life clinical settings. Meanwhile, several new candidates appeared and can offer promising novel treatment options in the future. Here, we summarize the newly available medications and the most encouraging drug candidates in the treatment of systemic lupus erythematosus, rheumatoid arthritis, Sjögren\'s disease, systemic sclerosis, systemic vasculitis, and autoimmune myositis.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    牛皮癣是一种炎症性皮肤病,影响普通人群的1-2%。病理机制基于1型免疫反应。牛皮癣中的表皮增生是由于细胞外基质蛋白的合成和表达增加引起的表皮结构破坏的结果。在我们的研究中,我们分析了骨膜素(POSTN)在银屑病发病机制中的作用,作为fasciclin家族的细胞外基质蛋白之一。研究组由70名银屑病患者组成,对照组由30名健康个体组成。POSTN的血清浓度,在所有参与者中测量Il-6、Il-17、Il-22、TNF-α和IFN-γ。使用PASI(牛皮癣面积和严重程度指数)评分确定牛皮癣的严重程度。使用直接免疫荧光方法评估了50名患者的活检样品中POSTN的存在。对结果进行统计分析。POSTN的血清浓度,研究组IL-6、IL-17、IL-22、TNF-α和IFN-γ均明显高于对照组。已证明PASI评分与所研究的细胞因子之间存在正相关,但不是POSTN。POSTN水平与细胞因子水平之间没有统计学上的显着相关性。在66%的牛皮癣患者中,POSTN沉积物位于表皮中。POSTN在银屑病发病机制中的作用尚不清楚。在银屑病皮肤中诱导POSTN合成和表达的机制尚未完全了解。需要进一步的研究来增强我们对牛皮癣表皮增生机制的理解。
    Psoriasis is an inflammatory skin disease that affects 1-2% of the general population. The pathomechanism is based on type 1 immunological reactions. Hyperplasia of the epidermis in psoriasis is a result of disrupted epidermal architecture due to increased synthesis and expression of extracellular matrix proteins. In our study, we analyzed the involvement of periostin (POSTN) in the pathogenesis of psoriasis, as one of the extracellular matrix proteins belonging to the fasciclin family. The study group consisted of 70 patients with psoriasis, while the control group comprised 30 healthy individuals. The serum concentrations of POSTN, Il-6, Il-17, Il-22, TNF-α and IFN-γ were measured in all participants. The severity of psoriasis was determined using the PASI (Psoriasis Area and Severity Index) score. The presence of POSTN in biopsy samples of 50 patients was assessed using the direct immunofluorescence method. The results were subjected to statistical analysis. The serum concentrations of POSTN, Il-6, Il-17, Il-22, TNF-α and IFN-γ in the study group are significantly higher than in the control group. Positive correlation has been demonstrated between the PASI score and the investigated cytokines, but not with POSTN. There was no statistically significant correlation between the POSTN level and the cytokines levels. POSTN deposits were localized in the epidermis in 66% of patients with psoriasis. The role of POSTN in the pathogenesis of psoriasis remains unclear. The mechanisms inducing the synthesis and expression of POSTN in psoriatic skin are not yet fully understood. Further research is needed to enhance our understanding of the mechanism underlying epidermal hyperplasia in psoriasis.
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  • 文章类型: Journal Article
    硒是健康必需的微量元素,只能通过食物获得。然而,牛硒缺乏的病理过程很少受到关注。这项研究调查了硒缺乏对氧化应激的影响,凋亡,炎症,与健康的小牛作为对照相比,断奶小牛的肺坏死。与对照组相比,缺硒小牛的肺硒含量和11种硒蛋白mRNA的表达显着降低。病理结果显示肺泡毛细血管充盈,增厚的肺泡间隔,整个肺泡隔弥漫性间质炎症。GSH和T-AOC的水平,以及CAT,SOD,和TrxR活动,与健康小牛相比显著下降。MDA和H2O2显著升高。同时,Se-D组的细胞凋亡激活被验证。接下来,在Se-D组中,几种促炎细胞因子表达较高。进一步的研究表明,Se-D组的肺经历了通过过度活跃的NF-κB和MAPK途径的炎症。c-FLIP的高水平表达,MLKL,RIPK1和RIPK3表明坏死性凋亡在硒缺乏期间也会引起肺损伤。
    Selenium is an essential trace element for health that can only be obtained through food. However, the pathological processes of selenium deficiency in cattle have received little attention. This study investigated the effects of selenium deficiency on oxidative stress, apoptosis, inflammation, and necroptosis in the lungs of weaning calves compared with healthy calves as controls. The lung selenium content and the expression of 11 selenoproteins mRNA in selenium-deficient calves were substantially reduced compared with the controls. Pathological results showed engorged alveolar capillaries, thickened alveolar septa, and diffuse interstitial inflammation throughout the alveolar septa. The levels of GSH and T-AOC, as well as the CAT, SOD, and TrxR activities, were significantly decreased compared with healthy calves. MDA and H2O2 were significantly elevated. Meanwhile, the apoptosis activation in the Se-D group was validated. Next, in the Se-D group, several pro-inflammatory cytokines showed higher expression. Further research revealed that the lungs in the Se-D group experienced inflammation via hyperactive NF-κB and MAPK pathways. The high level of expression of c-FLIP, MLKL, RIPK1, and RIPK3 indicated that necroptosis also causes lung damage during selenium deficiency.
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  • 文章类型: Journal Article
    .对于在德国使用的COVID-19疫苗,据报道,在非常罕见的病例中,接种疫苗后出现严重的过敏(过敏性)反应。虽然Comirnaty和Spikevax是mRNA疫苗,Vaxzevria和Jcovden包含载体疫苗,和Nuvaxovid重组刺突蛋白疫苗。在接受首次疫苗接种的女性中,mRNA疫苗接种后的过敏反应报告率较高,Comirnaty和Spikevax每100,000次疫苗接种报告为0.97和1.12次,分别,与接种疫苗的男性和随后的疫苗相比。保罗-埃利希研究所(PEI)调查了321例确诊的过敏反应中的106例,这些过敏反应涉及随后的过敏测试和再次接种COVID-19疫苗。收集的数据表明,只有一小部分病例(22%)是IgE介导的反应。很大比例(73%)的患者可以在预防措施下重新接种疫苗,而不会复发过敏反应。大多数过敏反应的发病机制尚不清楚,应在进一步的研究中进行研究。
    . For the COVID-19 vaccines used in Germany, severe allergic (anaphylactic) reactions after vaccination have been reported in very rare cases. While Comirnaty and Spikevax are mRNA vaccines, Vaxzevria and Jcovden comprise vector vaccines, and Nuvaxovid a recombinant spike protein vaccine. The reporting rate of anaphylaxis after mRNA vaccination was higher in females receiving their first vaccination dose, with 0.97 and 1.12 reports per 100,000 vaccinations for Comirnaty and Spikevax, respectively, compared with vaccinated males and subsequent vaccinations. The Paul-Ehrlich-Institut (PEI) investigated 106 responses of 321 cases of confirmed anaphylactic reactions concerning subsequent allergy testing and revaccination with a COVID-19 vaccine. The collected data indicate that only a small proportion of cases (22%) were IgE-mediated reactions. A large proportion (73%) of patients could be revaccinated under precautionary measures without recurrence of anaphylaxis. The pathomechanism of the majority of anaphylactic reactions remains unclear and should be investigated in further studies.
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  • 文章类型: Journal Article
    目的:琥珀酸半醛脱氢酶缺乏症(SSADHD)是一种由γ-氨基丁酸盐(GABA)分解代谢缺陷引起的罕见遗传性代谢紊乱。尽管代谢缺陷促进了高GABA能环境,这种疾病患者的癫痫患病率很高.我们旨在研究SSADHD中癫痫的特征及其与GABA相关代谢物和皮质兴奋的神经生理标志物的一致性。
    方法:一项SSADHD的国际自然史研究中的受试者接受了临床评估,脑电图,经颅磁刺激(TMS),用于GABA/NAA定量的磁共振波谱,和血浆GABA相关代谢物测量。
    结果:本研究共纳入61名SSADHD患者和42名健康对照。癫痫存在于49%的SSADHD队列中。随着时间的推移,33%的癫痫发作患者的严重程度增加.癫痫发作的存在与年龄增加(p=0.001)和GABA水平降低(p=0.002)有关,γ-羟基丁酸酯(GHB)(p=0.004),和γ-胍丁酸酯(GBA)(p=0.003)。癫痫发作的严重程度与年龄增加和GABA相关代谢物水平降低以及TMS衍生的静息运动阈值(rMT)降低有关(p=0.04)。预测癫痫发作的判别能力最高的临界值为年龄>9.2岁(p=0.001),GABA<2.57μM/L(p=0.002),GHB<143.6(p=0.004),GBA<0.075(p=0.007)。SSADHD癫痫发作的预测模型包括年龄较大的累加效应,降低血浆GABA,GHB,和GBA(ROC下的面积为0.798,p=0.008)。
    结论:癫痫在SSADHD中非常普遍,其发作和严重程度与年龄相关的GABA和GABA相关代谢物水平下降以及皮质抑制减少的TMS标记相关。在这种原本高GABA能的疾病中,GABA能活性的降低证明了癫痫发生和代偿反应之间的一致性。这些发现可能进一步为SSADHD的分子干预时机提供信息。
    Succinic semialdehyde dehydrogenase deficiency (SSADHD) is a rare inherited metabolic disorder caused by a defect of γ-aminobutyrate (GABA) catabolism. Despite the resultant hyper-GABAergic environment facilitated by the metabolic defect, individuals with this disorder have a paradoxically high prevalence of epilepsy. We aimed to study the characteristics of epilepsy in SSADHD and its concordance with GABA-related metabolites and neurophysiologic markers of cortical excitation.
    Subjects in an international natural history study of SSADHD underwent clinical assessments, electroencephalography, transcranial magnetic stimulation (TMS), magnetic resonance spectroscopy for GABA/N-acetyl aspartate quantification, and plasma GABA-related metabolite measurements.
    A total of 61 subjects with SSADHD and 42 healthy controls were included in the study. Epilepsy was present in 49% of the SSADHD cohort. Over time, there was an increase in severity in 33% of the subjects with seizures. The presence of seizures was associated with increasing age (p = .001) and lower levels of GABA (p = .002), γ-hydroxybutyrate (GHB; p = .004), and γ-guanidinobutyrate (GBA; p = .003). Seizure severity was associated with increasing age and lower levels of GABA-related metabolites as well as lower TMS-derived resting motor thresholds (p = .04). The cutoff values with the highest discriminative ability to predict seizures were age > 9.2 years (p = .001), GABA < 2.57 μmol·L-1 (p = .002), GHB < 143.6 μmol·L-1 (p = .004), and GBA < .075 μmol·L-1 (p = .007). A prediction model for seizures in SSADHD was comprised of the additive effect of older age and lower plasma GABA, GHB, and GBA (area under the receiver operating characteristic curve of .798, p = .008).
    Epilepsy is highly prevalent in SSADHD, and its onset and severity correlate with an age-related decline in GABA and GABA-related metabolite levels as well as TMS markers of reduced cortical inhibition. The reduction of GABAergic activity in this otherwise hyper-GABAergic disorder demonstrates a concordance between epileptogenesis and compensatory responses. These findings may furthermore inform the timing of molecular interventions for SSADHD.
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  • 文章类型: Journal Article
    COVID-19大流行显示了全球新型呼吸道感染的潜在破坏性影响。过去几年获得的有见地的数据揭示了SARS-CoV-2感染的病理生理学以及炎症反应在驱动疾病消退和严重病例中不受控制的有害炎症状态中的作用。在这个小型审查中,我们涵盖了T细胞在COVID-19中作用的一些重要方面,特别关注肺部的局部反应。我们专注于报道的T细胞表型在轻度,中度,和严重的COVID-19,专注于肺部炎症以及T细胞反应的保护和破坏作用,还突出了该领域的开放性问题。
    The COVID-19 pandemic has shown the potentially devastating impact of novel respiratory infections worldwide. Insightful data obtained in the last years have shed light on the pathophysiology of SARS-CoV-2 infection and the role of the inflammatory response in driving both the resolution of the disease and uncontrolled deleterious inflammatory status in severe cases. In this mini-review, we cover some important aspects of the role of T cells in COVID-19 with a special focus on the local response in the lung. We focus on the reported T cell phenotypes in mild, moderate, and severe COVID-19, focusing on lung inflammation and on both the protective and damaging roles of the T cell response, also highlighting the open questions in the field.
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  • 文章类型: Journal Article
    糖尿病伤口是糖尿病患者的常见并发症。由于周围神经损伤和血管功能障碍,糖尿病伤口容易进展为局部溃疡,伤口坏疽,甚至需要截肢,给患者带来巨大的心理和经济负担。然而,目前糖尿病创面的治疗方法主要有创面辅料,负压引流,植皮和手术;目前仍没有理想的治疗方法来促进糖尿病伤口愈合。适当的动物模型可以模拟糖尿病创面的生理机制,为治疗糖尿病伤口愈合的转化研究提供基础。虽然目前还没有能够完全模拟人类糖尿病伤口病理生理机制的动物模型,探索用于糖尿病伤口基础研究和临床前研究的动物模拟模型至关重要。此外,水凝胶材料由于其良好的抗菌活性而被认为是糖尿病伤口的有希望的治疗方法。生物相容性,生物降解和适当的机械性能。在这里,我们回顾并讨论了用于研究糖尿病伤口病理机制的不同动物模型。我们进一步讨论了水凝胶生物材料在糖尿病伤口愈合中的应用前景。
    Diabetic wounds are a common complication in diabetes patients. Due to peripheral nerve damage and vascular dysfunction, diabetic wounds are prone to progress to local ulcers, wound gangrene and even to require amputation, bringing huge psychological and economic burdens to patients. However, the current treatment methods for diabetic wounds mainly include wound accessories, negative pressure drainage, skin grafting and surgery; there is still no ideal treatment to promote diabetic wound healing at present. Appropriate animal models can simulate the physiological mechanism of diabetic wounds, providing a basis for translational research in treating diabetic wound healing. Although there are no animal models that can fully mimic the pathophysiological mechanisms of diabetic wounds in humans, it is vital to explore animal simulation models used in basic research and preclinical studies of diabetic wounds. In addition, hydrogel materials are regarded as a promising treatment for diabetic wounds because of their good antimicrobial activity, biocompatibility, biodegradation and appropriate mechanical properties. Herein, we review and discuss the different animal models used to investigate the pathological mechanisms of diabetic wounds. We further discuss the promising future application of hydrogel biomaterials in diabetic wound healing.
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