Therapeutic approaches

治疗方法
  • 文章类型: Journal Article
    砷,一种无处不在的环境毒物,由于饮用水和食品供应的广泛污染,已被认为是公共卫生的重要问题。本综述旨在研究与心脏系统相关的毒性。长期接触砷与一些有害的健康结果有关,尤其是心脏毒性.砷诱导的心脏毒性包括一系列心血管异常,包括心律失常,缺血性心脏病,和心肌病。为了解决这种毒性,了解分子标记,表观遗传预测因子,与砷诱导的心脏毒性有关的靶标对于创建预防和治疗方法至关重要。对于这种地下水重金属中毒的预防措施,定期监测水质至关重要,重新评估科学发现,并教育公众了解可能的风险。这篇综述彻底总结了目前在这一领域已知的内容,突出关键分子标记,表观遗传修饰,以及与砷诱导的心脏毒性相关的潜在治疗靶点。
    Arsenic, a ubiquitous environmental toxicant, has been acknowledged as a significant issue for public health due to its widespread pollution of drinking water and food supplies. The present review aimed to study the toxicity associated with the cardiac system. Prolonged exposure to arsenic has been associated with several harmful health outcomes, especially cardiotoxicity. Arsenic-induced cardiotoxicity encompasses a range of cardiovascular abnormalities, including cardiac arrhythmias, ischemic heart disease, and cardiomyopathy. To tackle this toxicity, understanding the molecular markers, epigenetic predictors, and targets involved in arsenic-induced cardiotoxicity is essential for creating preventative and therapeutic approaches. For preventive measures against this heavy metal poisoning of groundwater, it is crucial to regularly monitor water quality, re-evaluate scientific findings, and educate the public about the possible risks. This review thoroughly summarised what is currently known in this field, highlighting the key molecular markers, epigenetic modifications, and potential therapeutic targets associated with arsenic-induced cardiotoxicity.
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  • 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
    妇科癌症,包括卵巢,子宫颈,子宫内膜,和外阴癌,在全球范围内,诊断和治疗面临重大挑战。肿瘤微环境(TME)在癌症进展和治疗反应中起着关键作用。需要更深入地了解其组成和动态。这篇综述提供了妇科癌症肿瘤微环境的全面概述,强调其细胞复杂性和治疗潜力。TME的不同细胞成分,包括癌细胞,免疫细胞,基质细胞,和细胞外基质元素,正在探索,阐明它们在塑造肿瘤行为和治疗结果中的相互作用。在癌症进展的不同阶段,TME对肿瘤异质性产生深远的影响,免疫调节,血管生成,和代谢重编程。通过了解TME内的免疫逃避机制,强调了新治疗策略的紧迫性。新兴的方法,如免疫疗法,基质靶向疗法,抗血管生成剂,讨论了代谢抑制剂,为改善患者预后提供有希望的途径。强调跨学科合作和转化研究,旨在推进精准肿瘤学,提高妇科癌症的治疗效果。
    Gynecological cancers, including ovarian, cervical, endometrial, and vulvar cancers, present significant challenges in diagnosis and treatment globally. The tumor microenvironment (TME) plays a pivotal role in cancer progression and therapy response, necessitating a deeper understanding of its composition and dynamics. This review offers a comprehensive overview of the gynecological cancer tumor microenvironment, emphasizing its cellular complexity and therapeutic potential. The diverse cellular components of the TME, including cancer cells, immune cells, stromal cells, and extracellular matrix elements, are explored, elucidating their interplay in shaping tumor behavior and treatment outcomes. Across various stages of cancer progression, the TME exerts profound effects on tumor heterogeneity, immune modulation, angiogenesis, and metabolic reprogramming. The urgency for novel therapeutic strategies is underscored by understanding immune evasion mechanisms within the TME. Emerging approaches such as immunotherapy, stromal-targeting therapies, anti-angiogenic agents, and metabolic inhibitors are discussed, offering promising avenues for improving patient outcomes. Interdisciplinary collaborations and translational research are emphasized, aiming to advance precision oncology and enhance therapeutic efficacy in gynecological cancers.
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  • 文章类型: Journal Article
    牛皮癣是一种慢性炎症性疾病,影响约2%至3%的全球人口。银屑病的发病机制复杂,涉及免疫失调,过度增殖和血管生成。它是一种多因素疾病,受遗传和环境因素的影响。各种治疗剂的发展,如JAK抑制剂,小分子,随着对银屑病发病机制的广泛了解,具有潜在抗银屑病特性的生物制剂是可能的。各种信号通路,包括NF-κB,JAK-STAT,S1P,PDE-4和A3AR涉及银屑病的发病机理以及用于银屑病研究的临床前模型在这篇综述中得到了强调。该综述还侧重于有助于更好地理解牛皮癣的技术进步。然后,本综述重点介绍了仍在临床试验中或最近批准的靶向各自信号通路的分子,以及有助于改善银屑病管理的治疗和药物递送方法的最新突破.这篇综述提供了对银屑病研究现状的广泛理解。为研究人员提供了发现未来治疗突破和个性化干预措施的机会。通过对发病机制的广泛了解,可以实现银屑病个体的有效治疗选择。治疗剂,和新的药物输送策略。
    Psoriasis is a chronic inflammatory condition affecting approximately 2 % to 3 % of the global population. The pathogenesis of psoriasis is complex, involving immune dysregulation, hyperproliferation and angiogenesis. It is a multifactorial disease which is influenced by genetic and environmental factors. The development of various therapeutic agents, such as JAK inhibitors, small molecules, and biologics with potential anti-psoriatic properties was possible with the vast understanding of the pathogenesis of psoriasis. Various signalling pathways, including NF-κB, JAK-STAT, S1P, PDE-4, and A3AR that are involved in the pathogenesis of psoriasis as well as the preclinical models utilised in the research of psoriasis have been highlighted in this review. The review also focuses on technological advancements that have contributed to a better understanding of psoriasis. Then, the molecules targeting the respective signalling pathways that are still under clinical trials or recently approved as well as the latest breakthroughs in therapeutic and drug delivery approaches that can contribute to the improvement in the management of psoriasis are highlighted in this review. This review provides an extensive understanding of the current state of research in psoriasis, giving rise to opportunities for researchers to discover future therapeutic breakthroughs and personalised interventions. Efficient treatment options for individuals with psoriasis can be achieved by an extensive understanding of pathogenesis, therapeutic agents, and novel drug delivery strategies.
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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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