Therapeutic approaches

治疗方法
  • 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
    SEPHS1(硒磷酸盐合成酶1)基因编码合成硒磷酸盐的关键酶,硒蛋白生物合成所必需的硒(Se)的活性供体。硒蛋白对于抗氧化防御至关重要,甲状腺激素代谢,和细胞稳态。SEPHS1基因突变,与发育迟缓的神经发育障碍有关,增长不佳,低张力,和畸形特征。由于硒在大脑发育和功能中的关键作用,SEPHS1基因在神经发育研究中处于中心地位。本文综述了SEPHS1基因的结构和功能,它在神经发育中的作用,以及其失调对神经发育障碍的影响。治疗策略,包括硒补充,基因治疗,和靶向治疗,讨论了作为解决SEPHS1相关神经发育功能障碍的潜在干预措施。这项研究的发现揭示了SEPHS1突变如何破坏神经发育,强调基因对功能丧失的不容忍。未来的研究应该集中在SEPHS1变体的功能表征上,更广泛的基因筛查,和治疗发展。
    The SEPHS1 (Selenophosphate Synthetase 1) gene encodes a critical enzyme for synthesizing selenophosphate, the active donor of selenium (Se) necessary for selenoprotein biosynthesis. Selenoproteins are vital for antioxidant defense, thyroid hormone metabolism, and cellular homeostasis. Mutations in SEPHS1 gene, are associated with neurodevelopmental disorders with developmental delay, poor growth, hypotonia, and dysmorphic features. Due to Se\'s critical role in brain development and function, SEPHS1 gene has taken center stage in neurodevelopmental research. This review explores the structure and function of the SEPHS1 gene, its role in neurodevelopment, and the implications of its dysregulation for neurodevelopmental disorders. Therapeutic strategies, including Se supplementation, gene therapy, and targeted therapies, are discussed as potential interventions to address SEPHS1 associated neurodevelopmental dysfunction. The study\'s findings reveal how SEPHS1 mutations disrupt neurodevelopment, emphasizing the gene\'s intolerance to loss of function. Future research should focus on functional characterization of SEPHS1 variants, broader genetic screenings, and therapeutic developments.
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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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  • 文章类型: Journal Article
    表皮,皮肤的最外层,作为对外部因素的保护屏障。表皮分化,对表皮稳态至关重要的严格调控过程,表皮屏障的形成和皮肤完整性的维护,由几个玩家精心策划,包括信号分子,钙梯度和连接复合物,如间隙连接(GJs)。GJ蛋白,连接蛋白可促进相邻角质形成细胞之间的细胞间通讯。连接蛋白可以作为半通道或GJ,取决于它们与邻近角质形成细胞的其他连接子的相互作用。这些通道能够运输代谢物,cAMP,microRNAs,和离子,包括Ca2+,穿过细胞膜。至少10种不同的连接蛋白在表皮内表达,并且其中至少5种的突变与各种皮肤病有关。连接蛋白突变可能通过改变其合成而导致异常的通道活性,它们的门控属性,它们的胞内贩运,以及半通道和GJ通道的集合。除了突变,连接蛋白表达在其他皮肤病包括牛皮癣中失调,慢性伤口和皮肤癌,表明连接蛋白在皮肤稳态中的关键作用。对于具有突变或改变的连接蛋白的病症的当前治疗选择是有限的,并且主要集中于症状管理。几种疗法,包括非肽化学物质,抗体,模拟肽和等位基因特异性小干扰RNA在治疗与连接蛋白相关的皮肤疾病中很有希望.由于连接蛋白在维持表皮稳态中起着至关重要的作用,如与一系列皮肤病和癌症有关,需要进一步的研究来破译由于突变或表达改变而引起的细胞内的分子和细胞变化,导致异常增殖和分化。这也将有助于表征每个同工型在皮肤稳态中的作用,除了开发创新的治疗干预措施。这篇综述强调了表皮中连接蛋白的关键功能以及连接蛋白与皮肤疾病之间的关联。并讨论了潜在的治疗选择。
    The epidermis, the outermost layer of the skin, serves as a protective barrier against external factors. Epidermal differentiation, a tightly regulated process essential for epidermal homeostasis, epidermal barrier formation and skin integrity maintenance, is orchestrated by several players, including signaling molecules, calcium gradient and junctional complexes such as gap junctions (GJs). GJ proteins, known as connexins facilitate cell-to-cell communication between adjacent keratinocytes. Connexins can function as either hemichannels or GJs, depending on their interaction with other connexons from neighboring keratinocytes. These channels enable the transport of metabolites, cAMP, microRNAs, and ions, including Ca2+, across cell membranes. At least ten distinct connexins are expressed within the epidermis and mutations in at least five of them has been linked to various skin disorders. Connexin mutations may cause aberrant channel activity by altering their synthesis, their gating properties, their intracellular trafficking, and the assembly of hemichannels and GJ channels. In addition to mutations, connexin expression is dysregulated in other skin conditions including psoriasis, chronic wound and skin cancers, indicating the crucial role of connexins in skin homeostasis. Current treatment options for conditions with mutant or altered connexins are limited and primarily focus on symptom management. Several therapeutics, including non-peptide chemicals, antibodies, mimetic peptides and allele-specific small interfering RNAs are promising in treating connexin-related skin disorders. Since connexins play crucial roles in maintaining epidermal homeostasis as shown with linkage to a range of skin disorders and cancer, further investigations are warranted to decipher the molecular and cellular alterations within cells due to mutations or altered expression, leading to abnormal proliferation and differentiation. This would also help characterize the roles of each isoform in skin homeostasis, in addition to the development of innovative therapeutic interventions. This review highlights the critical functions of connexins in the epidermis and the association between connexins and skin disorders, and discusses potential therapeutic options.
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  • 文章类型: Journal Article
    亨廷顿氏病(HD)是遗传性神经退行性疾病的范例,其特征是HTT基因中CAG重复序列的扩展。这篇广泛的综述通过强调突变亨廷顿蛋白引发的致病机制来研究HD的分子复杂性。HD的不良结局包括线粒体功能障碍,受损的蛋白质清除率,和细胞内信号的破坏,从而导致神经元的逐渐恶化。许多治疗策略,特别是精准医学,目前用于HD管理。反义寡核苷酸,比如Tominersen,在靶向和调节突变型亨廷顿蛋白的表达中起主导作用。尽管这些疗法有希望,挑战依然存在,特别是在改善输送系统和长期安全评估的必要性。考虑到未来的景观,这篇综述描述了HD研究和治疗的有希望的方向。诸如聚集的定期间隔短回文重复相关系统疗法(CRISPR)的创新基于基因组编辑和新兴的神经保护方法为干预提供了前所未有的机会。跨学科的协作努力和对HD发病机制的更有见地的理解正处于重塑治疗前景的边缘。当我们驾驭复杂的高清景观时,这篇综述可以作为揭示这种疾病的复杂性并朝着转化治疗方向发展的指南。
    Huntington\'s disease (HD) is a paradigm of a genetic neurodegenerative disorder characterized by the expansion of CAG repeats in the HTT gene. This extensive review investigates the molecular complexities of HD by highlighting the pathogenic mechanisms initiated by the mutant huntingtin protein. Adverse outcomes of HD include mitochondrial dysfunction, compromised protein clearance, and disruption of intracellular signaling, consequently contributing to the gradual deterioration of neurons. Numerous therapeutic strategies, particularly precision medicine, are currently used for HD management. Antisense oligonucleotides, such as Tominersen, play a leading role in targeting and modulating the expression of mutant huntingtin. Despite the promise of these therapies, challenges persist, particularly in improving delivery systems and the necessity for long-term safety assessments. Considering the future landscape, the review delineates promising directions for HD research and treatment. Innovations such as Clustered regularly interspaced short palindromic repeats associated system therapies (CRISPR)-based genome editing and emerging neuroprotective approaches present unprecedented opportunities for intervention. Collaborative interdisciplinary endeavors and a more insightful understanding of HD pathogenesis are on the verge of reshaping the therapeutic landscape. As we navigate the intricate landscape of HD, this review serves as a guide for unraveling the intricacies of this disease and progressing toward transformative treatments.
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  • 文章类型: Journal Article
    在针对SARS-CoV-2的感染和疫苗接种之后,适应性免疫系统的体液组分在保护宿主中起关键作用。具体来说,B细胞产生针对病毒的各种抗原的高亲和力抗体。在这次审查中,我们讨论了通过自然感染和疫苗接种引发免疫的机制,阐明SARS-CoV-2感染和疫苗接种后B细胞亚群的激活。先天免疫系统是抵御病毒的初级和非特异性防御的初始线。然而,在感染或接种疫苗后几天内,病毒特异性免疫反应启动,主要由B细胞产生抗体。这些抗体有助于疾病的解决。随后,这些B细胞转变为记忆B细胞,在提供对病毒的长期免疫力方面起着至关重要的作用。CD4+T辅助细胞启动级联反应,导致B细胞体细胞超突变,生发中心记忆B细胞,和中和抗体的产生。B细胞功能障碍可使疾病严重程度恶化并降低疫苗效力。值得注意的是,具有B细胞免疫缺陷的个体显示较低的IL-6产生。此外,这篇综述深入研究了免疫反应的几个方面,比如杂交免疫,这在促进广谱保护方面显示出了希望。交叉反应免疫也在受到审查,因为预先存在的抗体可以提供针对疾病的保护。我们还破译了突破性的感染机制,尤其是病毒的新变种.最后,我们讨论了一些关于B细胞的潜在治疗解决方案,包括恢复期血浆疗法,B-1细胞,B调节细胞(Breg)调制,以及中和单克隆抗体在对抗感染中的应用。正在进行的研究对于掌握人群免疫趋势和评估增强剂量的潜在需求至关重要,以维持针对潜在病毒威胁的有效免疫反应。
    Following infection and vaccination against SARS-CoV-2, humoral components of the adaptive immune system play a key role in protecting the host. Specifically, B cells generate high-affinity antibodies against various antigens of the virus. In this review, we discuss the mechanisms of immunity initiation through both natural infection and vaccination, shedding light on the activation of B cell subsets in response to SARS-CoV-2 infection and vaccination. The innate immune system serves as the initial line of primary and nonspecific defence against viruses. However, within several days following infection or a vaccine dose, a virus-specific immune response is initiated, primarily by B cells that produce antibodies. These antibodies contribute to the resolution of the disease. Subsequently, these B cells transition into memory B cells, which play a crucial role in providing long-term immunity against the virus. CD4+ T helper cells initiate a cascade, leading to B cell somatic hypermutation, germinal center memory B cells, and the production of neutralizing antibodies. B-cell dysfunction can worsen disease severity and reduce vaccine efficacy. Notably, individuals with B cell immunodeficiency show lower IL-6 production. Furthermore, this review delves into several aspects of immune responses, such as hybrid immunity, which has shown promise in boosting broad-spectrum protection. Cross-reactive immunity is under scrutiny as well, as pre-existing antibodies can offer protection against the disease. We also decipher breakthrough infection mechanisms, especially with the novel variants of the virus. Finally, we discuss some potential therapeutic solutions regarding B cells including convalescent plasma therapy, B-1 cells, B regulatory cell (Breg) modulation, and the use of neutralizing monoclonal antibodies in combating the infection. Ongoing research is crucial to grasp population immunity trends and assess the potential need for booster doses in maintaining effective immune responses against potential viral threats.
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  • 文章类型: Journal Article
    肌腱是连接肌肉和骨骼的成纤维细胞结构。有两种肌腱损伤,包括急性和慢性。每种形式的损伤或恶化都会导致明显的疼痛和肌腱功能丧失。肌腱损伤的恢复是一个复杂而耗时的恢复过程。根据肌腱组织的解剖位置,临床结果不一样.伤口愈合过程分为三个重叠阶段:炎症,扩散,和组织重塑。此外,固化肌腱具有高的再撕裂率。面对挑战,肌腱损伤的处理仍然是一个必须尽快解决的临床问题。近年来,肌腱恢复出现了几个新的方向和突破。本文介绍了肌腱损伤,并总结了肌腱恢复的最新进展,随着干细胞治疗,基因治疗,富含血小板的血浆药物,生长因子,药物治疗,和组织工程。尽管最近在肌腱恢复治疗方面的研究快速增长,仍然,它们都没有转化为临床环境。这篇综述提供了肌腱损伤和治疗肌腱损伤的潜在临床前方法的详细概述。
    Tendons are fibroblastic structures that link muscle and bone. There are two kinds of tendon injuries, including acute and chronic. Each form of injury or deterioration can result in significant pain and loss of tendon function. The recovery of tendon damage is a complex and time-consuming recovery process. Depending on the anatomical location of the tendon tissue, the clinical outcomes are not the same. The healing of the wound process is divided into three stages that overlap: inflammation, proliferation, and tissue remodeling. Furthermore, the curing tendon has a high re-tear rate. Faced with the challenges, tendon injury management is still a clinical issue that must be resolved as soon as possible. Several newer directions and breakthroughs in tendon recovery have emerged in recent years. This article describes tendon injury and summarizes recent advances in tendon recovery, along with stem cell therapy, gene therapy, Platelet-rich plasma remedy, growth factors, drug treatment, and tissue engineering. Despite the recent fast-growing research in tendon recovery treatment, still, none of them translated to the clinical setting. This review provides a detailed overview of tendon injuries and potential preclinical approaches for treating tendon injuries.
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