iNOS, inducible nitric oxide synthase

iNOS,诱导型一氧化氮合酶
  • 文章类型: Journal Article
    褪黑素是松果体中的主要神经内分泌产物。褪黑素可以调节昼夜节律相关的生理过程。证据表明褪黑素在毛囊中的重要作用,皮肤,和直觉。褪黑激素和皮肤病之间似乎有密切的联系。在这次审查中,我们专注于褪黑激素的生化活性(特别是在皮肤中)及其有前途的临床应用的最新研究。
    Melatonin is the main neuroendocrine product in the pineal gland. Melatonin can regulate circadian rhythm-related physiological processes. Evidence indicates an important role of melatonin in hair follicles, skin, and gut. There appears to be a close association between melatonin and skin disorders. In this review, we focus on the latest research of the biochemical activities of melatonin (especially in the skin) and its promising clinical applications.
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  • 文章类型: Journal Article
    髓源性抑制细胞(MDSCs),积聚在肿瘤携带者身上,已知抑制抗肿瘤免疫并因此促进肿瘤进展。MDSC被认为是癌症患者对免疫检查点抑制剂产生耐药性的主要原因。因此,MDSCs是癌症免疫治疗的潜在靶标。在这项研究中,我们修改了MDSC分化的体外方法。在体外用粒细胞-巨噬细胞集落刺激因子刺激骨髓(BM)细胞时,我们获得了淋巴细胞抗原6G阳性(Ly-6G)和阴性(Ly-6G-)MDSCs(统称,以下称为常规MDSCs),非免疫抑制和免疫抑制,分别。然后我们发现从Ly-6G-BM(以下称为6G-BM-MDSC)分化的MDSCs比常规MDSCs更强烈地抑制T细胞增殖。而从Ly-6GBM(以下称为6GBM-MDSC)分化的细胞是非免疫抑制性的。与此相符,常规MDSCs或6G-BM-MDSC,但不是6G+BM-MDSC,促进荷瘤小鼠的肿瘤进展。此外,我们发现活化的谷胱甘肽代谢是6G-BM-MDSC免疫抑制能力增强的原因。最后,我们表明,6G-BM-MDSC中的Ly-6G+细胞,表现出微弱的免疫抑制,表达更高水平的CybbmRNA,MDSCs的免疫抑制基因,比6G+BM-MDSC。一起,这些数据表明,Ly-6G+细胞从BM细胞的消耗导致免疫抑制性Ly-6G+MDSC的分化.总之,我们提出了一种更好的MDSC体外分化方法。此外,我们的研究结果有助于了解MDSC亚群,并为进一步研究MDSCs提供基础。
    Myeloid-derived suppressor cells (MDSCs), which accumulate in tumor bearers, are known to suppress anti-tumor immunity and thus promote tumor progression. MDSCs are considered a major cause of resistance against immune checkpoint inhibitors in patients with cancer. Therefore, MDSCs are potential targets in cancer immunotherapy. In this study, we modified an in vitro method of MDSC differentiation. Upon stimulating bone marrow (BM) cells with granulocyte-macrophage colony-stimulating factor in vitro, we obtained both lymphocyte antigen 6G positive (Ly-6G+) and negative (Ly-6G-) MDSCs (collectively, hereafter referred to as conventional MDSCs), which were non-immunosuppressive and immunosuppressive, respectively. We then found that MDSCs differentiated from Ly-6G- BM (hereafter called 6G- BM-MDSC) suppressed T-cell proliferation more strongly than conventional MDSCs, whereas the cells differentiated from Ly-6G+ BM (hereafter called 6G+ BM-MDSC) were non-immunosuppressive. In line with this, conventional MDSCs or 6G- BM-MDSC, but not 6G+ BM-MDSC, promoted tumor progression in tumor-bearing mice. Moreover, we identified that activated glutathione metabolism was responsible for the enhanced immunosuppressive ability of 6G- BM-MDSC. Finally, we showed that Ly-6G+ cells in 6G- BM-MDSC, which exhibited weak immunosuppression, expressed higher levels of Cybb mRNA, an immunosuppressive gene of MDSCs, than 6G+ BM-MDSC. Together, these data suggest that the depletion of Ly-6G+ cells from the BM cells leads to differentiation of immunosuppressive Ly-6G+ MDSCs. In summary, we propose a better method for MDSC differentiation in vitro. Moreover, our findings contribute to the understanding of MDSC subpopulations and provide a basis for further research on MDSCs.
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  • 文章类型: Journal Article
    甲氨蝶呤(MTX)是一种用于治疗癌症和自身免疫性疾病的免疫抑制剂。MTX有主要的不良影响,急性肾损伤,这限制了它的使用。芒果苷(MF)是一种天然的生物活性黄原酮,用作传统的草药补充剂,以增强免疫系统,由于其有效的抗炎和抗氧化活性。本研究评估了MF对MTX诱导的肾脏损伤的保护作用。雄性Wistar大鼠接受MTX诱导肾毒性或用MF预处理10天,然后再给予MTX。MF剂量依赖性地改善了MTX处理的大鼠的肾功能,并且该活性与PPARγ的肾表达增加相关。免疫反应的众所周知的转录调节因子。用PPARγ抑制剂预处理大鼠,徽章,降低了MF的肾脏保护活性。此外,MF治疗显着降低了MTX诱导的促炎上调(NFκB,白细胞介素-1β,TNF-α,和COX-2),氧化应激(Nrf-2,血红素加氧酶-1,谷胱甘肽,和丙二醛),和肾脏中的硝化应激(一氧化氮和iNOS)标志物。重要的是,BADGE处理显著降低了MF的抗炎和抗氧化活性。因此,我们的数据表明,MF对MTX诱导的肾毒性的肾保护作用是由于以PPAR-γ依赖性方式抑制了炎症和氧化应激.
    Methotrexate (MTX) is an immunosuppressant used for the treatment of cancer and autoimmune diseases. MTX has a major adverse effect, acute kidney injury, which limits its use. Mangiferin (MF) is a natural bioactive xanthonoid used as a traditional herbal supplement to boost the immune system due to its potent anti-inflammatory and antioxidant activity. The present study evaluates the protective effect of MF against MTX-induced kidney damage. Male Wistar rats received MTX to induce nephrotoxicity or were pretreated with MF for 10 constitutive days before MTX administration. MF dose-dependently improved renal functions of MTX-treated rats and this activity was correlated with increased renal expression of PPARγ, a well-known transcriptional regulator of the immune response. Pretreating rats with PPARγ inhibitor, BADGE, reduced the reno-protective activity of MF. Furthermore, MF treatment significantly reduced MTX-induced upregulation of the pro-inflammatory (NFκB, interleukin-1ß, TNF-α, and COX-2), oxidative stress (Nrf-2, hemoxygenase-1, glutathione, and malondialdehyde), and nitrosative stress (nitric oxide and iNOS) markers in the kidney. Importantly, BADGE treatment significantly reduced the anti-inflammatory and antioxidant activity of MF. Therefore, our data suggest that the reno-protective effect of MF against MTX-induced nephrotoxicity is due to inhibition of inflammation and oxidative stress in a PPAR-γ-dependent manner.
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  • 文章类型: Journal Article
    糖尿病伤口表现出慢性炎症和延迟的组织增殖或重塑,主要是由于延长的促炎(M1)巨噬细胞活性和过渡到修复/重塑(M2a/M2c;CD206和/或CD163)巨噬细胞的缺陷。我们发现用ON101局部治疗,这是一种基于植物的糖尿病足溃疡的潜在治疗方法,增加M2c样(CD163+和CD206+)细胞和抑制M1样细胞,与对照组相比,在糖尿病小鼠模型中改变炎症基因谱。体外巨噬细胞极化模型显示,ON101在蛋白质和转录水平上直接抑制CD80和CD86M1巨噬细胞极化以及M1相关的促炎细胞因子。值得注意的是,从ON101处理的M1巨噬细胞收集的条件培养基逆转了M1条件培养基介导的对CD206巨噬细胞的抑制。此外,来自ON101处理的脂肪细胞祖细胞的条件培养基显着促进CD206和CD163巨噬细胞,但强烈抑制M1样细胞。ON101处理还刺激人脂肪细胞祖细胞中GCSF和CXCL3基因的表达。有趣的是,用重组GCSF蛋白治疗增强了CD206+和CD163+M2标志物,而CXCL3处理仅刺激CD163+M2巨噬细胞。皮肤M2巨噬细胞的消耗抑制了ON101诱导的糖尿病伤口愈合。因此,ON101直接抑制M1巨噬细胞并促进GCSF-和CXCL3-介导的M1至M2巨噬细胞的转变,降低炎症和导致更快的糖尿病伤口愈合。
    Diabetic wounds exhibit chronic inflammation and delayed tissue proliferation or remodeling, mainly owing to prolonged proinflammatory (M1) macrophage activity and defects in transition to prohealing/proremodeling (M2a/M2c; CD206+ and/or CD163+) macrophages. We found that topical treatment with ON101, a plant-based potential therapeutic for diabetic foot ulcers, increased M2c-like (CD163+ and CD206+) cells and suppressed M1-like cells, altering the inflammatory gene profile in a diabetic mouse model compared with that in the controls. An in vitro macrophage-polarizing model revealed that ON101 directly suppressed CD80+ and CD86+ M1-macrophage polarization and M1-associated proinflammatory cytokines at both protein and transcriptional levels. Notably, conditioned medium collected from ON101-treated M1 macrophages reversed the M1-conditioned medium‒mediated suppression of CD206+ macrophages. Furthermore, conditioned medium from ON101-treated adipocyte progenitor cells significantly promoted CD206+ and CD163+ macrophages but strongly inhibited M1-like cells. ON101 treatment also stimulated the expression of GCSF and CXCL3 genes in human adipocyte progenitor cells. Interestingly, treatment with recombinant GCSF protein enhanced both CD206+ and CD163+ M2 markers, whereas CXCL3 treatment only stimulated CD163+ M2 macrophages. Depletion of cutaneous M2 macrophages inhibited ON101-induced diabetic wound healing. Thus, ON101 directly suppressed M1 macrophages and facilitated the GCSF- and CXCL3-mediated transition from M1 to M2 macrophages, lowering inflammation and leading to faster diabetic wound healing.
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  • 文章类型: Journal Article
    心血管疾病是死亡的主要原因,血管损伤,心血管疾病的共同病理基础,与巨噬细胞凋亡和炎症反应密切相关。金雀异黄素,一种植物雌激素,发挥心血管保护作用,但是潜在的机制尚未完全阐明。在这项研究中,RAW264.7细胞用金雀异黄素处理,脂多糖(LPS),核因子-κB(NF-κB)抑制剂,和/或蛋白激酶B(AKT)激动剂,以确定染料木素在LPS刺激的细胞凋亡和炎症中的作用。同时,高脂饮食喂养的C57BL/6小鼠给予金雀异黄素以评价金雀异黄素对LPS诱导的心血管损伤小鼠模型的作用。这里,我们证明LPS通过促进miR-21的表达显著增加巨噬细胞的凋亡抵抗和炎症反应,miR-21通过靶向编码区下调肿瘤坏死因子-α诱导的蛋白8样2(TIPE2)表达。金雀异黄素通过抑制NF-κB降低miR-21表达,然后阻断Toll样受体4(TLR4)通路和依赖于TIPE2的AKT磷酸化,从而抑制LPS。我们的研究提示miR-21/TIPE2通路参与M1巨噬细胞凋亡和炎症反应,金雀异黄素通过NF-κB调节Vmp1的启动子区,在表观遗传水平上抑制LPS诱导的心血管损伤的进展。
    Cardiovascular diseases are a major cause of mortality, and vascular injury, a common pathological basis of cardiovascular disease, is deeply correlated with macrophage apoptosis and inflammatory response. Genistein, a type of phytoestrogen, exerts cardiovascular protective activities, but the underlying mechanism has not been fully elucidated. In this study, RAW264.7 cells were treated with genistein, lipopolysaccharide (LPS), nuclear factor-kappa B (NF-κB) inhibitor, and/or protein kinase B (AKT) agonist to determine the role of genistein in apoptosis and inflammation in LPS-stimulated cells. Simultaneously, high fat diet-fed C57BL/6 mice were administered genistein to evaluate the function of genistein on LPS-induced cardiovascular injury mouse model. Here, we demonstrated that LPS obviously increased apoptosis resistance and inflammatory response of macrophages by promoting miR-21 expression, and miR-21 downregulated tumor necrosis factor-α-induced protein 8-like 2 (TIPE2) expression by targeting the coding region. Genistein reduced miR-21 expression by inhibiting NF-κB, then blocked toll-like receptor 4 (TLR4) pathway and AKT phosphorylation dependent on TIPE2, resulting in inhibition of LPS. Our research suggests that miR-21/TIPE2 pathway is involved in M1 macrophage apoptosis and inflammatory response, and genistein inhibits the progression of LPS-induced cardiovascular injury at the epigenetic level via regulating the promoter region of Vmp1 by NF-κB.
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  • 文章类型: Journal Article
    内镜粘膜下剥离术(ESD)是早期食管癌的微创治疗方法。然而,食管ESD后较大的粘膜缺损导致难治性狭窄。在本研究中,我们在组织学上评估了内镜下移植同种异体表皮细胞片(ECSs)作为一种可行的治疗方法,用于预防猪环行ESD后食管狭窄.
    从同种异体猪的皮肤组织中分离表皮细胞,并在温度响应性细胞培养插入物上培养2周。通过降低温度并在食管ESD后立即将片材内窥镜移植到溃疡部位来收获可移植的ECS。然后在移植后7天在两只猪中评估移植的ECS的植入。接下来,将10头猪分为两组,以评估内镜下同种异体ECS移植预防ESD后食管狭窄的效果。移植组食管ESD术后即刻移植同种异体ECS(n=5),而对照组(n=5)没有进行移植。
    大多数移植的同种异体ECS在早期成功移植到溃疡部位。荧光原位杂交分析表明,ESD后7天,移植区域中存在几种同种异体细胞。ESD后14天,体重下降的显著差异,吞咽困难评分,对照组和移植组之间观察到粘膜狭窄。食管ESD后移植同种异体ECSs促进粘膜愈合和血管生成,并防止过度炎症和肉芽组织形成。
    内窥镜和组织学分析显示,同种异体ECS促进ESD后的人工溃疡愈合,预防ESD后食管狭窄。
    UNASSIGNED: Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early esophageal cancer. However, large mucosal defects after esophageal ESD result in refractory strictures. In the present study, we histologically evaluated the endoscopic transplantation of allogeneic epidermal cell sheets (ECSs) as a feasible therapy for preventing esophageal stricture after circumferential ESD in a porcine model.
    UNASSIGNED: Epidermal cells were isolated from the skin tissue of allogeneic pigs and cultured on temperature-responsive cell culture inserts for 2 weeks. Transplantable ECSs were harvested by reducing the temperature and endoscopically transplanting the sheets to ulcer sites immediately after esophageal ESD. The engraftment of transplanted ECSs was then evaluated in two pigs at 7 days after transplantation. Next, ten pigs were divided into two groups to evaluate the endoscopic transplantation of allogeneic ECSs for the prevention of esophageal strictures after ESD. Allogeneic ECSs were transplanted immediately after esophageal ESD in the transplantation group (n = 5), whereas the control group (n = 5) did not undergo transplantation.
    UNASSIGNED: Most of the transplanted allogeneic ECSs were successfully engrafted at the ulcer sites in the early phase. Fluorescence in situ hybridization analysis revealed that several allogeneic cells were present in the transplanted area at 7 days after ESD. At 14 days after ESD, significant differences in body weight loss, dysphagia scores, and mucosal strictures were observed between the control and transplantation groups. Transplanting allogeneic ECSs after esophageal ESD promotes mucosal healing and angiogenesis and prevents excessive inflammation and granulation tissue formation.
    UNASSIGNED: Endoscopic and histological analyses revealed that allogeneic ECSs promoted artificial ulcer healing after ESD, preventing esophageal strictures after ESD.
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  • 文章类型: Journal Article
    背景:未控制的炎症会导致健康问题。细胞外信号调节激酶(ERK)在Ser727处磷酸化信号转导子和转录激活因子3(STAT3),导致炎症。Vernoniaamgdalina(VA)的叶子是一种用于治疗炎症相关疾病的草药。口服或局部施用VA叶提取物在大鼠模型中发挥抗炎作用。然而,该草药的抗炎机制尚未完全了解。
    目的:在本研究中,我们旨在研究ERK/STAT3(Ser727)信号在VA叶乙醇提取物抗炎作用中的作用.
    方法:用不同浓度的乙醇制备VA叶提取物。LPS刺激的RAW264.7细胞模型用于体外测定,和TPA(12-O-十四烷酰基佛波醇-13-乙酸酯)诱导的耳水肿小鼠模型用于体内测定。VA叶(VAE)的95%乙醇提取物对LPS刺激的巨噬细胞中一氧化氮(NO)的产生具有最强的抑制作用;因此,将其选择用于本研究。苏木精和伊红(H&E)染色用于检查小鼠耳组织的病理状况。使用Griess试剂检查细胞培养物中的NO生成。免疫印迹和ELISA用于检测蛋白质水平,采用RT-qPCR检测mRNA水平。
    结果:局部应用VAE可改善TPA诱导的小鼠耳部水肿。VAE抑制了ERK(Thr202/Tyr204)和STAT3(Ser727)的磷酸化;并降低了诱导型一氧化氮合酶(iNOS)的蛋白质水平,环氧合酶-2(COX-2),小鼠耳组织和LPS刺激的RAW264.7细胞中的白介素(IL)-6,IL-1β和肿瘤坏死因子-α(TNF-α)。VAE还抑制NO的产生,并降低巨噬细胞中IL-6,IL-1β和TNF-α的mRNA水平。
    结论:VAE可改善TPA诱导的小鼠耳部水肿。ERK/STAT3(Ser727)信号传导的抑制涉及VAE的抗炎作用。这些新数据为VA在治疗炎症相关疾病中的药用用途提供了进一步的药理学理由。并为将VAE开发成新型抗炎药奠定基础。
    BACKGROUND: Uncontrolled inflammation causes health problems. Extracellular signal-regulated kinase (ERK) phosphorylates signal transducer and activator of transcription 3 (STAT3) at Ser727, resulting in inflammation. The leaf of Vernonia amygdalina (VA) is a medicinal herb for managing inflammation-associated diseases. Oral administration or topical application of VA leaf extract exerts anti-inflammatory effects in rat models. However, the anti-inflammatory mechanisms of the herb are not fully understood.
    OBJECTIVE: In this study, we aimed to investigate the involvement of ERK/STAT3 (Ser727) signaling in the anti-inflammatory effects of an ethanolic extract of VA leaves.
    METHODS: Extracts of VA leaves were prepared with different concentrations of ethanol. A LPS-stimulated RAW264.7 cell model was used for in vitro assays, and a TPA (12-O-tetradecanoylphorbol-13-acetate)-induced ear edema mouse model was employed for in vivo assays. The 95% ethanol extract of VA leaves (VAE) exerted the strongest inhibitory effect on nitric oxide (NO) production in LPS-stimulated macrophages; thus it was selected for use in this study. Hematoxylin and eosin (H&E) staining was used to examine pathological conditions of mouse ear tissues. Griess reagent was employed to examine NO generation in cell cultures. Immunoblotting and ELISA were used to examine protein levels, and RT-qPCR was employed to examine mRNA levels.
    RESULTS: Topical application of VAE ameliorated mouse ear edema induced by TPA. VAE suppressed the phosphorylation of ERK (Thr202/Tyr204) and STAT3 (Ser727); and decreased protein levels of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), interleukin (IL)-6, IL-1β and tumor necrosis factor-α (TNF-α) in the mouse ear tissues and in LPS-stimulated RAW 264.7 cells. VAE also inhibited NO production, and lowered mRNA levels of IL-6, IL-1β and TNF-α in the macrophages.
    CONCLUSIONS: VAE ameliorates TPA-induced mouse ear edema. Suppression of ERK/STAT3 (Ser727) signaling is involved in VAE\'s anti-inflammatory effects. These novel data provide further pharmacological justifications for the medicinal use of VA in treating inflammation-associated diseases, and lay the groundwork for developing VAE into a new anti-inflammatory agent.
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  • 文章类型: Journal Article
    在脊髓损伤的急性期,最初的损伤会引发神经炎症引起的继发性损伤,导致损害神经再生的空洞和神经胶质疤痕的形成。中枢神经系统受伤后,早期动员促进身体功能的恢复。因此,在本研究中,我们研究了早期动员对大鼠运动功能恢复和神经炎症的影响。完全脊髓横断的大鼠早期动员3周后后肢运动功能恢复良好。脊髓损伤后1周,早期动员的大鼠表达较少的炎性M1小胶质细胞/巨噬细胞和较多的抗炎M2小胶质细胞。此外,在早期动员的大鼠损伤后1周,在病变部位观察到明显更多的基质金属蛋白酶2(MMP2)阳性细胞。多重标记研究表明,许多MMP2阳性细胞是M2小胶质细胞。在早期动员的大鼠中也更频繁地观察到高度共表达GFAP的MMP9阳性细胞。脊髓损伤后3周,早期动员的大鼠病变中心的生长相关蛋白阳性结构的密度显着升高。目前的结果表明,脊髓损伤后的早期动员减少了M1小胶质细胞/巨噬细胞的产生,同时增加了病变部位M2小胶质细胞的产生。早期动员还可能激活M2小胶质细胞中MMP2和星形胶质细胞中MMP9的表达。这些细胞动力学可能会抑制病变部位的神经炎症,从而抑制组织破坏的进展并促进神经再生以恢复运动功能。
    In the acute phase of spinal cord injury, the initial injury triggers secondary damage due to neuroinflammation, leading to the formation of cavities and glial scars that impair nerve regeneration. Following injuries to the central nervous system, early mobilization promotes the recovery of physical function. Therefore, in the present study, we investigated the effects of early mobilization on motor function recovery and neuroinflammation in rats. Early mobilization of rats with complete spinal cord transection resulted in good recovery of hindlimb motor function after 3 weeks. At 1 week after spinal cord injury, the early-mobilized rats expressed fewer inflammatory M1 microglia/macrophages and more anti-inflammatory M2 microglia. In addition, significantly more matrix metalloproteinase 2 (MMP2)-positive cells were observed at the lesion site 1 week after injury in the early-mobilized rats. Multiple labeling studies suggested that many MMP2-positive cells were M2 microglia. MMP9-positive cells that highly co-expressed GFAP were also observed more frequently in the early-mobilized rats. The density of growth-associated protein-positive structures in the lesion center was significantly higher in the early-mobilized rats at 3 weeks after spinal cord injury. The present results suggest that early mobilization after spinal cord injury reduced the production of M1 microglia/macrophages while increasing the production of M2 microglia at the lesion site. Early mobilization might also activate the expression of MMP2 in M2 microglia and MMP9 in astrocytes. These cellular dynamics might suppress neuroinflammation at the lesion site, thereby inhibiting the progression of tissue destruction and promoting nerve regeneration to recover motor function.
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  • 文章类型: Journal Article
    辣木。(M.oleiferaLam)是一种多年生的热带落叶树,属于辣根科。多糖是油茶中主要的生物活性化合物之一,抗癌,抗氧化剂,肠道健康保护和抗糖尿病活性。目前,油茶多糖(MOPs)的结构和功能活性得到了广泛的研究,但是研究数据相对分散。此外,MOPs的结构与生物活性之间的关系尚未总结。在这次审查中,目前对提取的研究,净化,综述了不同来源油茶多糖的结构特征和生物活性,本文对纯化多糖的结构特征进行了综述。同时,介绍了MOPs的生物活性,并列举了一些分子机制。此外,讨论了MOPs的结构与生物活性之间的关系。此外,本文对油茶多糖的研究提出了新的观点和未来的研究方向。
    Moringa oleifera Lam. (M. oleifera Lam) is a perennial tropical deciduous tree that belongs to the Moringaceae family. Polysaccharides are one of the major bioactive compounds in M. oleifera Lam and show immunomodulatory, anticancer, antioxidant, intestinal health protection and antidiabetic activities. At present, the structure and functional activities of M. oleifera Lam polysaccharides (MOPs) have been widespread, but the research data are relatively scattered. Moreover, the relationship between the structure and biological activities of MOPs has not been summarized. In this review, the current research on the extraction, purification, structural characteristics and biological activities of polysaccharides from different sources of M. oleifera Lam were summarized, and the structural characteristics of purified polysaccharides were focused on this review. Meanwhile, the biological activities of MOPs were introduced, and some molecular mechanisms were listed. In addition, the relationship between the structure and biological activities of MOPs was discussed. Furthermore, new perspectives and some future research of M. oleifera Lam polysaccharides were proposed in this review.
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  • 文章类型: Journal Article
    疲劳是肝病患者的常见症状,对健康相关生活质量(HR-QoL)有重大影响。其发病机理知之甚少,被认为是多因素的。肝脏是疲劳发病的核心,因为它独特地调节了许多生产,storage,和释放用于产生能量的基质。此外,肝脏“交叉对话”与负责这种症状复杂的关键器官-肠道,骨骼肌,和大脑。疲劳可以同时具有外围(即,神经肌肉)和中枢(即,由于大脑内神经传递的变化)成分。治疗疲劳的治疗策略是行为改变和药物治疗,以及饮食干预和锻炼。然而,对于肝病患者的疲劳管理策略尚无共识.本文概述了疲劳作为一个概念,它的病理生理学,评估肝病患者疲劳的措施,疲劳对慢性肝病的影响,在适当的临床环境中评估疲劳,和各种干预措施来管理疲劳。
    Fatigue is a common symptom in patients with liver disease and has a significant impact on the health-related quality of life (HR-QoL). Its pathogenesis is poorly understood and is considered multifactorial. The liver is central in the pathogenesis of fatigue because it uniquely regulates much of the production, storage, and release of substrate for energy generation. Also, the liver \"cross-talks\" with the key organs that are responsible for this symptom complex-gut, skeletal muscle, and brain. Fatigue can have both peripheral (i.e., neuromuscular) and central (i.e., resulting from changes in neurotransmission within the brain) components. The treatment strategies for the management of fatigue are behavioral changes and pharmacotherapy, along with dietetic intervention and exercise. However, there is no consensus on management strategies for fatigue in patients with liver disease. This article gives an overview of fatigue as a concept, its pathophysiology, measures to evaluate fatigue in patients with liver disease, the impact of fatigue on chronic liver disease, assessment of fatigue in an appropriate clinical setting, and various interventions to manage fatigue.
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