高迁移率族蛋白B1介导神经炎症在抑郁症中的研究进展

抑郁症是一种常见的慢性情感障碍性疾病,带来严重的经济和社会负担。神经炎症机制在抑郁症的研究中逐渐深入。临床和动物模型均证实,抑郁症体内高水平的炎性细胞因子和被激活的小胶质细胞等典型神经炎症反应与抑郁症的发病机制密切相关。高迁移率族蛋白B1(high mobility group box 1 protein, HMGB1)是一种高度保守的染色体结合蛋白,是一种重要的危险相关模式分子,可被免疫活性细胞和坏死细胞释放至细胞外,启动脑内炎症反应。HMGB1拮抗剂的研发也为神经精神类疾病治疗拓宽了治疗途径。该文重点介绍了HMGB1介导神经炎症的分子机制及其在抑郁症发病及治疗中的研究现状,以期为后续临床诊疗提供重要理论基础。     

神经免疫学基础研究的前沿与进展

神经系统、内分泌系统和免疫系统相互作用构成复杂网络。神经免疫学(neuroimmunology)是从分子、细胞、组织器官以及机体整体水平研究神经-内分泌-免疫调节网络的交叉学科。神经-免疫互作(neuro-immune interactions)贯穿机体生命周期的全过程，其功能紊乱导致多种疾病的发生发展。近年来我国在以中枢神经系统调控为主的神经-内分泌-免疫-代谢交叉领域前沿已取得了许多重大突破。一方面，揭示神经调控外周系统功能的新机制，首次发现“脑-脾”轴，明确了情绪通过中枢神经调节免疫的新机制；阐明神经元分泌的神经营养因子在调节脾脏免疫功能中的机制；完成了传统中医针刺治疗抗炎的神经机制解析，阐明了足三里穴位刺激通过脊髓特定神经元调节免疫功能。另一方面，在外周脏器反向调控神经功能方面也取得突破，在“肠-脑”轴参与动物呕吐、光调控血糖代谢等方面取得突破。这些成果夯实了我国在神经-内分泌-免疫-代谢交叉研究领域的研究基础。本文聚焦国内科学家在神经免疫学基础研究的最新进展，从“神经-免疫互作的基本单元”、“系统生理的神经-内分泌-免疫调控”、“神经-免疫互作与疾病”、“类淋巴系统(glym...     

高脂饮食诱导情绪障碍及药物干预研究进展

近年来代谢性疾病和抑郁症的发病率逐渐上升,临床研究表明代谢紊乱疾病与抑郁症之间存在共病现象。富含高糖高脂的西方饮食通常可造成肥胖、糖尿病、代谢综合征等代谢紊乱性疾病,近期研究发现高脂饮食是情绪障碍发病的危险因素,然而具体高脂饮食对情绪紊乱的影响机制尚未明确,其可能机制包括胰岛素抵抗、瘦素抵抗、炎症、氧化应激、神经凋亡、大脑奖赏回路系统等。本文对近年来报道的高脂饮食诱发情绪障碍可能机制及药物研究进行阐述。     

小胶质细胞极化在抑郁症发病中的作用

应激可诱发抑郁症,严重影响人们的身心健康。小胶质细胞是中枢神经系统的主要免疫细胞,在各种神经退行性疾病中发挥重要作用。不同极化类型的小胶质细胞可分泌不同作用的炎症因子,介导神经炎症,与抑郁症的发生密切相关,但目前其机制尚不明确。抑郁症与应激、小胶质细胞极化和神经炎症等因素的相互作用有关。本文综述了小胶质细胞极化在抑郁症发病中的作用研究进展。     

肠道微生物与神经及精神疾病的研究现状

近年来随着微生物16S rRNA、高通量测序以及序列识别技术的成熟,肠道微生物与多种疾病相关性的研究呈蓬勃发展。大量的研究证据表明肠道微生物可通过刺激迷走神经、调节下丘脑-垂体-肾上腺轴功能、参与调节机体免疫系统、合成分泌神经递质、产生多种自身代谢产物(如短链脂肪酸、Lipid456、BDNF等小分子物质)机制参与中枢神经系统自身免疫性疾病、癫痫、神经变性疾病、抑郁症、自闭症、精神分裂症的发病过程。研究肠道微生物与中枢神经系统疾病的相互作用,为揭示复杂的中枢神经系统疾病以及精神疾病的发病机制提供科学证据,以期通过调解肠道菌群的微环境治疗神经精神类疾病。     

肠道菌群与相关疾病

近年来肠道菌群的研究发展迅速,肠道菌群对宿主消化、代谢和免疫功能的影响逐渐被人们所熟知并重视。大量研究提示,肠道菌群的改变可能引发代谢、肝脏和肠道等方面的多种相关疾病。因此,研究肠道菌群对宿主健康及疾病的影响尤为重要,也能为预防和治疗肠道菌群相关疾病提供建议。     

我国疾病靶点研究最新进展

主要通过对中国学者2013—2014 年间在国内外发表的相关论文进行查阅和整理,分类综述我国在神经退行性疾病、抑郁症、 心脑血管疾病、代谢性疾病、感染性疾病、肿瘤、自身免疫性疾病等各种重大疾病靶点研究方面的最新进展。     

微生物药物在神经系统疾病中的研究进展

最近大量的研究表明,肠道微生物与帕金森病、抑郁症、孤独症谱系障碍和阿尔茨海默症等神经系统疾病的发生发展密切相关。其中涉及神经内分泌代谢、神经和免疫等途径,肠道微生物稳态经由以上途径参与大脑功能的维持与调控。反之,脑功能的紊乱也会破坏微生物组成以及肠道屏障的完整性。“肠-微生物-脑轴”近年来成为神经科学研究的焦点。肠道微生物产生的代谢产物可从肠腔进入人体血液循环系统,通过靶向特定器官、调控信号通路以及配-受体结合等方式,调控神经系统疾病的发生与发展。针对“肠-微生物-脑轴”所研发的多种微生物药物为治疗神经系统疾病打开了新的窗口,然而其具体作用机制仍不明确。本综述介绍微生物药物在神经系统疾病治疗方面的最新研究进展,解析其可能的作用机制,并对未来的研究方向进行展望。     

肠道菌群与中枢神经系统相互作用及相关疾病

肠道菌群参与宿主的多项生理过程,包括营养物质吸收、代谢及免疫系统的发育成熟、抵抗外来病原体入侵等,新的研究显示肠道菌群通过神经、内分泌、代谢和免疫的途径参与了肠道和中枢神经系统的双向调节。肠道菌群的变化与自闭症、多发性硬化、帕金森病、焦虑和抑郁症等一系列神经精神疾病有关,通过改善肠道菌群的微生态疗法有望成为治疗和预防一些神经系统疾病的有效措施。     

脑铁代谢及调控

随着研究的深入,脑铁代谢相关分子突变引起的疾病越来越多的被人们所认识。脑铁代谢紊乱可能是神经退行性疾病的发病原因之一。对脑铁代谢机理的认识将为预防和治疗脑铁代谢紊乱相关疾病提供重要的理论根据。对脑铁代谢的过程,脑铁代谢的相关分子以及这些分子对脑内铁稳态的调控作用作一介绍。     

Is the Neutrophil-to-Lymphocyte Ratio an Exceptional Indicator for Metabolic Syndrome Disease and Outcomes?

ObjectivesTo show that there is relation between neutrophil-to-lymphocyte ratio (NLR) and metabolic syndrome and also, its components.FindingsMetabolic syndrome is associated with elevated fasting blood glucose, increased blood pressure, central obesity, decreased high-density lipoprotein, and increased triglyceride levels. Because of its growing incidence and prevalence and the effect that it has on developing other noncommunicable diseases, the importance gets even more value. The prediction and control of this disease in its early stages and in the most inexpensive way is of crucial need. Due to the role of chronic low-grade inflammation in metabolic syndrome, cytokines and inflammatory factors (like interleukin-6 and tumor necrosis factor-α) play a critical role on this phenomenon. The NLR is an inflammatory marker that has an unchallenging availability and has a reasonable cost. The NLR is related to obesity, type 2 diabetes, hypertension, and blood cholesterol levels.ConclusionThis suggests that there may be a relationship between the NLR and metabolic syndrome. The NLR, as a low-grade inflammation marker, indicates a positive relationship with central obesity. Also, studies indicate that the incidence of diabetes, its severity, and its control are related to the NLR. Hypertension and hyperlipidemia can both be noticed with higher NLRs. This rapid review assesses the association between metabolic syndrome and the NLR.     

Comparative evaluation of obesity-related parameters in junior sumo wrestlers and children with obesity

[Purpose]Exercise is a key factor in preventing obesity and metabolic syndrome. Sumo wrestlers increase their body size from childhood for athletic advantage; however, the risk of metabolic syndrome in junior sumo wrestlers is undetermined. Preventive measures against pediatric obesity should be initiated during childhood to prevent obesity in adulthood, considering its high global incidence. We comparatively evaluated the risk factors for metabolic syndrome in junior sumo wrestlers and children with obesity.[Methods]We enrolled 70 male children (age 9–17 years [sumo group, n = 14] and 9–14 years [other sports and non-exercise groups, n = 28 each]) and evaluated their anthropometric parameters (height, weight, body mass index z-score, obesity rate, waist circumference, waist to height ratio) and hematological parameters (total, low-density, high-density, and non-high-density lipoprotein-cholesterol; triglycerides; plasma glucose, and glycated hemoglobin levels).[Results]The BMI z-score, obesity rate, waist circumference (p < 0.05, along with the non-exercise group), and systolic blood pressure were significantly higher and the high-density cholesterol level was lower in the sumo group than in the other sports group (p < 0.05). The waist to height ratio was significantly higher in the non-exercise group than in the other sports group (p < 0.05). No significant difference was found in other blood lipid, plasma glucose (significantly lower level than the reference range in the sumo group, p < 0.05), and glycated hemoglobin (within the reference range in all groups) levels among the three groups.[Conclusion]Junior sumo wrestlers had a larger body size and higher blood pressure than children with obesity who exercised regularly. This provides direction for future research into targeted preventive interventions against metabolic syndrome for junior sumo wrestlers with large body size.     

Epidemiology,risk factors across the spectrum of age-related metabolic diseases

BackgroundPopulation aging is dynamic process of increasing proportion of older adults in the total population, which is an inescapable result of decline in fertility rate and extension in life expectancy. Inevitably, age-related metabolic diseases, for example obesity, type 2 diabetes, metabolic syndrome, dyslipidemia, and nonalcoholic fatty liver disease, are becoming epidemic globally along with the demographic transition.ContentThe review examines the literatures related to: 1) the epidemiology of age related metabolic diseases including obesity, type 2 diabetes, metabolic syndrome, dyslipidemia, and nonalcoholic fatty liver disease; and 2) the risk factors of age related metabolic diseases including genetic factors, diet, smoking, Physical activity, intestinal microbiota and environmental factors.ConclusionPopulation aging is becoming epidemic worldwide, resulting in increasing incidence and prevalence of a serious of age-related metabolic diseases. Both genetic and environmental factors contribute to the diseases, thus interventions targeting on these factors may have beneficial effect on the development of age-related metabolic diseases.     

Polycystic Ovary Syndrome,Depression, and Affective Disorders

ObjectiveTo assess the prevalence of depression and psychologic disorders and their effect on the quality of life in women with polycystic ovary syndrome.MethodsWe performed a PubMed search of major relevant articles published during the period from 1985 to 2009 dealing with polycystic ovary syndrome, associated psychologic morbidity, and the relationship to clinical and biochemical changes affecting the quality of life.ResultsIn patients with polycystic ovary syndrome, the presence of depression and allied disorders was frequently noted to diminish mental well-being, affect, and self-worth. The symptoms often associated with this syndrome, such as hirsutism, obesity, irregular menses, and subfertility, were a major source of psychologic morbidity. Obesity was the most prevalent cause of mental distress, whereas other features such as hirsutism and infertility were less well defined as major factors. Although the findings in some studies have been inconclusive, the presence of clinically significant eating disorders and a 7-fold increase in the suicide rate have been reported in women with polycystic ovary syndrome.ConclusionWomen with polycystic ovary syndrome have a high risk for depression and affective disorders that impair their quality of life. The presence of obesity, eating disorders, hirsutism, poor self-image, and a significant suicide rate makes evaluation of their emotional state an integral part of their assessment and treatment. For adequate treatment of the woman with polycystic ovary syndrome, a biopsychosocial model should be used, with all aspects of the patient’s mental status considered before implementation of optimal intervention. (Endocr Pract. 2009;15:475-482)     

Metabolic and Body Composition Risk Factors Associated with Metabolic Syndrome in a Cohort of Women with a High Prevalence of Cardiometabolic Disease

BackgroundThe aetiology of the metabolic syndrome and the inter-relationship between risk factors for this syndrome are poorly understood. The purpose of this investigation was to determine the risk factors for metabolic syndrome and their interactions in a cohort of women with a high prevalence of metabolic syndrome.ResultsMetabolic syndrome was present in 49.6% of the study cohort. Logistic regression analysis demonstrated that adiponectin (odds ratio [95% CIs]: 0.84 [0.77, 0.92], p<0.0005) and abdominal subcutaneous fat (0.56 [0.39, 0.79], p = 0.001) reduced metabolic syndrome risk whilst insulin resistance (1.31 [1.16, 1.48], p<0.0005) and trunk fat-free soft-tissue mass (1.34 [1.10, 1.61], p = 0.002) increased risk. Within this group of risk factors, the relationship of adiponectin with metabolic syndrome risk, when analysed across adiponectin hexiles, was the least affected by adjustment for the other risk factors.ConclusionsAdiponectin has a significant protective role against metabolic syndrome and is independent of other risk factors. The protective and possible augmentive effects of abdominal subcutaneous fat and lean trunk mass, respectively on metabolic syndrome risk demonstrate the existence of novel interactions between body composition and cardiometabolic disease.     

A central role of eNOS in the protective effect of wine against metabolic syndrome

The positive health effects derived from moderate wine consumption are pleiotropic. They appear as improvements in cardiovascular risk factors such as plasma lipids, haemostatic mechanisms, endothelial function and antioxidant defences. The active principles would be ethanol and mainly polyphenols. Results from our and other laboratories support the unifying hypothesis that the improvements in risk factors after red wine consumption are mediated by endothelial nitric oxide synthase (eNOS). Many genes are involved, but the participation of eNOS would be a constant feature.The metabolic syndrome is a cluster of metabolic risk factors associated with high risk of cardiovascular disease (CVD). The National Cholesterol Education Programmmes Adult Treatment Panel III (NCEPATP III) clinical definition of the metabolic syndrome requires the presence of at least three risk factors, from among abdominal obesity, high plasma triacylglycerols, low plasma HDL, high blood pressure and high fasting plasma glucose. The molecular mechanisms responsible for the metabolic syndrome are not known. Since metabolic syndrome apparently affects 10-30% of the population in the world, research on its pathogenesis and control is needed.The recent finding that eNOS knockout mice present a cluster of cardiovascular risk factors comparable to those of the metabolic syndrome suggests that defects in eNOS function may cause human metabolic syndrome. These mice are hypertensive, insulin resistant and dyslipidemic. Further support for a pathogenic role of eNOS comes from the finding in humans that eNOS polymorphisms associate with insulin resistance and diabetes, with hypertension, with inflammatory and oxidative stress markers and with albuminuria. So, the data sustain the hypothesis that eNOS enhancement should reduce metabolic syndrome incidence and its consequences. Therefore red wine, since it enhances eNOS function, should be considered as a potential tool for the control of metabolic syndrome. This hypothesis is supported by epidemiological observations and needs experimental validation in human intervention studies.     

中西医治疗代谢综合征的认识发展过程

代谢综合征是一系列代谢紊乱的状态和疾病。近年来代谢综合征在心脑血管疾病中的作用越来越引起学者们的重视。目前,腹型肥胖和胰岛素抵抗被认为是代谢综合征的核心因素,另外也有众多研究揭示了代谢综合征的其他致病机制。各个国家也在出台相应的诊断标准,这些标准都将指导临床的诊断及分型。在治疗方面,西药尚缺乏有效的综合治疗手段,已经有很多研究证实中药治疗疗效显著,复方治疗或单味药治疗均可以明显改善代谢综合征的症状。本文就中医及西医对于代谢综合征的各种认识的发展过程及其相应的治疗手段治疗做一综述。     

Metabolic depression in animals: physiological perspectives and biochemical generalizations

Depression of metabolic rate has been recorded for virtually all major animal phyla in response to environmental stress. The extent of depression is usually measured as the ratio of the depressed metabolic rate to the normal resting metabolic rate. Metabolic rate is sometimes only depressed to approx. 80% of the resting value (i.e. a depression of approx. 20% of resting); it is more commonly 5-40 % of resting (i.e. a depression of approx. 60-95% of resting); extreme depression is to 1% or less of resting, or even to an unmeasurably low metabolic rate (i.e. a depression of approx. 99-100% of resting). We have examined the resting and depressed metabolic rate of animals as a function of their body mass, corrected to a common temperature. This allometric approach allows ready comparison of the absolute level of both resting and depressed metabolic rate for various animals, and suggests three general patterns of metabolic depression. Firstly, metabolic depression to approx. 0.05-0.4 of rest is a common and remarkably consistent pattern for various non-cryptobiotic animals (e.g. molluscs, earthworms, crustaceans, fishes, amphibians, reptiles). This extent of metabolic depression is typical for dormant animals with ‘intrinsic’ depression, i.e. reduction of metabolic rate in anticipation of adverse environmental conditions but without substantial changes to their ionic or osmotic status, or state of body water. Some of these types of animal are able to survive anoxia for limited periods, and their anaerobic metabolic depression is also to approx. 0.05-0.4 of resting. Metabolic depression to much less than 0.2 of resting is apparent for some ‘resting’, ‘over-wintering’ or diapaused eggs of these animals, but this can be due to early developmental arrest so that the egg has a low ‘metabolic mass’ of developed tissue (compared to the overall mass of the egg) with no metabolic depression, rather than having metabolic depression of the entire cell mass. A profound decrease in metabolic rate occurs in hibernating (or aestivating) mammals and birds during torpor, e.g. to less than 0.01 of pre-torpor metabolic rate, but there is often no intrinsic metabolic depression in addition to that reduction in metabolic rate due to readjustment of thermoregulatory control and a decrease in body temperature with a concommitant Q₁₀ effect. There may be a modest intrinsic metabolic depression for some species in shallow torpor (to approx. 0.86) and a more substantial metabolic depression for deep torpor (approx. 0.6), but any energy saving accruing from this intrinsic depression is small compared to the substantial savings accrued from the readjustment of thermoregulation and the Q₁₀ effect. Secondly, a more extreme pattern of metabolic depression (to < 0.05 of rest) is evident for cryptobiotic animals. For these animals there is a profound change in their internal environment-for anoxybiotic animals there is an absence of oxygen and for osmobiotic, anhydrobiotic or cryobiotic animals there is an alteration of the ionic/osmotic balance or state of body water. Some normally aerobic animals can tolerate anoxia for considerable periods, and their duration of tolerance is inversely related to their magnitude of metabolic depression; anaerobic metabolic rate can be less than 0.005 of resting. The metabolic rate of anhydrobiotic animals is often so low as to be unmeasurable, if not zero. Thus, anhydrobiosis is the ultimate strategy for eggs or other stages of the life cycle to survive extended periods of environmental stress. Thirdly, a pattern of absence of metabolism when normally hydrated (as opposed to anhydrobiotic or cryobiotic) is apparently unique to diapaused eggs of the brine-shrimp (Artemia spp., an anostracan crustacean) during anoxia. The apparent complete metabolic depression of anoxic yet hydrated cysts (and extreme metabolic depression of normoxic, hypoxic, or osmobiotic, yet hydrated cysts), is an obvious exception to the above patterns. In searching for biochemical mechanisms for metabolic depression, it is clear that there are five general characteristics at the molecular level of cells which have a depressed metabolism; a decrease in pH, the presence of latent mRNA, a change in protein phosphorylation state, the maintenance of one particular energy-utilizing process (ion pumping), and the down-regulation of another (protein synthesis). Oxygen sensing is now the focus of intense investigation and obviously plays an important role in many aspects of cell biology. Recent studies show that oxygen sensing is involved in metabolic depression and research is now being directed towards characterising the proteins and mechanisms that comprise this response. As more data accumulate, oxygen sensing as a mechanism will probably become the sixth general characteristic of depressed cells. The majority of studies on these general characteristics of metabolically depressed cells come from members of the most common group of animals that depress metabolism, those non-cryptobiotic animals that remain hydrated and depress to 0.05-0.4 of rest. These biochemical investigations are becoming more molecular and sophisticated, and directed towards defined processes, but as yet no complete mechanism has been delineated. The consistency of the molecular data within this group of animals suggests similar metabolic strategies and mechanisms associated with metabolic depression. The biochemical ‘adaptations’ of anhydrobiotic organisms would seem to be related more to surviving the dramatic reduction in cell water content and its physico-chemical state, than to molecular mechanisms for lowering metabolic rate. Metabolic depression would seem to be an almost inevitable consequence of their altered hydration state. The unique case of profound metabolic depression of hydrated Artemia spp. cysts under a variety of conditions could reflect unique mechanisms at the molecular level. However, the available data are not consistent with this possibility (with the exception of a uniquely large decrease in ATP concentration of depressed, hydrated Artemia spp. cysts) and the question remains: how do cells of anoxic and hydrated Artemia spp. differ from anoxic goldfish or turtle cells, enabling them so much more completely to depress their metabolism?