维生素D与阿尔茨海默病的关系

阿尔茨海默病(Alzheimer disease,AD)是神经科学领域研究最热点的问题之一,同时也是老年痴呆的最常见类型之一。流行病学研究发现老年人血清中维生素D普遍缺乏,而阿尔茨海默病患者血清中维生素D也普遍缺乏,这可能是老年人患阿尔茨海默病的重要原因之一。老年人皮肤合成维生素D前体的能力下降,活动能力下降导致接受日光照射减少,进而影响血清中维生素D含量。近年的研究表明,维生素D具有保护神经元的潜在功能和调节多种大脑靶组织,如提高神经生长因子水平、神经保护作用、提高其抗氧化酶活性、增加抗氧化及水平、降低自由基含量、减少炎症因子的产生及影响APOE基因多态性等,这些功能与AD的病理生理改变相关。这些研究为AD的发病机制及其早期预防和治疗奠定了基础。     

Parkin、PINK1、DJ-1和线粒体功能障碍与帕金森病

帕金森病(Parkinson’s disese,PD)是一种常见的神经退行性疾病,但到目前为止发病机制尚不明确,环境和遗传等因素与其发病有密切关系。研究表明,蛋白质异常积聚(泛素/蛋白酶体途径)和线粒体氧化损伤(线粒体途径),可能是导致PD患者发病的关键分子机制。Parkin、PINK1和DJ-1等基因突变与常染色体隐性的家族性PD有关,这些相关基因编码的蛋白对于维持线粒体形态和功能起着重要的作用。本文将主要从Parkin、PINK1、DJ-1和线粒体功能障碍与帕金森病的关系进行综述。     

胰岛素抵抗与帕金森病

帕金森病(PD)是第二大神经退行性疾病,而糖尿病是帕金森病的一个高危因素。胰岛素不仅是一种作用于外周的激素,负责葡萄糖平衡和能量代谢,它也可以通过血脑屏障,影响大脑的许多生命过程,包括调节神经元存活和生长、维持突触稳定性等。越来越多的研究显示,在帕金森病患者和动物模型的脑中出现胰岛素抵抗。胰岛素信号通路的异常引起α-突触核蛋白的聚集、线粒体功能障碍、神经炎症,以及认知功能减退等。这些都是与PD的发病机制紧密相关的。使用胰岛素增敏药物将是一种潜在的,缓解PD神经退行性病变的新策略。     

维生素D3及其类似物调控细胞生长分化的可能机制

维生素D3 是一种脂溶性维生素, 其活性形式是1α,25(OH)2D3.它除了分布于传统的靶组织如肠、成骨细胞、肾远曲小管外, 亦分布于许多非经典的靶组织细胞中, 如造血组织、神经肌肉组织、生殖细胞以及免疫细胞等, 这强烈提示1α,25(OH)2D3具有更多的其它生物效应[1].现已清楚, 1α,25(OH)2D3除了能调节钙磷代谢和免疫系统的功能外, 还能调控多种组织来源的正常细胞和肿瘤细胞的生长和分化, 主要表现为抑制细胞的增殖和促进细胞分化[2～4].然而其分子机制并不完全清楚.本文就维生素D3及其类似物调节细胞生长分化的可能分子机制作一简要综述.     

线粒体自噬与帕金森病的研究进展

帕金森病是一种以黑质多巴胺能神经元选择性变性为主要病理特征的神经退行性疾病,严重影响患者的生活质量.遗传因素和环境因素是帕金森病可能诱因,但帕金森病的具体发病机制尚未完全解析.研究表明,线粒体自噬异常是神经退行性病变的重要诱因之一.线粒体自噬是细胞内稳态的“质控机制”,其调控途径与帕金森病发病机制明确相关.综述了线粒体...     

维生素D受体最新研究进展

维生素D受体(vitamin D receptor,VDR)是一种核转录因子,通过与配体特异结合,调控多种基因的表达,从而调节多种生命活动的进行.本文总结了近年来VDR的研究进展,主要包括VDR的作用机制、VDR行使功能所需共激活子及共抑制子、VDR在生长分化、免疫调节和抑制肿瘤等方面的作用及VDR配体类似物在药物开发研究领域的最新进展.     

维生素D介导肿瘤微环境调控的研究进展

肿瘤微环境(tumor microenvironment,TME)与肿瘤发生、转移、耐药等息息相关,研究肿瘤微环境的调控机制能为肿瘤治疗提供新的线索。维生素D作为机体代谢性物质,广泛分布在细胞微环境中,能够参与肿瘤微环境的调控并发挥抑制肿瘤的功能。本文总结了维生素D的代谢以及作用机制,并综述了维生素D在肿瘤微环境中影响肿瘤细胞、肿瘤干细胞、肿瘤相关成纤维细胞等研究进展,为维生素D及其类似物在肿瘤治疗中的基础研究和临床应用研究等方面奠定基础。     

维生素B_3与帕金森病的防治

帕金森病(PD)是以运动功能失调为主要表现的神经退行性疾病,其病理特征是黑质致密部多巴胺能神经元的丢失和路易氏小体的形成。线粒体能量供应障碍和氧化应激在PD发生与发展过程中起重要作用,抗氧化和改善线粒体功能的物质可延缓PD的发展。维生素B_3是体内氧化还原体系的重要组分,参与抗氧化、抗炎、促进自噬以及维护神经元正常结构和功能,提示补充维生素B_3可能是延缓PD的方法之一。     

皮层-基底神经节环路功能性连接与PD运动防治的神经可塑性机制研究进展

帕金森病(Parkinson's Disease,PD)是一种以运动功能障碍为主要临床症状的神经退行性疾病,皮层-基底神经节环路功能性连接异常是PD运动障碍发生发展的病理基础。运动疗法防治PD的神经可塑性机制可能与该环路的结构与功能重塑有关。本文拟以皮层-基底神经节环路为切入点,分别从皮层-基底神经节环路功能性连接与运动调控、皮层-基底神经节环路功能性连接异常与PD、皮层-基底神经节环路功能性连接重塑与PD运动防治三方面对该领域的相关研究进行综述。     

帕金森病发病机制与治疗研究进展

帕金森病(Parkinson's disease PD)是第二大中枢神经退行性疾病,常见于老年人。其最主要的临床表现是静止性震颤、肌强直、运动迟缓和姿势不稳等运动症状。典型的病理特征是中脑黑质多巴胺能神经元进行性变性缺失,残存的多巴胺能神经元胞质内出现病理标志物路易体(lewy's body)。PD的病因和发病机制尚不完全清楚,目前认为PD可能是遗传、环境、老龄化等因素共同作用的结果,具体机制涉及线粒体功能障碍、氧化应激、神经炎症、兴奋性毒性损伤等。由于病因不清、发病机制复杂导致PD的治疗依旧是一个亟待解决的问题,目前已有的治疗手段包括药物治疗、外科手术治疗、细胞和组织移植治疗、基因治疗等,但均存在不同程度的弊端。本文主要结合近年来文献研究进展,对PD发病机制及其治疗现状进行概述,旨在为PD基础研究及药物研发提供一定线索。     

VD缺乏相关疾病及其合理补充的临床意义

众所周知,人体内维生素D水平与少年佝偻病和老年骨质疏松直接相关。最近大量流行病学证据还表明,维生素D(VD)缺乏是多种自身免疫性疾病,癌症,心血管疾病,抑郁症,老年痴呆症,感染性疾病,肌肉骨骼功能下降等的危险因素之一。另外,胰岛素抵抗,高血压和高胆固醇血症也与维生素D缺乏有关。因此,合理补充维生素D可以降低多种疾病风险,并对心血管疾病的风险有益。本文系根据已有的研究结论,阐述维生素D水平与多种临床疾病之间的关联,并对人体血清VD浓度合理监测及合理补充的临床意义做一综述。     

Vitamin D status and nutrition in Europe and Asia

Vitamin D status is highly different in various countries of Europe, the Middle East and Asia. For this review, vitamin D deficiency is defined as serum 25-hydroxyvitamin D (25(OH)D) <25 nmol/l. Within European countries, serum 25(OH)D is <25 nmol/l in 2–30% of adults, increasing in the elderly and institutionalized to more than 80% in some studies. A north-south gradient was observed for serum 25(OH)D in the Euronut and MORE studies with higher levels in Scandinavia and lower levels in Italy and Spain and some Eastern European countries. This points to other determinants than sunshine, e.g. nutrition, food fortification and supplement use. Mean vitamin D intake in Scandinavia is 200–400 IU/d, twice that in other European countries. Very low serum 25(OH)D levels have been reported in the Middle East, e.g. Turkey, Lebanon, Jordan and Iran. In these countries serum 25(OH)D was lower in women than in men and associated with clothing habits. In a Lebanese survey, vitamin D deficiency was observed in the majority and occurred mainly in veiled women. In India, vitamin D deficiency was observed in more than 30%, vitamin D status being poor in school children, pregnant women and large cities. Vitamin D status was much better in Malaysia and Singapore, but lower serum 25(OH)D was observed in Japan and China. Rickets and osteomalacia appear quite common in India, but precise data are lacking. Immigrants in Europe from the Middle East and Asia carry a high risk for vitamin D deficiency, pregnant women being especially at risk. Comparison of vitamin D status between countries is hampered by interlaboratory variation of serum 25(OH)D measurement. In addition, there is a need of population-based data. In conclusion, vitamin D deficiency is common in Southern Europe, the Middle East, India, China and Japan. It is less common in Northern Europe and Southeast Asia. Risk groups are young children, the elderly, pregnant women and non-western immigrants in Europe. Important determinants are skin type, sex, clothing, nutrition, food fortification, supplement use, BMI and degree of urbanization.     

Vitamin D in foods and as supplements

Numerous studies have shown that the vitamin D status is far from optimal in many countries all over the world. The main reason for this is lack of sunshine. Only a limited number of foods naturally contain vitamin D. Good sources of vitamin D(3) are fish (not only fatty fish), egg yolk, and offal such as liver. Some foods such as milk are fortified with vitamin D in some countries. Dietary vitamin D intake is low in many countries, especially as the dietary sources are limited. The use of supplements is important and seems to be high in some countries. Current dietary intake recommendations are too low to preserve/reach optimal S-25-OHD concentrations, when UVB radiation is not available. We suggest that the recommendations should be increased to at least 10 microg per day in all age groups when solar UVB is scarce. The elderly may need a daily vitamin D intake of 25 microg. If dietary intake of vitamin D is to be increased, food habits will have to change. From a public health point of view it is better to increase the potential sources of vitamin D by fortifying specific products that are consumed commonly in a whole population, or if necessary by especially vulnerable groups. Supplement use is probably the right alternative for vulnerable groups such as infants and inactive elderly in whom this is more easily implemented.     

VD缺乏相关疾病及其合理补充的临床意义

：众所周知,人体内维生素D水平与少年佝偻病和老年骨质疏松直接相关。最近大量流行病学证据还表明,维生素D（VD）缺乏是多种自身免疫性疾病,癌症,心血管疾病,抑郁症,老年痴呆症,感染性疾病,肌肉骨骼功能下降等的危险因素之一。另外,胰岛素抵抗,高血压和高胆固醇血症也与维生素D缺乏有关。因此,合理补充维生素D可以降低多种疾病风险,并对心血管疾病的风险有益。本文系根据已有的研究结论,阐述维生素D水平与多种临床疾病之间的关联,并对人体血清VD浓度合理监测及合理补充的临床意义做一综述。     

Vitamin D deficiency as a risk factor for urinary tract infection in women at reproductive age

Vitamin D deficiency is a pandemic problem and an ever-increasing issue in human nutrition and health. Vitamin D (serum 25-hydroxyvitamin D) deficiency causes many health problems such as autoimmune diseases, Crohn’s disease, diabetes, inflammation, asthma, hypertension, and cancer. Vitamin D3 (cholecalciferol) deficiency has been documented as a persistent problem among adults, children, and elderly persons in most of the countries. Our main objective of this study was to determine the hypothesis that the vitamin D deficiency among women can lead to them developing frequent urinary tract infections. Vitamin D has a potential role in immune regulation and it prevents infections especially urinary tract infections (UTI). Therefore it has positive regulatory role in both acute and recurrent infections especially in women of reproductive ages. As women at this age group have specific differences in their urinary tract and the reproductive organ anatomy, make them more prone for micro-organisms' invasion, The present study was carried out to ascertain certain relation between serum 25-hydroxyvitamin D levels and UTI in women while contemplating the significance of knowing the risk factors associated with UTI and also finding ways to avoid serious complications. 75 women with (case group) UTI were differentiated with 35 healthy with no UTI (control group) and 40 women with UTI and their serum 25-hydroxyvitamin D levels were checked in a case control study. The women were between at 17–52 years of age. Using ELISA, Serum 25-hydroxyvitamin D levels were measured. Analysis and comparison of the results were done among the two groups. Vitamin D mean levels in the case group was considerably lower when in comparison with the control group (11.09 ± 7.571 ng/mL vs. 24.08 ± 11.95 ng/mL, P < 0.001).     

Integrative Network Analysis Unveils Convergent Molecular Pathways in Parkinson's Disease and Diabetes

Background

Shared dysregulated pathways may contribute to Parkinson''s disease and type 2 diabetes, chronic diseases that afflict millions of people worldwide. Despite the evidence provided by epidemiological and gene profiling studies, the molecular and functional networks implicated in both diseases, have not been fully explored. In this study, we used an integrated network approach to investigate the extent to which Parkinson''s disease and type 2 diabetes are linked at the molecular level.

Methods and Findings

Using a random walk algorithm within the human functional linkage network we identified a molecular cluster of 478 neighboring genes closely associated with confirmed Parkinson''s disease and type 2 diabetes genes. Biological and functional analysis identified the protein serine-threonine kinase activity, MAPK cascade, activation of the immune response, and insulin receptor and lipid signaling as convergent pathways. Integration of results from microarrays studies identified a blood signature comprising seven genes whose expression is dysregulated in Parkinson''s disease and type 2 diabetes. Among this group of genes, is the amyloid precursor protein (APP), previously associated with neurodegeneration and insulin regulation. Quantification of RNA from whole blood of 192 samples from two independent clinical trials, the Harvard Biomarker Study (HBS) and the Prognostic Biomarker Study (PROBE), revealed that expression of APP is significantly upregulated in Parkinson''s disease patients compared to healthy controls. Assessment of biomarker performance revealed that expression of APP could distinguish Parkinson''s disease from healthy individuals with a diagnostic accuracy of 80% in both cohorts of patients.

Conclusions

These results provide the first evidence that Parkinson''s disease and diabetes are strongly linked at the molecular level and that shared molecular networks provide an additional source for identifying highly sensitive biomarkers. Further, these results suggest for the first time that increased expression of APP in blood may modulate the neurodegenerative phenotype in type 2 diabetes patients.     

Vitamin B12 in neurology and ageing; Clinical and genetic aspects

The classic neurological and psychiatric features associated with vitamin B₁₂ deficiency have been well described and are the subject of many excellent review articles. The advent of sensitive diagnostic tests, including homocysteine and methylmalonic acid assays, has revealed a surprisingly high prevalence of a more subtle ‘subclinical’ form of B₁₂ deficiency, particularly within the elderly. This is often associated with cognitive impairment and dementia, including Alzheimer's disease. Metabolic evidence of B₁₂ deficiency is also reported in association with other neurodegenerative disorders including vascular dementia, Parkinson's disease and multiple sclerosis. These conditions are all associated with chronic neuro-inflammation and oxidative stress. It is possible that these clinical associations reflect compromised vitamin B₁₂ metabolism due to such stress. Physicians are also increasingly aware of considerable inter-individual variation in the clinical response to B₁₂ replacement therapy. Further research is needed to determine to what extent this is attributable to genetic determinants of vitamin B₁₂ absorption, distribution and cellular uptake.     

Assessment of evidence for a protective role of vitamin D in multiple sclerosis

Evidence for a role of vitamin D insufficiency in determining risk in Multiple Sclerosis (MS) is supported by studies in both pediatric- and adult-onset patients. The potential role of vitamin D in modulating MS disease activity is an area of active clinical trials research, and the possibility of primary disease prevention with vitamin D supplementation in early life is an emerging concept. With Sir Austin Bradford Hill's criteria as a framework, the present review assesses the evidence for a causal relationship between vitamin D insufficiency and the pathobiology of MS, and discusses rationale for future clinical trials with vitamin D.