甲钴胺联合血液透析治疗尿毒症患者周围神经病变的效果及对患者血清微炎症介质水平的影响

目的:探讨甲钴胺联合血液透析治疗尿毒症患者周围神经病变的效果及对患者血清微炎症介质水平的影响。方法:将86例合并周围神经病变的尿毒症患者随机分为观察组46例与对照组40例,两组均接受血液净化治疗,观察组同时加用甲钴胺治疗。比较两组治疗前后的血清C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6)及IL-8水平,肢体正中神经与腓浅神经的感觉神经传导速度(SCV)以及临床症状、体征改善情况。结果:治疗后,两组血清CRP、TNF-α、IL-6、IL-8水平均较治疗前明显下降(P0.05),正中神经与腓总神经的SCV均较治疗前明显提高(P0.05),且观察组血清CRP、TNF-α、IL-6、IL-8水平明显低于对照组(P0.05),正中神经SCV显著高于对照组(P0.05),四肢感觉减退、四肢远端麻木与烧灼感、不宁腿综合征、肢端疼痛的发生率明显低于对照组(P0.05)。结论:甲钴胺联合血液透析对尿毒症性周围神经病变的疗效明显优于单用血液透析治疗,且可显著改善机体的微炎症状态。     

The altered activity of complex III may contribute to the high penetrance of Leber's hereditary optic neuropathy in a Chinese family carrying the ND4 G11778A mutation

The ND4 G11778A mutation is the most common mitochondrial DNA mutation leading to Leber's hereditary optic neuropathy (LHON). Despite considerable clinical evidences, the modifier role of nuclear background and mitochondrial haplotypes in phenotypic manifestation of LHON remains poorly understood. We investigated the effect of these modifiers on bioenergetics in lymphoblastoid cell lines derived from five affected subjects of one Chinese family carrying the G11778A mutation and five Chinese controls. Significant reductions in the activities of complexes I and III were observed in mutant cell lines from the Chinese family, whereas the mutant cell lines from other families carrying the same mutation exhibited only reduced activity of complex I. The reduced activities of complexes I and III caused remarkably higher reductions of ATP synthesis in mutant cell lines from the Chinese family than those from other families. The deficient respiration increased generation of reactive oxygen species. The defect in complex III activity, likely resulting from the mitochondrial haplotype or nuclear gene alteration, worsens mitochondrial dysfunction caused by the G11778A mutation, thereby causing extremely high penetrance and expressivity of optic neuropathy in this Chinese family. Our data provide the first experimental evidence that altered activity of complex III modulates the phenotypic manifestation of LHON-associated G11778A mutation. Thus, our findings may provide new insights into the pathophysiology of LHON.     

昆虫神经毒性酯酶活性的测定

首次报道了针对昆虫建立的神经毒性酯酶(NTE)活性检测方法以及据此法所测得的棉铃虫幼虫的NTE活性。将测定脊椎动物NTE活性的方法改进并微量化以适用于无脊椎动物昆虫体内NTE活性测定。对于棉铃虫幼虫,该法测得其头部、中肠和脂肪体等3个部位的NTE活性分别为5.30,1.40和14.50nmolminmgprotein。     

普罗布考联合胰激肽原酶对老年糖尿病周围神经病变患者氧化应激反应及血清NSE水平的影响

目的:探讨普罗布考联合胰激肽原酶对老年糖尿病周围神经病变患者氧化应激反应及血清神经元特异性烯醇化酶(NSE)水平的影响。方法:选择2015年8月至2017年8月我院接诊的94例老年糖尿病周围神经病变患者作为本研究对象,通过随机数表法将其分为观察组(n=47)和对照组(n=47)。对照组在常规治疗基础上给予胰激肽原酶治疗,观察组在对照组基础上联合普罗布考治疗,两组均连续治疗12周。比较两组治疗后的临床疗效、治疗前后运动传导速度(MNCV)、感觉传导速度(SNCV)、多伦多临床评分系统(TCSS)评分、血清丙二醛(MDA)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)及NSE水平的变化和不良反应的发生情况。结果:治疗后,观察组临床疗效总有效率为93.62%(44/47),明显高于对照组[70.21%(33/47)](P0.05);两组正中神经、腓总神经MNCV、SNCV较治疗前均显著延长(P0.05),且观察组正中神经、腓总神经MNCV、SNCV均明显高于对照组(P0.05);两组TCSS评分各内容和总分、血清MDA、NSE水平较治疗前均显著降低(P0.05),且观察组TCSS评分中症状评分、反射评分、感觉评分和总分及、血清MDA、NSE水平均明显低于对照组(P0.05);两组血清超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)水平较治疗前均显著升高(P0.05),且观察组血清SOD、CAT、GSH-Px水平均明显比对照组高(P0.05)。两组治疗期间不良反应总发生率分别为10.64%(5/47)、4.26%(2/47),组间比较差异无统计学意义(P0.05)。结论:普罗布考联合胰激肽原酶治疗老年糖尿病周围神经病变患者的效果显著优于单用胰激肽原酶治疗,可更有效改善神经病变程度,其机制可能和缓解氧化应激反应、降低血清NSE水平有关。     

How T118M peripheral myelin protein 22 predisposes humans to Charcot–Marie–Tooth disease

Data from gnomAD indicate that a missense mutation encoding the T118M variation in human peripheral myelin protein 22 (PMP22) is found in roughly one of every 75 genomes of western European lineage (1:120 in the overall human population). It is unusual among PMP22 variants that cause Charcot–Marie–Tooth (CMT) disease in that it is not 100% penetrant. Here, we conducted cellular and biophysical studies to determine why T118M PMP22 predisposes humans to CMT, but with only incomplete penetrance. We found that T118M PMP22 is prone to mistraffic but differs even from the WT protein in that increased expression levels do not result in a reduction in trafficking efficiency. Moreover, the T118M mutant exhibits a reduced tendency to form large intracellular aggregates relative to other disease mutants and even WT PMP22. NMR spectroscopy revealed that the structure and dynamics of T118M PMP22 resembled those of WT. These results show that the main consequence of T118M PMP22 in WT/T118M heterozygous individuals is a reduction in surface-trafficked PMP22, unaccompanied by formation of toxic intracellular aggregates. This explains the incomplete disease penetrance and the mild neuropathy observed for WT/T118M CMT cases. We also analyzed BioVU, a biobank linked to deidentified electronic medical records, and found a statistically robust association of the T118M mutation with the occurrence of long and/or repeated episodes of carpal tunnel syndrome. Collectively, our results illuminate the cellular effects of the T118M PMP22 variation leading to CMT disease and indicate a second disorder for which it is a risk factor.     

IFN-γ/mTORC1 decreased Rab11 in Schwann cells of diabetic peripheral neuropathy,inhibiting cell proliferation via GLUT1 downregulation

Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes mellitus. Rab11 is conserved gene-regulating vesicle traffic and reported to be involved in the pathogenesis of diabetes mellitus by affecting insulin sensitivity. We aimed to investigate the role of Rab11 in the pathogenesis of DPN. In this study, Rab11 expression decreased in the sciatic nerves of diabetic mice with impaired conduction function versus those of normal mice. In vitro experiment revealed interferon-γ (IFN-γ), not high glucose and interleukin 1β was the main factor to lead to Rab11 downregulation in RSC96 cells. Again, both Rab11 knockdown and IFN-γ treatment caused cell viability inhibition and the decrease in BrdU-positive cells. In contrast, overexpression of Rab11 reversed IFN-γ-reduced cell proliferation. Furthermore, mTORC1 not mTORC2 was proven to be suppressed by IFN-γ treatment in RSC96 cells, indicated in decreased phospho-p70S6K. Inhibition of the mTORC1 pathway resulted in Rab11 expression downregulation in RSC96 cells. Activation of the mTORC1 pathway effectively prevented IFN-γ-reduced Rab11 expression in RSC96 cells. Also, glucose transporter 1 (GLUT1) was found to be downregulated in RSC96 cells with Rab11 silence and overexpression of GLUT1 reversed Rab11 blocking-caused proliferation inhibition. Taken together, our findings suggest that IFN-γ decreases Rab11 expression via the inhibition of the mTORC1 signaling pathway, causing reduced cell proliferation in Schwann cells of DPN by GLUT1 downregulation.     

Comparison of sensory tests and neuronal quantity of peripheral nerves between streptozotocin (STZ)-induced diabetic rats and paclitaxel (PAC)-treated rats

Although diabetic peripheral neuropathy (DPN) and chemotherapy-induced peripheral neuropathy (CIPN) are different disease entities, they share similar neuropathic symptoms that impede quality of life for these patients. Despite having very similar downstream effects, there have been no direct comparisons between DPN and CIPN with respect to symptom severity and therapeutic responses. We compared peripheral nerve damage due to hyperglycemia with that caused by paclitaxel (PAC) treatment as represented by biochemical parameters, diverse sensory tests, and immunohistochemistry of cutaneous and sciatic nerves. The therapeutic effects of alpha-lipoic acid and DA-9801 were also compared in the two models. Animals were divided into seven groups (n?=?7–10) as follows: normal, diabetes (DM), DM?+?alpha-lipoic acid 100?mg/kg (ALA), DM?+?DA-9801 (100?mg/kg), paclitaxel-treated rat (PAC), PAC?+?ALA (100?mg/kg), and PAC?+?DA-9801 (100?mg/kg). The sensory thresholds of animals to mechanical, heat, and pressure stimuli were altered by both hyperglycemia and PAC when compared with controls, and the responses to sensory tests were different between both groups. There were no significant differences in the biochemical markers of blood glutathione between DM and PAC groups (p?>?.05). Quantitative comparisons of peripheral nerves by intraepidermal nerve fiber density (IENFD) analysis indicated that the DM and PAC groups were similar (6.18?±?1.03 vs. 5.01?±?2.57). IENFD was significantly improved after ALA and DA-9801 treatment in diabetic animals (7.6?±?1.28, 7.7?±?1.28, respectively, p?p?>?.05). Sciatic nerves were less damaged in the PAC-treated groups compared with the DM groups with respect to axonal diameter and area (8.60?±?1.14?μm vs. 6.66?±?1.07?μm, and 59.04?±?15.16?μm² vs. 35.71?±?11.2?μm², respectively, p?相似文献   

Effect of Fructose Supplementation on Sorbitol Accumulation and myolnositol Metabolism in Cultured Neuroblastoma Cells Exposed to Increased Glucose Concentrations

Aldose reductase activity is increased in neuroblastoma cells grown in media containing 30 mM fructose and/or 30 mM glucose. Neuroblastoma cells cultured in media supplemented with increased concentrations of glucose and fructose amass greater amounts of sorbitol than do cells exposed to media containing only high glucose concentrations. The increase in sorbitol content is dependent on the fructose and glucose concentration in the media. The increase in sorbitol content caused by exposing neuroblastoma cells to media containing 30 mM glucose/30 mM fructose is due to a protein synthesis sensitive mechanism and not to an alteration in the redox state. The addition of sorbinil to media containing 30 mM glucose blocks the increase in sorbitol content. In contrast, sorbinil treatment of media containing 30 mM glucose/30 mM fructose does not totally block the increase in sorbitol levels. myo-Inositol accumulation and incorporation into inositol phospholipids and intracellular myo-inositol content are decreased in cells chronically exposed to media containing 30 mM glucose or 30 mM glucose/30 mM fructose compared to cells cultured in unsupplemented media or media containing 30 mM fructose. However, maximal depletion of myo-inositol accumulation and intracellular content occurs earlier in cells exposed to media containing 30 mM glucose/30 mM fructose than in cells exposed to media supplemented with 30 mM glucose. Sorbinil treatment of media containing 30 mM glucose/30 mM fructose maintains cellular myo-inositol accumulation and incorporation into phospholipids at near normal levels. myo-Inositol content in neuroblastoma cells chronically exposed to media containing 30 mM glucose or 30 mM glucose/30 mM fructose recovers within 72 h when the cells are transferred to unsupplemented media or media containing 30 mM fructose. In contrast, the sorbitol content of cells previously exposed to media containing 30 mM glucose or 30 mM glucose/30 mM fructose then transferred into media containing 30 mM fructose remains elevated compared to the sorbitol content of cells transferred into unsupplemented media. These data suggest that fructose may be activating or increasing sorbinil-resistant aldose reductase activity as well as partially blocking sorbitol dehydrogenase activity. The presence of increased concentrations of fructose in combination with increased glucose levels may enhance alterations in cell metabolism and properties due to increased sorbitol levels.