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Nanodomain cAMP signalling in cardiac pathophysiology: potential for developing targeted therapeutic interventions. 心脏病理生理学中的纳米域 cAMP 信号:开发靶向治疗干预的潜力。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-08-08 DOI: 10.1152/physrev.00013.2024
Manuela Zaccolo, Duangnapa Kovanich

3', 5'-cyclic adenosine monophosphate (cAMP) mediates the effects of sympathetic stimulation on the rate and strength of cardiac contraction. Beyond this pivotal role, in cardiac myocytes cAMP also orchestrates a diverse array of reactions to various stimuli. To ensure specificity of response, the cAMP signaling pathway is intricately organized into multiple, spatially confined, subcellular domains, each governing a distinct cellular function. In this review, we describe the molecular components of the cAMP signalling pathway, how they organized are inside the intracellular space and how they achieve exquisite regulation of signalling within nanometer-size domains. We delineate the key experimental findings that lead to the current model of compartmentalised cAMP signaling and we offer an overview of our present understanding of how cAMP nanodomains are structured and regulated within cardiac myocytes. Furthermore, we discuss how compartmentalized cAMP signaling is affected in cardiac disease and consider the potential therapeutic opportunities arising from understanding such organization. By exploiting the nuances of compartmentalized cAMP signaling, novel and more effective therapeutic strategies for managing cardiac conditions may emerge. Finally, we highlight the unresolved questions and hurdles that must be addressed to translate these insights into interventions that may benefit patients.

3',5'-环单磷酸腺苷(cAMP)介导交感神经刺激对心脏收缩速率和强度的影响。除了这一关键作用外,cAMP 还能在心肌细胞中协调对各种刺激的各种反应。为了确保反应的特异性,cAMP 信号通路被复杂地组织成多个空间受限的亚细胞结构域,每个结构域管理着不同的细胞功能。在这篇综述中,我们将介绍 cAMP 信号通路的分子成分、它们在细胞内空间的组织方式,以及它们如何在纳米级结构域内实现对信号的精细调控。我们描述了导致当前分区 cAMP 信号传导模型的关键实验发现,并概述了我们目前对 cAMP 纳米域在心肌细胞内的结构和调控方式的理解。此外,我们还讨论了心脏疾病是如何影响分区化 cAMP 信号传导的,并探讨了了解这种组织结构可能带来的治疗机会。通过利用cAMP信号分区的细微差别,可能会出现新的、更有效的治疗策略来控制心脏疾病。最后,我们强调了尚未解决的问题和必须解决的障碍,以便将这些见解转化为可能造福患者的干预措施。
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引用次数: 0
Modulating Vertebrate Physiology by Genomic Fine-Tuning of GPCR Functions. 通过基因组微调 GPCR 功能调节脊椎动物的生理学。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-07-25 DOI: 10.1152/physrev.00017.2024
Torsten Schoneberg

G protein-coupled receptors (GPCRs) play a crucial role as membrane receptors, facilitating the communication of eukaryotic species with their environment and regulating cellular and organ interactions. Consequently, GPCRs hold immense potential in contributing to adaptation to ecological niches and responding to environmental shifts. Comparative analyses of vertebrate genomes reveal patterns of GPCR gene loss, expansion, and signatures of selection. Integrating this genomic data with insights from functional analyses of gene variants enables the interpretation of genotype-phenotype correlations. This review underscores the involvement of GPCRs in adaptive processes, presenting numerous examples of how alterations in GPCR functionality influence vertebrate physiology, or conversely, how environmental changes impact GPCR functions. The findings demonstrate that modifications in GPCR function contribute to adapting to aquatic, arid, and nocturnal habitats, influencing camouflage strategies, and specializing in particular dietary preferences. Furthermore, the adaptability of GPCR functions provides an effective mechanism in facilitating past, recent, or ongoing adaptations in animal domestication and human evolution and should be considered in therapeutic strategies and drug development.

G 蛋白偶联受体(GPCR)作为膜受体发挥着关键作用,促进真核生物与环境的交流,并调节细胞和器官的相互作用。因此,GPCR 在帮助适应生态位和应对环境变化方面具有巨大的潜力。脊椎动物基因组的比较分析揭示了 GPCR 基因的缺失、扩增模式和选择特征。将这些基因组数据与基因变异的功能分析结果相结合,可以解释基因型与表型之间的相关性。本综述强调了 GPCR 在适应过程中的参与,列举了大量实例,说明 GPCR 功能的改变如何影响脊椎动物的生理机能,或者反过来说,环境变化如何影响 GPCR 的功能。研究结果表明,GPCR功能的改变有助于适应水生、干旱和夜间栖息地,影响伪装策略,以及专门化特定的饮食偏好。此外,GPCR 功能的适应性为促进动物驯化和人类进化中过去、最近或正在进行的适应性提供了有效机制,在治疗策略和药物开发中应加以考虑。
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引用次数: 0
Lipids shape brain function through ion channel and receptor modulations: physiological mechanisms and clinical perspectives. 脂质通过离子通道和受体调节影响大脑功能:生理机制和临床视角。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-07-11 DOI: 10.1152/physrev.00004.2024
Salvatore Incontro, Maria Laura Musella, Malika Sammari, Coralie Di Scala, Jacques Fantini, Dominique Debanne

Lipids represent the most abundant molecular type in the brain with a fat content of approximately 60% of the dry brain weight in humans. Despite this fact, little attention has been paid to circumscribe the dynamic role of lipids in brain function and disease. Membrane lipids such as cholesterol, phosphoinositide, sphingolipids, arachidonic acid and endocannabinoids finely regulate both synaptic receptors and ion channels that insure critical neural functions. After a brief introduction on brain lipids and their respective properties, we review here their role in regulating synaptic function and ion channel activity, action potential propagation, neuronal development, functional plasticity and their contribution in the development of neurological and neuropsychiatric diseases. We also provide possible directions for future research on lipid function in brain plasticity and diseases.

脂质是大脑中最丰富的分子类型,其脂肪含量约占人类大脑干重的 60%。尽管如此,人们却很少关注脂质在大脑功能和疾病中的动态作用。胆固醇、磷脂、鞘磷脂、花生四烯酸和内源性大麻素等膜脂类物质可精细调节突触受体和离子通道,从而确保关键的神经功能。在简要介绍了脑脂质及其各自特性之后,我们在此回顾了它们在调节突触功能和离子通道活性、动作电位传播、神经元发育、功能可塑性方面的作用,以及它们在神经和神经精神疾病发展中的贡献。我们还为今后研究脂质在大脑可塑性和疾病中的功能提供了可能的方向。
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引用次数: 0
Hepatic glucagon action: beyond glucose mobilization. 肝脏胰高血糖素的作用--超越葡萄糖动员。
IF 33.6 1区 医学 Q1 Biochemistry, Genetics and Molecular Biology Pub Date : 2024-07-01 Epub Date: 2024-02-01 DOI: 10.1152/physrev.00028.2023
Sarina Kajani, Rhianna C Laker, Ekaterina Ratkova, Sarah Will, Christopher J Rhodes

Glucagon's ability to promote hepatic glucose production has been known for over a century, with initial observations touting this hormone as a diabetogenic agent. However, glucagon receptor agonism [when balanced with an incretin, including glucagon-like peptide 1 (GLP-1) to dampen glucose excursions] is now being developed as a promising therapeutic target in the treatment of metabolic diseases, like metabolic dysfunction-associated steatotic disease/metabolic dysfunction-associated steatohepatitis (MASLD/MASH), and may also have benefit for obesity and chronic kidney disease. Conventionally regarded as the opposing tag-team partner of the anabolic mediator insulin, glucagon is gradually emerging as more than just a "catabolic hormone." Glucagon action on glucose homeostasis within the liver has been well characterized. However, growing evidence, in part thanks to new and sensitive "omics" technologies, has implicated glucagon as more than just a "glucose liberator." Elucidation of glucagon's capacity to increase fatty acid oxidation while attenuating endogenous lipid synthesis speaks to the dichotomous nature of the hormone. Furthermore, glucagon action is not limited to just glucose homeostasis and lipid metabolism, as traditionally reported. Glucagon plays key regulatory roles in hepatic amino acid and ketone body metabolism, as well as mitochondrial turnover and function, indicating broader glucagon signaling consequences for metabolic homeostasis mediated by the liver. Here we examine the broadening role of glucagon signaling within the hepatocyte and question the current dogma, to appreciate glucagon as more than just that "catabolic hormone."

胰高血糖素促进肝脏葡萄糖生成的能力早在一个多世纪前就已为人所知,最初的观察将这种激素吹捧为一种致糖尿病剂。然而,胰高血糖素受体激动(在与增量素(包括胰高血糖素样肽 1 (GLP-1))平衡后可抑制葡萄糖激增)目前正被开发为治疗代谢性疾病(如代谢功能障碍相关性脂肪性疾病/代谢功能障碍相关性脂肪性肝炎 (MASLD/MASH))的一个很有前景的治疗靶点,而且还可能对肥胖症和慢性肾病有益。传统上,胰高血糖素被认为是合成代谢介质胰岛素的对立伙伴,但现在,它逐渐不仅仅是一种 "分解代谢激素"。胰高血糖素对肝脏内葡萄糖平衡的作用已被充分描述。然而,越来越多的证据表明,胰高血糖素不仅仅是一种 "葡萄糖释放激素",这部分要归功于新的、敏感的 "全息 "技术。胰高血糖素既能增加脂肪酸氧化,又能减少内源性脂质合成,这说明了胰高血糖素的两面性。此外,胰高血糖素的作用并不像传统报道的那样仅限于葡萄糖稳态和脂质代谢。胰高血糖素在肝脏氨基酸和酮体代谢以及线粒体代谢和功能中发挥着关键的调节作用,这表明胰高血糖素信号对肝脏介导的代谢平衡具有更广泛的影响。在这里,我们研究了胰高血糖素信号在肝细胞内不断扩大的作用,并对目前的教条提出质疑,从而认识到胰高血糖素不仅仅是 "分解代谢激素"。
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引用次数: 0
Proteomics of the heart. 心脏蛋白质组学
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-07-01 Epub Date: 2024-02-01 DOI: 10.1152/physrev.00026.2023
Oleg A Karpov, Aleksandr Stotland, Koen Raedschelders, Blandine Chazarin, Lizhuo Ai, Christopher I Murray, Jennifer E Van Eyk

Mass spectrometry-based proteomics is a sophisticated identification tool specializing in portraying protein dynamics at a molecular level. Proteomics provides biologists with a snapshot of context-dependent protein and proteoform expression, structural conformations, dynamic turnover, and protein-protein interactions. Cardiac proteomics can offer a broader and deeper understanding of the molecular mechanisms that underscore cardiovascular disease, and it is foundational to the development of future therapeutic interventions. This review encapsulates the evolution, current technologies, and future perspectives of proteomic-based mass spectrometry as it applies to the study of the heart. Key technological advancements have allowed researchers to study proteomes at a single-cell level and employ robot-assisted automation systems for enhanced sample preparation techniques, and the increase in fidelity of the mass spectrometers has allowed for the unambiguous identification of numerous dynamic posttranslational modifications. Animal models of cardiovascular disease, ranging from early animal experiments to current sophisticated models of heart failure with preserved ejection fraction, have provided the tools to study a challenging organ in the laboratory. Further technological development will pave the way for the implementation of proteomics even closer within the clinical setting, allowing not only scientists but also patients to benefit from an understanding of protein interplay as it relates to cardiac disease physiology.

基于质谱的蛋白质组学是一种复杂的鉴定工具,专门用于在分子水平上描述蛋白质的动态变化。蛋白质组学为生物学家提供了与上下文相关的蛋白质表达、异构构象、动态周转信息以及蛋白质与蛋白质之间直接相互作用的数据。心脏蛋白质组学让研究人员和临床医生对心血管疾病的分子机制有了更深入的了解,并为未来治疗干预措施的开发奠定了基础。本综述概述了基于蛋白质组学的质谱技术在心脏研究中的发展、现有技术和未来展望。关键技术的进步使研究人员能够在单细胞水平上研究蛋白质组,采用机器人辅助的自动化系统来增强样品制备技术,质谱仪保真度的提高使众多动态翻译后修饰(PTM)得以明确鉴定。从早期的动物实验到目前复杂的射血分数保留型心力衰竭(HFpEF)动物模型,心血管疾病动物模型为在实验室研究具有挑战性的器官提供了工具。进一步的技术发展将为蛋白质组学在临床环境中的应用铺平道路,使科学家和患者都能从了解蛋白质相互作用与心脏疾病生理学的关系中获益。
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引用次数: 0
The ion channels of endomembranes. 内膜的离子通道
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-07-01 Epub Date: 2024-03-07 DOI: 10.1152/physrev.00025.2023
Meiqin Hu, Xinghua Feng, Qiang Liu, Siyu Liu, Fangqian Huang, Haoxing Xu

The endomembrane system consists of organellar membranes in the biosynthetic pathway [endoplasmic reticulum (ER), Golgi apparatus, and secretory vesicles] as well as those in the degradative pathway (early endosomes, macropinosomes, phagosomes, autophagosomes, late endosomes, and lysosomes). These endomembrane organelles/vesicles work together to synthesize, modify, package, transport, and degrade proteins, carbohydrates, and lipids, regulating the balance between cellular anabolism and catabolism. Large ion concentration gradients exist across endomembranes: Ca2+ gradients for most endomembrane organelles and H+ gradients for the acidic compartments. Ion (Na+, K+, H+, Ca2+, and Cl-) channels on the organellar membranes control ion flux in response to cellular cues, allowing rapid informational exchange between the cytosol and organelle lumen. Recent advances in organelle proteomics, organellar electrophysiology, and luminal and juxtaorganellar ion imaging have led to molecular identification and functional characterization of about two dozen endomembrane ion channels. For example, whereas IP3R1-3 channels mediate Ca2+ release from the ER in response to neurotransmitter and hormone stimulation, TRPML1-3 and TMEM175 channels mediate lysosomal Ca2+ and H+ release, respectively, in response to nutritional and trafficking cues. This review aims to summarize the current understanding of these endomembrane channels, with a focus on their subcellular localizations, ion permeation properties, gating mechanisms, cell biological functions, and disease relevance.

内膜系统包括生物合成途径中的细胞器膜:内质网(ER)、高尔基体和分泌囊泡,以及降解途径中的细胞器膜:早期内体、大体、吞噬体、自噬体、晚期内体和溶酶体。这些内膜细胞器/囊泡共同合成、修饰、包装、运输和降解蛋白质、碳水化合物和脂质,调节细胞合成代谢和分解代谢之间的平衡。内膜上存在巨大的离子浓度梯度--大多数内膜细胞器存在 Ca2+ 梯度,酸性细胞器存在 H+ 梯度。细胞器膜上的离子(Na+、K+、H+、Ca2+和Cl-)通道根据细胞的提示控制离子通量,使细胞膜和细胞器腔之间的信息交流迅速进行。最近,细胞器蛋白质组学、细胞器电生理学、细胞器腔内和细胞器外离子成像技术的进步,已导致对大约二十多种内膜离子通道的分子鉴定和功能表征。例如,IP3R1-3通道在神经递质和激素刺激下介导ER释放Ca2+,而TRPML1-3和TMEM175通道则在营养和贩运线索下分别介导溶酶体释放Ca2+和H+。本综述旨在总结目前对这些内膜通道的认识,重点是它们的亚细胞定位、离子渗透特性、门控机制、细胞生物学功能和疾病相关性。
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引用次数: 0
Computational modeling of cardiac electrophysiology and arrhythmogenesis: toward clinical translation. 心脏电生理学和心律失常发生的计算建模。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-07-01 Epub Date: 2023-12-28 DOI: 10.1152/physrev.00017.2023
Natalia A Trayanova, Aurore Lyon, Julie Shade, Jordi Heijman

The complexity of cardiac electrophysiology, involving dynamic changes in numerous components across multiple spatial (from ion channel to organ) and temporal (from milliseconds to days) scales, makes an intuitive or empirical analysis of cardiac arrhythmogenesis challenging. Multiscale mechanistic computational models of cardiac electrophysiology provide precise control over individual parameters, and their reproducibility enables a thorough assessment of arrhythmia mechanisms. This review provides a comprehensive analysis of models of cardiac electrophysiology and arrhythmias, from the single cell to the organ level, and how they can be leveraged to better understand rhythm disorders in cardiac disease and to improve heart patient care. Key issues related to model development based on experimental data are discussed, and major families of human cardiomyocyte models and their applications are highlighted. An overview of organ-level computational modeling of cardiac electrophysiology and its clinical applications in personalized arrhythmia risk assessment and patient-specific therapy of atrial and ventricular arrhythmias is provided. The advancements presented here highlight how patient-specific computational models of the heart reconstructed from patient data have achieved success in predicting risk of sudden cardiac death and guiding optimal treatments of heart rhythm disorders. Finally, an outlook toward potential future advances, including the combination of mechanistic modeling and machine learning/artificial intelligence, is provided. As the field of cardiology is embarking on a journey toward precision medicine, personalized modeling of the heart is expected to become a key technology to guide pharmaceutical therapy, deployment of devices, and surgical interventions.

心脏电生理学非常复杂,涉及多个空间(从离子通道到器官)和时间(从毫秒到数天)尺度上众多成分的动态变化,因此对心律失常发生机制进行直观或经验分析具有挑战性。心脏电生理学的多尺度机理计算模型可对单个参数进行精确控制,其可重复性可对心律失常机理进行全面评估。本综述全面分析了从单细胞到器官水平的心脏电生理学和心律失常模型,以及如何利用这些模型更好地理解心脏疾病中的节律紊乱并改善心脏病患者的护理。讨论了与基于实验数据的模型开发有关的关键问题,并重点介绍了人类心肌细胞模型的主要系列及其应用。综述了心脏电生理学器官级计算模型及其在个性化心律失常风险评估和房性与室性心律失常患者特异性治疗中的临床应用。本文重点介绍了根据患者临床数据重建的患者特异性心脏计算模型如何成功预测心脏性猝死风险并指导心律失常的最佳治疗。最后,展望了未来可能取得的进展,包括机理建模与机器学习/人工智能的结合。随着心脏病学领域踏上精准医疗的征程,心脏的个性化建模有望成为指导药物治疗、设备部署和手术干预的关键技术。
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引用次数: 0
Navigating the multifaceted intricacies of the Na+-Cl- cotransporter, a highly regulated key effector in the control of hydromineral homeostasis. 驾驭 Na+-Cl- 共转运体的多面复杂性,它是控制水矿物质平衡的高度调节和关键效应器。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-07-01 Epub Date: 2024-02-08 DOI: 10.1152/physrev.00027.2023
A V Rioux, T R Nsimba-Batomene, S Slimani, N A D Bergeron, M A M Gravel, S V Schreiber, M J Fiola, L Haydock, A P Garneau, P Isenring

The Na+-Cl- cotransporter (NCC; SLC12A3) is a highly regulated integral membrane protein that is known to exist as three splice variants in primates. Its primary role in the kidney is to mediate the cosymport of Na+ and Cl- across the apical membrane of the distal convoluted tubule. Through this role and the involvement of other ion transport systems, NCC allows the systemic circulation to reclaim a fraction of the ultrafiltered Na+, K+, Cl-, and Mg+ loads in exchange for Ca2+ and [Formula: see text]. The physiological relevance of the Na+-Cl- cotransport mechanism in humans is illustrated by several abnormalities that result from NCC inactivation through the administration of thiazides or in the setting of hereditary disorders. The purpose of the present review is to discuss the molecular mechanisms and overall roles of Na+-Cl- cotransport as the main topics of interest. On reading the narrative proposed, one will realize that the knowledge gained in regard to these themes will continue to progress unrelentingly no matter how refined it has now become.

Na+-Cl- 共转运体(NCC;SLC12A3)是一种高度调节的整体膜蛋白,在灵长类动物中已知有 3 种剪接变体。它在肾脏中的主要作用是介导 Na+ 和 Cl- 跨远端曲小管顶端膜的共转运。通过这一作用以及其他离子转运系统的参与,NCC 允许全身循环回收一部分超滤的 Na+、K+、Cl- 和 Mg+,以交换 Ca2+ 和 HCO3-。人体 Na+-Cl- 共转运机制的生理意义体现在服用噻嗪类药物或因遗传性疾病导致 NCC 失活而出现的一些异常现象。本综述的目的是讨论 Na+-Cl- 共转运的分子机制和整体作用,这是我们感兴趣的主要话题。在阅读所提出的叙述时,人们会意识到,无论现在的知识多么精炼,有关这些主题的知识仍将不断进步。
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引用次数: 0
Neurobiology and systems biology of stress resilience. 压力复原力的神经生物学和系统生物学。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-07-01 Epub Date: 2024-03-14 DOI: 10.1152/physrev.00042.2023
Raffael Kalisch, Scott J Russo, Marianne B Müller

Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.

抗压能力是指一些人在面临逆境时仍能保持心理健康,或仅表现出暂时的心理障碍,随后又能迅速恢复的现象。抗压能力研究试图揭示使抗压能力成为可能的因素和机制,并利用其洞察力为有可能出现压力相关功能障碍的人制定预防性干预措施。生物复原力研究一直落后于心理和社会科学研究,但近年来却出现了大幅增长。与此同时,这一领域的研究进展也受到了方法论挑战的阻碍,这些挑战包括寻找合适的操作方法和研究设计、复制研究结果以及建立动物复原力模型。我们将对成人的行为学、神经影像学、神经生物学和系统生物学研究结果进行回顾,并对关键方法进行讨论。我们发现有初步证据表明,基于海马体的模式分离和基于前额叶的认知控制功能可以通过促进对安全的感知,在单一的事件型压力之后防止病态恐惧的发展(如在与恐惧相关的疾病中发现的那样,包括创伤后应激障碍(PTSD)的较简单形式)。基于奖赏系统的对积极强化物的追求和品味似乎可以防止因更严重或更持久的压力(如抑郁症、广泛或合并焦虑症或严重创伤后应激障碍)而导致的焦虑抑郁谱系中更广泛的功能障碍的发展。这些神经系统在应激状态下的功能保持与神经可塑性、免疫调节、肠道微生物组的组成以及肠道屏障和血脑屏障的完整性之间的联系已开始显现。在此基础上,指出了生物干预的途径。
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引用次数: 0
Physiological basis for xenotransplantation from genetically modified pigs to humans. 转基因猪向人类异种移植的生理基础:综述。
IF 29.9 1区 医学 Q1 PHYSIOLOGY Pub Date : 2024-07-01 Epub Date: 2024-03-22 DOI: 10.1152/physrev.00041.2023
Leigh Peterson, Magdi H Yacoub, David Ayares, Kazuhiko Yamada, Daniel Eisenson, Bartley P Griffith, Muhammad M Mohiuddin, Willard Eyestone, J Craig Venter, Ryszard T Smolenski, Martine Rothblatt

The collective efforts of scientists over multiple decades have led to advancements in molecular and cellular biology-based technologies including genetic engineering and animal cloning that are now being harnessed to enhance the suitability of pig organs for xenotransplantation into humans. Using organs sourced from pigs with multiple gene deletions and human transgene insertions, investigators have overcome formidable immunological and physiological barriers in pig-to-nonhuman primate (NHP) xenotransplantation and achieved prolonged pig xenograft survival. These studies informed the design of Revivicor's (Revivicor Inc, Blacksburg, VA) genetically engineered pigs with 10 genetic modifications (10 GE) (including the inactivation of 4 endogenous porcine genes and insertion of 6 human transgenes), whose hearts and kidneys have now been studied in preclinical human xenotransplantation models with brain-dead recipients. Additionally, the first two clinical cases of pig-to-human heart xenotransplantation were recently performed with hearts from this 10 GE pig at the University of Maryland. Although this review focuses on xenotransplantation of hearts and kidneys, multiple organs, tissues, and cell types from genetically engineered pigs will provide much-needed therapeutic interventions in the future.

经过科学家们几十年的共同努力,以分子和细胞生物学为基础的技术(包括基因工程和动物克隆)取得了进步,现在这些技术正被用来提高猪器官异种移植到人体内的适宜性。研究人员利用多基因缺失和人类转基因插入的猪器官,克服了猪与非人灵长类动物(NHP)异种移植中难以克服的免疫学和生理学障碍,延长了猪异种移植的存活时间。这些研究为 Revivicor 公司(Revivicor Inc,弗吉尼亚州布莱克斯堡)设计具有 10 个基因修饰(10 GE)(包括 4 个猪内源基因失活和 6 个人类转基因插入)的基因工程猪提供了依据,目前已在临床前人类异种移植模型中使用脑死亡受体对其心脏和肾脏进行了研究。此外,马里兰大学最近利用这头 10 GE 猪的心脏进行了首两例猪对人心脏异种移植临床试验。虽然这篇综述的重点是心脏和肾脏的异种移植,但来自基因工程猪的多种器官、组织和细胞类型将在未来提供急需的治疗干预。
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引用次数: 0
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Physiological reviews
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