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A Multi-Year Monitoring of Swiss Grain Maize: Which Cropping Factors Influence Fusarium Species Incidence and Associated Mycotoxins? 瑞士谷物玉米的多年监测:哪些种植因素影响镰刀菌的发病率和相关真菌毒素?
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-26 DOI: 10.3390/toxins18020065
Tomke Musa, Karen E Sullam, Heike Rollwage, Michael Sulyok, Petr Karlovsky, Susanne Vogelgsang

A complex of Fusarium species frequently infects maize, causing root, ear, and stem rot, yield losses, reduced seed quality, and mycotoxin accumulation. To quantify Fusarium species composition and mycotoxin contamination, we conducted a first nationwide monitoring in Swiss commercial grain maize over three years (2008-2010), followed by grain maize hybrid experiments across five sites (2011-2013). Samples were analysed for species incidence, fungal DNA, and the mycotoxins deoxynivalenol, zearalenone, and fumonisins. For each field, crop management data were collected. Fusarium graminearum, F. verticillioides, F. subglutinans, and F. proliferatum were predominant, and deoxynivalenol was the most frequent toxin, with 55% of the samples exceeding the European pig feed guidance value (0.9 mg kg-1). Overall, fumonisin contamination was low: only 11% of samples were above the limit of detection. The year, the length of the growing period, and the timing of the harvest were the principal determinants of F. graminearum infection and deoxynivalenol/zearalenone accumulation, whereas other agronomic factors, including crop rotation, soil management, and maturity class, showed only limited or inconsistent effects. Results from this study provide evidence that farmers should avoid long growing periods and late harvests to reduce the risk of high deoxynivalenol/zearalenone content. The maize hybrid experiments confirmed the overriding influence of weather conditions on Fusarium species incidence and mycotoxin content, leading to high inter-annual variability. These results highlight the need for standardised, long-term field experiments to disentangle agronomic effects and environmental drivers.

一种镰刀菌的复合体经常感染玉米,造成根、穗和茎腐烂、产量损失、种子质量下降和霉菌毒素积累。为了量化镰刀菌的种类组成和霉菌毒素污染,我们在瑞士进行了为期三年(2008-2010年)的首次全国范围内的商业谷物玉米监测,随后在五个地点进行了谷物玉米杂交试验(2011-2013年)。分析样品的种类发生率、真菌DNA以及真菌毒素脱氧雪腐镰刀菌醇、玉米赤霉烯酮和伏马菌素。对每个地块收集作物管理数据。以谷草镰刀菌、黄萎病镰刀菌、粘质次镰刀菌和增殖镰刀菌为主,脱氧雪腐镰刀菌醇为最常见的毒素,超过欧洲猪饲料指导值(0.9 mg kg-1)的样品占55%。总体而言,伏马菌素污染较低:只有11%的样品超过检测限。年份、生长期长短和收获时间是谷草镰刀菌感染和脱氧雪腐镰刀菌醇/玉米赤霉烯酮积累的主要决定因素,而其他农艺因素,包括作物轮作、土壤管理和成熟度等级,仅显示有限或不一致的影响。本研究结果表明,农民应避免长生长期和晚收获,以降低脱氧雪腐菌烯醇/玉米赤霉烯酮含量过高的风险。玉米杂交试验证实,天气条件对镰刀菌发病率和霉菌毒素含量的影响最大,导致年际变化较大。这些结果突出表明,需要进行标准化的长期田间试验,以理清农艺效应和环境驱动因素。
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引用次数: 0
Gender Differences in Post-Stroke Spasticity Patients Treated with OnabotulinumtoxinA: Insights from the BOTOX Economic Spasticity Trial (BEST). 肉毒杆菌毒素治疗脑卒中后痉挛患者的性别差异:来自肉毒杆菌经济痉挛试验(BEST)的见解。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-26 DOI: 10.3390/toxins18020064
Monica Verduzco-Gutierrez, Reema Kaloti, Akinpelumi A Beckley, Adil Syed Hussain, Sima A Desai, Kimberly Becker Ifantides, Natasha L Romanoski

Limited data are available on gender differences in patients with post-stroke spasticity (PSS) treated with onabotulinumtoxinA (onabotA). This subgroup analysis of data from the BOTOX® Economic Spasticity Trial (BEST) focused on onabotA-treated patients stratified by gender. BEST was a double-blind, placebo-controlled, randomized study with an open-label extension that allowed for up to five treatments. It evaluated the effectiveness of onabotA + Standard of Care (SC) vs. placebo + SC for the treatment of PSS. At baseline, out of 139 patients treated with onabotA, females (n = 54) had a slightly higher body mass index (BMI) compared to males (n = 85) (28.3 vs. 26.9 kg/m2), and a greater percentage of females (40.7%) took analgesic medications compared to males (31.8%). Scores from baseline assessments for pain, spasticity severity, and stroke recovery were comparable between groups. Despite these similarities at baseline, females received an average lower dose (range, 337-365 U) of onabotA compared to males (range, 343-421 U) across treatment sessions. Females also had lower changes from baseline compared to males on pain, spasticity severity, stroke recovery, and functional goal achievement assessments across most onabotA treatment sessions. There is a need for further investigation into treatment approaches to optimize outcomes for both males and females with PSS.

关于使用肉毒杆菌毒素a (onabotA)治疗卒中后痉挛(PSS)患者的性别差异的数据有限。本亚组分析来自BOTOX®经济痉挛试验(BEST)的数据,重点是按性别分层的onabota治疗患者。BEST是一项双盲、安慰剂对照、随机研究,具有开放标签扩展,允许多达五种治疗。它评估了onabotA +标准治疗(SC)与安慰剂+ SC治疗PSS的有效性。在基线时,139例接受onabotA治疗的患者中,女性(n = 54)的体重指数(BMI)略高于男性(n = 85) (28.3 vs. 26.9 kg/m2),服用镇痛药物的女性比例(40.7%)高于男性(31.8%)。疼痛、痉挛严重程度和中风恢复的基线评分在两组之间具有可比性。尽管基线有这些相似之处,但在整个治疗过程中,女性接受的onabotA平均剂量(337-365 U)低于男性(343-421 U)。在大多数onabotA治疗期间,女性在疼痛、痉挛严重程度、中风恢复和功能目标实现评估方面与基线相比的变化也较低。有必要进一步研究治疗方法,以优化男性和女性PSS患者的预后。
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引用次数: 0
The Cardioprotective Potential of Marine Venom and Toxins. 海洋毒液和毒素的心脏保护潜力。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-26 DOI: 10.3390/toxins18020063
Virginia Heaven Mariboto Siagian, Rina Fajri Nuwarda

Cardiovascular disease (CVD) continues to be the primary cause of morbidity and mortality worldwide, underscoring the urgent need for novel therapeutic alternatives. In recent years, marine ecosystems have garnered increasing attention as a promising source of bioactive compounds with unique structural and pharmacological properties. Marine-derived toxins and venoms, including tetrodotoxin, ω-conotoxins, anthopleurins, palytoxin, brevetoxin, aplysiatoxin, and asterosaponins, exert cardioprotective effects through diverse mechanisms such as modulation of ion channels, inhibition of sympathetic overactivity, antioxidative actions, and enhancement of myocardial contractility. These properties make them potential candidates for addressing various CVD manifestations, including arrhythmia, hypertension, ischemia-reperfusion injury, and heart failure. However, despite their therapeutic promise, the clinical application of these marine compounds remains limited due to poor tissue selectivity, narrow therapeutic indices, proinflammatory activity, and limited metabolic stability. Structural modifications, advanced drug delivery platforms, and in vivo validation studies are crucial for overcoming these challenges. This review highlights the pharmacological actions, molecular targets, and cardiovascular relevance of selected marine toxins and venoms while also addressing key translational barriers. Advances in biotechnology and peptide engineering are enabling the safer and more targeted use of these compounds. Collectively, marine-derived toxins and venoms represent a largely untapped but highly promising frontier in cardiovascular drug discovery. Strategic research focused on elucidating mechanisms, optimizing delivery, and translating clinical applications will be critical to unlocking their full therapeutic potential.

心血管疾病(CVD)仍然是世界范围内发病率和死亡率的主要原因,强调迫切需要新的治疗方案。近年来,海洋生态系统作为具有独特结构和药理特性的生物活性化合物的重要来源而受到越来越多的关注。海洋来源的毒素和毒液,包括河豚毒素、ω-conotoxins、刺胸膜毒素、palytoxin、brevetoxin、applsiatoxin和asterosaponins,通过多种机制,如调节离子通道、抑制交感神经过度活跃、抗氧化作用和增强心肌收缩性,发挥心脏保护作用。这些特性使其成为治疗各种CVD表现的潜在候选者,包括心律失常、高血压、缺血再灌注损伤和心力衰竭。然而,尽管这些海洋化合物具有治疗前景,但由于组织选择性差、治疗指标窄、促炎活性和代谢稳定性有限,它们的临床应用仍然受到限制。结构修饰、先进的给药平台和体内验证研究对于克服这些挑战至关重要。这篇综述强调了选定的海洋毒素和毒液的药理作用、分子靶点和心血管相关性,同时也解决了关键的翻译障碍。生物技术和肽工程的进步使这些化合物能够更安全、更有针对性地使用。总的来说,海洋来源的毒素和毒液在心血管药物发现方面是一个很大程度上尚未开发但非常有前途的前沿领域。战略研究的重点是阐明机制、优化递送和转化临床应用,这对于释放它们的全部治疗潜力至关重要。
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引用次数: 0
Field-Evolved Resistance to Bt Cry Toxins in Lepidopteran Pests: Insights into Multilayered Regulatory Mechanisms and Next-Generation Management Strategies. 鳞翅目害虫对Bt Cry毒素的田间进化抗性:多层调控机制和新一代管理策略的见解。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-25 DOI: 10.3390/toxins18020060
Junfei Xie, Wenfeng He, Min Qiu, Jiaxin Lin, Haoran Shu, Jintao Wang, Leilei Liu

Bt Cry toxins remain the cornerstone of transgenic crop protection against Lepidopteran pests, yet field-evolved resistance, particularly in invasive species such as Spodoptera frugiperda and Helicoverpa armigera, can threaten their long-term efficacy. This review presents a comprehensive and unified mechanistic framework that synthesizes current understanding of Bt Cry toxin modes of action and the complex, multilayered regulatory mechanisms of field-evolved resistance. Beyond the classical pore-formation model, emerging evidence highlights signal transduction cascades, immune evasion via suppression of Toll/IMD pathways, and tripartite toxin-host-microbiota interactions that can dynamically modulate protoxin activation and receptor accessibility. Resistance arises from target-site alterations (e.g., ABCC2/ABCC3, Cadherin mutations), altered midgut protease profiles, enhanced immune regeneration, and microbiota-mediated detoxification, orchestrated by transcription factor networks (GATA, FoxA, FTZ-F1), constitutive MAPK hyperactivation (especially MAP4K4-driven cascades), along with preliminary emerging findings on non-coding RNA involvement. Countermeasures now integrate synergistic Cry/Vip pyramiding, CRISPR/Cas9-validated receptor knockouts revealing functional redundancy, Domain III chimerization (e.g., Cry1A.105), phage-assisted continuous evolution (PACE), and the emerging application of AlphaFold3 for structure-guided rational redesign of resistance-breaking variants. Future sustainability hinges on system-level integration of single-cell transcriptomics, midgut-specific CRISPR screens, microbiome engineering, and AI-accelerated protein design to preempt resistance trajectories and secure Bt biotechnology within integrated resistance and pest management frameworks.

Bt Cry毒素仍然是转基因作物抵御鳞翅目害虫的基石,然而田间进化出的抗性,特别是对入侵物种如狐尾翅目和棉铃虫的抗性,可能会威胁到它们的长期功效。这篇综述提出了一个全面和统一的机制框架,综合了目前对Bt Cry毒素作用模式的理解和田间进化抗性的复杂、多层调控机制。除了经典的孔隙形成模型之外,新出现的证据强调了信号转导级联,通过抑制Toll/IMD途径进行免疫逃避,以及毒素-宿主-微生物群的三重相互作用,这些相互作用可以动态调节原蛋白的激活和受体的可及性。耐药产生于靶点改变(例如,ABCC2/ABCC3,钙粘蛋白突变),中肠蛋白酶谱改变,免疫再生增强,微生物介导的解毒,转录因子网络(GATA, FoxA, FTZ-F1),构成性MAPK超激活(特别是map4k4驱动的级联反应),以及非编码RNA参与的初步发现。目前的对策包括协同Cry/Vip构建、CRISPR/ cas9验证的受体敲除揭示功能冗余、Domain III嵌合(例如Cry1A.105)、噬菌体辅助连续进化(PACE)以及AlphaFold3在结构指导下的合理重新设计抗性变异的新应用。未来的可持续性取决于单细胞转录组学、中肠特异性CRISPR筛选、微生物组工程和人工智能加速的蛋白质设计的系统级整合,以先发制人地控制抗性轨迹,并在综合抗性和病虫害管理框架内确保Bt生物技术的安全。
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引用次数: 0
Beyond Improvement of Motor Symptoms: Central Effects of Botulinum Toxin on Anxiety and Depression in Focal Dystonia, Hemifacial Spasm, and Blepharospasm. 除改善运动症状外:肉毒毒素对局灶性肌张力障碍、面肌痉挛和眼睑痉挛患者焦虑和抑郁的中枢作用
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-25 DOI: 10.3390/toxins18020062
Tihana Gilman Kuric, Zvonimir Popovic, Sara Matosa, Eleonora Strujic, Ivana Gacic, Tea Mirosevic Zubonja, Stjepan Juric, Melita Pecek Prpic, Vera Jelusic, Dubravka Biuk, Svetlana Tomic

Cervical dystonia (CD), blepharospasm (BSP), and idiopathic hemifacial spasm (HFS) are focal hyperkinetic movement disorders with distinct underlying mechanisms. While CD and BSP involve central network dysfunctions within the basal ganglia-thalamo-cortical and cerebellar circuits, HFS primarily results from peripheral facial nerve hyperexcitability. Still, people living with all three conditions often struggle with mood issues like depression and anxiety, which can originate from both the burden of illness and changes in brain biology. We studied 61 patients (CD, n = 30; BSP, n = 9; HFS, n = 22) and assessed depression and anxiety before and three weeks after botulinum neurotoxin type A (BoNT-A) therapy, considering injection site and dose. BoNT-A significantly reduced depressive and anxiety symptoms across all groups, regardless of disease type, dose, or glabellar injection. These psychiatric improvements were not associated with the degree of motor symptom reduction, suggesting a partially independent mechanism of mood modulation. Our findings indicate that BoNT-A's mood benefits may extend beyond local motor effects, possibly involving broader sensorimotor-limbic interactions. These results highlight the therapeutic potential of BoNT-A for addressing non-motor symptoms in both dystonic and non-dystonic hyperkinetic disorders. Future studies employing imaging and neurophysiological methods are necessary to explain the neural pathways underlying these effects.

颈肌张力障碍(CD)、眼睑痉挛(BSP)和特发性面肌痉挛(HFS)是局灶性多动运动障碍,具有不同的潜在机制。虽然CD和BSP涉及基底神经节-丘脑-皮质和小脑回路的中枢网络功能障碍,但HFS主要由外周面神经过度兴奋性引起。尽管如此,患有这三种疾病的人经常会受到抑郁和焦虑等情绪问题的困扰,这可能源于疾病的负担和大脑生物学的变化。我们研究了61例患者(CD, n = 30; BSP, n = 9; HFS, n = 22),并评估了A型肉毒杆菌神经毒素(BoNT-A)治疗前和治疗后3周的抑郁和焦虑,考虑注射部位和剂量。BoNT-A显著减轻了所有组的抑郁和焦虑症状,与疾病类型、剂量或额骨注射无关。这些精神改善与运动症状减轻的程度无关,表明情绪调节的部分独立机制。我们的研究结果表明,BoNT-A对情绪的益处可能超出了局部运动效应,可能涉及更广泛的感觉运动-边缘相互作用。这些结果突出了BoNT-A在治疗肌张力障碍和非肌张力障碍的非运动症状方面的治疗潜力。未来有必要利用影像学和神经生理学方法来解释这些效应背后的神经通路。
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引用次数: 0
Aflatoxin and Liver Cancer in China: The Evolving Research Landscape. 黄曲霉毒素与中国肝癌:不断发展的研究格局。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-25 DOI: 10.3390/toxins18020061
Jian-Guo Chen, Thomas W Kensler, Gui-Ju Sun, Jian Zhu, Jian-Hua Lu, Da Pan, Yong-Hui Zhang, John D Groopman

Aflatoxins, particularly aflatoxin B1 (AFB1), are among the most potent naturally occurring carcinogens and remain a major food-borne hazard in parts of Asia and Africa. China has generated a uniquely cohesive body of evidence connecting aflatoxin contamination to hepatocellular carcinoma (HCC), especially in settings where chronic hepatitis B virus (HBV) infection is highly prevalent and acts synergistically with aflatoxin exposure. Over five decades, field investigations and laboratory innovations-exemplified by long-term work in Qidong-have assembled a multi-layered causal chain spanning the following: (i) contamination monitoring in staple foods; (ii) quantification of internal dose and biologically effective dose using validated biomarkers (e.g., urinary AFB1-N7-guanine, AFM1, and serum AFB1-lysine albumin adducts); (iii) a characteristic molecular fingerprint in tumors and circulation (TP53 R249S); (iv) reversibility demonstrated through randomized intervention trials and policy-driven natural experiments. Chemoprevention and dietary interception studies (e.g., oltipraz, chlorophyllin, and broccoli sprout beverages) showed that enhancing detoxication pathways can lower biomarker burdens in exposed populations. At the population level, a sustained dietary transition from maize to rice, together with strengthened food governance, was accompanied by marked decreases in biomarker distributions and subsequent declines in HCC mortality in endemic regions. Nevertheless, regional heterogeneity, multi-mycotoxin co-exposure, and climate variability are expected to increase exposure volatility and complicate surveillance. Here, we translate and synthesize the Chinese evidence base, highlight biomarker-enabled monitoring and policy evaluation, and propose an integrated "5+1" prevention framework spanning source control, process detoxification, tiered governance, short-course interception, precision follow-up of high-risk individuals, and climate-sensitive early warning along the climate-agriculture-storage-processing-population (CAT-CSPP) chain.

黄曲霉毒素,特别是黄曲霉毒素B1 (AFB1),是最有效的自然致癌物之一,在亚洲和非洲部分地区仍然是主要的食源性危害。中国已经形成了一个独特的证据体系,将黄曲霉毒素污染与肝细胞癌(HCC)联系起来,特别是在慢性乙型肝炎病毒(HBV)感染高度流行并与黄曲霉毒素暴露协同作用的环境中。50多年来,实地调查和实验室创新——以启东的长期工作为例——已经形成了一个多层次的因果链,涵盖以下内容:(1)主食污染监测;(ii)使用经过验证的生物标志物(例如,尿afb1 - n7 -鸟嘌呤、AFM1和血清afb1 -赖氨酸白蛋白加合物)定量内剂量和生物有效剂量;(iii)肿瘤和循环中的特征性分子指纹(TP53 R249S);(iv)通过随机干预试验和政策驱动的自然实验证明的可逆性。化学预防和饮食拦截研究(例如,oltipraz、叶绿素和西兰花芽饮料)表明,增强解毒途径可以降低暴露人群的生物标志物负担。在人群水平上,从玉米到大米的持续饮食转变,以及加强食物管理,伴随着生物标志物分布的显著减少,以及随后HCC流行地区死亡率的下降。然而,区域异质性、多种真菌毒素共同暴露和气候变化预计会增加暴露的波动性,并使监测复杂化。在此,我们翻译和综合了中国的证据基础,突出了生物标志物监测和政策评估,并提出了一个综合的“5+1”预防框架,涵盖了气候-农业-储存-加工-人口(CAT-CSPP)链上的源头控制、过程解毒、分层治理、短期拦截、高风险个体的精确随访和气候敏感预警。
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引用次数: 0
From Bite to Recovery: Safety and Efficacy of Pan-African Polyvalent Antivenom Used for Treating Snakebites in Cameroon. 从咬伤到恢复:泛非多价抗蛇毒血清用于治疗喀麦隆蛇咬伤的安全性和有效性。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-23 DOI: 10.3390/toxins18020059
Tatiana K Djikeussi, Vishwas Sovani, Rogacien Kana, Lorraine G Nekame, Awelsa Benoit, Malama Toussaint, Louabalbe P Emmanuel, Ngu Hilmann, Baba Souley, Issaka Sali, Yaouba Daoauda, Balkissou A Dodo, Armelle Messa, Maraimou I Issa, Sogueba I Maruis, Arthur Djoumessi, Nathalie Elombo, Gavli Dongoa, Gilbert Keblouabe, Yaoua Z Aladji

Snakebite envenomation (SBE) is a major public health issue in sub-Saharan Africa (SSA), particularly in Cameroon. This Phase IV, multicenter, open-label study was conducted from June 2024 to December 2024 to evaluate the safety and efficacy of PANAF-Premium™, a World Health Organization (WHO)-approved polyvalent antivenom that was introduced in Cameroon in 2023, given that prospectively gathered data and studies on this antivenom's safety in SSA are limited. In total, 130 victims admitted to four district hospitals in North Cameroon with confirmed SBE were included. Data on envenomation syndromes, clinical outcomes, adverse events, and treatment response were recorded. Echis species were responsible for most bites, while clinical syndromes included hemotoxic (68.5%), cytotoxic (30.8%), and neurotoxic (0.8%) presentations. On average, victims required 3.34 vials and 5.55 days for clinical recovery. Early antivenom administration significantly reduced the number of antivenom vials required to manage the symptoms (p = 0.003) and hospital stay (p = 0.049). Seventeen patients experienced mild to moderate adverse events. Two deaths and a case of kidney injury were noted, all unrelated to antivenom use. These study findings indicate the safety and effectiveness of PANAF-Premium™ antivenom, meeting WHO performance targets. The results highlight the importance of timely antivenom administration in treating SBEs.

蛇咬伤中毒(SBE)是撒哈拉以南非洲(SSA)的一个主要公共卫生问题,特别是在喀麦隆。这项IV期、多中心、开放标签研究于2024年6月至2024年12月进行,以评估PANAF-Premium™的安全性和有效性,PANAF-Premium™是世界卫生组织(WHO)批准的多价抗蛇毒血清,于2023年在喀麦隆引入,考虑到该抗蛇毒血清在SSA中的安全性的前瞻性收集数据和研究有限。在喀麦隆北部的四家县医院共收治了130名确诊为SBE的受害者。记录中毒综合征、临床结局、不良事件和治疗反应的数据。大多数叮咬是由eches引起的,临床症状包括血液毒性(68.5%)、细胞毒性(30.8%)和神经毒性(0.8%)。患者平均需要3.34个小瓶和5.55天的临床恢复时间。早期抗蛇毒血清治疗显著减少了治疗症状所需的抗蛇毒血清小瓶数量(p = 0.003)和住院时间(p = 0.049)。17例患者出现轻至中度不良事件。两例死亡和一例肾损伤都与抗蛇毒血清的使用无关。这些研究结果表明,PANAF-Premium™抗蛇毒血清的安全性和有效性符合世卫组织的绩效目标。结果强调了及时抗蛇毒血清治疗SBEs的重要性。
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引用次数: 0
Strategies for Removal of Protein-Bound Uremic Toxins in Hemodialysis. 去除血液透析中蛋白结合尿毒症毒素的策略。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-22 DOI: 10.3390/toxins18010057
Joost C de Vries, João G Brás, Geert M de Vries, Jeroen C Vollenbroek, Fokko P Wieringa, Joachim Jankowski, Marianne C Verhaar, Dimitrios Stamatialis, Rosalinde Masereeuw, Karin G F Gerritsen

The removal of protein-bound uremic toxins (PBUTs) from the blood of kidney failure patients with conventional dialysis is limited. However, as their harmful effects and association with morbidity and mortality in dialysis patients are increasingly recognized, PBUTs have become important therapeutic targets. In this review, PBUT removal with current state-of-the-art dialysis technologies and future perspectives are discussed. Strategies to enhance PBUT clearance include methods that interfere with PBUT-albumin binding, such as chemical displacers, high ionic strength, pH changes, or electromagnetic fields, thereby increasing the free fraction available for dialysis. While these methods have shown promise in vitro, and some also in vivo, long-term safety data are lacking. PBUT removal can also be increased by adsorption, either directly via hemoperfusion, or indirectly, e.g., via sorbents incorporated in a mixed-matrix membrane or dissolved in the dialysate. In the kidney, PBUTs are secreted in the proximal tubules; hence, a cell-based bioartificial kidney (BAK) that secretes PBUTs is proposed as an add-on to current dialysis. Yet both PBUT adsorption strategies and, in particular, BAKs face considerable challenges in upscaling and mass production at acceptable costs. In conclusion, many novel technologies are under development, all requiring further (pre)clinical testing and upscaling before these strategies can be applied in the clinic.

通过常规透析从肾衰竭患者血液中去除蛋白结合尿毒症毒素(PBUTs)是有限的。然而,随着pbut在透析患者中的有害影响及其与发病率和死亡率的关联日益被认识,pbut已成为重要的治疗靶点。在这篇综述中,PBUT的去除与当前最先进的透析技术和未来的前景进行了讨论。增强PBUT清除的策略包括干扰PBUT-白蛋白结合的方法,如化学置换剂、高离子强度、pH变化或电磁场,从而增加可用于透析的游离分数。虽然这些方法在体外显示出前景,有些在体内也显示出前景,但缺乏长期的安全性数据。PBUT的去除也可以通过吸附来增加,要么直接通过血液灌流,要么间接,例如,通过将吸附剂掺入混合基质膜或溶解在透析液中。在肾脏中,PBUTs在近端小管中分泌;因此,一种分泌PBUTs的基于细胞的生物人工肾(BAK)被提议作为当前透析的补充。然而,PBUT吸附策略,特别是BAKs,在可接受的成本下进行规模化和大规模生产都面临着相当大的挑战。总之,许多新技术正在开发中,在这些策略应用于临床之前,都需要进一步的(前)临床测试和升级。
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引用次数: 0
Aligning Minds in Spasticity Care-A Two-Phase Delphi-Dialogue Study of Patients and Professionals in Spain. 在痉挛护理中调整思想-西班牙患者和专业人员的两阶段德尔福对话研究。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-22 DOI: 10.3390/toxins18010056
Helena Bascuñana-Ambrós, Jacobo Formigo-Couceiro, José Maria Climent-Barberá, Lluis Guirao-Cano, Michelle Catta-Preta, Alex Trejo-Omeñaca, Josep Maria Monguet-Fierro

Background: Spasticity, which occurs with certain neurological conditions, substantially affects quality of life, function, and social participation. Despite widespread botulinum toxin use, variability persists in patient information, access to specialized rehabilitation, and follow-up models.

Methods: This two-phase Delphi-Dialogue Patients-Professionals study (DDPP), promoted by SERMEF, integrated perspectives from 77 patients and 141 rehabilitation professionals. Phase 1 used parallel surveys to assess satisfaction, perceived effectiveness of botulinum toxin, communication preferences, and rehabilitation follow-up. Phase 2 applied Real-Time Delphi with 38 experts to generate consensus recommendations to improve spasticity management.

Results: Patients and professionals agreed on botulinum toxin benefits, the importance of ongoing rehabilitation, and the value of hybrid (in-person/remote) follow-up. Key gaps concerned access to Physical Medicine and Rehabilitation services, clarity and timing of information, and shared goal setting. Experts translated these misalignments into 10 prioritized recommendations, with highest feasibility for actions standardizing access pathways, optimizing botulinum toxin use, reinforcing structured education, and consolidating hybrid rehabilitation models.

Conclusions: The DDPP approach offers a reproducible framework to align stakeholder perspectives by converting quantified divergence into consensus-based innovation priorities. Implementing the recommendations-particularly those strengthening communication, education, and hybrid pathways regarding botulinum toxin treatment-may support more accessible, personalized, patient-centered spasticity care.

背景:痉挛发生于某些神经系统疾病,严重影响生活质量、功能和社会参与。尽管肉毒杆菌毒素广泛使用,但患者信息、专科康复治疗和随访模型的可变性仍然存在。方法:采用两阶段的德尔菲-对话患者-专业人员研究(DDPP),由SERMEF推动,整合了77名患者和141名康复专业人员的观点。第一阶段采用平行调查来评估满意度、肉毒杆菌毒素的感知有效性、沟通偏好和康复随访。第二阶段应用实时德尔福与38位专家产生共识的建议,以改善痉挛管理。结果:患者和专业人员对肉毒杆菌毒素治疗的益处、持续康复的重要性以及混合(现场/远程)随访的价值达成一致。主要差距涉及获得物理医学和康复服务、信息的清晰度和时机以及共同目标的设定。专家将这些错位转化为10项优先建议,这些建议在标准化获取途径、优化肉毒杆菌毒素使用、加强结构化教育和巩固混合康复模式方面具有最高的可行性。结论:DDPP方法提供了一个可复制的框架,通过将量化的分歧转化为基于共识的创新优先级,来协调利益相关者的观点。实施这些建议,特别是加强关于肉毒杆菌毒素治疗的沟通、教育和混合途径,可能会支持更容易获得的、个性化的、以患者为中心的痉挛治疗。
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引用次数: 0
Aflatoxin Exposure and Human Health with a Focus on Northern Latin America. 黄曲霉毒素暴露与人类健康——以拉丁美洲北部为重点。
IF 4 3区 医学 Q2 FOOD SCIENCE & TECHNOLOGY Pub Date : 2026-01-22 DOI: 10.3390/toxins18010058
Karen A Corleto, Christian S Alvarez, Manuel Ramirez-Zea, John D Groopman, Katherine A McGlynn

Aflatoxins, mycotoxins produced by Aspergillus flavus and Aspergillus parasiticus, were discovered sixty-five years ago and remain a significant public health threat, particularly amid increasing instances of extreme weather events. Of the four principal forms of aflatoxins found in foods (B1, B2, G1, and G2), aflatoxin B1 is the most potent carcinogen. Aflatoxins commonly contaminate a variety of foodstuffs, with maize being among the most susceptible. Chronic exposure to aflatoxins has been linked to liver cancer, childhood stunting, gallbladder cancer, and other adverse health effects. Due to public health concerns related to the consumption of aflatoxin-contaminated foods, most countries have established regulatory limits. Here, we present estimated aflatoxin exposure per day derived from human biomarker data across many studies around the world spanning more than forty years. We specifically focus on the impact of dietary aflatoxin in northern Latin America, where assessment of the total problem remains limited. These findings suggest a multipronged toolkit could mitigate aflatoxin exposure in the region, which would help to decrease the health burden.

黄曲霉毒素是由黄曲霉和寄生曲霉产生的真菌毒素,65年前被发现,目前仍是一个重大的公共卫生威胁,特别是在极端天气事件日益增多的情况下。在食物中发现的四种主要黄曲霉毒素(B1、B2、G1和G2)中,黄曲霉毒素B1是最有效的致癌物。黄曲霉毒素通常污染多种食品,玉米是最易受影响的食品之一。长期接触黄曲霉毒素与肝癌、儿童发育迟缓、胆囊癌和其他不良健康影响有关。由于与食用受黄曲霉毒素污染的食品有关的公共卫生问题,大多数国家都制定了监管限制。在这里,我们从世界各地40多年来的许多研究中获得的人类生物标志物数据中提出了每天黄曲霉毒素暴露的估计。我们特别关注饮食黄曲霉毒素在拉丁美洲北部的影响,在那里对整个问题的评估仍然有限。这些发现表明,多管齐下的工具包可以减轻该地区黄曲霉毒素的暴露,这将有助于减轻健康负担。
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引用次数: 0
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Toxins
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