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Advancing cancer cachexia diagnosis with -omics technology and exercise as molecular medicine 利用-组学技术和运动分子医学推进癌症恶病质诊断
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2024.01.006
Stuart J. Hesketh

Muscle atrophy exacerbates disease outcomes and increases mortality, whereas the preservation of skeletal muscle mass and function play pivotal roles in ensuring long-term health and overall quality-of-life. Muscle atrophy represents a significant clinical challenge, involving the continued loss of muscle mass and strength, which frequently accompany the development of numerous types of cancer. Cancer cachexia is a highly prevalent multifactorial syndrome, and although cachexia is one of the main causes of cancer-related deaths, there are still no approved management strategies for the disease. The etiology of this condition is based on the upregulation of systemic inflammation factors and catabolic stimuli, resulting in the inhibition of protein synthesis and enhancement of protein degradation. Numerous necessary cellular processes are disrupted by cachectic pathology, which mediate intracellular signalling pathways resulting in the net loss of muscle and organelles. However, the exact underpinning molecular mechanisms of how these changes are orchestrated are incompletely understood. Much work is still required, but structured exercise has the capacity to counteract numerous detrimental effects linked to cancer cachexia. Primarily through the stimulation of muscle protein synthesis, enhancement of mitochondrial function, and the release of myokines. As a result, muscle mass and strength increase, leading to improved mobility, and quality-of-life. This review summarises existing knowledge of the complex molecular networks that regulate cancer cachexia and exercise, highlighting the molecular interplay between the two for potential therapeutic intervention. Finally, the utility of mass spectrometry-based proteomics is considered as a way of establishing early diagnostic biomarkers of cachectic patients.

肌肉萎缩会加重疾病的后果并增加死亡率,而保持骨骼肌的质量和功能对确保长期健康和整体生活质量起着关键作用。肌肉萎缩是一项重大的临床挑战,涉及肌肉质量和力量的持续丧失,常常伴随着多种癌症的发生。癌症恶病质是一种多因素综合征,发病率很高,虽然恶病质是癌症相关死亡的主要原因之一,但目前仍没有针对这种疾病的有效治疗策略。癌症恶病质的病因是全身炎症因子上调和分解代谢刺激,导致蛋白质合成受抑制,蛋白质降解增强。许多必要的细胞过程都会被恶病质破坏,从而介导细胞内信号通路,导致肌肉和细胞器的净损失。然而,人们对如何协调这些变化的分子机制还不完全了解。虽然仍有许多工作要做,但有组织的运动有能力抵消与癌症恶病质相关的许多不利影响。主要是通过刺激肌肉蛋白质合成、增强线粒体功能和释放肌动素。因此,肌肉质量和力量会增加,从而改善活动能力和生活质量。本综述总结了调控癌症恶病质和运动的复杂分子网络的现有知识,强调了两者之间的分子相互作用,以便进行潜在的治疗干预。最后,还考虑了基于质谱的蛋白质组学作为建立恶病质患者早期诊断生物标志物的一种方法的实用性。
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引用次数: 0
Influence of cardiorespiratory fitness and body composition on resting and post-exercise indices of vascular health in young adults 心肺功能和身体成分对青壮年静息和运动后血管健康指数的影响
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2023.11.003
Rian Q. Landers-Ramos , Kathleen Dondero , Ian Imery , Nicholas Reveille , Hannah A. Zabriskie , Devon A. Dobrosielski

Poor cardiorespiratory fitness may mediate vascular impairments at rest and following an acute bout of exercise in young healthy individuals. This study aimed to compare flow mediated dilation (FMD) and vascular augmentation index (AIx75) between young adults with low, moderate, and high levels of cardiorespiratory fitness before and after an acute bout of aerobic exercise. Forty-three participants (22 men; 21 women) between 18 and 29 years of age completed the study. Participants were classified into low, moderate, and high health-related cardiorespiratory fitness groups according to age- and sex-based relative maximal oxygen consumption (V˙O2 max) percentile rankings. FMD was performed using Doppler ultrasound and AIx75 was performed using pulse wave analysis at baseline and 60-min after a 30-min bout of treadmill running at 70% V˙O2 max. A significant interaction (p ​= ​0.047; ηp2 ​= ​0.142) was observed, with the moderate fitness group exhibiting a higher FMD post-exercise compared with baseline ([6.7% ​± ​3.1%] vs. [8.5% ​± ​2.8%], p ​= ​0.028; d ​= ​0.598). We found a significant main effect of group for AIx75 (p ​= ​0.023; ηp2 ​= ​0.168), with the high fitness group exhibiting lower AIx75 compared to low fitness group ([−10% ​± ​10%] vs. [2% ​± ​10%], respectively, p ​= ​0.019; g ​= ​1.07). This was eliminated after covarying for body fat percentage (p ​= ​0.489). Our findings suggest that resting FMD and AIx75 responses are not significantly influenced by cardiorespiratory fitness, but FMD recovery responses to exercise may be enhanced in individuals with moderate cardiorespiratory fitness levels.

心肺功能不佳可能会介导健康年轻人在休息时和急性运动后的血管损伤。本研究旨在比较急性有氧运动前后,心肺功能处于低、中、高水平的年轻人的血流介导扩张(FMD)和血管增强指数(AIx75)。43 名年龄在 18 至 29 岁之间的参与者(22 名男性;21 名女性)完成了这项研究。根据年龄和性别的相对最大耗氧量(V˙O2 max)百分位数排名,参与者被分为低、中和高健康相关心肺功能组。FMD 采用多普勒超声进行,AIx75 采用脉搏波分析进行,分别在基线和以 70% V˙O2 max 的速度在跑步机上跑步 30 分钟后的 60 分钟进行。观察到了明显的交互作用(p = 0.047;ηp2 = 0.142),与基线相比,中等体能组在运动后表现出更高的 FMD([6.7% ± 3.1%] vs. [8.5% ± 2.8%],p = 0.028;d = 0.598)。我们发现组别对 AIx75 有明显的主效应(p = 0.023;ηp2 = 0.168),高体能组的 AIx75 低于低体能组(分别为 [-10% ± 10%] vs. [2% ± 10%] ,p = 0.019;g = 1.07)。在与体脂百分比协方差(p = 0.489)后,这一差异被消除。我们的研究结果表明,静息 FMD 和 AIx75 反应并不受心肺功能的显著影响,但中等心肺功能水平的人对运动的 FMD 恢复反应可能会增强。
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引用次数: 0
Oxygen uptake during the last bouts of exercise incorporated into high-intensity intermittent cross-exercise exceeds the V˙ O2max of the same exercise mode 在高强度间歇性交叉运动的最后一轮运动中,摄氧量超过了相同运动模式下的В˙ O2max。
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2024.01.002
Yuzhong Xu, Xin Liu, Katsunori Tsuji, Takafumi Hamaoka, Izumi Tabata

Oxygen uptake (V˙ O2) was measured during a non-exhaustive high-intensity intermittent cross-exercise (HIICE) protocol consisting of four alternating bouts of 20 ​s running (R) and three bouts of bicycle exercise (BE) at ∼160% and ∼170% maximal oxygen uptake (V˙ O2max), respectively, with 10 ​s between-bout rests (sequence R-BE-R-BE-R-BE-R). The V˙ O2 during the last BE ([52.2 ​± ​5.0] mL·kg−1·min−1) was significantly higher than the V˙ O2max of the BE ([48.0 ​± ​5.4] mL·kg−1·min−1, n ​= ​30) and similar to that of running. For clarifying the underlying mechanisms, a corresponding HIICE-protocol with BE and arm cranking ergometer exercise (AC) was used (sequence AC-AC-BE-AC-BE-AC-AC-BE). In some experiments, thigh blood flow was occluded by a cuff around the upper thigh. Without occlusion, the V˙ O2 during the AC ([39.2 ​± ​7.1] mL·kg−1·min−1 [6th bout]) was significantly higher than the V˙ O2max of AC ([30.2 ​± ​4.4] mL·kg−1·min−1, n ​= ​7). With occlusion, the corresponding V˙ O2 ([29.8 ​± ​3.9] mL·kg−1·min−1) was reduced to that of the V˙ O2max of AC and significantly less than the V˙ O2 without occlusion. These findings suggest that during the last bouts of HIICE may exceed the of the specific exercise, probably because it is a summation of the V˙ O2 for the ongoing exercise plus excess post-oxygen consumption (EPOC) produced by the previous exercise with a higher V˙ O2max.

在非消耗性高强度间歇交叉运动(HIICE)方案中测量了摄氧量(V˙ O2),该方案包括四次交替进行的 20 秒跑步(R)和三次自行车运动(BE),最大摄氧量(V˙ O2max)分别为∼160%和∼170%,两次运动之间休息 10 秒(序列 R-BE-R-BE-R-BE-R)。最后一次BE时的V˙ O2([52.2 ± 5.0] mL-kg-1-min-1)明显高于BE时的V˙ O2max([48.0 ± 5.4] mL-kg-1-min-1,n = 30),与跑步时相似。为阐明其基本机制,采用了相应的 HIICE 方案,即 BE 和曲臂测力计运动(AC)(序列为 AC-AC-BE-AC-BE-AC-AC-BE)。在一些实验中,大腿血流被大腿上部的袖带阻断。在没有闭塞的情况下,交流时的 V ˙ O2([39.2 ± 7.1] mL-kg-1-min-1 [第 6 次])明显高于交流的 V ˙ O2max([30.2 ± 4.4] mL-kg-1-min-1,n = 7)。闭塞时,相应的 V˙ O2([29.8 ± 3.9] mL-kg-1-min-1)降低到 AC 的 V˙ O2max,明显低于未闭塞时的 V˙ O2。这些研究结果表明,在 HIICE 的最后一次运动中,V˙ O2max 可能会超过特定运动的 V˙O2max,这可能是因为它是正在进行的运动的 V˙ O2max 加上之前运动产生的过量氧消耗(EPOC)的总和,而之前运动的 V˙ O2max 较高。
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引用次数: 0
The effect of incline walking on lower extremity and trunk mechanics in older adults 倾斜行走对老年人下肢和躯干力学的影响
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2024.03.010
Seth Higgins, D. C. Dickin, D. Hankemeier, Meredith D. Wells, Henry Wang
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引用次数: 0
Exertional calf pain at kilometer five – Finding the cause 五公里处小腿剧烈疼痛--查找原因
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2023.10.001
Samuel A. Renier , Angela M. Voight , Emilee J. Trost , William O. Roberts

A 23-year-old professional distance runner with several years of exertional calf pain was diagnosed with a unique mixed type III and functional popliteal artery entrapment syndrome (PAES). Surgical reduction of the obstructing tissue allowed her to return to professional running. This case highlights the importance of including PAES in the differential for chronic intermittent lower extremity claudication and outlines the work-up required to diagnose this vascular obstruction in younger athletes.

一名 23 岁的专业长跑运动员数年来一直感到小腿疼痛难忍,经诊断,她患上了独特的混合型 III 和功能性腘动脉夹层综合征(PAES)。手术切除阻塞组织后,她得以重返职业赛场。本病例强调了将 PAES 纳入慢性间歇性下肢跛行鉴别诊断的重要性,并概述了诊断年轻运动员这种血管阻塞所需的工作检查。
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引用次数: 0
Exercise-induced hypoalgesia in chronic neck pain: A narrative review 运动引起的慢性颈痛低痛觉:叙述性综述
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2023.09.011
Fernando Rojas-Galleguillos , Cecilia Clark-Hormazábal , Eduardo Méndez-Fuentes , Francisco Guede-Rojas , Cristhian Mendoza , Andrés Riveros Valdés , Claudio Carvajal-Parodi

Chronic neck pain (CNP) is a worldwide health problem with several risk factors. One of the most widely used treatments for managing this condition is therapeutic exercise, which could generate a response called exercise-induced hypoalgesia (EIH). There is no consensus on the best exercise modality to induce hypoalgesia. Therefore, this review aims to analyze and synthesize the state-of-the-art about the hypoalgesic effect of exercise in subjects with CNP. We included articles on EIH and CNP in patients older than 18 years, with pain for more than three months, where the EIH response was measured. Articles that studied CNP associated with comorbidities or measured the response to treatments other than exercise were excluded. The studies reviewed reported variable results. Exercise in healthy subjects has been shown to reduce indicators of pain sensitivity; however, in people with chronic pain, the response is variable. Some investigations reported adverse effects with increased pain intensity and decreased pain sensitivity, others found no clinical response, and some even reported EIH with decreased pain and increased sensitivity. EIH is an identifiable, stimulable, and helpful therapeutic response in people with pain. More research is still needed on subjects with CNP to clarify the protocols and therapeutic variables that facilitate the EIH phenomenon. In addition, it is necessary to deepen the knowledge of the intrinsic and extrinsic factors that influence EIH in people with CNP.

慢性颈痛(CNP)是一个世界性的健康问题,存在多种风险因素。治疗性运动是控制这种病症最广泛使用的治疗方法之一,它可产生一种称为运动诱导低痛觉(EIH)的反应。关于诱导低痛觉的最佳运动方式,目前还没有达成共识。因此,本综述旨在分析和总结有关中枢神经痛患者运动减痛效应的最新研究成果。我们收录了有关 EIH 和 CNP 的文章,研究对象为 18 岁以上、疼痛持续时间超过三个月的患者,并对 EIH 反应进行了测量。排除了研究与合并症相关的 CNP 或测量对运动以外的治疗反应的文章。所审查的研究报告结果各不相同。对健康受试者进行锻炼可降低疼痛敏感性指标;但对慢性疼痛患者的反应则不尽相同。一些研究报告称,运动会增加疼痛强度和降低疼痛敏感性,从而产生不良反应;另一些研究则发现运动没有临床反应;还有一些研究甚至报告称,EIH 会降低疼痛和增加敏感性。对于疼痛患者来说,EIH 是一种可识别、可刺激且有益的治疗反应。仍需对患有中枢神经痛的受试者进行更多研究,以明确促进 EIH 现象的方案和治疗变量。此外,有必要加深对影响 CNP 患者 EIH 的内在和外在因素的了解。
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引用次数: 0
Exploring urban-rural differences in 24-h movement behaviours among tunisian preschoolers: Insights from the SUNRISE study 探索突尼斯学龄前儿童 24 小时运动行为的城乡差异:阳光研究的启示
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2024.03.004
M. Ltifi, Olfa Turki, Ghaith Ben-Bouzaiene, K. Chong, Anthony D. Okely, M. Chelly
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引用次数: 0
Influence of puberty on high intensity exercise induced skeletal muscle damage and inflammatory response in sedentary boys 青春期对久坐男孩高强度运动引起的骨骼肌损伤和炎症反应的影响
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2024.03.002
Biswajit Chaki, Sangita Pal, Sreya Chattopadhyay, Amit Bandyopadhyay
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引用次数: 0
Reasons and promotion strategies of physical activity constraints in obese/overweight children and adolescents 肥胖/超重儿童和青少年体育锻炼受限的原因及促进策略
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2023.10.004
Jiangxi Chen, Yinmengke Bai, Weiguang Ni

To explore the reasons for low levels of physical activity in obese/overweight children and adolescents and to propose appropriate strategies to promote their physical activity (PA). This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by searching and analyzing the literature of studies related to physical activity in obese/overweight children and adolescents published between January 2003 and January 2023 in Web of Science, Scopus, and PubMed databases. A total of 31 relevant studies were included for analysis, of which 16 were quantitative and 15 qualitative. According to these studies, the PA of obese/overweight children and adolescents is mainly constrained by negative factors: Individual, interpersonal, and environmental. Among these factors, low levels of individual motivation and psychological sensitivity and vulnerability, lack of family support, negative social feedback, insufficient protection from government policies, and inadequate support from the built environment are the main reasons that constrain their PA. The promotion of PA in obese/overweight children and adolescents, who are subject to more constraints at all levels, requires a system of security that involves the government, the community, the school, and the family to address the problems they encounter and enhance the sustainability of engagement in PA.

探讨肥胖/超重儿童和青少年体育锻炼水平低的原因,并提出促进其体育锻炼(PA)的适当策略。本综述遵循系统综述和荟萃分析首选报告项目(PRISMA)指南,检索并分析了 2003 年 1 月至 2023 年 1 月期间在 Web of Science、Scopus 和 PubMed 数据库中发表的与肥胖/超重儿童和青少年体育活动相关的研究文献。共纳入 31 项相关研究进行分析,其中 16 项为定量研究,15 项为定性研究。根据这些研究,肥胖/超重儿童和青少年的 PA 主要受到负面因素的制约:个人因素、人际因素和环境因素。在这些因素中,个人动力不足、心理敏感和脆弱程度低、缺乏家庭支持、社会负面反馈、政府政策保护不足、建筑环境支持不足是制约他们进行体育锻炼的主要原因。肥胖/超重儿童和青少年在各个层面受到的制约因素较多,要促进他们的体育锻炼,就需要建立一个由政府、社区、学校和家庭共同参与的保障体系,以解决他们遇到的问题,提高参与体育锻炼的可持续性。
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引用次数: 0
Injuries and illness of athletes at the Tokyo 2020 Olympic and Paralympic summer games visiting outside facilities 2020 年东京奥运会和夏季残奥会运动员在外部设施受伤和生病的情况
Q1 Medicine Pub Date : 2024-03-01 DOI: 10.1016/j.smhs.2024.01.003
Shuji Sakanashi , Hideharu Tanaka , Hiroyuki Yokota , Yasuhiro Otomo , Tomohiko Masuno , Kousuke Nakano , Junichi Inoue , Manabu Sugita , Takahiko Tokunaga , Nagisa Kato , Tomoya Kinoshi , Hironori Inoue , Hiroto Numata , Koshi Nakagawa , Ryo Sagisaka , Shota Tanaka , Tetsuya Miyamoto , Takao Akama

This study aimed to identify the reasons for transferring athletes to local medical facilities during the Olympic and Paralympic Games. Data on 567 injuries and other illnesses of athletes treated at the on-site clinics were collected from the Tokyo 2020 Organizing Committee. Of these, 84 athletes who required outpatient care during the Games were registered for this survey. During the Olympic and Paralympic Games, 66 (8.3/1 000) and 18 (7.2/1 000) athletes, respectively, consulted external medical facilities. In the Olympic Games, the reasons for these visits included 48 cases (72.7%) of injuries, 13 (19.7%) cases of illnesses, and 5 (7.6%) cases of heat stroke illness (HSI). Of these patients, 56 (84.9%) were treated as outpatients and 10 (15.1%) were hospitalized, while three of these patients required hospitalization for > 7 days. On the other hand, in the Paralympics Games, there were 7 (38.8%) cases of injuries, 9 (50.0%) other illnesses, 1 (5.6%) case of HSI, and 1 (5.6%) other cases, of which 11 (61.1%) were treated as outpatients and 7 (38.9%) were hospitalized, but none was hospitalized for > 7 days. Injuries accounted for 70% of the total cases at the 2021 Olympic Games, but only three (0.05%) were severe cases that required hospitalization for more than 1 week. In contrast, in the Paralympic Games, other illnesses accounted for approximately half of the total cases. This study provides details on the extent of injuries and other illnesses that were transferred to outside facilities, which has not been documented in previous games.

本研究旨在找出奥运会和残奥会期间运动员转往当地医疗机构的原因。研究人员从东京 2020 奥组委收集了 567 名运动员在现场诊所治疗的受伤和其他疾病的数据。其中,84 名在奥运会期间需要门诊治疗的运动员登记参加了此次调查。在奥运会和残奥会期间,分别有 66 名(8.3/1000)和 18 名(7.2/1000)运动员到外部医疗机构就诊。在奥运会期间,就诊原因包括 48 例(72.7%)受伤、13 例(19.7%)生病和 5 例(7.6%)中暑。在这些患者中,56 人(84.9%)接受了门诊治疗,10 人(15.1%)住院治疗,其中 3 人需要住院 7 天。另一方面,在残奥会期间,共有 7 例(38.8%)受伤病例、9 例(50.0%)其他疾病病例、1 例(5.6%)HSI 病例和 1 例(5.6%)其他病例,其中 11 例(61.1%)接受了门诊治疗,7 例(38.9%)住院治疗,但无一人住院超过 7 天。在 2021 年奥运会上,受伤病例占总病例的 70%,但只有 3 例(0.05%)是需要住院 1 周以上的重症病例。相比之下,在残奥会上,其他疾病约占总病例的一半。本研究提供了转到外部设施的受伤和其他疾病的详细情况,这在以往的奥运会中没有记录。
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引用次数: 0
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Sports Medicine and Health Science
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