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Understanding the regulatory landscape of protein phosphatase 2A (PP2A): Pharmacological modulators and potential therapeutics 了解蛋白磷酸酶2A (PP2A)的调控景观:药理学调节剂和潜在的治疗方法。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-27 DOI: 10.1016/j.pharmthera.2025.108834
David A. Neale , Jonathan C. Morris , Nicole M. Verrills , Alaina J. Ammit
Protein phosphatase 2A (PP2A) is a ubiquitously expressed serine/threonine phosphatase with a diverse and integral role in cellular signalling pathways. Consequently, its dysfunction is frequently observed in disease states such as cancer, inflammation and Alzheimer’s disease. A growing understanding of both PP2A and its endogenous regulatory proteins has presented numerous targets for therapeutic intervention. This provides important context for the dynamic control and dysregulation of PP2A function in disease states. Understanding the intricate regulation of PP2A signalling in disease has resulted in the development of novel pharmacological agents aimed at restoring cellular homeostasis. Herein we review the structure and function of PP2A together with pharmacological modulators, both endogenous (proteins) and exogenous (small molecules and peptides), with relevance to targeting PP2A as a future pharmacotherapeutic strategy.
蛋白磷酸酶2A (PP2A)是一种普遍表达的丝氨酸/苏氨酸磷酸酶,在细胞信号通路中具有多种和完整的作用。因此,在癌症、炎症和阿尔茨海默病等疾病状态中经常观察到其功能障碍。对PP2A及其内源性调节蛋白的了解不断增加,为治疗干预提供了许多靶点。这为疾病状态下PP2A功能的动态控制和失调提供了重要的背景。了解疾病中PP2A信号传导的复杂调控导致了旨在恢复细胞稳态的新型药理学药物的发展。在此,我们回顾了PP2A的结构和功能以及内源性(蛋白质)和外源性(小分子和肽)的药物调节剂,并将其作为未来的药物治疗策略。
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引用次数: 0
Receptor dimers and biased ligands: Novel strategies for targeting G protein-coupled receptors 受体二聚体和偏置配体:靶向G蛋白偶联受体的新策略。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-27 DOI: 10.1016/j.pharmthera.2025.108829
Wenkai Liu , Dexiu Wang , Luoqi Wang , Shujuan Hu , Yunlu Jiang , Yixiang Wang , Xin Cai , Jing Chen
G protein-coupled receptors (GPCRs) are the largest superfamily of membrane receptors. They regulate physiological and pathological processes such as metabolic homeostasis, cell proliferation and differentiation, and the immune response, and are one of the most important classes of drug targets, being targeted by 30–40 % of marketed drugs. A growing number of studies continue to reveal the complexity of GPCRs, especially their ability to interact with each other to form higher-order structures such as homodimers and heterodimers, which have different functions than monomers, and are involved in disease development and progression. The existence of GPCR homodimers and heterodimers is opening up new directions in drug discovery and development to harness their therapeutic potential. Particularly striking is the ability of GPCR dimers to trigger unique biased signalling pathways, which exquisitely balance the relationship between therapeutic effects and side effects. By suppressing adverse reactions and enhancing beneficial drug effects, GPCR dimers provide an unprecedented opportunity to minimise side effects, maximise therapeutic efficacy and enhance safety. This review aims to highlight the latest research advances in GPCR dimerization and GPCR-biased signalling, focusing on the development of dimer-targeting and biased ligands as innovative drugs that will likely provide new strategies for treating GPCR-related diseases as well as a better understanding of drug design for compounds that target GPCRs. GPCRs will play an increasingly important role in precision medicine and personalised therapy, leading us towards a safer, more efficient and smarter pharmaceutical future.
G蛋白偶联受体(gpcr)是膜受体中最大的超家族。它们调节生理和病理过程,如代谢稳态、细胞增殖和分化以及免疫反应,是最重要的药物靶点之一,是30- 40% %上市药物的靶点。越来越多的研究不断揭示gpcr的复杂性,特别是它们相互作用形成高阶结构的能力,如同型二聚体和异源二聚体,它们具有不同于单体的功能,参与疾病的发生和进展。GPCR同源二聚体和异源二聚体的存在为利用其治疗潜力的药物发现和开发开辟了新的方向。特别引人注目的是GPCR二聚体触发独特的偏倚信号通路的能力,它巧妙地平衡了治疗效果和副作用之间的关系。通过抑制不良反应和增强有益的药物作用,GPCR二聚体提供了一个前所未有的机会,以尽量减少副作用,最大限度地提高治疗效果和提高安全性。本文综述了GPCR二聚体和GPCR偏态信号的最新研究进展,重点介绍了二聚体靶向和偏态配体作为创新药物的发展,这些药物可能为治疗GPCR相关疾病提供新的策略,以及更好地理解靶向GPCR化合物的药物设计。gpcr将在精准医疗和个性化治疗中发挥越来越重要的作用,引领我们走向更安全、更高效、更智能的制药未来。
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引用次数: 0
Inflammatory bowel disease and neuropsychiatric disorders: Mechanisms and emerging therapeutics targeting the microbiota-gut-brain axis 炎症性肠病和神经精神疾病:针对微生物-肠-脑轴的机制和新兴治疗方法。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-27 DOI: 10.1016/j.pharmthera.2025.108831
Giulia Petracco , Isabella Faimann , Florian Reichmann
Crohn's disease (CD) and ulcerative colitis (UC) are the two major entities of inflammatory bowel disease (IBD). These disorders are known for their relapsing disease course and severe gastrointestinal symptoms including pain, diarrhoea and bloody stool. Accumulating evidence suggests that IBD is not only restricted to the gastrointestinal tract and that disease processes are able to reach distant organs including the brain. In fact, up to 35 % of IBD patients also suffer from neuropsychiatric disorders such as generalized anxiety disorder and major depressive disorder. Emerging research in this area indicates that in many cases these neuropsychiatric disorders are a secondary condition as a consequence of the disturbed communication between the gut and the brain via the microbiota-gut-brain axis. In this review, we summarise the current knowledge on IBD-associated neuropsychiatric disorders. We examine the role of different pathways of the microbiota-gut-brain axis in the development of CNS disorders highlighting altered neural, immunological, humoral and microbial communication. Finally, we discuss emerging therapies targeting the microbiota-gut-brain axis to alleviate IBD and neuropsychiatric symptoms including faecal microbiota transplantation, psychobiotics, microbial metabolites and vagus nerve stimulation.
克罗恩病(CD)和溃疡性结肠炎(UC)是炎症性肠病(IBD)的两个主要实体。这些疾病以其反复发作的病程和严重的胃肠道症状(包括疼痛、腹泻和便血)而闻名。越来越多的证据表明,IBD不仅局限于胃肠道,而且疾病过程能够到达包括大脑在内的远处器官。事实上,高达35% %的IBD患者还患有神经精神障碍,如广泛性焦虑症和重度抑郁症。这一领域的新兴研究表明,在许多情况下,这些神经精神疾病是肠道和大脑之间通过微生物-肠道-大脑轴的交流受到干扰的继发性疾病。在这篇综述中,我们总结了目前关于ibd相关神经精神疾病的知识。我们研究了微生物-肠-脑轴的不同途径在中枢神经系统疾病发展中的作用,突出了神经、免疫、体液和微生物通讯的改变。最后,我们讨论了针对微生物-肠-脑轴的新兴治疗方法,以减轻IBD和神经精神症状,包括粪便微生物群移植,精神微生物,微生物代谢物和迷走神经刺激。
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引用次数: 0
Improvement of chronic metabolic inflammation and regulation of gut homeostasis: Tea as a potential therapy 改善慢性代谢性炎症和调节肠道稳态:茶是一种潜在的治疗方法。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-26 DOI: 10.1016/j.pharmthera.2025.108828
Shiyi Yu , Xuan Zhu , Xiayu Zhao , Yan Li , Xinghe Niu , Yinghua Chen , Jian Ying
Chronic metabolic inflammation is a common mechanism linked to the development of metabolic disorders such as obesity, diabetes, and cardiovascular disease (CVD). Chronic metabolic inflammation often related to alterations in gut homeostasis, and pathological processes involve the activation of endotoxin receptors, metabolic reprogramming, mitochondrial dysfunction, and disruption of intestinal nuclear receptor activity. Recent investigations into homeostasis and chronic metabolic inflammation have revealed a novel mechanism which is characterized by a timing interaction involving multiple components and targets. This article explores the positive impact of tea consumption on metabolic health of populations, with a special focus on the improvement of inflammatory indicators and the regulation of gut microbiota. Studies showed that tea consumption is related to the enrichment of gut microbiota. The relative proportion of Firmicutes/Bacteroidetes (F/B) is altered, while the abundance of Lactobacillus, Bifidobacterium, and A. muciniphila increased significantly in most of the studies. Thus, tea consumption could provide potential protection from the development of chronic diseases by improving gut homeostasis and reducing chronic metabolic inflammation. The direct impact of tea on intestinal homeostasis primarily targets lipopolysaccharide (LPS)-related pathways. This includes reducing the synthesis of intestinal LPS, inhibiting LPS translocation, and preventing the binding of LPS to TLR4 receptors to block downstream inflammatory pathways. The TLR4/MyD88/NF-κB p65 pathway is crucial for anti-metaflammatory responses. The antioxidant properties of tea are linked to enhancing mitochondrial function and mitigating mitochondria-related inflammation by eliminating free radicals, inhibiting NLRP3 inflammasomes, and modulating Nrf2/ARE activity. Tea also contributes to safeguarding the intestinal barrier through various mechanisms, such as promoting the synthesis of short-chain fatty acids in the intestine, activating intestinal aryl hydrocarbon receptor (AhR) and farnesoid X receptor (FXR), and improving enteritis. Functional components that improve chronic metabolic inflammation include tea polyphenols, tea pigments, TPS, etc. Tea metabolites such as 4-Hydroxyphenylacetic acid and 3,4-Dihydroxyflavan derivatives, etc., also contribute to anti-chronic metabolic inflammation effects of tea consumption. The raw materials and processing technologies affect the functional component compositions of tea; therefore, consuming different types of tea may result in varying action characteristics and mechanisms. However, there is currently limited elaboration on this aspect. Future research should conduct in-depth studies on the mechanism of tea and its functional components in improving chronic metabolic inflammation. Researchers should pay attention to whether there are interactions between tea and other foods or drugs, explor
慢性代谢性炎症是与肥胖、糖尿病和心血管疾病(CVD)等代谢性疾病发展相关的常见机制。慢性代谢性炎症通常与肠道稳态的改变有关,病理过程涉及内毒素受体的激活、代谢重编程、线粒体功能障碍以及肠道核受体活性的破坏。最近对平衡和慢性代谢性炎症的研究揭示了一种新的机制,其特点是涉及多种成分和靶点的定时相互作用。本文探讨了饮茶对人群代谢健康的积极影响,特别关注炎症指标的改善和肠道微生物群的调节。研究表明,饮茶与肠道微生物群的丰富有关。在大多数研究中,固着菌/类杆菌(F/B)的相对比例发生了变化,而乳酸杆菌、双歧杆菌和粘液嗜酸乳杆菌的数量则显著增加。因此,通过改善肠道平衡和减少慢性代谢炎症,饮茶可以为慢性疾病的发生提供潜在的保护。茶对肠道稳态的直接影响主要针对脂多糖(LPS)相关途径。这包括减少肠道 LPS 的合成、抑制 LPS 转位、阻止 LPS 与 TLR4 受体结合以阻断下游炎症途径。TLR4/MyD88/NF-κB p65 通路对于抗甲型肝炎反应至关重要。茶叶的抗氧化特性通过消除自由基、抑制 NLRP3 炎症小体和调节 Nrf2/ARE 活性,与增强线粒体功能和减轻线粒体相关炎症有关。茶叶还能通过各种机制保护肠道屏障,如促进肠道中短链脂肪酸的合成、激活肠道芳基烃受体(AhR)和法呢类 X 受体(FXR)以及改善肠炎。改善慢性代谢性炎症的功能成分包括茶多酚、茶色素、TPS 等。茶叶代谢产物,如 4-羟基苯乙酸和 3,4-二羟基黄烷衍生物等,也有助于茶叶的抗慢性代谢性炎症作用。原料和加工技术会影响茶叶的功能成分组成,因此,饮用不同类型的茶可能会产生不同的作用特征和机制。然而,目前对这方面的阐述还很有限。未来的研究应深入探讨茶叶及其功能成分在改善慢性代谢性炎症方面的作用机制。研究人员应关注茶与其他食物或药物之间是否存在相互作用,探讨安全有效的用法和用量,并调查饮茶人群中是否存在个体差异导致茶干预的不同效果。最终,饮茶可以成为调节肠道平衡、抗慢性代谢炎症反应、促进代谢健康的通用疗法。
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引用次数: 0
Neuroimmune modulators derived from natural products: Mechanisms and potential therapies 天然产物衍生的神经免疫调节剂:机制和潜在疗法。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-25 DOI: 10.1016/j.pharmthera.2025.108830
Wan-Di Feng, Dong-Ni Liu, Yu-Fu Shang, Wen-Fang Zhang, Shuang Xu, Dan-Hong Feng, Yue-Hua Wang
Neuroimmunology is a multidisciplinary field that investigates the interactions between the nervous and immune systems. Neuroimmune interactions persist throughout the entire lifespan, and their dysregulation can lead to the onset and development of multiple diseases. Despite significant progress over the past decades in elucidating the interaction between neuroscience and immunology, the exact mechanism underlying neuroimmune crosstalk has not yet been fully elucidated. In recent years, natural products have emerged as a promising avenue for the therapeutic implications of neuroimmune diseases. Naturally derived anti-neuroimmune disease agents, such as polyphenols, flavonoids, alkaloids, and saponins, have been extensively studied for their potential neuroimmune modulatory effects. This comprehensive review delves into the specific molecular mechanisms of bidirectional neuro-immune interactions, with particular emphasis on the role of neuro-immune units. The review synthesizes a substantial body of evidence from in vitro and in vivo experiments as well as clinical studies, highlighting the therapeutic potential of various natural products in intervening in neuroimmune disorders.
神经免疫学是研究神经系统与免疫系统相互作用的多学科交叉领域。神经免疫相互作用持续整个生命周期,其失调可导致多种疾病的发生和发展。尽管过去几十年来在阐明神经科学和免疫学之间的相互作用方面取得了重大进展,但神经免疫串扰的确切机制尚未完全阐明。近年来,天然产物已成为神经免疫疾病治疗意义的有前途的途径。天然衍生的抗神经免疫疾病药物,如多酚、类黄酮、生物碱和皂苷,因其潜在的神经免疫调节作用而被广泛研究。这篇全面的综述深入探讨了双向神经免疫相互作用的特定分子机制,特别强调了神经免疫单位的作用。这篇综述综合了大量来自体外和体内实验以及临床研究的证据,强调了各种天然产物在干预神经免疫疾病方面的治疗潜力。
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引用次数: 0
Recent advances in target identification technology of natural products 天然产物目标识别技术研究进展
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-25 DOI: 10.1016/j.pharmthera.2025.108833
Ting-Ting Liu , Ke-Wu Zeng
Natural products, characterized by their structural diversity, broad spectrum of biological activities, and safe yet effective therapeutic potential, have become pivotal resources in drug research and development. However, the target proteins of many natural products remain unidentified, a significant challenge that impedes their development into viable drug candidates. Therefore, the target identification is crucial for elucidating the pharmacological mechanisms of natural products and facilitating their therapeutic applications. In this review, we present a comprehensive overview of recent advancements in methodologies for target identification of natural products. Additionally, we predict future developments in new technologies for target discovery. Collectively, this review establishes a methodological framework for uncovering the cellular targets and pharmacological mechanisms of natural products, thereby advancing the development of innovative natural product-based drugs.
天然产物具有结构多样、生物活性谱广、安全有效的治疗潜力等特点,已成为药物研究和开发的关键资源。然而,许多天然产物的靶蛋白仍然是未知的,这是一个重大的挑战,阻碍了它们发展成为可行的候选药物。因此,靶点鉴定对于阐明天然产物的药理机制和促进其治疗应用至关重要。在这篇综述中,我们全面概述了天然产物靶标鉴定方法的最新进展。此外,我们预测了目标发现新技术的未来发展。总之,本综述为揭示天然产物的细胞靶点和药理机制建立了一个方法学框架,从而促进了基于天然产物的创新药物的开发。
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引用次数: 0
The anti-inflammatory effects of saponins from natural herbs 天然草药皂苷的抗炎作用。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-25 DOI: 10.1016/j.pharmthera.2025.108827
Qinpin Zheng , Tian Wang , Sensen Wang , Zhuoxi Chen , Xue Jia , Hui Yang , Huijin Chen , Xin Sun , Kejun Wang , Leiming Zhang , Fenghua Fu
Inflammation is a protective mechanism that also starts the healing process. However, inflammatory reaction may cause severe tissue damage. The increased influx of phagocytic leukocytes may produce excessive amount of reactive oxygen species, which leads to additional cell injury. Inflammatory response activates the leukocytes and thus induces tissue damage and prolongs inflammation. The inflammation-induced activation of the complement system may also contribute to cell injury. Non-steroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids are chief agents for treating inflammation associated with the diseases. However, the unwanted side effects of NSAIDs (e.g., gastrointestinal disturbances, skin reactions, adverse renal effects, cardiovascular side effects) and glucocorticoids (e.g., suppression of immune system, Cushing's syndrome, osteoporosis, hyperglycemia) limit their use in patients. Natural herbs are important sources of anti-inflammatory drugs. The ingredients extracted from natural herbs display anti-inflammatory effects to work through multiple pathways with lower risk of adverse reaction. At present, the main anti-inflammatory natural agents include saponins, flavonoids, alkaloids, polysaccharides, and so on. The present article will review the anti-inflammatory effects of saponins including escin, ginsenosides, glycyrrhizin, astragaloside, Panax notoginseng saponins, saikosaponin, platycodin, timosaponin, ophiopogonin D, dioscin, senegenin.
炎症是一种保护机制,它也启动了愈合过程。然而,炎症反应可能导致严重的组织损伤。吞噬白细胞的增加可能产生过多的活性氧,从而导致额外的细胞损伤。炎症反应激活白细胞,从而引起组织损伤,延长炎症。炎症诱导的补体系统激活也可能导致细胞损伤。非甾体抗炎药(NSAIDs)和糖皮质激素是治疗与疾病相关的炎症的主要药物。然而,非甾体抗炎药的不良副作用(如胃肠道紊乱、皮肤反应、肾脏不良反应、心血管副作用)和糖皮质激素(如免疫系统抑制、库欣综合征、骨质疏松症、高血糖症)限制了它们在患者中的应用。天然草药是消炎药的重要来源。从天然草药中提取的成分具有多种抗炎作用途径,不良反应风险较低。目前,主要的抗炎天然药物有皂苷、黄酮类、生物碱、多糖等。本文综述了estin、人参皂苷、甘草酸苷、黄芪甲苷、三七皂苷、柴胡皂苷、桔梗皂苷、天牛皂苷、麦冬皂苷D、薯蓣皂苷、人参皂苷等皂苷类化合物的抗炎作用。
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引用次数: 0
The role of macrophages in asthma-related fibrosis and remodelling 巨噬细胞在哮喘相关纤维化和重构中的作用。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-19 DOI: 10.1016/j.pharmthera.2025.108820
Xin Yuan Yang , Fuguang Li , Guojun Zhang , Paul S. Foster , Ming Yang
Airway remodelling significantly contributes to the progressive loss of lung function and heightened symptom severity in chronic asthma. Additionally, it often persists and demonstrates reduced responsiveness to the mainstay treatments. The excessive deposition of collagen and extracellular matrix proteins leads to subepithelial fibrosis and airway remodelling, resulting in increased stiffness and decreased elasticity in the airway. Studies have emphasized the crucial role of subepithelial fibrosis in the pathogenesis of asthma. Fibrotic processes eventually cause airway narrowing, reduced lung function, and exacerbation of asthma symptoms. Macrophages play a crucial role in this process by producing pro-fibrotic cytokines, growth factors, and enzymes such as matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). Additionally, identification of novel genetic markers has provided evidence for a strong genetic component in fibrosis within macrophage regulated fibrosis. Although macrophages contribute to the progression of airway remodelling and subepithelial fibrosis, interventions targeting macrophage-driven fibrotic changes have not yet been developed. This review synthesizes research on the intricate pathways through which macrophages contribute to subepithelial fibrosis in chronic asthma and its' pathological features. Understanding the interplay between macrophages, fibrosis, and asthma pathogenesis is essential for developing effective therapeutic strategies to manage severe asthma and improve patient outcomes.
气道重塑对慢性哮喘患者肺功能的进行性丧失和症状严重程度的提高有重要作用。此外,它经常持续存在,并表现出对主要治疗的反应性降低。胶原蛋白和细胞外基质蛋白的过度沉积导致上皮下纤维化和气道重塑,导致气道刚度增加和弹性降低。研究强调了上皮下纤维化在哮喘发病机制中的关键作用。纤维化过程最终导致气道狭窄、肺功能降低和哮喘症状加重。巨噬细胞通过产生促纤维化细胞因子、生长因子和基质金属蛋白酶(MMPs)和金属蛋白酶组织抑制剂(TIMPs)等酶在这一过程中起着至关重要的作用。此外,新的遗传标记的鉴定为巨噬细胞调节纤维化中纤维化的强大遗传成分提供了证据。虽然巨噬细胞有助于气道重塑和上皮下纤维化的进展,但针对巨噬细胞驱动的纤维化改变的干预措施尚未开发。本文综述了巨噬细胞参与慢性哮喘上皮下纤维化的复杂途径及其病理特征。了解巨噬细胞、纤维化和哮喘发病机制之间的相互作用对于制定有效的治疗策略来管理严重哮喘和改善患者预后至关重要。
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引用次数: 0
The (neuro)inflammatory system in anxiety disorders and PTSD: Potential treatment targets 焦虑障碍和创伤后应激障碍的(神经)炎症系统:潜在的治疗目标。
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-19 DOI: 10.1016/j.pharmthera.2025.108825
Anupam Sah, Nicolas Singewald
Targeting the immune system has recently garnered attention in the treatment of stress- associated psychiatric disorders resistant to existing pharmacotherapeutics. While such approaches have been studied in considerable detail in depression, the role of (neuro)inflammation in anxiety-related disorders, or in anxiety as an important transdiagnostic symptom, is much less clear. In this review we first critically review clinical and in part preclinical evidence of central and peripheral immune dysregulation in anxiety disorders and post-traumatic stress disorder (PTSD) and briefly discuss proposed mechanisms of how inflammation can affect anxiety-related symptoms. We then give an overview of existing and potential future targets in inflammation-associated signal transduction pathways and discuss effects of different immune-modulatory drugs in anxiety-related disorders. Finally, we discuss key gaps in current clinical trials such as the lack of prospective studies involving anxiety patient stratification strategies based on inflammatory biomarkers. Overall, although evidence is rather limited so far, there is data to indicate that increased (neuro)inflammation is present in subgroups of anxiety disorder patients. Although exact identification of such immune subtypes of anxiety disorders and PTSD is still challenging, these patients will likely particularly benefit from therapeutic targeting of aspects of the inflammatory system. Different anti-inflammatory treatment approaches (microglia-directed treatments, pro-inflammatory cytokine inhibitors, COX-inhibitors, phytochemicals and a number of novel anti-inflammatory agents) have indeed shown some efficacy even in non-stratified anxiety patient groups and appear promising as novel alternative or complimentary therapeutic options in specific (“inflammatory”) subtypes of anxiety disorder and PTSD patients.
以免疫系统为靶点,最近在治疗对现有药物治疗产生耐药性的压力相关精神疾病方面引起了人们的注意。虽然这些方法已经在抑郁症中进行了相当详细的研究,但(神经)炎症在焦虑相关疾病中的作用,或者作为重要的跨诊断症状的焦虑中的作用,还不太清楚。在这篇综述中,我们首先回顾了焦虑障碍和创伤后应激障碍(PTSD)中中枢和外周免疫失调的临床前和临床证据,并简要讨论了炎症如何影响焦虑相关症状的拟议机制。然后,我们概述了炎症相关信号转导途径中现有和潜在的未来靶点,并讨论了不同免疫调节药物在焦虑相关疾病中的作用。最后,我们讨论了当前临床试验中的关键空白,例如缺乏基于炎症生物标志物的焦虑患者分层策略的前瞻性研究。总的来说,尽管到目前为止证据相当有限,但有数据表明,焦虑障碍患者亚组中存在(神经)炎症增加。尽管对焦虑症和创伤后应激障碍的这种免疫亚型的确切识别仍然具有挑战性,但这些患者可能会特别受益于炎症系统方面的治疗靶向。不同的抗炎治疗方法(小胶质细胞导向治疗,促炎细胞因子抑制剂,cox抑制剂,植物化学物质和一些新型抗炎剂)确实在非分层焦虑患者群体中显示出一定的疗效,并且在特定(“炎症”)亚型焦虑障碍和创伤后应激障碍患者中显示出新的替代或补充治疗选择的希望。
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引用次数: 0
GLP-1 receptor agonists, are we witnessing the emergence of a paradigm shift for neuro-cardio-metabolic disorders? GLP-1 受体激动剂,我们是否正在见证神经-心血管-代谢疾病治疗模式的转变?
IF 12 1区 医学 Q1 PHARMACOLOGY & PHARMACY Pub Date : 2025-02-19 DOI: 10.1016/j.pharmthera.2025.108824
Abdelilah Arredouani
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as groundbreaking therapeutic agents in managing a spectrum of metabolic disorders, demonstrating remarkable efficacy across multiple organ systems and disease states. These compounds are not only well-established in the treatment of type 2 diabetes (T2D) and obesity—conditions for which they have received widespread approval—but also exhibit promising potential in addressing cardiovascular disease (CVD) and Metabolic dysfunction-associated steatotic liver disease (MASLD).
Recent investigations have begun to illuminate the utility of GLP-1RAs in the management of type 1 diabetes (T1D), as well as neurodegenerative disorders such as Alzheimer's and Parkinson's disease and various behavioral disorders. A plethora of clinical trials have consistently validated the capacity of GLP-1RAs to improve glycemic control, promote weight loss, and mitigate cardiovascular risk factors in individuals with T2D and obesity. While their application in T1D remains limited due to safety concerns—particularly regarding the risks of hypoglycemia and hyperglycemic ketoacidosis—emerging data suggest that GLP-1RAs may offer hepatoprotective benefits, potentially reducing liver fat content and decelerating the progression of MASLD.
The neuroprotective attributes of GLP-1 RAs have garnered significant interest, with research indicating their potential to alleviate cognitive decline associated with neurodegenerative diseases. Furthermore, preliminary findings highlight the role of GLP-1 RAs in addressing behavioral disorders, emphasizing their extensive therapeutic promise.
This comprehensive review synthesizes the current evidence supporting the diverse therapeutic applications of GLP-1RAs, positioning them as “magic drug” therapies for metabolic and neurological disorders. As ongoing research continues to explore innovative applications and combinations of GLP-1RAs, the landscape of disease management in metabolic and neurological contexts is poised for transformative advancements. This review will also critically assess safety considerations and underscore the need for personalized treatment strategies to optimize patient outcomes in these complex and often comorbid conditions.
胰高血糖素样肽-1受体激动剂(GLP-1RAs)已成为管理一系列代谢紊乱的开创性治疗药物,在多器官系统和疾病状态中显示出显着的疗效。这些化合物不仅在治疗2型糖尿病(T2D)和肥胖方面得到了广泛的认可,而且在治疗心血管疾病(CVD)和代谢功能障碍相关的脂肪变性肝病(MASLD)方面也表现出了良好的潜力。最近的研究已经开始阐明GLP-1RAs在1型糖尿病(T1D)以及神经退行性疾病(如阿尔茨海默病和帕金森病)和各种行为障碍治疗中的效用。大量的临床试验一致证实了GLP-1RAs在t2dm和肥胖患者中改善血糖控制、促进体重减轻和减轻心血管危险因素的能力。虽然由于安全性考虑,GLP-1RAs在T1D中的应用仍然有限,尤其是低血糖和高血糖酮症酸中毒的风险,但新出现的数据表明,GLP-1RAs可能具有肝脏保护作用,可能降低肝脏脂肪含量,减缓MASLD的进展。GLP-1 RAs的神经保护特性引起了极大的兴趣,研究表明它们有可能减轻与神经退行性疾病相关的认知能力下降。此外,初步研究结果强调了GLP-1 RAs在解决行为障碍中的作用,强调了它们广泛的治疗前景。本综述综合了目前支持GLP-1RAs多种治疗应用的证据,将其定位为治疗代谢和神经疾病的“神奇药物”。随着正在进行的研究继续探索GLP-1RAs的创新应用和组合,代谢和神经环境下的疾病管理领域正准备取得变革性进展。本综述还将严格评估安全性考虑因素,并强调个性化治疗策略的必要性,以优化这些复杂且通常合并症的患者预后。
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