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Pharmacological Advances in Incretin-Based Polyagonism: What We Know and What We Don't. 基于胰岛素的多拮抗剂的药理研究进展--我们知道什么,我们不知道什么t.
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-14 DOI: 10.1152/physiol.00032.2023
Aaron Novikoff, Timo D Müller

The prevalence of obesity continues to rise in both adolescents and adults, in parallel obesity is strongly associated with the increased incidence of type 2 diabetes, heart failure, certain types of cancer, and all-cause mortality. In relation to obesity, many pharmacological approaches of the past have tried and failed to combat the rising obesity epidemic, particularly due to insufficient efficacy or unacceptable side effects. However, while the history of antiobesity medication is plagued by failures and disappointments, we have witnessed over the last 10 years substantial progress, particularly in regard to biochemically optimized agonists at the receptor for glucagon-like peptide-1 (GLP-1R) and unimolecular coagonists at the receptors for GLP-1 and the glucose-dependent insulinotropic polypeptide (GIP). Although the GIP receptor:GLP-1R coagonists are being heralded as premier pharmacological tools for the treatment of obesity and diabetes, uncertainty remains as to why these drugs testify superiority over best-in-class GLP-1R monoagonists. Particularly with regard to GIP, there remains great uncertainty if and how GIP acts on systems metabolism and if the GIP system should be activated or inhibited to improve metabolic outcome in adjunct to GLP-1R agonism. In this review, we summarize recent advances in GLP-1- and GIP-based pharmacology and discuss recent findings and open questions related to how the GIP system affects systemic energy and glucose metabolism.

肥胖症在青少年和成年人中的发病率持续上升,与此同时,肥胖症与 2 型糖尿病(T2D)、心力衰竭、某些类型的癌症以及全因死亡率的增加密切相关。针对肥胖症,过去有许多药物治疗方法都曾尝试过,但都以失败告终,特别是由于疗效不佳或无法接受的副作用。不过,虽然抗肥胖药物的历史充满了失败和失望,但在过去 10 年里,我们看到了实质性的进展,特别是在胰高血糖素样肽-1(GLP-1)受体的生化优化激动剂以及 GLP-1 和葡萄糖依赖性促胰岛素多肽(GIP)受体的单分子协同激动剂方面。虽然 GIPR:GLP-1R 联合拮抗剂被誉为治疗肥胖症和糖尿病的主要药理工具,但这些药物为何优于同类最佳的 GLP-1R 单拮抗剂,这一点仍不确定。特别是在 GIP 方面,对于 GIP 是否以及如何作用于系统代谢,以及在 GLP-1R 激动剂的辅助下是否应该激活或抑制 GIP 系统以改善代谢结果,仍然存在很大的不确定性。在这篇综述中,我们总结了 GLP-1 和 GIP 药理学的最新进展,并讨论了与 GIP 系统如何影响全身能量和葡萄糖代谢有关的最新发现和未决问题。
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引用次数: 0
IUPS: Physiology on a Global Scale. IUPS:全球范围的生理学。
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-05-01 DOI: 10.1152/physiol.00005.2024
Susan Wray
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引用次数: 0
Emerging Pathophysiological Roles of Ketone Bodies. 新出现的酮体的病理生理作用。
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-05-01 Epub Date: 2024-01-23 DOI: 10.1152/physiol.00031.2023
Hiroaki Tsuruta, Kosuke Yamahara, Mako Yasuda-Yamahara, Shinji Kume

The discovery of insulin approximately a century ago greatly improved the management of diabetes, including many of its life-threatening acute complications like ketoacidosis. This breakthrough saved many lives and extended the healthy lifespan of many patients with diabetes. However, there is still a negative perception of ketone bodies stemming from ketoacidosis. Originally, ketone bodies were thought of as a vital source of energy during fasting and exercise. Furthermore, in recent years, research on calorie restriction and its potential impact on extending healthy lifespans, as well as studies on ketone bodies, have gradually led to a reevaluation of the significance of ketone bodies in promoting longevity. Thus, in this review, we discuss the emerging and hidden roles of ketone bodies in various organs, including the heart, kidneys, skeletal muscles, and brain, as well as their potential impact on malignancies and lifespan.

大约一个世纪前,胰岛素的发现大大改善了糖尿病的治疗,包括许多危及生命的急性并发症,如酮症酸中毒。这一突破挽救了许多人的生命,延长了许多糖尿病患者的健康寿命。然而,人们对酮体的负面看法仍然源于酮症酸中毒。最初,人们认为酮体是禁食和运动时的重要能量来源。此外,近年来,有关卡路里限制及其对延长健康寿命的潜在影响的研究,以及有关酮体的研究,逐渐促使人们重新评估酮体在促进长寿方面的意义。因此,在这篇综述中,我们将讨论酮体在心脏、肾脏、骨骼肌和大脑等不同器官中新出现的和隐藏的作用,以及它们对恶性肿瘤和寿命的潜在影响。
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引用次数: 0
Circadian Rhythm Regulation by Pacemaker Neuron Chloride Oscillation in Flies. 苍蝇起搏神经元氯离子振荡对昼夜节律的调节
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-27 DOI: 10.1152/physiol.00006.2024
Aylin R Rodan

Circadian rhythms in physiology and behavior sync organisms to external environmental cycles. Here, circadian oscillation in intracellular chloride in central pacemaker neurons of the fly, Drosophila melanogaster, is reviewed. Intracellular chloride links SLC12 cation-coupled chloride transporter function with kinase signaling and the regulation of inwardly rectifying potassium channels.

生理和行为的昼夜节律使生物与外部环境周期同步。本文综述了黑腹果蝇中枢起搏神经元细胞内氯化物的昼夜节律振荡。细胞内氯化物将 SLC12 阳离子偶联氯化物转运体的功能与激酶信号传导和内向整流钾通道的调控联系起来。
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引用次数: 0
Complementing Cell Taxonomies with a Multicellular Analysis of Tissues. 用组织的多细胞分析补充细胞分类法。
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-06 DOI: 10.1152/physiol.00001.2024
Ricardo Omar Ramirez Flores, Philipp Sven Lars Schäfer, Leonie Küchenhoff, Julio Saez-Rodriguez

The application of single-cell molecular profiling coupled with spatial technologies has enabled charting of cellular heterogeneity in reference tissues and in disease. This new wave of molecular data has highlighted the expected diversity of single-cell dynamics upon shared external queues and spatial organizations. However, little is known about the relationship between single-cell heterogeneity and the emergence and maintenance of robust multicellular processes in developed tissues and its role in (patho)physiology. Here, we present emerging computational modeling strategies that use increasingly available large-scale cross-condition single-cell and spatial datasets to study multicellular organization in tissues and complement cell taxonomies. This perspective should enable us to better understand how cells within tissues collectively process information and adapt synchronized responses in disease contexts and to bridge the gap between structural changes and functions in tissues.

单细胞分子图谱与空间技术的应用,使人们能够绘制参考组织和疾病中的细胞异质性图谱。这一新的分子数据浪潮凸显了单细胞动态在共享外部队列和空间组织中的预期多样性。然而,人们对单细胞异质性与发育组织中稳健多细胞过程的出现和维持之间的关系及其在(病理)生理学中的作用知之甚少。在这里,我们将介绍新兴的计算建模策略,这些策略利用越来越多的大规模跨条件单细胞和空间数据集来研究组织中的多细胞组织并补充细胞分类学。这一视角应能让我们更好地理解组织内的细胞是如何在疾病环境中集体处理信息并作出同步反应的,并缩小组织结构变化与功能之间的差距。
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引用次数: 0
Physiology in Perspective. 透视生理学
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-05-01 DOI: 10.1152/physiol.00016.2024
Nikki Forrester
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引用次数: 0
From Beats to Metabolism: the Heart at the Core of Interorgan Metabolic Cross Talk. 从节拍到新陈代谢:器官间串联的核心是心脏。
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-03-01 Epub Date: 2023-12-05 DOI: 10.1152/physiol.00018.2023
Rafael Romero-Becera, Ayelén M Santamans, Alba C Arcones, Guadalupe Sabio

The heart, once considered a mere blood pump, is now recognized as a multifunctional metabolic and endocrine organ. Its function is tightly regulated by various metabolic processes, at the same time it serves as an endocrine organ, secreting bioactive molecules that impact systemic metabolism. In recent years, research has shed light on the intricate interplay between the heart and other metabolic organs, such as adipose tissue, liver, and skeletal muscle. The metabolic flexibility of the heart and its ability to switch between different energy substrates play a crucial role in maintaining cardiac function and overall metabolic homeostasis. Gaining a comprehensive understanding of how metabolic disorders disrupt cardiac metabolism is crucial, as it plays a pivotal role in the development and progression of cardiac diseases. The emerging understanding of the heart as a metabolic and endocrine organ highlights its essential contribution to whole body metabolic regulation and offers new insights into the pathogenesis of metabolic diseases, such as obesity, diabetes, and cardiovascular disorders. In this review, we provide an in-depth exploration of the heart's metabolic and endocrine functions, emphasizing its role in systemic metabolism and the interplay between the heart and other metabolic organs. Furthermore, emerging evidence suggests a correlation between heart disease and other conditions such as aging and cancer, indicating that the metabolic dysfunction observed in these conditions may share common underlying mechanisms. By unraveling the complex mechanisms underlying cardiac metabolism, we aim to contribute to the development of novel therapeutic strategies for metabolic diseases and improve overall cardiovascular health.

心脏曾被认为只是一个泵,但现在人们已认识到它是一个多功能的代谢和内分泌器官。心脏的功能受到各种新陈代谢过程的严格调节,同时它也是一个内分泌器官,分泌影响全身新陈代谢的生物活性分子。近年来,研究揭示了心脏与其他代谢器官(如脂肪组织、肝脏和骨骼肌)之间错综复杂的相互作用。心脏新陈代谢的灵活性及其在不同能量底物之间切换的能力在维持心脏功能和整体新陈代谢平衡方面发挥着至关重要的作用。全面了解代谢紊乱如何破坏心脏代谢至关重要,因为心脏代谢在心脏疾病的发生和发展中起着举足轻重的作用。人们逐渐认识到心脏是一个代谢和内分泌器官,这凸显了心脏对全身代谢调节的重要贡献,并为肥胖、糖尿病和心血管疾病等代谢性疾病的发病机制提供了新的见解。本文深入探讨了心脏的代谢和内分泌功能,强调了心脏在全身代谢中的作用以及心脏与其他代谢器官之间的相互作用。此外,新出现的证据表明,心脏病与癌症之间存在相关性,这表明在这两种疾病中观察到的代谢功能障碍可能具有共同的潜在机制。通过揭示心脏代谢的复杂机制,我们的目标是为代谢性疾病的新型治疗策略的开发做出贡献,并改善整体心血管健康状况。
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引用次数: 0
Tracers and Imaging of Fatty Acid and Energy Metabolism of Human Adipose Tissues. 人体脂肪组织脂肪酸和能量代谢的示踪剂和成像。
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-03-01 Epub Date: 2023-12-19 DOI: 10.1152/physiol.00012.2023
André C Carpentier

White adipose tissue and brown adipose tissue (WAT and BAT) regulate fatty acid metabolism and control lipid fluxes to other organs. Dysfunction of these key metabolic processes contributes to organ insulin resistance and inflammation leading to chronic diseases such as type 2 diabetes, metabolic dysfunction-associated steatohepatitis, and cardiovascular diseases. Metabolic tracers combined with molecular imaging methods are powerful tools for the investigation of these pathogenic mechanisms. Herein, I review some of the positron emission tomography and magnetic resonance imaging methods combined with stable isotopic metabolic tracers to investigate fatty acid and energy metabolism, focusing on human WAT and BAT metabolism. I will discuss the complementary strengths offered by these methods for human investigations and current gaps in the field.

白色脂肪组织和棕色脂肪组织(WAT 和 BAT)调节脂肪酸代谢并控制流向其他器官的脂质。这些关键代谢过程的功能障碍会导致器官胰岛素抵抗和炎症,从而引发慢性疾病,如 2 型糖尿病(T2D)、代谢功能障碍相关性脂肪性肝炎(MASH)和心血管疾病(CVD)。代谢示踪结合分子成像方法是研究这些致病机制的有力工具。在此,我将回顾一些结合稳定同位素代谢示踪剂研究脂肪酸和能量代谢的正电子发射断层扫描(PET)和磁共振成像(MRI)方法,重点是人体脂肪和胆固醇代谢。我将讨论这些方法为人类研究提供的互补优势以及该领域目前存在的差距。
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引用次数: 0
The Elusive Hypertrophy of the Python Heart. 难以捉摸的蟒蛇心脏肥大。
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-03-01 Epub Date: 2023-12-12 DOI: 10.1152/physiol.00025.2023
Bjarke Jensen, Tobias Wang

The Burmese python, one of the world's largest snakes, has reached celebrity status for its dramatic physiological responses associated with digestion of enormous meals. The meals elicit a rapid gain of mass and function of most visceral organs, particularly the small intestine. There is also a manyfold elevation of oxygen consumption that demands the heart to deliver more oxygen. It therefore made intuitive sense when it was reported that the postprandial response entailed a 40% growth of heart mass that could accommodate a rise in stroke volume. Many studies, however, have not been able to reproduce the 40% growth of the heart. We collated published values on postprandial heart mass in pythons, which include several instances of no change in heart mass. On average, the heart mass is only 15% greater. The changes in heart mass did not correlate to the mass gain of the small intestine or peak oxygen consumption. Hemodynamic studies show that the rise in cardiac output does not require increased heart mass but can be fully explained by augmented cardiac filling and postprandial tachycardia. Under the assumption that hypertrophy is a contingent phenomenon, more recent experiments have employed two interventions such as feeding with a concomitant reduction in hematocrit. The results suggest that the postprandial response of the heart can be enhanced, but the 40% hypertrophy of the python heart remains elusive.

缅甸蟒蛇是世界上最大的蛇类之一,因其在消化巨大食物时产生的剧烈生理反应而享有盛名。进食后,大多数内脏器官(尤其是小肠)的质量和功能都会迅速增加。同时,耗氧量也会成倍增加,这就要求心脏提供更多的氧气。因此,当有报道称餐后反应会导致心脏质量增长 40%,以适应中风量的增加时,这是很直观的。然而,许多研究都无法再现心脏增长 40% 的现象。我们整理了已发表的蟒蛇餐后心脏质量值,其中有几例心脏质量没有变化。平均而言,心脏质量只增加了 15%。心脏质量的变化与小肠质量的增加或峰值耗氧量无关。血液动力学研究表明,心输出量的增加并不需要心脏质量的增加,心脏充盈增加和餐后心动过速完全可以解释这一点。在肥大是一种偶然现象的假设下,最近的实验采用了两种干预措施,如喂食的同时降低血细胞比容。结果表明,心脏的餐后反应可以增强,但蟒蛇心脏 40% 的肥大仍然难以捉摸。
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引用次数: 0
Membrane Dynamics and Cation Handling in Ferroptosis. 铁突变过程中的膜动力学和阳离子处理
IF 5.3 2区 医学 Q1 PHYSIOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-09 DOI: 10.1152/physiol.00029.2023
Yusuke Hirata, Eikan Mishima

Ferroptosis, a regulated cell death hallmarked by excessive lipid peroxidation, is implicated in various (patho)physiological contexts. During ferroptosis, lipid peroxidation leads to a diverse change in membrane properties and the dysregulation of ion homeostasis via the cation channels, ultimately resulting in plasma membrane rupture. This review illuminates cellular membrane dynamics and cation handling in ferroptosis regulation.

铁中毒是一种以过度脂质过氧化为特征的调节性细胞死亡,与各种(病理)生理环境有关。在铁中毒过程中,脂质过氧化导致膜特性发生多种变化,并通过阳离子通道导致离子平衡失调,最终导致质膜破裂。这篇综述阐明了铁变态反应调节过程中的细胞膜动力学和阳离子处理。
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引用次数: 0
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Physiology
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