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Impacts of cancer therapy on male fertility: Past and present 癌症治疗对男性生育能力的影响:过去与现在
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-09-11 DOI: 10.1016/j.mam.2024.101308

Over the past two decades, advances in cancer therapy have significantly improved survival rates, particularly in childhood cancers. Still, many treatments pose a substantial risk for diminishing future fertility potential due to the gonadotoxic nature of many cancer regimens, justifying fertility preservation programs for both childhood and adult cancer patients. To assure a balance between offering fertility preservation and actual chance of infertility post-treatment, guidelines are in place. However, assessing the actual risk of infertility after treatment remains challenging, given the multi-faceted approach of many cancer treatment plans, which are continuously evolving. This review discusses the evolution of cancer therapy over the past 20 years and attempts to assess their impact on fertility after treatment. Overall, cancer regimens have shifted from broadly killing fast dividing cells to more targeting therapies, reducing collateral damage in general. Although progress has been made to reduce overall toxicity, unfortunately this does not automatically translate to reduced gonadotoxicity. Therefore, current fertility preservation programs continue to be an important part of cancer care.

过去二十年来,癌症治疗的进步大大提高了患者的生存率,尤其是儿童癌症患者。尽管如此,由于许多癌症治疗方案都具有性腺毒性,因此许多治疗方案都会对患者未来的生育能力造成很大的影响,这就为儿童和成人癌症患者的生育力保护计划提供了依据。为了确保在提供生育力保护和治疗后实际不孕几率之间取得平衡,已制定了相关指南。然而,由于许多癌症治疗方案是多方面的,而且在不断演变,因此评估治疗后不孕的实际风险仍具有挑战性。本综述讨论了癌症疗法在过去 20 年中的演变,并尝试评估其对治疗后生育的影响。总体而言,癌症治疗方案已从广泛杀灭快速分裂细胞转变为更具针对性的疗法,从总体上减少了附带损害。虽然在降低总体毒性方面取得了进展,但遗憾的是,这并不能自动转化为性腺毒性的降低。因此,目前的生育力保护计划仍然是癌症治疗的重要组成部分。
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引用次数: 0
Immunomodulation: A new approach to cancer cachexia, potentially suitable for aging 免疫调节:治疗癌症恶病质的新方法,可能适用于老龄化
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-09-10 DOI: 10.1016/j.mam.2024.101318

Cancer cachexia is the prototypical example of comorbidity, occurring in most of cancer patients. It is a direct consequence of tumor growth and of the associated inflammatory/immune response. Cachexia can be exacerbated by anti-cancer therapies, frequently resulting in dose limitation and/or treatment delay or discontinuation. The pathogenesis of cancer cachexia is still unclear and includes nutritional, metabolic, hormonal and immunological components.

Tumor ability to shape the immune response to its own advantage is now well accepted, while the possibility that such an altered immune response could play a role in the onset of cachexia is still an undefined issue. Indeed, most of the immune-related research on cachexia mainly focused on pro-inflammatory mediators, almost totally disregarding the interactions among immune cells and the homeostasis of peripheral tissues. The present review provides an overview of the immune system dysregulations occurring in cancer cachexia, focusing on the possibility that immunomodulating strategies, mainly developed to stimulate the anti-cancer immune response, could be useful to counteract cachexia as well.

Cancer and cachexia are frequent comorbidities of aging. Along this line, cancer- and aging-associated muscle wasting likely coexist in the same patients. Since both conditions share some of the underlying mechanisms, the potential effectiveness of immunomodulation on sarcopenia of aging is discussed.

癌症恶病质是合并症的典型例子,大多数癌症患者都会出现。它是肿瘤生长和相关炎症/免疫反应的直接后果。抗癌疗法会加重恶病质,经常导致剂量限制和/或治疗延迟或中断。癌症恶病质的发病机理尚不清楚,包括营养、代谢、激素和免疫学等方面的因素。目前,人们普遍认为肿瘤有能力塑造对自身有利的免疫反应,而这种免疫反应的改变可能在恶病质的发生中起作用,这仍然是一个未确定的问题。事实上,大多数关于恶病质的免疫相关研究主要集中在促炎介质上,几乎完全忽视了免疫细胞之间的相互作用和外周组织的平衡。本综述概述了癌症恶病质中出现的免疫系统失调,重点探讨了主要为刺激抗癌免疫反应而开发的免疫调节策略也可用于对抗恶病质的可能性。沿着这一思路,癌症和衰老相关的肌肉萎缩很可能在同一患者身上同时存在。由于这两种病症有一些共同的潜在机制,我们将讨论免疫调节对衰老性肌肉萎缩症的潜在疗效。
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引用次数: 0
Insights into Women's health: Exploring the vaginal microbiome, quorum sensing dynamics, and therapeutic potential of quorum sensing quenchers 洞察女性健康:探索阴道微生物群、定量感应动态以及定量感应拮抗剂的治疗潜力
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-09-09 DOI: 10.1016/j.mam.2024.101304

The vaginal microbiome is an important aspect of women's health that changes dynamically with various stages of the woman's life. Just like the gut microbiome, the vaginal microbiome can also be affected by pathologies that dramatically change the typical composition of native vaginal microorganisms. However, the mechanism as to how both vaginal endemic and gut endemic opportunistic microbes can express pathogenicity in vaginal polymicrobial biofilms is poorly understood. Quorum sensing is the cellular density-dependent bacterial and fungal communication process in which chemical signaling molecules, known as autoinducers, activate expression for genes responsible for virulence and pathogenicity, such as biofilm formation and virulence factor production. Quorum sensing inhibition, or quorum quenching, has been explored as a potential therapeutic route for both bacterial and fungal infections. By applying these quorum quenchers, one can reduce biofilm formation of opportunistic vaginal microbes and combine them with antibiotics for a synergistic effect. This review aims to display the relationship between the vaginal and gut microbiome, the role of quorum sensing in polymicrobial biofilm formation which cause pathology in the vaginal microbiome, and how quorum quenchers can be utilized to attenuate the severity of bacterial and fungal infections.

阴道微生物群是女性健康的一个重要方面,它会随着女性生命的不同阶段而发生动态变化。与肠道微生物群一样,阴道微生物群也会受到病理变化的影响,从而极大地改变阴道本地微生物的典型组成。然而,人们对阴道特有微生物和肠道特有机会性微生物如何在阴道多微生物生物膜中表达致病性的机制还知之甚少。法定量感应是一种依赖于细胞密度的细菌和真菌交流过程,在这一过程中,化学信号分子(称为自诱导剂)会激活负责毒力和致病性的基因的表达,如生物膜的形成和毒力因子的产生。抑制法定人数感应(或法定人数淬灭)已被视为细菌和真菌感染的潜在治疗途径。通过应用这些法定量拮抗剂,人们可以减少机会性阴道微生物生物膜的形成,并将它们与抗生素结合起来产生协同效应。本综述旨在说明阴道微生物群与肠道微生物群之间的关系、法定量感应在多微生物生物膜形成过程中的作用(多微生物生物膜会导致阴道微生物群病变),以及如何利用法定量拮抗剂来减轻细菌和真菌感染的严重程度。
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引用次数: 0
Understanding the role of endocrine disrupting chemicals in testicular germ cell cancer: Insights into molecular mechanisms 了解干扰内分泌的化学物质在睾丸生殖细胞癌中的作用:洞察分子机制
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-29 DOI: 10.1016/j.mam.2024.101307

This comprehensive review examines the complex interplay between endocrine disrupting chemicals (EDCs) and the development of testicular germ cell tumors (TGCTs). Despite the high cure rates of TGCTs, challenges in diagnosis and treatment remain, necessitating a deeper understanding of the etiology of the disease. Here, we emphasize current knowledge on the role of EDCs as potential risk factors for TGCTs, focusing on pesticides and perfluorinated and polyfluoroalkyl substances (PFAs/PFCs). Evidence suggests that EDCs disrupt endocrine pathways and induce epigenetic changes that contribute to the development of TGCTs. However, the direct link between EDCs and TGCTs remains elusive and requires further investigation of the molecular mechanisms. We also highlighted the importance of studying nuclear receptors as potential targets for understanding TGCT etiology. In addition, recent evidence implicates PFAs/PFCs in TGCT incidence, highlighting the need for further research into their impact on human health. Overall, this review provides valuable insights into the potential role of EDCs in TGCT development and suggests avenues for future research, while also highlighting how understanding their influence may pave the way for novel therapeutic approaches to improve disease management.

这篇综合性综述探讨了干扰内分泌的化学物质(EDCs)与睾丸生殖细胞瘤(TGCTs)发病之间复杂的相互作用。尽管睾丸生殖细胞瘤的治愈率很高,但诊断和治疗方面的挑战依然存在,因此有必要加深对该疾病病因的了解。在此,我们强调了目前关于 EDCs 作为 TGCTs 潜在风险因素的作用的知识,重点是杀虫剂和全氟及多氟烷基物质(PFAs/PFCs)。有证据表明,EDCs 会扰乱内分泌途径并诱发表观遗传学变化,从而导致 TGCTs 的发生。然而,EDCs 与 TGCTs 之间的直接联系仍然难以捉摸,需要进一步研究其分子机制。我们还强调了研究核受体作为了解 TGCT 病因学潜在靶点的重要性。此外,最近有证据表明,PFAs/PFCs 与 TGCT 的发病率有关,因此需要进一步研究它们对人类健康的影响。总之,这篇综述为了解 EDCs 在 TGCT 发展过程中的潜在作用提供了宝贵的见解,并为今后的研究提出了建议,同时还强调了了解 EDCs 的影响可能会为新型治疗方法铺平道路,从而改善疾病管理。
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引用次数: 0
Unveiling multifaceted roles of myeloid innate immune cells in the pathogenesis of psoriasis 揭示髓系先天性免疫细胞在银屑病发病机制中的多方面作用
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-26 DOI: 10.1016/j.mam.2024.101306

Psoriasis is a chronic inflammatory skin disease occurring worldwide. Initially viewed as a keratinocyte disorder, psoriasis is now recognized to involve a complex interplay between genetic predisposition, environmental triggers, and a dysregulated immune system, with a significant role of CD4+ T cells producing IL-17. Recent genetic studies have identified susceptibility loci that underscore the importance of innate immune responses, particularly the roles of myeloid cells, such as dendritic cells, macrophages, and neutrophils. These cells initiate and sustain inflammation through cytokine production triggered by external stimuli. They influence keratinocyte behavior and interact with adaptive immune cells. Recent techniques have further revealed the heterogeneity of myeloid cells in psoriatic lesions, highlighting the contributions of less-studied subsets, such as eosinophils and mast cells. This review examines the multifaceted roles of myeloid innate immune cells in psoriasis, emphasizing their functional diversity in promoting psoriatic inflammation. It also describes current treatment targeting myeloid innate immune cells and explores potential new therapeutic strategies based on the functional characteristics of these subsets. Future research should focus on the detailed characterization of myeloid subsets and their interactions to develop targeted treatments that address the complex immune landscape of psoriasis.

银屑病是一种发生于世界各地的慢性炎症性皮肤病。银屑病最初被认为是一种角质细胞疾病,但现在人们认识到,银屑病涉及遗传易感性、环境诱因和免疫系统失调之间复杂的相互作用,其中产生 IL-17 的 CD4+ T 细胞起着重要作用。最近的遗传学研究确定了易感基因位点,强调了先天性免疫反应的重要性,尤其是树突状细胞、巨噬细胞和中性粒细胞等髓系细胞的作用。这些细胞在外界刺激下产生细胞因子,从而引发和维持炎症。它们影响角质细胞的行为,并与适应性免疫细胞相互作用。最近的技术进一步揭示了银屑病皮损中髓系细胞的异质性,强调了嗜酸性粒细胞和肥大细胞等研究较少的亚群的贡献。本综述探讨了髓系先天性免疫细胞在银屑病中的多方面作用,强调了它们在促进银屑病炎症方面的功能多样性。它还介绍了目前针对髓系先天性免疫细胞的治疗方法,并根据这些亚群的功能特点探讨了潜在的新治疗策略。未来的研究应重点关注髓系亚群及其相互作用的详细特征,以开发针对银屑病复杂免疫环境的靶向治疗方法。
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引用次数: 0
Hepatitis C virus chronicity and oncogenic potential: Vaccine development progress 丙型肝炎病毒的慢性化和致癌潜力:疫苗开发进展
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-20 DOI: 10.1016/j.mam.2024.101305

Hepatitis C virus (HCV) infection is a major health problem worldwide. It can cause liver cirrhosis and hepatocellular carcinoma (HCC), making it a cause of morbidity from liver disease. Thus, there is an urgent need for a prophylactic HCV vaccine. Fortunately, modern medicine has transformed the therapy for HCV infection through development of direct-acting antiviral agents (DAAs), achieving high rates of sustained virologic response and giving significant relief from HCC and associated mortality, but unfortunately it fails to eradicate the risk of HCC, especially in HCV-cleared patients with already advanced liver disease. Additionally, DAA-cured patients do not develop sufficient antiviral immunity and are susceptible to reinfection. A comprehensive strategy to control HCV infection must include a vaccine development approach in which the host can develop humoral and cellular immunity to eradicate HCV successfully; however, this remains a challenge as HCV has developed systems to evade immune attacks from its host. This review highlights the current understanding of HCV's effect on liver disease and cancer progression, the nature of immune responses from cell populations interacting with HCV, and the current strategies for vaccine development. The information in this review will advance prophylactic intervention strategies for HCV infection, with the end goal being to prevent chronicity and subsequent liver disease leading to HCC.

丙型肝炎病毒(HCV)感染是全球的一大健康问题。丙型肝炎病毒可导致肝硬化和肝细胞癌(HCC),是肝病发病率高的原因之一。因此,迫切需要一种预防性的 HCV 疫苗。幸运的是,现代医学通过开发直接作用抗病毒药物(DAAs)改变了 HCV 感染的治疗方法,实现了较高的持续病毒学应答率,大大缓解了 HCC 及相关死亡率,但不幸的是,这种治疗方法未能根除 HCC 风险,尤其是对于已清除 HCV 病毒的晚期肝病患者。此外,DAA 治愈的患者不会产生足够的抗病毒免疫力,容易再次感染。控制 HCV 感染的综合策略必须包括疫苗开发方法,使宿主能够产生体液免疫和细胞免疫,从而成功根除 HCV;然而,这仍然是一项挑战,因为 HCV 已经开发出了躲避宿主免疫攻击的系统。本综述重点介绍了目前对 HCV 对肝病和癌症进展的影响、与 HCV 相互作用的细胞群的免疫反应的性质以及目前的疫苗开发策略的理解。本综述中的信息将推动针对 HCV 感染的预防性干预策略,其最终目标是预防慢性化和随后导致 HCC 的肝病。
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引用次数: 0
Extracellular vesicles transport RNA between cells: Unraveling their dual role in diagnostics and therapeutics 细胞外囊泡在细胞间运输 RNA:揭示细胞外囊泡在诊断和治疗中的双重作用
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.mam.2024.101302

Modern methods of molecular diagnostics and therapy have revolutionized the field of medicine in recent years by providing more precise and effective tools for detecting and treating diseases. This progress includes a growing exploration of the body's secreted vesicles, known as extracellular vesicles (EVs), for both diagnostic and therapeutic purposes. EVs are a heterogeneous population of lipid bilayer vesicles secreted by almost every cell type studied so far. They are detected in body fluids and conditioned culture media from living cells. EVs play a crucial role in communication between cells and organs, both locally and over long distances. They are recognized for their ability to transport endogenous RNA and proteins between cells, including messenger RNA (mRNA), microRNA (miRNA), misfolded neurodegenerative proteins, and several other biomolecules. This review explores the dual utilization of EVs, serving not only for diagnostic purposes but also as a platform for delivering therapeutic molecules to cells and tissues. Through an exploration of their composition, biogenesis, and selective cargo packaging, we elucidate the intricate mechanisms behind RNA transport between cells via EVs, highlighting their potential use for both diagnostic and therapeutic applications. Finally, it addresses challenges and outlines prospective directions for the clinical utilization of EVs.

近年来,现代分子诊断和治疗方法为检测和治疗疾病提供了更精确、更有效的工具,从而彻底改变了医学领域。这一进步包括越来越多地探索用于诊断和治疗目的的人体分泌囊泡,即细胞外囊泡(EVs)。细胞外囊泡是由脂质双分子层囊泡组成的异质群体,几乎所有研究过的细胞类型都会分泌细胞外囊泡。它们可在体液和活细胞的条件培养基中检测到。EVs在细胞和器官之间的局部和远距离交流中发挥着至关重要的作用。它们在细胞间运输内源性 RNA 和蛋白质(包括信使 RNA (mRNA)、microRNA (miRNA)、折叠错误的神经退行性蛋白质和其他一些生物大分子)的能力已得到公认。本综述探讨了 EVs 的双重用途,它不仅可用于诊断,还可作为向细胞和组织输送治疗分子的平台。通过探讨 EVs 的组成、生物生成和选择性货物包装,我们阐明了 RNA 通过 EVs 在细胞间转运背后的复杂机制,强调了 EVs 在诊断和治疗应用中的潜在用途。最后,报告探讨了 EVs 在临床应用中面临的挑战,并概述了其未来的发展方向。
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引用次数: 0
Diabetes and male fertility disorders 糖尿病与男性生育障碍
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-07-30 DOI: 10.1016/j.mam.2024.101303

Couple infertility is a common condition, defined as being unable to conceive after 12 months of regular unprotected sexual intercourse. Male Factor Infertility (MFI) is responsible, alone or in combination with female factors, for about half of the overall cases of couple infertility. MFI is gradually increasing in prevalence, with a notable decline in semen parameters over the last decades. The aetiologies behind the finding of decreasing sperm counts are difficult to pinpoint but might be due in part to increasing rates of overweight and obesity in men of childbearing age. Diabetes mellitus (DM) is a common and chronic metabolic disease, whose prevalence is also gradually increasing, rising up to 10% of the population. The International Diabetes Federation estimates that there are currently more than 500 million people living with DM worldwide, the vast majority of whom suffering from type 2 DM (T2DM). There is growing awareness of the relationship between unhealthy lifestyle, in particular unhealthy diet, and MFI. Starting from all these premises, the aim of this narrative review is to describe the current evidence on the link between DM and MFI, both in terms of DM as a cause of/a risk factor for MFI and of MFI as a possible predictive marker for T2DM. Finally, we will discuss the risk of DM as a consequence of the therapy of MFI or assisted reproductive techniques.

夫妇不孕症是一种常见病,其定义是在定期无保护性交 12 个月后仍无法受孕。男性因素不孕症(MFI)单独或与女性因素共同造成的不孕症约占夫妇不孕症总数的一半。过去几十年来,男性因素不孕症的发病率逐渐上升,精液参数明显下降。精子数量下降的病因难以确定,但部分原因可能是育龄男性超重和肥胖的比例不断增加。糖尿病(DM)是一种常见的慢性代谢性疾病,其发病率也在逐渐上升,已上升到人口的 10%。据国际糖尿病联合会估计,目前全球有超过 5 亿糖尿病患者,其中绝大多数为 2 型糖尿病(T2DM)。人们越来越意识到不健康的生活方式,特别是不健康的饮食,与 MFI 之间的关系。从所有这些前提出发,本叙述性综述旨在描述目前有关 DM 与 MFI 之间关系的证据,既包括 DM 作为 MFI 病因/风险因素的证据,也包括 MFI 作为 T2DM 可能的预测标志物的证据。最后,我们将讨论MFI治疗或辅助生殖技术导致的DM风险。
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引用次数: 0
Molecular mechanisms of cancer cachexia. Role of exercise training 癌症恶病质的分子机制。运动训练的作用
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-07-25 DOI: 10.1016/j.mam.2024.101293

Cancer-associated cachexia represents a multifactorial syndrome mainly characterized by muscle mass loss, which causes both a decrease in quality of life and anti-cancer therapy failure, among other consequences. The definition and diagnostic criteria of cachexia have changed and improved over time, including three different stages (pre-cachexia, cachexia, and refractory cachexia) and objective diagnostic markers. This metabolic wasting syndrome is characterized by a negative protein balance, and anti-cancer drugs like chemotherapy or immunotherapy exacerbate it through relatively unknown mechanisms. Due to its complexity, cachexia management involves a multidisciplinary strategy including not only nutritional and pharmacological interventions. Physical exercise has been proposed as a strategy to counteract the effects of cachexia on skeletal muscle, as it influences the mechanisms involved in the disease such as protein turnover, inflammation, oxidative stress, and mitochondrial dysfunction. This review will summarize the experimental and clinical evidence of the impact of physical exercise on cancer-associated cachexia.

癌症相关恶病质是一种多因素综合征,主要特征是肌肉质量下降,导致生活质量下降和抗癌治疗失败等后果。随着时间的推移,恶病质的定义和诊断标准也在不断变化和改进,包括三个不同阶段(恶病质前期、恶病质和难治性恶病质)和客观诊断指标。这种代谢消耗综合征的特点是蛋白质负平衡,而化疗或免疫疗法等抗癌药物会通过相对未知的机制使其恶化。由于其复杂性,恶病质的治疗涉及多学科策略,不仅包括营养和药物干预。体育锻炼被认为是对抗恶病质对骨骼肌影响的一种策略,因为体育锻炼会影响疾病的相关机制,如蛋白质周转、炎症、氧化应激和线粒体功能障碍。本综述将总结体育锻炼对癌症相关恶病质影响的实验和临床证据。
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引用次数: 0
Vaccines for breast cancer prevention: Are we there yet? 预防乳腺癌的疫苗:我们成功了吗?
IF 8.7 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2024-07-10 DOI: 10.1016/j.mam.2024.101292
Shaveta Vinayak , Denise L. Cecil , Mary L. Disis
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引用次数: 0
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Molecular Aspects of Medicine
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