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Dental Stem Cell-Based Therapy for Glycemic Control and the Scope of Clinical Translation: A Systematic Review and Meta-Analysis 基于牙科干细胞的血糖控制疗法和临床转化的范围:系统回顾与元分析
Pub Date : 2024-01-15 DOI: 10.3390/ijtm4010005
Pallavi Tonsekar, Vidya Tonsekar, Shuying Jiang, Gang Yue
Background: The tooth is a repository of stem cells, garnering interest in recent years for its therapeutic potential. The aim of this systematic review and meta-analysis was to test the hypothesis that dental stem cell administration can reduce blood glucose and ameliorate polyneuropathy in diabetes mellitus. The scope of clinical translation was also assessed. Methods: PubMed, Cochrane, Ovid, Web of Science, and Scopus databases were searched for animal studies that were published in or before July 2023. A search was conducted in OpenGrey for unpublished manuscripts. Subgroup analyses were performed to identify potential sources of heterogeneity among studies. The risk for publication bias was assessed by funnel plot, regression, and rank correlation tests. Internal validity, external validity, and translation potential were determined using the SYRCLE (Systematic Review Center for Laboratory Animal Experimentation) risk of bias tool and comparative analysis. Results: Out of 5031 initial records identified, 17 animal studies were included in the review. There was a significant decrease in blood glucose in diabetes-induced animals following DSC administration compared to that observed with saline or vehicle (SMD: −3.905; 95% CI: −5.633 to −2.177; p = 0.0004). The improvement in sensory nerve conduction velocity (SMD: 4.4952; 95% CI: 0.5959 to 8.3945; p = 0.035) and capillary-muscle ratio (SMD: 2.4027; 95% CI: 0.8923 to 3.9132; p = 0.0095) was significant. However, motor nerve conduction velocity (SMD: 3.1001; 95% CI: −1.4558 to 7.6559; p = 0.119) and intra-epidermal nerve fiber ratio (SMD: 1.8802; 95% CI: −0.4809 to 4.2413; p = 0.0915) did not increase significantly. Regression (p < 0.0001) and rank correlation (p = 0.0018) tests indicated the presence of funnel plot asymmetry. Due to disparate number of studies in subgroups, the analyses could not reliably explain the sources of heterogeneity. Interpretation: The direction of the data indicates that DSCs can provide good glycemic control in diabetic animals. However, methodological and reporting quality of preclinical studies, heterogeneity, risk of publication bias, and species differences may hamper translation to humans. Appropriate dose, mode of administration, and preparation must be ascertained for safe and effective use in humans. Longer-duration studies that reflect disease complexity and help predict treatment outcomes in clinical settings are warranted. This review is registered in PROSEPRO (number CRD42023423423).
背景:牙齿是干细胞的宝库,近年来因其治疗潜力而备受关注。本系统综述和荟萃分析旨在检验牙齿干细胞用药可降低血糖和改善糖尿病多发性神经病变的假设。同时还评估了临床转化的范围。研究方法在PubMed、Cochrane、Ovid、Web of Science和Scopus数据库中检索了2023年7月或之前发表的动物研究。还在 OpenGrey 中检索了未发表的手稿。进行了分组分析,以确定研究之间潜在的异质性来源。通过漏斗图、回归和秩相关检验评估发表偏倚风险。使用 SYRCLE(实验动物实验系统性综述中心)偏倚风险工具和比较分析确定了内部有效性、外部有效性和转化潜力。结果在确定的 5031 份初始记录中,有 17 项动物研究被纳入审查范围。与生理盐水或载体相比,服用 DSC 后糖尿病动物的血糖明显下降(SMD:-3.905;95% CI:-5.633 至 -2.177;P = 0.0004)。感觉神经传导速度(SMD:4.4952;95% CI:0.5959 至 8.3945;p = 0.035)和毛细血管-肌肉比率(SMD:2.4027;95% CI:0.8923 至 3.9132;p = 0.0095)显著改善。然而,运动神经传导速度(SMD:3.1001;95% CI:-1.4558 至 7.6559;p = 0.119)和表皮内神经纤维比率(SMD:1.8802;95% CI:-0.4809 至 4.2413;p = 0.0915)没有明显增加。回归(p < 0.0001)和秩相关(p = 0.0018)检验表明漏斗图存在不对称性。由于亚组中的研究数量不同,分析无法可靠地解释异质性的来源。解释:数据方向表明,DSCs 可为糖尿病动物提供良好的血糖控制。然而,临床前研究的方法和报告质量、异质性、发表偏倚风险和物种差异可能会妨碍将其应用于人类。必须确定适当的剂量、给药方式和制剂,才能安全有效地用于人体。有必要进行持续时间更长的研究,以反映疾病的复杂性并帮助预测临床治疗结果。本综述已在 PROSEPRO 中注册(编号 CRD42023423423)。
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引用次数: 0
The Natural History of SARS-CoV-2-Incurred Disease: From Infection to Long COVID SARS-CoV-2 感染疾病的自然史:从感染到长期COVID
Pub Date : 2024-01-08 DOI: 10.3390/ijtm4010004
Kung-Hao Liang, Yuan-Chi Teng, Yi-Ting Liao, A. Yarmishyn, Su-Hua Chiang, Wei-Chun Hung, Chun-Yen Hsiao, En-Tung Tsai, Tai‐Jay Chang, De-Ming Yang, Mong-Lien Wang
The coronavirus SARS-CoV-2 is the causative pathogen of the COVID-19 pandemic that has been causing global upheaval since 2019. The widespread administration of vaccines has partially deterred the spread of SARS-CoV-2, yet the virus is mutating its genome to reduce its antigenicity and evade the human herd immunity. It seems that SARS-CoV-2 will co-exist with the human population for many decades to come. While most infected individuals only experience mild to moderate symptoms, some develop severe pulmonary and systemic disease that can result in hospitalization or even death. The natural history model of SARS-CoV-2 infection has been proposed which includes three sequential stages: the early infection stage, pulmonary stage, and hyper-inflammatory stage. Recently, it has been observed that many people who recovered from an acute infection still experience persistent symptoms for weeks or months, a condition known as long COVID. Furthermore, some COVID-19 patients display escalated rates of both macro- and micro-thrombosis due to endotheliopathy. Hence, we added the thrombosis and convalescent stages to the natural history model, encompassing the entire period from early infection to long COVID. The early infection stage is characterized by symptomatic or asymptomatic elevation of viral titers. Some patients progress to the pulmonary stage characterized by opacities in chest X-rays and computed tomography. The thrombosis stage is characterized by heightened rates of pulmonary thrombosis and consistently elevated D-dimer levels. The hyper-inflammatory stage is characterized by storms of cytokines, such as IL-6, IL-17, and interferons, which is a systemic effect. In the convalescent stage, some people recover completely, while others suffer from long COVID with persistent symptoms such as fatigue, shortness of breath, or brain fog. The natural history model of SARS-CoV-2 infection can be used to elucidate treatment and care.
冠状病毒 SARS-CoV-2 是 COVID-19 大流行的致病病原体,自 2019 年以来一直在全球范围内引发动荡。疫苗的广泛使用在一定程度上遏制了 SARS-CoV-2 的传播,但该病毒仍在进行基因组变异,以降低其抗原性,逃避人类的群体免疫。看来,SARS-CoV-2 还将与人类共存几十年。虽然大多数受感染者只出现轻度至中度症状,但有些人会出现严重的肺部和全身疾病,导致住院甚至死亡。已提出的 SARS-CoV-2 感染自然史模型包括三个连续阶段:早期感染阶段、肺部感染阶段和高炎症阶段。最近观察到,许多急性感染康复者在数周或数月内仍有持续症状,这种情况被称为长 COVID。此外,由于内皮细胞病变,一些 COVID-19 患者的大血栓和微血栓形成率都有所上升。因此,我们在自然病史模型中增加了血栓形成和康复阶段,涵盖了从早期感染到长期 COVID 的整个时期。早期感染阶段的特征是无症状或无症状的病毒滴度升高。有些患者会发展到肺部阶段,其特征是胸部 X 光片和计算机断层扫描出现不透明。血栓形成阶段的特征是肺血栓形成率升高和 D-二聚体水平持续升高。高炎症阶段的特点是细胞因子(如 IL-6、IL-17 和干扰素)风暴,这是一种全身性效应。在康复阶段,一些人完全康复,而另一些人则出现长时间的 COVID,并伴有疲劳、气短或脑雾等持续症状。SARS-CoV-2 感染的自然史模型可用于阐明治疗和护理。
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引用次数: 0
Clinical Implementation of MicroRNAs in Cancer Immunology 癌症免疫学中微小核糖核酸的临床应用
Pub Date : 2024-01-05 DOI: 10.3390/ijtm4010003
H. Schwarzenbach
MicroRNAs (miRNAs), or small non-coding RNAs, modulate the expression of mRNAs and, consequently, a variety of signal transduction pathways. Due to their dysregulation in cancer, they exert oncogenic pressure and have an impact on the immune system with their protective functions. These immunosuppressive characteristics of miRNAs in cancer promote cancer progression and metastasis, causing the dysregulation of immune cells and the immune escape of tumor cells. In contrast, there are also tumor suppressor miRNAs that are able to activate the immune system. Therefore, studies on the altered expression of miRNAs that consider both the oncogenic and tumor-suppressive aspects of miRNAs have become an important research field for advancing immunotherapeutic interventions using miRNAs or their inhibitors as therapeutics. In the current review, their potential in the immunomodulation of immune cells and their use as immune stimulatory molecules to elicit specific cytotoxic responses against the tumor are discussed.
微小核糖核酸(miRNA),即小型非编码核糖核酸,可调节 mRNA 的表达,进而调节各种信号转导途径。由于它们在癌症中的失调,它们会产生致癌压力,并以其保护功能对免疫系统产生影响。癌症中 miRNAs 的这些免疫抑制特性促进了癌症的进展和转移,导致免疫细胞失调和肿瘤细胞的免疫逃逸。相反,也有一些抑瘤 miRNA 能够激活免疫系统。因此,考虑到 miRNAs 的致癌和抑瘤两方面的 miRNAs 表达变化研究,已成为利用 miRNAs 或其抑制剂作为疗法推进免疫治疗干预的重要研究领域。本综述讨论了 miRNA 在免疫细胞免疫调节方面的潜力,以及 miRNA 作为免疫刺激分子诱发针对肿瘤的特异性细胞毒性反应的用途。
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引用次数: 0
Does Precision-Based Medicine Hold the Promise of a New Approach to Predicting and Treating Spontaneous Preterm Birth? 精准医学是否有望成为预测和治疗自发性早产的新方法?
Pub Date : 2024-01-05 DOI: 10.3390/ijtm4010002
Hiba Khan, Natasha Singh, Luis Y. Leyva, Johann Malawana, N. Shah
Background: Preterm birth (PTB) is a leading cause of childhood disability, and it has become a key public health priority recognized by the World Health Organization and the United Nations. Objectives: This review will: (1) summarize current practice in the diagnosis and management of PTB, (2) outline developments in precision-based medicine for diagnostics to improve the care provided to pregnant women at risk of PTB, and (3) discuss the implications of current research in personalized medicine and the potential of future advances to influence the clinical care of women at risk of PTB. Methodology: This is a narrative literature review. Relevant journal articles were identified following searches of computerized databases. Key Results: Current and emerging technologies for the utility of personalized medicine in the context of PTB have the potential for applications in: (1) direct diagnostics to identify and target infection as one of the main known causes of PTB, (2) identifying novel maternal and fetal biomarkers, (3) the use of artificial intelligence and computational modeling, and (4) combining methods to enhance diagnosis and treatment. Conclusions: In this paper, we show how current research has moved in the direction of the targeted use of biomarkers in the context of PTB, with many novel approaches.
背景:早产(PTB)是导致儿童残疾的主要原因之一,已成为世界卫生组织和联合国公认的公共卫生优先事项。本综述的目的是本综述将(1)总结目前早产儿诊断和管理方面的实践;(2)概述精准医学在诊断方面的发展,以改善为早产儿高危孕妇提供的护理;(3)讨论目前个性化医学研究的意义以及未来进展对早产儿高危孕妇临床护理的潜在影响。研究方法:这是一篇叙述性文献综述。通过检索计算机数据库确定了相关期刊文章。主要结果:当前和新兴的个性化医疗技术在PTB方面的应用潜力包括:(1)直接诊断,以确定和锁定感染是PTB的主要已知病因之一;(2)确定新的母体和胎儿生物标志物;(3)使用人工智能和计算建模;以及(4)结合各种方法来加强诊断和治疗。结论:在本文中,我们展示了目前的研究是如何通过许多新颖的方法,将生物标志物有针对性地应用于 PTB 的。
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引用次数: 0
Prognostic Value of the Width of Invasion in pT3 Cutaneous Melanomas pT3 皮肤黑色素瘤侵袭宽度的预后价值
Pub Date : 2023-12-26 DOI: 10.3390/ijtm4010001
D. Țăpoi, A. Gheorghisan-Galateanu, Laura Maria Gosman, A. Dumitru, A. Ciongariu, Mariana Costache
Intermediate-thickness melanomas display highly variable outcomes influenced by both clinical and histopathological characteristics. This study investigates several clinicopathological prognostic factors for pT3 cutaneous melanomas, focusing on a novel parameter, the width of invasion. This is a retrospective study of 49 patients diagnosed with cutaneous melanoma between 2012 and 2018 who were followed up for at least five years. We evaluated the age, gender, tumor location, Breslow depth of invasion, width of invasion, mitotic index, the presence/absence of ulceration, regression, microsatellites, lymphovascular invasion, and perineural invasion for their association with disease progression and survival. Cox univariate analysis revealed that progression-free survival (PFS) was significantly associated with age, depth of invasion, width of invasion, lymphovascular invasion, microsatellites, and perineural invasion. Overall survival (OS) was significantly associated with age, depth of invasion, width of invasion, microsatellites, and perineural invasion. Through multivariate Cox proportional hazards regression, the only factor associated with both PFS and OS was the width of the invasion. This is one of the few studies to assess the width of invasion and we have demonstrated that this parameter could become an important prognostic factor for cutaneous melanomas.
中厚度黑色素瘤的预后受临床和组织病理学特征的影响而变化很大。本研究调查了pT3皮肤黑色素瘤的几个临床病理预后因素,重点关注一个新参数--侵袭宽度。这是一项回顾性研究,研究对象是2012年至2018年期间确诊的49例皮肤黑色素瘤患者,这些患者接受了至少5年的随访。我们评估了年龄、性别、肿瘤位置、布瑞斯洛浸润深度、浸润宽度、有丝分裂指数、有无溃疡、回归、微卫星、淋巴管浸润和神经周围浸润与疾病进展和生存期的关系。Cox 单变量分析显示,无进展生存期(PFS)与年龄、侵袭深度、侵袭宽度、淋巴管侵袭、微卫星和神经周围侵袭显著相关。总生存期(OS)与年龄、浸润深度、浸润宽度、微卫星和神经周围浸润显著相关。通过多变量考克斯比例危险回归,唯一与PFS和OS相关的因素是浸润的宽度。这是为数不多的评估浸润宽度的研究之一,我们证明了这一参数可能成为皮肤黑色素瘤的一个重要预后因素。
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引用次数: 0
Chronic Inhibition of Nitric Oxide Synthases Impairs Spatiotemporal Learning and Memory to a Similar Extent in C57BL/6 and hAPP23+/− Mice 慢性抑制一氧化氮合成酶对 C57BL/6 和 hAPP23+/- 小鼠时空学习和记忆的损害程度相似
Pub Date : 2023-12-14 DOI: 10.3390/ijtm3040036
Jhana O. Hendrickx, E. Calus, Peter Paul De Deyn, D. Van Dam, G. D. De Meyer
Due to global population growth, age-related disorders like cardiovascular disease and dementia are anticipated to increase. Recent data suggests a connection between cardiovascular disease and neurodegeneration, especially focusing on arterial stiffness (AS) and Alzheimer’s disease (AD). In light of this, we conducted a study to explore the impact of long-term nitric oxide synthase (NOS) isoform inhibition, which leads to AS, on neurobehavioral performance. We also compared these effects in an AD model and control mice. C57BL/6 and hAPP23+/− mice (an established AD model) were given 0.5 mg/mL N(G)-Nitro-L-Arginine Methyl Ester (L-NAME) in their drinking water for 16 weeks. Our findings indicate that chronic non-selective NOS inhibition increased AS and reduced spatiotemporal learning and memory in both C57BL/6 and hAPP23+/− mice. These effects were consistent across both groups, emphasizing the role of neuronal NOS (nNOS) in cognitive aging, regardless of genetic predisposition to AD.
由于全球人口增长,心血管疾病和痴呆症等老年相关疾病预计会增加。最近的数据表明,心血管疾病和神经变性之间存在联系,尤其是动脉僵化(AS)和阿尔茨海默病(AD)。有鉴于此,我们开展了一项研究,探讨长期一氧化氮合酶(NOS)同工酶抑制(导致动脉僵化)对神经行为表现的影响。我们还比较了 AD 模型和对照组小鼠的这些影响。在C57BL/6和hAPP23+/-小鼠(已建立的AD模型)的饮用水中添加0.5 mg/mL的N(G)-硝基-L-精氨酸甲酯(L-NAME),持续16周。我们的研究结果表明,慢性非选择性 NOS 抑制增加了 C57BL/6 和 hAPP23+/- 小鼠的 AS,并降低了它们的时空学习和记忆能力。这些影响在两组小鼠中都是一致的,强调了神经元NOS(nNOS)在认知衰老中的作用,与AD的遗传易感性无关。
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引用次数: 0
Influence of the Core Branching Density on Drug Release from Arborescent Poly(γ-benzyl L-glutamate) End-Grafted with Poly(ethylene oxide) 核心分支密度对与聚环氧乙烷末端接枝的树胶状聚(γ-苄基 L-谷氨酸)药物释放的影响
Pub Date : 2023-12-12 DOI: 10.3390/ijtm3040035
Mosa H. Alsehli, Mario Gauthier
Amphiphilic dendritic copolymers of arborescent poly(γ-benzyl L-glutamate) (PBG) of generations G1 and G2, grafted at their chain ends with poly(ethylene oxide) (PEO) segments (PBG-eg-PEO) were synthesized, characterized, and evaluated as nanocarriers for doxorubicin (DOX). The copolymers were designed with hydrophobic PBG cores having three different branching densities and were characterized by proton nuclear magnetic resonance (1H NMR) spectroscopy, size exclusion chromatography (SEC), transmission electron microscopy (TEM), and atomic force microscopy (AFM). Dynamic light scattering (DLS) measurements revealed that these amphiphilic molecules behaved like unimolecular micelles without significant aggregation in aqueous media such as phosphate-buffered saline (PBS), with diameters in the 13–29 nm range depending on the generation number and the core structure. Efficient encapsulation of DOX by these unimolecular micelles was demonstrated with drug loading capacities of up to 11.2 wt%, drug loading efficiencies of up to 67%, and pH-responsive sustained drug release, as determined by UV spectroscopy. The generation number of the copolymers and the branching density of the dendritic PBG core were found to have influenced the encapsulation and release properties of the micelles. Given the tailorable characteristics, good water dispersibility, and biocompatibility of the components used to synthesize the amphiphilic arborescent copolymers, these systems should be useful as robust nanocarriers for a broad range of therapeutic and diagnostic agents.
研究人员合成、表征并评估了 G1 代和 G2 代树枝状聚(γ-苄基 L-谷氨酸)(PBG)两亲树枝状共聚物(PBG-eg-PEO),并在其链端接枝了聚(环氧乙烷)(PEO)片段(PBG-eg-PEO),将其作为多柔比星(DOX)的纳米载体。设计的共聚物具有三种不同支化密度的疏水性 PBG 核心,并通过质子核磁共振(1H NMR)光谱、尺寸排阻色谱(SEC)、透射电子显微镜(TEM)和原子力显微镜(AFM)进行了表征。动态光散射(DLS)测量结果表明,这些两亲性分子在磷酸盐缓冲盐水(PBS)等水介质中表现得像单分子胶束,没有明显的聚集现象,直径在 13-29 纳米范围内,具体取决于代数和核心结构。经紫外光谱测定,这些单分子胶束对 DOX 的有效包封能力高达 11.2 wt%,药物负载效率高达 67%,并具有 pH 响应性持续释药功能。研究发现,共聚物的世代数和树枝状 PBG 核心的分支密度会影响胶束的封装和释放特性。鉴于合成两亲树枝状共聚物所用的成分具有可定制的特性、良好的水分散性和生物相容性,这些系统应可用作多种治疗和诊断药物的强效纳米载体。
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引用次数: 0
Inhibition of Spontaneous Hepatocarcinogenesis by 4,5-Didehydrogeranylgeranoic Acid: Effects of Small-Dose and Infrequent Administration 4,5-Didehydrogeranylgeranoic Acid 对自发性肝癌发生的抑制:小剂量和非频繁给药的影响
Pub Date : 2023-11-28 DOI: 10.3390/ijtm3040034
Masahide Omori, Yoshihiro Shidoji, Hisataka Moriwaki
Inhibitory effects of 4,5-didehydrogeranylgeranoic acid (dGGA) on the development of tumors were investigated in spontaneous hepatoma mice, C3H/HeNCrj. Experiment 1: Male mice at 8 weeks of age were raised on a basal diet, and then provided with a diet containing 0.02% dGGA from 32 to 91 weeks of age. Experiment 2: dGGA was administered to the animals only once at different time points, from 2 months to 17 months after birth, respectively. Experiment 3: dGGA was administered twice to the mice at different time points: at 5 months and 11 months, and at 8 months and 11 months, respectively. When the inhibitory effects on tumor development were evaluated with the incidences of tumors, average numbers, and weight of tumors per mouse, there was a marked relationship between the time of single or dual dosing and the inhibitory effects of dGGA. The greatest inhibitory effects were observed in Experiment 3 in the group of animals given dGGA at the ages of 8 and 11 months, which were far superior to the results with a large dose of the compounds for a long time. These results might indicate that dGGA administered at the right time in the right amount effectively prevents the development of cancer.
在自发性肝癌小鼠 C3H/HeNCrj 中研究了 4,5-二脱氢geranylgeranoic acid(dGGA)对肿瘤发生的抑制作用。实验 1:雄性小鼠在 8 周龄时以基础饮食饲养,然后在 32 至 91 周龄期间以含有 0.02% dGGA 的饮食饲养。实验 2:分别在小鼠出生后 2 个月至 17 个月的不同时间点只给小鼠注射一次 dGGA。实验 3:分别在小鼠出生后 5 个月和 11 个月以及 8 个月和 11 个月的不同时间点给小鼠注射两次 dGGA。用每只小鼠的肿瘤发生率、肿瘤平均数量和重量来评估对肿瘤发生的抑制作用时,发现单次或两次给药的时间与 dGGA 的抑制作用有明显的关系。在实验 3 中,在 8 个月和 11 个月大时服用 dGGA 的动物组的抑制效果最好,远远优于长期大剂量服用化合物的结果。这些结果可能表明,在适当的时间服用适当剂量的 dGGA 可以有效地预防癌症的发生。
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引用次数: 0
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International Journal of Translational Medicine
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