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MicroRNA-455–3P as a peripheral biomarker and therapeutic target for mild cognitive impairment and Alzheimer’s disease MicroRNA-455-3P 作为轻度认知障碍和阿尔茨海默病的外周生物标记物和治疗靶点。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-15 DOI: 10.1016/j.arr.2024.102459

MicroRNAs are small non-coding RNAs evolutionary conserved molecules. They regulate cellular processes, including RNA silencing, post-translational gene expression and neurodegeneration. MicroRNAs are involved with human diseases such as cancer, Alzheimer’s disease (AD) and others. Interestingly, cerebrospinal fluids (CSF) and the blood of AD patients have altered expressions of many RNAs, which may serve as potential peripheral biomarkers. The intensive investigation from our lab revealed that microRNA-455–3 P (miR-455–3p) is a strong candidate as a potential biomarker and therapeutic target for AD. Several genes implicated in the pathogenesis of AD are directly targeted by miR-455–3p. Several years of our lab research revealed that miR-455–3p regulates important physiological processes associated with AD, such as the processing of the amyloid precursor protein (APP), TGF-β signaling, the regulation of oxidative stress, mitochondrial biogenesis, and synaptic damages. The expression of miR-455–3p in mild cognitive impaired subjects and AD patients pointed out its involvement in AD progression. Recently, our lab generated both transgenic and knockout mice for miR-455–3p. Interestingly miR-455–3p transgenic mice showed superior cognitive learning, improved memory and extended lifespan compared to age matched wild-type mice, whereas miR-455–3-p knockout mice showed cognitive decline and reduced lifespan. Information derived from mouse models further demonstrated the advantageous impact of miR-455–3p on dendritic growth, synaptogenesis, and mitochondrial biogenesis in preventing the onset and progression of AD. The identification of miR-455–3p as a biomarker was suggested by its presence in postmortem AD brains, B-lymphocytes, and fibroblasts. Our hypothesis that miR-455–3p could be a peripheral biomarker and therapeutic target for AD.

MicroRNA 是小型非编码 RNA 进化保守分子。它们调控细胞过程,包括 RNA 沉默、翻译后基因表达和神经变性。MicroRNAs 与癌症、阿尔茨海默病(AD)等人类疾病有关。有趣的是,阿尔茨海默病患者的脑脊液(CSF)和血液中许多 RNA 的表达发生了改变,这可能成为潜在的外周生物标志物。我们实验室的深入研究发现,microRNA-455-3P(miR-455-3p)是AD潜在生物标志物和治疗靶点的有力候选者。miR-455-3p可直接靶向与AD发病机制有关的多个基因。我们实验室数年的研究发现,miR-455-3p 可调控与 AD 相关的重要生理过程,如淀粉样前体蛋白(APP)的处理、TGF-β 信号传导、氧化应激调控、线粒体生物生成和突触损伤。miR-455-3p在轻度认知障碍受试者和AD患者中的表达表明,它参与了AD的进展。最近,我们实验室产生了 miR-455-3p 的转基因小鼠和基因敲除小鼠。有趣的是,与年龄匹配的野生型小鼠相比,miR-455-3p 转基因小鼠表现出更优越的认知学习能力、更强的记忆力和更长的寿命,而 miR-455-3-p 基因敲除小鼠则表现出认知能力下降和寿命缩短。从小鼠模型中获得的信息进一步证明,miR-455-3p 对树突生长、突触生成和线粒体生物生成具有有利影响,可预防注意力缺失症的发生和发展。miR-455-3p在AD死后大脑、B淋巴细胞和成纤维细胞中的存在表明,miR-455-3p是一种生物标志物。我们的假设是,miR-455-3p 可能是 AD 的外周生物标志物和治疗靶标。
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引用次数: 0
Does personality affect the cognitive decline in aging? A systematic review 性格会影响老年认知能力的衰退吗?系统综述。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-15 DOI: 10.1016/j.arr.2024.102455

Cognitive decline is a natural consequence of aging, but several genetic, environmental, and psychological factors can influence its trajectories. Among the most enduring factors, the Big Five personality traits – defined as relatively stable tendencies to think, behave, and react to the environment – can influence both directly (e.g., by physiological correlates) and indirectly (e.g., healthy or risky behaviors) the risk of developing dementia and mild cognitive impairment (MCI) – a preclinical form of cognitive decline. Despite the great amount of studies focusing on the relationship between personality and cognitive decline, an updated systematic synthesis of the results including a broader range of study designs is still lacking. This systematic review aims to summarize the findings of studies investigating: (i) differences in personality traits between groups of healthy individuals and those with MCI, (ii) the impact of personality traits on the risk for both MCI and dementia, and (iii) changes in personality traits among individuals progressing from normal cognition to MCI. Neuroticism emerged as a significant risk factor for MCI and dementia; Conscientiousness and Openness appear to offer protection against dementia and moderate cognitive decline. Overall, these findings suggest a pivotal role of personality structure in shaping cognitive outcomes on the long run.

认知能力衰退是衰老的自然结果,但有几种遗传、环境和心理因素会影响认知能力衰退的轨迹。在最持久的因素中,大五人格特质(被定义为相对稳定的思维、行为和对环境的反应倾向)可以直接(如通过生理相关性)或间接(如健康或危险行为)影响痴呆症和轻度认知功能障碍(MCI)--认知功能衰退的临床前形式--的发病风险。尽管有大量研究关注人格与认知功能衰退之间的关系,但目前仍缺乏对研究结果的最新系统综述,包括更广泛的研究设计。本系统综述旨在总结以下方面的研究结果:(i) 健康人群与 MCI 患者在人格特质上的差异;(ii) 人格特质对 MCI 和痴呆症风险的影响;(iii) 从认知正常发展到 MCI 的人群在人格特质上的变化。神经质是导致 MCI 和痴呆症的重要风险因素;自觉性和开放性似乎能防止痴呆症和认知能力的中度衰退。总之,这些研究结果表明,人格结构在塑造长期认知结果方面起着关键作用。
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引用次数: 0
Consolidating multiple evolutionary theories of ageing suggests a need for new approaches to study genetic contributions to ageing decline 综合多种老龄化进化理论,我们需要新的方法来研究遗传因素对老龄化衰退的影响。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-15 DOI: 10.1016/j.arr.2024.102456

Understanding mechanisms of ageing remains a complex challenge for biogerontologists, but recent adaptations of evolutionary ageing theories offer a compelling lens in which to view both age-related molecular and physiological deterioration. Ageing is commonly associated with progressive declines in biochemical and molecular processes resulting from damage accumulation, yet the role of continued developmental gene activation is less appreciated. Natural selection pressures are at their highest in youthful periods to modify gene expression towards maximising reproductive capacity. After sexual maturation, selective pressure diminishes, subjecting individuals to maladaptive pleiotropic gene functions that were once beneficial for developmental growth but become pathogenic later in life. Due to this selective ‘shadowing’ in ageing, mechanisms to counter such hyper/hypofunctional genes are unlikely to evolve. Interventions aimed at targeting gene hyper/hypofunction during ageing might, therefore, represent an attractive therapeutic strategy. The nematode Caenorhabditis elegans offers a strong model for post-reproductive mechanistic and therapeutic investigations, yet studies examining the mechanisms of, and countermeasures against, ageing decline largely intervene from larval stages onwards. Importantly, however, lifespan extending conditions frequently impair early-life fitness and fail to correspondingly increase healthspan. Here, we consolidate multiple evolutionary theories of ageing and discuss data supporting hyper/hypofunctional changes at a global molecular and functional level in C. elegans, and how classical lifespan-extension mutations alter these dynamics. The relevance of such mutant models for exploring mechanisms of ageing are discussed, highlighting that post-reproductive gene optimisation represents a more translatable approach for C. elegans research that is not constrained by evolutionary trade-offs. Where some genetic mutations in C. elegans that promote late-life health map accordingly with healthy ageing in humans, other widely used genetic mutations that extend worm lifespan are associated with life-limiting pathologies in people. Lifespan has also become the gold standard for quantifying ‘ageing’, but we argue that gerospan compression (i.e., ‘healthier’ ageing) is an appropriate goal for anti-ageing research, the mechanisms of which appear distinct from those regulating lifespan alone. There is, therefore, an evident need to re-evaluate experimental approaches to study the role of hyper/hypofunctional genes in ageing in C. elegans.

对于生物老年学家来说,理解衰老的机制仍然是一个复杂的挑战,但最近对进化衰老理论的调整提供了一个令人信服的视角来看待与年龄有关的分子和生理退化。衰老通常与损伤积累导致的生化和分子过程的逐渐衰退有关,但持续的发育基因激活所起的作用却不那么为人所知。青年时期的自然选择压力最大,基因表达会发生改变,以最大限度地提高生殖能力。性成熟后,选择压力减弱,个体会受到适应不良的多向性基因功能的影响,这些基因功能曾经对发育成长有益,但在生命后期却成为致病基因。由于衰老过程中的这种选择性 "阴影",对抗这种功能亢进/低下基因的机制不太可能进化出来。因此,针对衰老过程中基因功能亢进/减退的干预可能是一种有吸引力的治疗策略。线虫秀丽隐杆线虫(Caenorhabditis elegans)为生殖后机理和治疗研究提供了一个强有力的模型,但针对衰老机制和对策的研究大多是从幼虫阶段开始的。然而,重要的是,延长寿命的条件经常会损害早期生命的适应性,而且不能相应地延长健康寿命。在此,我们整合了多种老化进化理论,并讨论了在全球分子和功能水平上支持高功能/低功能变化的数据,以及经典的寿命延长突变是如何改变这些动态变化的。讨论了这种突变模型与探索衰老机制的相关性,强调生殖后基因优化是一种不受进化权衡限制的、更易于转化的秀丽隐杆线虫研究方法。在 elegans 中,一些能促进晚年健康的基因突变与人类的健康老龄化有相应的映射关系,而其他被广泛使用的能延长蠕虫寿命的基因突变则与人类限制寿命的病症有关。寿命也已成为量化 "衰老 "的黄金标准,但我们认为,压缩寿命(即 "更健康 "的衰老)是抗衰老研究的适当目标,其机制似乎不同于仅调节寿命的机制。因此,显然有必要重新评估实验方法,以研究高/低功能基因在秀丽隐杆线虫衰老中的作用。
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引用次数: 0
Comprehensive review on single-cell RNA sequencing: A new frontier in Alzheimer's disease research 单细胞 RNA 测序综述:阿尔茨海默病研究的新前沿。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-12 DOI: 10.1016/j.arr.2024.102454

Alzheimer's disease (AD) is a multifaceted neurodegenerative condition marked by gradual cognitive deterioration and the loss of neurons. While conventional bulk RNA sequencing techniques have shed light on AD pathology, they frequently obscure the cellular diversity within brain tissues. The advent of single-cell RNA sequencing (scRNA-seq) has transformed our capability to analyze the cellular composition of AD, allowing for the detection of unique cell populations, rare cell types, and gene expression alterations at an individual cell level. This review examines the use of scRNA-seq in AD research, focusing on its contributions to understanding cellular diversity, disease progression, and potential therapeutic targets. We discuss key technological innovations, data analysis techniques, and challenges associated with scRNA-seq in studying AD. Furthermore, we highlight recent studies that have utilized scRNA-seq to identify novel biomarkers, uncover disease-associated pathways, and elucidate the role of non-neuronal cells, such as microglia and astrocytes, in AD pathogenesis. By providing a comprehensive overview of advancements in scRNA-seq for unraveling cellular heterogeneity in AD, this review highlights the transformative impact of scRNA-seq on our comprehension of disease mechanisms and the creation of targeted treatments.

阿尔茨海默病(AD)是一种多发性神经退行性疾病,以认知能力逐渐退化和神经元丧失为特征。虽然传统的大容量 RNA 测序技术已经揭示了阿尔茨海默病的病理,但它们常常掩盖了脑组织内细胞的多样性。单细胞RNA测序(scRNA-seq)的出现改变了我们分析AD细胞组成的能力,使我们能够在单个细胞水平上检测独特的细胞群、罕见的细胞类型和基因表达的改变。本综述探讨了 scRNA-seq 在 AD 研究中的应用,重点是它对了解细胞多样性、疾病进展和潜在治疗靶点的贡献。我们讨论了与 scRNA-seq 研究 AD 相关的关键技术创新、数据分析技术和挑战。此外,我们还重点介绍了利用 scRNA-seq 鉴定新型生物标记物、发现疾病相关通路以及阐明小胶质细胞和星形胶质细胞等非神经元细胞在 AD 发病机制中的作用的最新研究。本综述全面概述了 scRNA-seq 在揭示 AD 中细胞异质性方面取得的进展,强调了 scRNA-seq 对我们理解疾病机制和创造靶向治疗方法的变革性影响。
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引用次数: 0
Advancing the understanding of diabetic encephalopathy through unravelling pathogenesis and exploring future treatment perspectives 通过揭示发病机制和探索未来治疗前景,增进对糖尿病脑病的了解。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-10 DOI: 10.1016/j.arr.2024.102450

Diabetic encephalopathy (DE), a significant micro-complication of diabetes, manifests as neurochemical, structural, behavioral, and cognitive alterations. This condition is especially dangerous for the elderly because aging raises the risk of neurodegenerative disorders and cognitive impairment, both of which can be made worse by diabetes. Despite its severity, diagnosis of this disease is challenging, and there is a paucity of information on its pathogenesis. The pivotal roles of various cellular pathways, activated or influenced by hyperglycemia, insulin sensitivity, amyloid accumulation, tau hyperphosphorylation, brain vasculopathy, neuroinflammation, and oxidative stress, are widely recognized for contributing to the potential causes of diabetic encephalopathy. We also reviewed current pharmacological strategies for DE encompassing a comprehensive approach targeting metabolic dysregulations and neurological manifestations. Antioxidant-based therapies hold promise in mitigating oxidative stress-induced neuronal damage, while anti-diabetic drugs offer neuroprotective effects through diverse mechanisms, including modulation of insulin signaling pathways and neuroinflammation. Additionally, tissue engineering and nanomedicine-based approaches present innovative strategies for targeted drug delivery and regenerative therapies for DE. Despite significant progress, challenges remain in translating these therapeutic interventions into clinical practice, including long-term safety, scalability, and regulatory approval. Further research is warranted to optimize these approaches and address remaining gaps in the management of DE and associated neurodegenerative disorders.

糖尿病脑病(DE)是糖尿病的一种重要微并发症,表现为神经化学、结构、行为和认知的改变。这种病症对老年人尤为危险,因为衰老会增加神经退行性疾病和认知障碍的风险,而这两种疾病都会因糖尿病而恶化。尽管这种疾病很严重,但诊断却很困难,有关其发病机制的信息也很少。高血糖、胰岛素敏感性、淀粉样蛋白累积、tau 高磷酸化、脑血管病变、神经炎症和氧化应激激活或影响了各种细胞通路,它们在糖尿病脑病潜在病因中的关键作用已得到广泛认可。我们还回顾了目前针对糖尿病脑病的药物治疗策略,包括针对代谢失调和神经系统表现的综合方法。以抗氧化剂为基础的疗法有望减轻氧化应激诱导的神经元损伤,而抗糖尿病药物则通过不同的机制提供神经保护作用,包括调节胰岛素信号通路和神经炎症。此外,组织工程和基于纳米药物的方法为定向给药和神经损伤再生疗法提供了创新策略。尽管取得了重大进展,但将这些治疗干预措施转化为临床实践仍面临挑战,包括长期安全性、可扩展性和监管审批。有必要开展进一步的研究,以优化这些方法,并解决在治疗 DE 和相关神经退行性疾病方面仍然存在的差距。
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引用次数: 0
The metabolic and endocrine impact of diet-derived gut microbiota metabolites on ageing and longevity 源自饮食的肠道微生物群代谢物对衰老和长寿的代谢和内分泌影响。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-09 DOI: 10.1016/j.arr.2024.102451

Gut dysbiosis has been recently recognized as a hallmark of ageing. At this stage of life, gut microbiota becomes depleted from bacteria involved in the production of short-chain fatty acids (SCFA), indole and its derivative indole-3-propionic acid (IPA), metabolites shown to improve host glycemic control as well as insulin sensitivity and secretion. Moreover, gut microbiota becomes enriched in pathobiont bacteria involved in the production of imidazole propionate, phenols and trimethylamine, metabolites that promote host insulin resistance and atherosclerosis. The magnitude of these changes is much more pronounced in unhealthy than in healthy ageing. On the other hand, a distinct gut microbiota signature is displayed during longevity, the most prominent being an enrichment in both SCFA and IPA bacterial producers. This short Review discusses, in an innovative and integrative way, cutting-edge research on the composition of gut microorganisms and profile of metabolites secreted by them, that are associated with a healthy and unhealthy ageing pattern and with longevity. A detailed description of the positive or detrimental metabolic effects, in the ageing host, of diet-derived gut microbial metabolites is provided. Finally, microbiota-targeted interventions that counteract gut dysbiosis associated with ageing, are briefly outlined.

肠道菌群失调最近被认为是老龄化的一个标志。在生命的这一阶段,肠道微生物群中参与产生短链脂肪酸(SCFA)、吲哚及其衍生物吲哚-3-丙酸(IPA)的细菌逐渐减少,而这些代谢产物被证明可改善宿主的血糖控制以及胰岛素敏感性和分泌。此外,肠道微生物群会富集病原菌,这些病原菌参与产生咪唑丙酸盐、酚类和三甲胺,这些代谢物会促进宿主的胰岛素抵抗和动脉粥样硬化。这些变化在不健康的老龄化中比在健康的老龄化中更为明显。另一方面,在长寿过程中会出现独特的肠道微生物群特征,其中最突出的是富含 SCFA 和 IPA 细菌。这篇简短的综述以创新和综合的方式,讨论了与健康和不健康老龄化模式以及长寿相关的肠道微生物组成及其分泌的代谢物概况的前沿研究。研究还详细描述了饮食中的肠道微生物代谢物对老龄化宿主产生的积极或有害代谢影响。最后,还简要介绍了以微生物群为目标的干预措施,这些措施可以抵御与老龄化相关的肠道菌群失调。
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引用次数: 0
Suicide and dementia: A systematic review and meta-analysis of prevalence and risk factors 自杀与痴呆症:自杀与痴呆症:发病率与风险因素的系统回顾与荟萃分析。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-08 DOI: 10.1016/j.arr.2024.102445

Dementia is a global health concern with increasing numbers of people living long enough to develop dementia. People with dementia (PwD) may be particularly vulnerable to suicidality. However, suicide in PwD has not been thoroughly explored. The objective of this review was to determine the prevalence and risk factors of suicide in PwD. Five databases were searched from inception to July 2023. Peer-reviewed publications reporting prevalence, risk factors or quantitative summary data for suicide outcomes in PwD were included. Random effects models were used to calculate the pooled prevalence and effect sizes. 54 studies met inclusion criteria. In PwD, the point prevalence of suicidal ideation was 10 % (95 %CI=6 %;16 %), 2-year period prevalence of suicide attempts was 0.8 % (95 %CI=0.3 %;2 %), 10-year period prevalence of suicide attempts was 8.7 % (95 %CI=6.0 %%;12.7 %) and the incidence of death by suicide 0.1 % (95 %CI=0.1 %;0.2 %). Compared to not having dementia, a diagnosis of dementia increased risk of suicidal ideation (OR=1.62[95 %CI=1.17;2.24]) but not risk of suicide attempt (OR=1.77 [95 %CI=0.85;3.69]) or death by suicide (OR=1.30 [95 %CI=0.81;2.10]). People with moderate dementia had significantly increased risk of suicidal ideation than those with mild dementia (OR=1.59[95 %CI=1.11;2.28]), younger PwD were at increased risk of dying by suicide (OR=2.82[95 %CI=2.16;3.68]) and men with dementia were more likely to attempt (OR=1.28[95 %CI=1.25;1.31]) and die by suicide (OR=2.88[95 %CI=1.54;5.39]) than women with dementia. This review emphasises the need for mental health support and suicide prevention in dementia care, emphasising tailored approaches based on age, symptoms, and being male.

痴呆症是一个全球关注的健康问题,越来越多的人在足够长的寿命中患上痴呆症。痴呆症患者(PwD)可能特别容易出现自杀倾向。然而,人们尚未对痴呆症患者的自杀问题进行深入研究。本综述旨在确定痴呆症患者自杀的发生率和风险因素。我们检索了从开始到 2023 年 7 月的五个数据库。收录了报告残疾人自杀流行率、风险因素或自杀结果定量汇总数据的同行评议出版物。采用随机效应模型计算汇总的流行率和效应大小。55 项研究符合纳入标准。在残疾人中,自杀意念的点流行率为 10% (95%CI=6%;16%),2 年期间自杀未遂的流行率为 0.8% (95%CI=0.3%;2%),10 年期间自杀未遂的流行率为 8.7% (95%CI=6.0%;12.7%),自杀死亡的发生率为 0.1% (95%CI=0.1%;0.2%)。与未患痴呆症的患者相比,诊断出痴呆症会增加萌生自杀念头的风险(OR=1.62[95%CI=1.17;2.24]),但不会增加自杀未遂的风险(OR=1.77[95%CI=0.85;3.69])或自杀死亡的风险(OR=1.30[95%CI=0.81;2.10])。与轻度痴呆症患者相比,中度痴呆症患者出现自杀意念的风险明显增加(OR=1.59[95%CI=1.11;2.28]),年轻的残疾人死于自杀的风险增加(OR=2.82[95%CI=2.16;3.68]),与患有痴呆症的女性相比,患有痴呆症的男性更有可能自杀未遂(OR=1.28[95%CI=1.25;1.31])和自杀身亡(OR=2.88[95%CI=1.54;5.39])。本综述强调了在痴呆症护理中提供心理健康支持和预防自杀的必要性,并强调要根据患者的年龄、症状和男性身份采取针对性的方法。
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引用次数: 0
Friend or foe: Lactate in neurodegenerative diseases 朋友还是敌人:神经退行性疾病中的乳酸盐。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-08 DOI: 10.1016/j.arr.2024.102452

Lactate, a byproduct of glycolysis, was considered as a metabolic waste until identified by studies on the Warburg effect. Increasing evidence elucidates that lactate functions as energy fuel, signaling molecule, and donor for protein lactylation. Altered lactate utilization is a common metabolic feature of the onset and progression of neurodegenerative diseases, such as Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease and Huntington's disease. This review offers an overview of lactate metabolism from the perspective of production, transportation and clearance, and the role of lactate in neurodegenerative progression, as well as a summary of protein lactylation and the signaling function of lactate in neurodegenerative diseases. Besides, this review delves into the dual roles of changed lactate metabolism during neurodegeneration and explores prospective therapeutic methods targeting lactate. We propose that elucidating the correlation between lactate and neurodegeneration is pivotal for exploring innovative therapeutic interventions for neurodegenerative diseases.

乳酸是糖酵解的副产物,在被沃伯格效应研究发现之前,一直被认为是一种代谢废物。越来越多的证据表明,乳酸具有能量燃料、信号分子和蛋白质乳化供体的功能。乳酸利用的改变是阿尔茨海默病、多发性硬化症、肌萎缩性脊髓侧索硬化症、帕金森病和亨廷顿病等神经退行性疾病发病和进展过程中常见的代谢特征。本综述从乳酸的产生、运输和清除的角度概述了乳酸的代谢,以及乳酸在神经退行性疾病进展中的作用,并总结了蛋白质乳化和乳酸在神经退行性疾病中的信号功能。此外,本综述还深入探讨了神经退行性变过程中乳酸代谢变化的双重作用,并探讨了针对乳酸的前瞻性治疗方法。我们认为,阐明乳酸盐与神经退行性变之间的相关性对于探索神经退行性疾病的创新治疗干预措施至关重要。
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引用次数: 0
The current status and challenges of olfactory dysfunction study in Alzheimer's Disease 阿尔茨海默病嗅觉功能障碍研究的现状与挑战。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-08 DOI: 10.1016/j.arr.2024.102453

Olfactory functioning involves multiple cognitive processes and the coordinated actions of various neural systems. Any disruption at any stage of this process may result in olfactory dysfunction, which is consequently widely used to predict the onset and progression of diseases, such as Alzheimer’s Disease (AD). Although the underlying mechanisms have not yet been fully unraveled, apparent changes were observed in olfactory brain areas form patients who suffer from AD by means of medical imaging and electroencephalography (EEG). Olfactory dysfunction holds significant promise in detecting AD during the preclinical stage preceding mild cognitive impairment (MCI). Owing to the strong specificity, olfactory tests are prevalently applied for screening in community cohorts. And combining olfactory tests with other biomarkers may further establish an optimal model for AD prediction in studies of specific olfactory dysfunctions and improve the sensitivity and specificity of early AD diagnosis.

嗅觉功能涉及多个认知过程和各种神经系统的协调作用。这一过程中任何阶段的中断都可能导致嗅觉功能障碍,因此嗅觉功能障碍被广泛用于预测阿尔茨海默病(AD)等疾病的发生和发展。虽然其潜在机制尚未完全揭开,但通过医学成像和脑电图(EEG),我们在阿尔茨海默病患者的嗅觉脑区观察到了明显的变化。在轻度认知障碍(MCI)之前的临床前阶段,嗅觉功能障碍在检测注意力缺失症方面大有可为。由于嗅觉测试具有很强的特异性,因此被广泛应用于社区人群的筛查。将嗅觉测试与其他生物标志物相结合,可以在特定嗅觉功能障碍的研究中进一步建立最佳的注意力缺失症预测模型,并提高早期注意力缺失症诊断的灵敏度和特异性。
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引用次数: 0
The risk of cognitive decline and dementia in older adults diagnosed with COVID-19: A systematic review and meta-analysis 被诊断患有 COVID-19 的老年人认知能力下降和痴呆症的风险:系统回顾与荟萃分析。
IF 12.5 1区 医学 Q1 CELL BIOLOGY Pub Date : 2024-08-08 DOI: 10.1016/j.arr.2024.102448

Background

Cognitive impairment can be caused by infections with various pathogens, including SARS-CoV-2. Research has yet to determine the true incidence and course of cognitive impairment in older adults following COVID-19. Furthermore, research has theorised that COVID-19 is associated with dementia progression and diagnosis but this association has yet to be fully described.

Methods

A systematic review was registered in Prospero and conducted on the databases PubMed, Embase, Ovid, CENTRAL and Cochrane Library. Studies reporting cognitive impairment and dementia outcomes in post-acute and post-COVID-19 patients aged ≥65 years, and which included control data, were included in this review.

Results

15,124 articles were identified by the search strategy. After eliminating duplicate titles and completing title, abstracts and full-text review, 18 studies were included comprising of 412,957 patients with COVID-19 (46.63 % male) and 411,929 patients without COVID-19 (46.59 % male). The overall mean Montreal Cognitive Assessment (MoCA) score in COVID-19 patients was 23.34 out of 30 (95 % CI [22.24, 24.43]). indicating cognitive impairment. The overall proportion of patients identified as having new onset cognitive impairment was 65 % (95 % CI [44,81]). Subgroup analyses indicated that time since infection significantly improves overall MoCA score and reduces proportion of patients with cognitive impairment.

Conclusion

This study indicates that cognitive impairment may be an important sequela of COVID-19. Further research with adequate sample sizes is warranted regarding COVID-19’s association with new-onset dementia and dementia progression, and the effect of repeat infections. There is a need for development of diagnostic and management protocols for COVID-19 patients with cognitive impairment.

背景:包括 SARS-CoV-2 在内的各种病原体感染都可能导致认知障碍。目前的研究尚未确定 COVID-19 感染后老年人认知障碍的真正发病率和病程。此外,有研究推测 COVID-19 与痴呆症的发展和诊断有关,但这种关联尚未得到充分描述:方法:我们在 Prospero 中注册了一项系统综述,并在 PubMed、Embase、Ovid、CENTRAL 和 Cochrane Library 等数据库中进行了检索。本综述纳入了对年龄≥65岁的COVID-19急性期后和COVID-19后患者的认知功能障碍和痴呆症结果进行报告的研究,其中包括对照数据:结果:检索策略确定了 15124 篇文章。剔除重复标题并完成标题、摘要和全文审阅后,共纳入 18 项研究,包括 412 957 名 COVID-19 患者(46.63% 为男性)和 411 929 名无 COVID-19 患者(46.59% 为男性)。COVID-19患者的蒙特利尔认知评估(MoCA)总平均得分为23.34分(满分30分)(95% CI [22.24,24.43])。被确认患有新发认知障碍的患者总比例为 65%(95% CI [44, 81])。亚组分析表明,感染后的时间可显著提高 MoCA 总分,并降低认知障碍患者的比例:这项研究表明,认知障碍可能是 COVID-19 的一个重要后遗症。关于 COVID-19 与新发痴呆症和痴呆症进展的关系以及重复感染的影响,有必要进行样本量充足的进一步研究。有必要为有认知障碍的 COVID-19 患者制定诊断和管理方案。
{"title":"The risk of cognitive decline and dementia in older adults diagnosed with COVID-19: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.arr.2024.102448","DOIUrl":"10.1016/j.arr.2024.102448","url":null,"abstract":"<div><h3>Background</h3><p>Cognitive impairment can be caused by infections with various pathogens, including SARS-CoV-2. Research has yet to determine the true incidence and course of cognitive impairment in older adults following COVID-19. Furthermore, research has theorised that COVID-19 is associated with dementia progression and diagnosis but this association has yet to be fully described.</p></div><div><h3>Methods</h3><p>A systematic review was registered in Prospero and conducted on the databases PubMed, Embase, Ovid, CENTRAL and Cochrane Library. Studies reporting cognitive impairment and dementia outcomes in post-acute and post-COVID-19 patients aged ≥65 years, and which included control data, were included in this review.</p></div><div><h3>Results</h3><p>15,124 articles were identified by the search strategy. After eliminating duplicate titles and completing title, abstracts and full-text review, 18 studies were included comprising of 412,957 patients with COVID-19 (46.63 % male) and 411,929 patients without COVID-19 (46.59 % male). The overall mean Montreal Cognitive Assessment (MoCA) score in COVID-19 patients was 23.34 out of 30 (95 % CI [22.24, 24.43]). indicating cognitive impairment. The overall proportion of patients identified as having new onset cognitive impairment was 65 % (95 % CI [44,81]). Subgroup analyses indicated that time since infection significantly improves overall MoCA score and reduces proportion of patients with cognitive impairment.</p></div><div><h3>Conclusion</h3><p>This study indicates that cognitive impairment may be an important sequela of COVID-19. Further research with adequate sample sizes is warranted regarding COVID-19’s association with new-onset dementia and dementia progression, and the effect of repeat infections. There is a need for development of diagnostic and management protocols for COVID-19 patients with cognitive impairment.</p></div>","PeriodicalId":55545,"journal":{"name":"Ageing Research Reviews","volume":null,"pages":null},"PeriodicalIF":12.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Ageing Research Reviews
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