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Advancements in Thyroidectomy: A Mini Review 甲状腺切除术的进展:一个小回顾
Pub Date : 2022-12-07 DOI: 10.3390/endocrines3040065
Woochul Kim, Ja Kyung Lee, H. Yu, J. Choi
Demand for minimally invasive surgery has driven the development of new gadgets and surgical techniques. Yet, questions about safety and skeptical views on new technology have prevented proliferation of new modes of surgery. This skepticism is perhaps due to unfamiliarity of new fields. Likewise, there are currently various remote-access techniques available for thyroid surgeons that only few regions in the world have adapted. This review will explore the history of minimally invasive techniques in thyroid surgery and introduce new technology to be implemented.
对微创手术的需求推动了新器械和手术技术的发展。然而,关于安全性的问题和对新技术的怀疑态度阻碍了新手术模式的扩散。这种怀疑可能是由于对新领域的不熟悉。同样,目前有各种可供甲状腺外科医生使用的远程访问技术,世界上只有少数地区采用了这些技术。本文将探讨甲状腺手术中微创技术的发展历史,并介绍即将实施的新技术。
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引用次数: 0
Looking at Diabetes-Related Distress through a New Lens: The Socio-Ecological Health Model 从一个新的角度看糖尿病相关的痛苦:社会生态健康模型
Pub Date : 2022-12-06 DOI: 10.3390/endocrines3040064
Neeka Farnoudi, Mimi Lyang, Kees Vanderwyk, Sarah Vreeburg, Clipper F. Young
Diabetes-related distress (DRD) is defined as an emotional state experienced by people with diabetes (PWD) who are worried about their disease management, the emotional burden from the condition, and/or potential difficulties accessing care or support. The psychosocial aspect of diabetes management is a factor that directly influences patients’ well-being as well as the chronic management of the condition yet is not a primary clinical problem being addressed within the healthcare setting. This review advocates for a re-evaluation and subsequent adjustment of the current DRD screening methodology by implementing the five primary components (Intrapersonal, Interpersonal, Organizational, Community, and Public Policy) of the Socio-Ecological Model of Health (SEMH), bridging the gaps from a public-health perspective. We searched two electronic databases for studies published in the United States from 1995 to 2020 reporting the effects of social determinants of health (SDOH) on DRD. Articles that contained at least one of the five elements of the SEMH and focused on adults aged 18 years or older were included. SDOH, which include circumstances where individuals grow, work, and age, are highly influenced by external factors, such as the distribution of wealth, power, and resources. Current DRD screening tools lack the capacity to account for all major components of SDOH in a comprehensive manner. By applying the SEMH as a theory-based framework, a novel DRD screening tool addressing sex, ethnicity, and socioeconomic background should be implemented to better improve diabetes management outcomes. By exploring the relationships between each level of the SEMH and DRD, healthcare professionals will be better equipped to recognize potential stress-inducing factors for individuals managing diabetes. Further efforts should be invested with the goal of developing a novel screening tool founded on the all-encompassing SEMH in order to perpetuate a more comprehensive diabetes treatment plan to address barriers within the SDOH framework.
糖尿病相关痛苦(DRD)被定义为糖尿病患者所经历的一种情绪状态,他们担心自己的疾病管理、疾病带来的情绪负担和/或获得护理或支持的潜在困难。糖尿病管理的心理社会方面是一个直接影响患者健康和病情慢性管理的因素,但这并不是医疗环境中正在解决的主要临床问题。本审查主张通过实施健康社会生态模型(SEMH)的五个主要组成部分(个人内部、人际、组织、社区和公共政策),从公共卫生的角度弥合差距,重新评估并随后调整当前的DRD筛查方法。我们在两个电子数据库中搜索了1995年至2020年在美国发表的报告健康社会决定因素(SDOH)对DRD影响的研究。文章至少包含SEMH五个要素中的一个,并以18岁或以上的成年人为重点。SDOH,包括个人成长、工作和年龄的环境,在很大程度上受到外部因素的影响,如财富、权力和资源的分配。目前的DRD筛查工具缺乏全面解释SDOH所有主要成分的能力。通过应用SEMH作为一个基于理论的框架,应该实施一种新的DRD筛查工具,解决性别、种族和社会经济背景问题,以更好地改善糖尿病管理结果。通过探索SEMH和DRD的各个级别之间的关系,医疗保健专业人员将能够更好地识别糖尿病患者的潜在压力诱发因素。应进一步努力,以开发一种基于全面SEMH的新型筛查工具为目标,从而使更全面的糖尿病治疗计划永久化,以解决SDOH框架内的障碍。
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引用次数: 0
Neuroendocrine Blockade of the Reproductive Axis in Female Athletes 女性运动员生殖轴的神经内分泌阻断
Pub Date : 2022-12-05 DOI: 10.3390/endocrines3040063
W. Rossmanith
This review aims at defining the neuroendocrine mechanisms underlying the sport-induced restrictions of the reproductive axis in female athletes. Episodic gonadotropin release was found to be compromised, presumably a result of impaired hypothalamic pulsatile GnRH release. Any deviation from optimal gonadotropin release may result in a suboptimal function of the ovaries, leading to disorders of the menstrual cycle and ovulation. A whole spectrum of menstrual dysfunctions ranging from ovulatory eumenorrhea to luteal phase defects and amenorrhea has been reported in sportive women. As essential neuroendocrine factors underlying these observations, activation of the adrenal axis and altered central nervous neurotransmitter activity have been identified to transfer metabolic, nutritional, and stress signals into the hypothalamic GnRH release. The degree by which the neuroendocrine axis governing reproduction is impaired critically depends on the intensity and duration of exercise and the state of training. Other decisive factors may be energy expenditure and availability, nutritional components, and the maturity of the hypothalamic-pituitary-ovarian (HPO) axis when sport activity was initiated. In conclusion, the gradual cessation of reproductive function observed in female athletes may be interpreted as an adaptive mechanism in response to physical and psychological endurance during sport. This sport-induced restriction of reproductive capacity may serve as protection (endogenous contraception) to preserve a woman’s health.
这篇综述旨在确定女性运动员运动引起的生殖轴限制的神经内分泌机制。发作性促性腺激素释放被发现受到损害,可能是下丘脑搏动性GnRH释放受损的结果。任何偏离最佳促性腺激素释放的情况都可能导致卵巢功能不理想,导致月经周期和排卵紊乱。据报道,运动型女性出现了一系列月经功能障碍,从排卵期痛经到黄体期缺陷和闭经。作为这些观察结果的基本神经内分泌因素,肾上腺轴的激活和中枢神经递质活性的改变已被确定为将代谢、营养和应激信号转移到下丘脑GnRH释放中。控制生殖的神经内分泌轴受损的程度严重取决于运动的强度和持续时间以及训练状态。其他决定性因素可能是运动活动开始时的能量消耗和可用性、营养成分以及下丘脑-垂体-卵巢(HPO)轴的成熟度。总之,在女运动员身上观察到的生殖功能的逐渐停止可能被解释为运动过程中对身体和心理耐力的一种适应机制。这种由运动引起的对生育能力的限制可以作为保护(内源性避孕)来保护妇女的健康。
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引用次数: 0
Perceptions of Youth and Parent Decision-Making Roles Regarding Recombinant Human Growth Hormone Treatment. 关于重组人类生长激素治疗的青年和父母决策角色的认知。
Pub Date : 2022-12-01 DOI: 10.3390/endocrines3040050
Ettya R Fremont, Elizabeth A Friedrich, Chris Feudtner, Adda Grimberg, Victoria A Miller

Recombinant human growth hormone (rhGH) is prescribed to youth with growth hormone deficiency (GHD) to support normal growth and ensure healthy physical development, and to youth without GHD to address height concerns. Perceptions of youth involvement in rhGH treatment decisions have not been explored. This study aimed to examine perceptions of youth and parent roles in decisions around rhGH treatment. Youth (n = 22, 11.5 ± 2.0 years) who had undergone evaluation for short stature and their parents (n = 22) participated in semi-structured interviews after stimulation test results had been received. Interviews revealed the following themes: 1) parent provided youth with support; 2) parent facilitated youth's decision-making involvement; 3) youth had no role or did not remember their role; and 4) youth did not remember conversations with their parents or providers. Parents facilitated their children's involvement by sharing information and seeking their opinions. Whereas some participants described youth as having a substantial decision-making role, not all youth felt they were involved, and some youth could not recall conversations about rhGH. Parents can bolster youth involvement by having conversations using developmentally appropriate language, which is critical to youth feeling empowered and developing efficacy over their own care.

重组人生长激素(rhGH)用于患有生长激素缺乏症(GHD)的青少年,以支持正常生长和确保健康的身体发育,而对于没有GHD的青少年,则用于解决身高问题。对青少年参与rhGH治疗决策的看法尚未得到探讨。本研究旨在探讨青少年和父母在rhGH治疗决策中的作用。接受过矮小评价的青少年(n = 22, 11.5±2.0岁)及其父母(n = 22)在收到刺激测试结果后进行半结构化访谈。访谈揭示了以下主题:1)父母为青少年提供支持;2)家长促进青少年决策参与;3)年轻人没有角色或不记得自己的角色;年轻人不记得与父母或家庭成员的谈话。父母通过分享信息和征求孩子的意见来促进孩子的参与。尽管一些参与者认为年轻人在决策中起着重要作用,但并非所有年轻人都觉得自己参与其中,有些年轻人不记得关于rhGH的谈话。父母可以通过使用适合发展的语言进行对话来促进青少年的参与,这对青少年感到被赋予权力并对自己的照顾产生效力至关重要。
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引用次数: 0
Growth Hormone-Releasing Hormone Antagonist JV-1-36 Suppresses Reactive Oxygen Species Generation in A549 Lung Cancer Cells. 生长激素释放激素拮抗剂JV-1-36抑制A549肺癌细胞活性氧生成
Pub Date : 2022-12-01 DOI: 10.3390/endocrines3040067
Khadeja-Tul Kubra, Mohammad S Akhter, Kaitlyn Apperley, Nektarios Barabutis

Growth hormone-releasing hormone (GHRH) and its receptors are expressed in a variety of human cancers, and have been involved in malignancies. GHRH antagonists (GHRHAnt) were developed to suppress tumor progression and metastasis. Previous studies demonstrate the involvement of reactive oxygen species (ROS) in cancer progression. Herein, we investigate the effect of a commercially available GHRH antagonist, namely JV-1-36, in the redox status of the A549 human cancer cell line. Our results suggest that this peptide significantly reduces ROS production in those cells in a time-dependent manner and counteracts H2O2-induced ROS. Our study supports the anti-oxidative effects of JV-1-36 and contributes in our knowledge towards the in vitro effects of GHRHAnt in cancers.

生长激素释放激素(GHRH)及其受体在多种人类癌症中表达,并与恶性肿瘤有关。GHRH拮抗剂(GHRHAnt)被开发用于抑制肿瘤的进展和转移。先前的研究表明活性氧(ROS)参与了癌症的进展。在这里,我们研究了一种市售的GHRH拮抗剂,即JV-1-36,在A549人癌细胞系的氧化还原状态中的作用。我们的研究结果表明,这种肽以一种时间依赖性的方式显著减少了这些细胞中ROS的产生,并抵消了h2o2诱导的ROS。我们的研究支持了JV-1-36的抗氧化作用,并有助于我们了解GHRHAnt在癌症中的体外作用。
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引用次数: 4
Cost-Effectiveness of Screening to Identify Pre-Diabetes and Diabetes in the Oral Healthcare Setting 口腔保健环境中筛查糖尿病前期和糖尿病的成本效益
Pub Date : 2022-12-01 DOI: 10.3390/endocrines3040062
Lan Gao, Elise Tan, R. Mariño, Michelle King, Andre Priede, G. Adams, Maria Sicari, M. Moodie
Background: This study assesses the long-term cost-effectiveness of this screening protocol from a healthcare system perspective. Methods: Australians presenting to private oral healthcare practices recruited to the iDENTify study were included as the study population. A Markov model preceded by a decision tree was developed to assess the intervention’s long-term cost-effectiveness when rolled out to all eligible Australians, and measured against ‘no-intervention’ current practice. The model consisted of four health states: normoglycaemia; pre-diabetes; type 2 diabetes and death. Intervention reach of various levels (10%, 20%, 30%, and 40%) were assessed. The model adopted a 30-year lifetime horizon and a 2020 reference year. Costs and benefits were discounted at 5% per annum. Results: If the intervention reached a minimum of 10% of the target population, over the lifetime time horizon, each screened participant would incur a cost of $38,462 and a gain of 10.564 QALYs, compared to $38,469 and 10.561 QALYs for each participant under current practice. Screening was associated with lower costs and higher benefits (a saving of $8 per person and 0.003 QALYs gained), compared to current standard practice without such screening. Between 8 and 34 type 2 diabetes cases would be avoided per 10,000 patients screened if the intervention were taken up by 10% to 40% of private oral healthcare practices. Sensitivity analyses showed consistent results. Conclusions: Implementing type 2 diabetes screening in the private oral healthcare setting using a simple risk assessment tool was demonstrated to be cost-saving. The wider adoption of such screening is recommended.
背景:本研究从医疗保健系统的角度评估这种筛查方案的长期成本效益。方法:澳大利亚人提出的私人口腔保健实践招募识别研究包括作为研究人群。开发了一个决策树之前的马尔可夫模型,以评估干预措施在推广到所有符合条件的澳大利亚人时的长期成本效益,并与“不干预”的现行做法进行比较。该模型由四种健康状态组成:血糖正常;糖尿病前期;2型糖尿病和死亡评估不同水平(10%、20%、30%、40%)的干预效果。该模型采用了30年的生命周期和2020年的参考年。成本和收益按每年5%折现。结果:如果干预至少达到目标人群的10%,在一生的时间范围内,每个筛查的参与者将产生38,462美元的成本和10.564 QALYs的收益,而在目前的实践中,每个参与者的成本为38,469美元和10.561 QALYs。与目前没有进行筛查的标准做法相比,筛查的成本更低,收益更高(每人节省8美元,获得0.003个QALYs)。如果在私人口腔保健实践中采用10%至40%的干预措施,每10,000名接受筛查的患者中将避免8至34例2型糖尿病病例。敏感性分析结果一致。结论:使用简单的风险评估工具在私人口腔保健机构实施2型糖尿病筛查被证明是节省成本的。建议更广泛地采用这种筛查。
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引用次数: 0
Updates of Genomics and Proteomics of Parathyroid Carcinoma 甲状旁腺癌基因组学和蛋白质组学研究进展
Pub Date : 2022-11-21 DOI: 10.3390/endocrines3040061
S. Kong
Parathyroid carcinoma is a rare disease that needs an additional diagnostic tool and wide therapeutic options. The genomics and proteomics approach may help to find the tools to improve the prognosis of the disease by early detection and metastatic control. The findings from genomics were mainly CDC73, PRUNE2, CCND1, and genes related to PI3K/AKT/mTOR and Wnt pathways. CDC73, PRUNE2, and CCND1 were closely related to each other, and PRUNE2 and CCND1 genes are related to expression levels of parafibromin protein, which may aid in supporting the definite diagnosis of the disease. PI3K/AKT/mTOR and Wnt pathways could be a potential therapeutic target for the disease, which needs further basket trials to prove the concept. In this review, current findings from genomics and proteomics studies in parathyroid carcinoma were reviewed.
甲状旁腺癌是一种罕见的疾病,需要额外的诊断工具和广泛的治疗选择。基因组学和蛋白质组学方法可能有助于找到通过早期检测和转移控制来改善疾病预后的工具。基因组学的发现主要是CDC73、PRUNE2、CCND1,以及与PI3K/AKT/mTOR和Wnt通路相关的基因。CDC73、PRUNE2和CCND1基因关系密切,PRUNE2与CCND1与副纤维蛋白的表达水平有关,这可能有助于支持疾病的确切诊断。PI3K/AKT/mTOR和Wnt途径可能是该疾病的潜在治疗靶点,需要进一步的篮子试验来证明这一概念。本文综述了甲状旁腺癌基因组学和蛋白质组学研究的最新进展。
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引用次数: 4
Long COVID and the Neuroendocrinology of Microbial Translocation Outside the GI Tract: Some Treatment Strategies 长COVID与胃肠道外微生物易位的神经内分泌学:一些治疗策略
Pub Date : 2022-11-07 DOI: 10.3390/endocrines3040058
A. Sfera, C. Osorio, S. Hazan, Z. Kozlakidis, J. C. Maldonado, C. M. Zapata-Martín del Campo, Jonathan J. Anton, Leah Rahman, Christina V. Andronescu, G. Nicolson
Similar to previous pandemics, COVID-19 has been succeeded by well-documented post-infectious sequelae, including chronic fatigue, cough, shortness of breath, myalgia, and concentration difficulties, which may last 5 to 12 weeks or longer after the acute phase of illness. Both the psychological stress of SARS-CoV-2 infection and being diagnosed with COVID-19 can upregulate cortisol, a stress hormone that disrupts the efferocytosis effectors, macrophages, and natural killer cells, leading to the excessive accumulation of senescent cells and disruption of biological barriers. This has been well-established in cancer patients who often experience unrelenting fatigue as well as gut and blood–brain barrier dysfunction upon treatment with senescence-inducing radiation or chemotherapy. In our previous research from 2020 and 2021, we linked COVID-19 to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) via angiotensin II upregulation, premature endothelial senescence, intestinal barrier dysfunction, and microbial translocation from the gastrointestinal tract into the systemic circulation. In 2021 and 2022, these hypotheses were validated and SARS-CoV-2-induced cellular senescence as well as microbial translocation were documented in both acute SARS-CoV-2 infection, long COVID, and ME/CFS, connecting intestinal barrier dysfunction to disabling fatigue and specific infectious events. The purpose of this narrative review is to summarize what is currently known about host immune responses to translocated gut microbes and how these responses relate to fatiguing illnesses, including long COVID. To accomplish this goal, we examine the role of intestinal and blood–brain barriers in long COVID and other illnesses typified by chronic fatigue, with a special emphasis on commensal microbes functioning as viral reservoirs. Furthermore, we discuss the role of SARS-CoV-2/Mycoplasma coinfection in dysfunctional efferocytosis, emphasizing some potential novel treatment strategies, including the use of senotherapeutic drugs, HMGB1 inhibitors, Toll-like receptor 4 (TLR4) blockers, and membrane lipid replacement.
与以往的大流行类似,COVID-19之后出现了有充分记录的感染后后遗症,包括慢性疲劳、咳嗽、呼吸短促、肌痛和注意力集中困难,这些症状可能在疾病急性期后持续5至12周或更长时间。SARS-CoV-2感染的心理压力和被诊断为COVID-19的心理压力都可以上调皮质醇,皮质醇是一种破坏efferocytosis效应细胞、巨噬细胞和自然杀伤细胞的应激激素,导致衰老细胞的过度积累和生物屏障的破坏。这已经在癌症患者中得到了证实,这些患者在接受诱导衰老的放疗或化疗后,经常会经历持续的疲劳以及肠道和血脑屏障功能障碍。在我们之前的2020年和2021年的研究中,我们通过血管紧张素II上调、内皮细胞过早衰老、肠道屏障功能障碍和微生物从胃肠道进入体循环的易位,将COVID-19与肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)联系起来。在2021年和2022年,这些假设得到了验证,在急性SARS-CoV-2感染、长COVID和ME/CFS中都记录了SARS-CoV-2诱导的细胞衰老和微生物易位,将肠道屏障功能障碍与致残性疲劳和特定感染事件联系起来。这篇叙述性综述的目的是总结目前已知的宿主对易位肠道微生物的免疫反应,以及这些反应与包括长COVID在内的疲劳性疾病的关系。为了实现这一目标,我们研究了肠道和血脑屏障在长期COVID和其他以慢性疲劳为典型的疾病中的作用,特别强调了作为病毒宿主的共生微生物。此外,我们还讨论了SARS-CoV-2/支原体共感染在功能失调的efferocytosis中的作用,强调了一些潜在的新治疗策略,包括使用老年治疗药物、HMGB1抑制剂、toll样受体4 (TLR4)阻滞剂和膜脂替代。
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引用次数: 4
Interactions between 14-3-3 Proteins and Actin Cytoskeleton and Its Regulation by microRNAs and Long Non-Coding RNAs in Cancer 癌症14-3-3蛋白与肌动蛋白细胞骨架的相互作用及其微RNA和长非编码RNA的调控
Pub Date : 2022-11-01 DOI: 10.3390/endocrines3040057
J. Aseervatham
14-3-3s are a family of structurally similar proteins that bind to phosphoserine or phosphothreonine residues, forming the central signaling hub that coordinates or integrates various cellular functions, thereby controlling many pathways important in cancer, cell motility, cell death, cytoskeletal remodeling, neuro-degenerative disorders and many more. Their targets are present in all cellular compartments, and when they bind to proteins they alter their subcellular localization, stability, and molecular interactions with other proteins. Changes in environmental conditions that result in altered homeostasis trigger the interaction between 14-3-3 and other proteins to retrieve or rescue homeostasis. In circumstances where these regulatory proteins are dysregulated, it leads to pathological conditions. Therefore, deeper understanding is needed on how 14-3-3 proteins bind, and how these proteins are regulated or modified. This will help to detect disease in early stages or design inhibitors to block certain pathways. Recently, more research has been devoted to identifying the role of MicroRNAs, and long non-coding RNAs, which play an important role in regulating gene expression. Although there are many reviews on the role of 14-3-3 proteins in cancer, they do not provide a holistic view of the changes in the cell, which is the focus of this review. The unique feature of the review is that it not only focuses on how the 14-3-3 subunits associate and dissociate with their binding and regulatory proteins, but also includes the role of micro-RNAs and long non-coding RNAs and how they regulate 14-3-3 isoforms. The highlight of the review is that it focuses on the role of 14-3-3, actin, actin binding proteins and Rho GTPases in cancer, and how this complex is important for cell migration and invasion. Finally, the reader is provided with super-resolution high-clarity images of each subunit of the 14-3-3 protein family, further depicting their distribution in HeLa cells to illustrate their interactions in a cancer cell.
14-3-3 -3是一个结构相似的蛋白家族,与磷丝氨酸或磷苏氨酸残基结合,形成协调或整合各种细胞功能的中央信号枢纽,从而控制癌症、细胞运动、细胞死亡、细胞骨架重塑、神经退行性疾病等许多重要途径。它们的靶标存在于所有的细胞区室中,当它们与蛋白质结合时,它们会改变其亚细胞定位、稳定性以及与其他蛋白质的分子相互作用。环境条件的变化导致体内平衡的改变,从而触发14-3-3与其他蛋白质之间的相互作用,以恢复或挽救体内平衡。在这些调节蛋白失调的情况下,它会导致病理状况。因此,需要对14-3-3蛋白如何结合以及这些蛋白是如何被调节或修饰的有更深入的了解。这将有助于在早期阶段发现疾病或设计抑制剂来阻断某些途径。近年来,人们对MicroRNAs和长链非编码rna的研究越来越多,它们在基因表达调控中起着重要的作用。虽然有很多关于14-3-3蛋白在癌症中的作用的综述,但它们并没有提供细胞变化的整体观点,这是本文的重点。该综述的独特之处在于,它不仅关注14-3-3亚基如何与它们的结合蛋白和调节蛋白结合和分离,而且还包括微rna和长链非编码rna的作用以及它们如何调节14-3-3亚型。本综述的重点是14-3-3、肌动蛋白、肌动蛋白结合蛋白和Rho gtpase在癌症中的作用,以及该复合物对细胞迁移和侵袭的重要作用。最后,为读者提供14-3-3蛋白家族每个亚基的超分辨率高清晰度图像,进一步描绘它们在HeLa细胞中的分布,以说明它们在癌细胞中的相互作用。
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引用次数: 0
Dental Manifestations and Oral Management of X-Linked Hypophosphatemia x连锁低磷血症的口腔表现和口腔治疗
Pub Date : 2022-10-21 DOI: 10.3390/endocrines3040056
R. Okawa, K. Nakano
X-linked hypophosphatemia (XLH) is the most common genetic form of rickets and osteomalacia and is characterized by growth retardation, deformities of the lower limbs, and bone and muscular pain. Spontaneous dental abscesses caused by endodontic infections due to dentin dysplasia are well-known dental manifestations. When dentin affected by microcracks or attrition of the enamel is exposed to oral fluids, oral bacteria are able to invade the hypomineralized dentin and pulp space, leading to pulp necrosis, followed by the formation of a periapical gingival abscess. Without appropriate dental management, this dental manifestation results in early loss of teeth and deterioration in the patient’s quality of life. Early specific dental intervention and oral management in collaboration with medical personnel are strongly recommended for XLH patients. Importantly, dental manifestations sometimes appear before the diagnosis of XLH. Dentists should be alert for this first sign of XLH and refer affected children to a pediatrician for early diagnosis. A humanized monoclonal antibody for FGF23 (burosumab) is a promising new treatment for XLH; however, the effects on the dental manifestations remain to be elucidated. The establishment of fundamental dental therapy to solve dental problems is still underway and is eagerly anticipated.
X连锁低磷血症(XLH)是软骨病和骨软化症最常见的遗传形式,其特征是生长迟缓、下肢畸形以及骨骼和肌肉疼痛。由牙本质发育不良引起的牙髓感染引起的自发性牙脓肿是众所周知的牙齿表现。当受到微裂纹或牙釉质磨损影响的牙本质暴露在口腔液中时,口腔细菌能够侵入矿化不足的牙本质和牙髓间隙,导致牙髓坏死,随后形成根尖周牙龈脓肿。如果没有适当的牙齿管理,这种牙齿表现会导致早期牙齿脱落和患者生活质量恶化。强烈建议XLH患者与医务人员合作进行早期特定的牙科干预和口腔管理。重要的是,牙齿表现有时出现在XLH的诊断之前。牙医应该警惕XLH的第一个迹象,并将受影响的儿童转诊给儿科医生进行早期诊断。FGF23的人源化单克隆抗体(burosumab)是治疗XLH的一种有前景的新方法;然而,对牙齿表现的影响仍有待阐明。建立解决牙科问题的基础牙科疗法仍在进行中,备受期待。
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