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Making new drugs the hard way. 艰难地制造新药
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-07-12 DOI: 10.1016/bs.apha.2024.05.002
Dennis Liotta

A new drug can have its origin in either pharma, biotech or academia. In general, discovery scientists working in pharma and biotech are advantaged over their academic counterparts and the relative advantages and disadvantages associated are discussed in depth. Against all odds, an increasing number of important drugs have had their origins in academia. This article reports three case studies from the Liotta Research Group (LRG), which explores the special circumstances that allowed these drug development campaigns to be successful. The first involves the antiretroviral agent, emtricitabine. In this case efficient synthetic methodology, developed in the LRG, coupled with some key university and commercial sector partnerships, enabled a group of academic collaborators to discover and develop a highly effective HIV reverse transcriptase inhibitor. The second case study involves the discovery and development of the breakthrough hepatitis C drug, sofosbuvir. Based on key input from Professors Schinazi and Liotta at Emory University, scientists at the Emory startup, Pharmasset, identified the nucleoside core of the drug that would become sofosbuvir. Subsequent analysis of its phosphorylation profile by Pharmasset scientists suggested that converting it to its corresponding monophosphate prodrug would circumvent a kinase block and enable it to be an effective hepatitis C polymerase inhibitor. The third case study describes the formation of DRIVE (Drug Innovation Ventures at Emory)/EIDD (Emory Institute for Drug Development), which were created to circumvent unintended impediments for carrying out academic drug discovery and development. Although DRIVE/EIDD is a wholly-owned, not-for-profit subsidiary of Emory University, it contains many attributes that enables it to operate much more nimbly than a typical academic laboratory. With an experienced drug development team and no shareholders to distract them, DRIVE/EIDD was able to focus its attention of the development of drugs to address viral diseases of global concern. In particular, their strategy to identify and develop an antiviral agent active against multiple single-stranded RNA viruses led to molnupiravir, a broadly active, oral drug that received Emergency Use Authorization for the treatment of SARS-CoV-2 infections (i.e., COVID-19).

新药既可以源自制药业,也可以源自生物技术或学术界。一般来说,在制药公司和生物技术公司工作的新药发现科学家比在学术界工作的科学家更有优势,本文将深入讨论相关的相对优势和劣势。尽管困难重重,但越来越多的重要药物都源自学术界。本文报告了利奥塔研究小组(LRG)的三个案例研究,探讨了这些药物开发活动取得成功的特殊情况。第一个案例涉及抗逆转录病毒药物恩曲他滨。在这个案例中,LRG 开发的高效合成方法与一些重要的大学和商业部门合作,使一组学术合作者发现并开发出了一种高效的 HIV 逆转录酶抑制剂。第二个案例研究涉及丙型肝炎突破性药物索非布韦的发现和开发。根据埃默里大学 Schinazi 教授和 Liotta 教授的重要意见,埃默里大学初创公司 Pharmasset 的科学家们确定了药物的核苷核心,这就是后来的索非布韦。随后,Pharmasset 公司的科学家对其磷酸化特性进行了分析,发现将其转化为相应的单磷酸原药可以避开激酶阻断,使其成为一种有效的丙型肝炎聚合酶抑制剂。第三个案例研究介绍了 DRIVE(埃默里药物创新风险投资公司)/EIDD(埃默里药物开发研究所)的成立过程。尽管 DRIVE/EIDD 是埃默里大学全资拥有的非营利性子公司,但它的许多特性使其能够比一般的学术实验室更灵活地运作。DRIVE/EIDD 拥有一支经验丰富的药物开发团队,没有股东的干扰,因此能够集中精力开发药物,以应对全球关注的病毒性疾病。特别是,他们在确定和开发一种对多种单链 RNA 病毒具有活性的抗病毒药物的战略下,开发出了 molnupiravir,一种具有广泛活性的口服药物,并获得了治疗 SARS-CoV-2 感染的紧急使用授权(即 COVID-19)。
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引用次数: 0
BRD4 as an emerging epigenetic therapeutic target for inflammatory bowel disease. BRD4 作为炎症性肠病的新兴表观遗传治疗靶点。
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-10-22 DOI: 10.1016/bs.apha.2024.10.008
Zonghui Ma, Andrew A Bolinger, Irina V Pinchuk, Bing Tian, Jia Zhou

Inflammatory bowel disease (IBD) is a chronic gastrointestinal disorder, mainly comprising two subtypes: ulcerative colitis (UC) and Crohn's disease (CD). IBD, featured by recurrent symptoms and significant morbidity, poses a significant threat to global health and has an adverse impact on quality of life. Currently, there is no curative therapy for IBD, and the available medications are only for managing the disease condition, likely owing to the insufficient understanding of the underlying pathophysiology processes involved in IBD, and the lack of safe and effective medicines. Thus, novel targeted therapies for IBD are urgently needed for better efficacy with an improved adverse event profile. As the most extensively studied member of bromodomain and extra terminal domain (BET) family proteins, bromodomain-containing protein 4 (BRD4) is emerging as a promising epigenetic therapeutic target for IBD. Pharmacological inhibition of BRD4 with selective small molecule inhibitors shows potent anti-inflammatory effects in both in vitro and different IBD mouse models. Herein, we summarize current knowledge in understanding the role of BRD4 in the pathogenesis and development of IBD, and the clinical landscape of developing BET/BRD4 inhibitors and emerging BRD4-targeted degraders as promising therapeutical alternatives. Challenges and opportunities, as well as future directions in drug discovery by targeting BRD4 are also briefly discussed.

炎症性肠病(IBD)是一种慢性胃肠道疾病,主要包括两种亚型:溃疡性结肠炎(UC)和克罗恩病(CD)。肠道疾病以症状反复发作和发病率高为特征,对全球健康构成重大威胁,并对生活质量产生不利影响。目前,IBD 尚无根治性疗法,现有药物只能控制病情,这可能是由于对 IBD 的基本病理生理过程了解不足,以及缺乏安全有效的药物。因此,IBD 急需新型靶向疗法,以提高疗效并改善不良反应。作为溴化多域和末端外域(BET)家族蛋白中研究最为广泛的成员,含溴化多域蛋白 4(BRD4)正在成为治疗 IBD 的一个有前景的表观遗传治疗靶点。在体外和不同的 IBD 小鼠模型中,选择性小分子抑制剂对 BRD4 的药理抑制都显示出了强大的抗炎作用。在此,我们总结了目前了解 BRD4 在 IBD 发病和发展过程中作用的知识,以及开发 BET/BRD4 抑制剂和新兴 BRD4 靶向降解剂作为有前途的治疗替代品的临床前景。此外,还简要讨论了靶向 BRD4 的药物研发所面临的挑战和机遇以及未来的发展方向。
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引用次数: 0
Modeling methamphetamine use disorder in mammals: Sex differences in behavioral, biochemical, and transcriptional consequences. 哺乳动物甲基苯丙胺使用障碍模型:行为、生化和转录后果的性别差异。
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-02-09 DOI: 10.1016/bs.apha.2023.08.002
Atul P Daiwile, Jean Lud Cadet

Methamphetamine (METH) is the most commonly misused amphetamine-type stimulant throughout the globe. METH is very rewarding, and its misuse can lead to a diagnosis of METH use disorder (MUD). Although METH use is observed in both sexes, there are, however, reported differences in the clinical manifestations of METH use and its consequences. These observations indicate the need for more research on the long-term sex-dependent consequences of METH taking in both preclinical and clinical settings. In effect, sex is a biological variable that can impact conclusions drawn from various basic and clinical studies. Thus, the present chapter provides a succinct review of the current state of the research on METH and its sex-associated consequences. In addition to behavioral and cognitive aspects of METH use, we discuss METH-induced changes in neurotransmitter systems and structures in the brain. Thus, the book chapter serves to highlight the significance of sex as a critical element that needs to be considered during discussions of novel therapeutic approaches to MUD.

甲基苯丙胺(METH)是全球最常滥用的苯丙胺类兴奋剂。甲基苯丙胺具有很高的成瘾性,滥用甲基苯丙胺可导致甲基苯丙胺使用障碍(MUD)的诊断。虽然使用 METH 的情况男女都有,但据报道,使用 METH 的临床表现及其后果存在差异。这些观察结果表明,有必要在临床前和临床环境中对服用 METH 的长期性别依赖性后果进行更多研究。实际上,性别是一个生物变量,会影响各种基础和临床研究得出的结论。因此,本章简要回顾了有关 METH 及其性别相关后果的研究现状。除了使用 METH 的行为和认知方面,我们还讨论了 METH 引起的大脑神经递质系统和结构的变化。因此,本书的这一章旨在强调性作为一个关键因素的重要性,在讨论针对 MUD 的新型治疗方法时需要考虑到这一点。
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引用次数: 0
Dectin-1 as a therapeutic target for inflammatory bowel disease. 作为炎症性肠病治疗靶点的 Dectin-1。
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-10-16 DOI: 10.1016/bs.apha.2024.10.002
Yannan Li, Meixiang Huang, Santiago Cardinale, Yu Su, Diane E Peters, Barbara S Slusher, Xiaolei Zhu

Inflammatory bowel disease (IBD) encompasses chronic inflammatory conditions of the distal gastrointestinal tract, including Crohn's disease and ulcerative colitis. This chapter explores the potential of Dendritic cell-associated C-type lectin-1 (Dectin-1), a pattern recognition receptor, as a therapeutic target for IBD. We delve into the multifaceted roles of Dectin-1 in immune response modulation, focusing on its interactions with the gut microbiota and immune system. Key sections include an examination of intestinal dysbiosis and its impact on IBD, highlighting the critical role of fungal dysbiosis and immune responses mediated by Dectin-1. The chapter discusses the dual functions of Dectin-1 in maintaining gut homeostasis and its contribution to disease pathogenesis through interactions with the gut's fungal community. Furthermore, the genetic and molecular mechanisms underpinning Dectin-1's role in IBD susceptibility are explored, alongside its signaling pathways and their effects on immune modulation. We also present therapeutic strategies targeting Dectin-1, including innovative drug delivery systems that leverage its natural binding affinity for β-glucans, enhancing targeted delivery to inflamed tissues. The chapter underscores the potential of dietary modulation of Dectin-1 pathways to restore gut microbiota balance and suggests future research directions to fully exploit Dectin-1's therapeutic potential in managing IBD. By elucidating the complex interplay between Dectin-1 and the gut microbiota, this chapter provides insights into novel therapeutic approaches aimed at mitigating IBD symptoms and improving patient outcomes.

炎症性肠病(IBD)包括克罗恩病和溃疡性结肠炎等远端胃肠道慢性炎症。本章探讨了树突状细胞相关 C 型凝集素-1(Dectin-1)这种模式识别受体作为 IBD 治疗靶点的潜力。我们深入研究了 Dectin-1 在免疫反应调节中的多方面作用,重点关注它与肠道微生物群和免疫系统的相互作用。主要章节包括研究肠道菌群失调及其对 IBD 的影响,强调真菌菌群失调的关键作用以及 Dectin-1 介导的免疫反应。本章讨论了 Dectin-1 在维持肠道平衡方面的双重功能,以及它通过与肠道真菌群落的相互作用对疾病发病机制的贡献。此外,本章还探讨了 Dectin-1 在 IBD 易感性中发挥作用的遗传和分子机制,以及 Dectin-1 的信号通路及其对免疫调节的影响。我们还介绍了针对 Dectin-1 的治疗策略,包括利用其与β-葡聚糖天然结合亲和力的创新给药系统,以增强对炎症组织的靶向给药。本章强调了通过饮食调节 Dectin-1 通路来恢复肠道微生物群平衡的潜力,并提出了未来的研究方向,以充分利用 Dectin-1 在治疗 IBD 方面的潜力。通过阐明 Dectin-1 与肠道微生物群之间复杂的相互作用,本章为旨在减轻 IBD 症状和改善患者预后的新型治疗方法提供了见解。
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引用次数: 0
Cholesterol modulation of interactions between psychostimulants and dopamine transporters. 胆固醇调节精神兴奋剂与多巴胺转运体之间的相互作用。
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2023-10-24 DOI: 10.1016/bs.apha.2023.09.004
Rong Chen

The dopamine transporter (DAT) is a key site of action for cocaine and amphetamines. Dysfunctional DAT is associated with aberrant synaptic dopamine transmission and enhanced drug-seeking and taking behavior. Studies in cultured cells and ex vivo suggest that DAT function is sensitive to membrane cholesterol content. Although it is largely unknown whether psychostimulants alter cholesterol metabolism in the brain, emerging evidence indicates that peripheral cholesterol metabolism is altered in patients with psychostimulant use disorder and circulating cholesterol levels are associated with vulnerability to relapse. Cholesterol interacts with sphingolipids forming lipid raft microdomains on the membrane. These cholesterol-rich lipid raft microdomains serve to recruit and assemble other lipids and proteins to initiate signal transduction. There are two spatially and functionally distinct populations of the DAT segregated by cholesterol-rich lipid raft microdomains and cholesterol-scarce non-raft microdomains on the plasma membrane. These two DAT populations are differentially regulated by DAT blockers (e.g. cocaine), substrates (e.g. amphetamine), and protein kinase C providing distinct cholesterol-dependent modulation of dopamine uptake and efflux. In this chapter, we summarize the impact of depletion and addition of membrane cholesterol on DAT conformational changes between the outward-facing and the inward-facing states, lipid raft-associated DAT localization, basal and induced DAT internalization, and DAT function. In particular, we focus on how the interactions of the DAT with cocaine and amphetamine are influenced by membrane cholesterol. Lastly, we discuss the therapeutic potential of cholesterol-modifying drugs as a new avenue to normalize DAT function and dopamine transmission in patients with psychostimulant use disorder.

多巴胺转运体(DAT)是可卡因和苯丙胺的关键作用部位。多巴胺转运体功能失调与突触多巴胺传递失常以及觅药和服药行为增强有关。在培养细胞和体内外进行的研究表明,DAT 功能对膜胆固醇含量很敏感。虽然精神兴奋剂是否会改变大脑中的胆固醇代谢目前尚不清楚,但新的证据表明,精神兴奋剂使用障碍患者的外周胆固醇代谢会发生改变,循环中的胆固醇水平与易复发有关。胆固醇与鞘脂相互作用,在膜上形成脂质筏微域。这些富含胆固醇的脂质筏微域用于招募和组装其他脂质和蛋白质,以启动信号转导。DAT有两个在空间和功能上截然不同的群体,分别由质膜上富含胆固醇的脂筏微域和胆固醇稀缺的非脂筏微域隔离开来。DAT阻断剂(如可卡因)、底物(如苯丙胺)和蛋白激酶C对这两个DAT群进行不同的调控,从而对多巴胺的摄入和流出进行不同的胆固醇依赖性调节。在本章中,我们总结了消耗和添加膜胆固醇对外向型和内向型状态之间的 DAT 构象变化、脂筏相关的 DAT 定位、基础和诱导的 DAT 内化以及 DAT 功能的影响。我们特别关注膜胆固醇如何影响 DAT 与可卡因和苯丙胺的相互作用。最后,我们讨论了胆固醇修饰药物的治疗潜力,它是使精神兴奋剂使用障碍患者的 DAT 功能和多巴胺传导正常化的新途径。
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引用次数: 0
Nicotine use disorder and Neuregulin 3: Opportunities for precision medicine. 尼古丁使用障碍与 Neuregulin 3:精准医学的机遇。
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-02-09 DOI: 10.1016/bs.apha.2023.10.001
Taylor R Elder, Jill R Turner

Nicotine use disorder remains a major public health emergency despite years of trumpeting the consequences of smoking. This is likely due to the complex interplay of genetics and nicotine exposure across the lifespan of these individuals. Genetics influence all aspects of life, including complex disorders such as nicotine use disorder. This review first highlights the critical neurocircuitry underlying nicotine dependence and withdrawal, and then describes the cellular signaling mechanisms involved. Finally, current genetic, genomic, and transcriptomic evidence for new drug development of smoking cessation aids is discussed, with a focus on the Neuregulin 3 Signaling Pathway.

尽管多年来一直在大肆宣扬吸烟的后果,尼古丁使用障碍仍然是一个重大的公共卫生紧急问题。这可能是由于遗传和尼古丁暴露在这些人的整个生命周期中的复杂相互作用。遗传影响生活的方方面面,包括尼古丁使用障碍等复杂疾病。本综述首先强调了尼古丁依赖和戒断的关键神经回路,然后介绍了相关的细胞信号机制。最后,讨论了目前开发戒烟辅助新药的遗传学、基因组学和转录组学证据,重点是神经胶质蛋白 3 信号通路。
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引用次数: 0
The role of sex and drug use during adolescence in determining the risk for adverse consequences of amphetamines. 青春期性行为和吸毒在决定苯丙胺类药物不良后果风险中的作用。
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2023-10-20 DOI: 10.1016/bs.apha.2023.09.002
Lauren K Carrica, Joshua M Gulley

Use of amphetamines during adolescence, a critical period of brain development and reorganization, may lead to particularly adverse outcomes that are long-lasting. Similarly, female users may be uniquely vulnerable to certain aspects of drug use. A recognition of the role of use during adolescence and sex on outcomes of amphetamine and methamphetamine exposure are of critical importance in understanding and treating substance use disorders. This chapter highlights what human research, which has been largely epidemiological, suggests about sex and age differences in drug use patterns and outcomes. We also discuss work in laboratory animals that has typically utilized rats or mice exposed to drugs in a non-contingent manner (i.e., involuntarily) or through volitional self-administration. Lastly, we draw attention to the fact that advancing our understanding of the effects of amphetamine and methamphetamine use, the development of problematic drug taking, and the mechanisms that contribute to relapse will require an emphasis on inclusion of age and sex as moderating factors in future studies.

青春期是大脑发育和重组的关键时期,在此期间使用苯丙胺类药物可能会导致长期的不良后果。同样,女性吸毒者可能在某些方面特别容易受到药物使用的影响。认识到青春期吸毒和性别对苯丙胺和甲基苯丙胺暴露结果的影响,对于了解和治疗药物使用障碍至关重要。本章重点介绍人类研究(主要是流行病学研究)对毒品使用模式和结果的性别和年龄差异的启示。我们还讨论了实验室动物研究,这些研究通常利用大鼠或小鼠以非条件方式(即非自愿)或通过自愿自我给药的方式接触药物。最后,我们提请大家注意,要加深我们对使用苯丙胺和甲基苯丙胺的影响、吸毒问题的发展以及导致复吸的机制的了解,就需要在今后的研究中强调将年龄和性别作为调节因素。
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引用次数: 0
The many enigmas of nicotine. 尼古丁的诸多谜团
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2023-10-17 DOI: 10.1016/bs.apha.2023.08.001
Roger L Papke

This review discusses the diverse effects of nicotine on the various nicotinic acetylcholine receptors of the central and peripheral nervous system and how those effects may promote the usage and addiction to tobacco products.

这篇综述讨论了尼古丁对中枢和外周神经系统各种尼古丁乙酰胆碱受体的不同影响,以及这些影响如何促进烟草制品的使用和成瘾。
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引用次数: 0
The landscape of new therapeutic opportunities for IBD. IBD 新疗法的前景。
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-10-30 DOI: 10.1016/bs.apha.2024.10.011
Andrés Hurtado-Lorenzo, Jennifer L Swantek

This chapter presents an overview of the emerging strategies to address the unmet needs in the management of inflammatory bowel diseases (IBD). IBD poses significant challenges, as over half of patients experience disease progression despite interventions, leading to irreversible complications, and a substantial proportion do not respond to existing therapies, such as biologics. To overcome these limitations, we describe a diverse array of novel therapeutic approaches. In the area of immune homeostasis restoration, the focus is on targeting cytokine networks, leukocyte trafficking, novel immune pathways, and cell therapies involving regulatory T cells and mesenchymal stem cells (MSC). Recognizing the critical role of impaired intestinal barrier integrity in IBD, we highlight therapies aimed at restoring barrier function and promoting mucosal healing, such as those targeting cell proliferation, tight junctions, and lipid mediators. Addressing the challenges posed by fibrosis and fistulas, we describe emerging targets for reversing fibrosis like kinase and cytokine inhibitors and nuclear receptor agonists, as well as the potential of MSC for fistulas. The restoration of a healthy gut microbiome, through strategies like fecal microbiota transplantation, rationally defined bacterial consortia, and targeted antimicrobials, is also highlighted. We also describe innovative approaches to gut-targeted drug delivery to enhance efficacy and minimize side effects. Reinforcing these advancements is the critical role of precision medicine, which emphasizes the use of multiomics analysis for the discovery of biomarkers to enable personalized IBD care. Overall, the emerging landscape of therapeutic opportunities for IBD holds great potential to surpass the therapeutic ceiling of current treatments.

本章概述了为满足治疗炎症性肠病(IBD)的未满足需求而采取的新策略。IBD 带来了巨大的挑战,因为尽管采取了干预措施,但半数以上的患者病情仍在恶化,导致不可逆转的并发症,而且相当一部分患者对生物制剂等现有疗法没有反应。为了克服这些局限性,我们介绍了一系列新型治疗方法。在恢复免疫平衡方面,重点是针对细胞因子网络、白细胞贩运、新型免疫途径以及涉及调节性 T 细胞和间充质干细胞 (MSC) 的细胞疗法。认识到肠道屏障完整性受损在 IBD 中的关键作用,我们重点介绍了旨在恢复屏障功能和促进粘膜愈合的疗法,如针对细胞增殖、紧密连接和脂质介质的疗法。针对纤维化和瘘管带来的挑战,我们介绍了逆转纤维化的新兴靶点,如激酶和细胞因子抑制剂、核受体激动剂,以及间充质干细胞治疗瘘管的潜力。我们还重点介绍了通过粪便微生物群移植、合理定义的细菌联盟和靶向抗菌药等策略恢复健康肠道微生物群的方法。我们还介绍了肠道靶向给药的创新方法,以提高疗效和减少副作用。精准医疗强调利用多组学分析发现生物标志物,以实现个性化的 IBD 治疗,它的关键作用进一步加强了这些进展。总之,新出现的 IBD 治疗机会蕴含着巨大的潜力,有望超越现有疗法的治疗上限。
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引用次数: 0
The potential of targeting TREM-1 in IBD. 靶向 TREM-1 在 IBD 中的潜力。
Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2024-01-01 Epub Date: 2024-10-24 DOI: 10.1016/bs.apha.2024.10.010
Emilie Vinolo, Marine Maillefer, Lucie Jolly, Nelly Colné, Gregory Meiffren, Kevin Carrasco, Marc Derive

Innate immune dysfunction is a hallmark of the pathogenesis of Inflammatory Bowel Disease, both in Crohn's disease and ulcerative colitis. Despite considerable efforts in research to better understand the pathophysiology of IBD and for the development of new therapeutic modalities for IBD patients, there is no therapy specifically targeting the dysregulations of the innate immune response available today in that field. TREM-1 is exclusively expressed by innate immune cells and is an immune amplifier. Its engagement following the primary activation of Pattern Recognition Receptors, including Toll-Like Receptors, triggers the development of a dysregulated and sustained innate immune response, promoting the perpetuation of the inflammatory response in the mucosa of IBD patients, microscopic mucosal tissue alterations, impaired autophagy, impaired epithelial barrier integrity and function, ulcerations, and mucosal damages. In patients, TREM-1 activation is associated with the active status of the disease as well as with severity. Blocking TREM-1 in experimental colitis attenuates the dysregulated innate immune response leading to improved clinical signs. Anti-TREM-1 approaches have the potential of controlling the pathogenic dysregulation of the immune response in IBD by targeting an upstream amplification loop of the activation of innate immunity.

先天性免疫功能障碍是克罗恩病和溃疡性结肠炎等炎症性肠病发病机制的标志。尽管为更好地了解 IBD 的病理生理学以及为 IBD 患者开发新的治疗方法做出了巨大的研究努力,但目前在该领域还没有专门针对先天性免疫反应失调的疗法。TREM-1 专门由先天性免疫细胞表达,是一种免疫放大器。在模式识别受体(包括 Toll-Like 受体)一级激活后,TREM-1 参与触发失调和持续的先天性免疫反应,促进 IBD 患者粘膜炎症反应的持续、粘膜组织的微观改变、自噬功能受损、上皮屏障完整性和功能受损、溃疡和粘膜损伤。在患者体内,TREM-1 的激活与疾病的活动状态和严重程度有关。在实验性结肠炎中阻断 TREM-1 可减轻失调的先天性免疫反应,从而改善临床症状。针对先天性免疫激活的上游放大环,抗 TREM-1 方法有可能控制 IBD 免疫反应的致病性失调。
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引用次数: 0
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