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Transformation of healthcare models and creation of integrated care systems in an aging society: A comparative perspective of the Netherlands, Japan, and China. 老龄化社会中医疗模式的转变和综合护理系统的创建:荷兰、日本和中国的比较视角。
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2026-01-07 Epub Date: 2025-11-05 DOI: 10.5582/bst.2025.01317
Ren Chen, Wei Tang

Faced with the global challenges of population aging and a surge in dementia cases, healthcare models worldwide are undergoing profound transformation. The Netherlands' "dementia villages" concept simulates living environments, with their antipsychotic drug usage rate (11%) being significantly lower than in traditional facilities (52%). Japan has established over 12,000 "small-scale multi-functional" care facilities, striving to achieve "life in the community." Meanwhile, China is promoting community-embedded elderly care models, exemplified by Shanghai's plan to increase the number of daycare centers from 720 in 2019 to 919 by 2024, establishing a "15-minute elderly care circle." This commentary compares the Netherlands, Japan, and China across four dimensions: aging trends, innovative care models, the development of multifunctional healthcare systems, and end-of-life care philosophies. It assesses current policy developments and practical challenges, proposing that future sustainable care systems should integrate healthcare with community resources, institutional frameworks with ethical considerations, technological advancements with humanistic values, and education on death with the preservation of life with dignity.

面对人口老龄化和痴呆症病例激增的全球性挑战,世界范围内的医疗模式正在发生深刻的变革。荷兰的“痴呆村”概念模拟了生活环境,他们的抗精神病药物使用率(11%)明显低于传统设施(52%)。日本建立了1.2万多个“小型多功能”护理设施,努力实现“社区生活”。与此同时,中国正在推广社区养老模式,例如上海计划将日托中心的数量从2019年的720个增加到2024年的919个,建立一个“15分钟养老圈”。这篇评论从四个方面比较了荷兰、日本和中国:老龄化趋势、创新护理模式、多功能医疗保健系统的发展和临终关怀理念。它评估了当前的政策发展和实际挑战,提出未来的可持续护理系统应该将医疗保健与社区资源、制度框架与伦理考虑、技术进步与人文价值、死亡教育与尊严保护结合起来。
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引用次数: 0
Effect of Yiqi Bushen Shugan Huoxue Decoction on impaired endometrial receptivity associated with ovarian stimulation: A clinical trial, modular pharmacology, molecular docking, and experiment-based study. 益气补肾疏肝活血汤对卵巢刺激所致子宫内膜容受性受损的影响:临床试验、模块化药理学、分子对接、实验研究
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2026-01-07 Epub Date: 2025-12-17 DOI: 10.5582/bst.2025.01325
Xinyao Pan, Qing Qi, Jing Wang, Jing Zhou, Hongmei Sun, Lisha Li, Ling Wang

Endometrial receptivity plays a critical role in pregnancy, while controlled ovarian hyperstimulation (COH) - widely used for infertile patients - could impair endometrial receptivity and subsequent pregnancy outcomes. This study aims to explore the effect of Yiqi Bushen Shugan Huoxue Decoction (YBSHD) on impaired endometrial receptivity in patients with unexplained infertility (UI) undergoing COH and to determine the mechanism for it through modular pharmacology, molecular docking, and a murine model. First, we retrospectively studied 422 patients with UI who underwent COH to get pregnant. Results indicated that the live birth rate significantly increased in the YBSHD group. Second, a systematic network pharmacology analysis was performed to screen the ingredients and possible targets of YBSHD. The main targets concerning YBSHD and endometrial receptivity involved pathways including hormone regulation, inflammatory responses, and apoptosis. The active components of quercetin and kaempferol from YBSHD exhibited a strong binding affinity to key molecules, including BCL2, ESR1, IL6, IL1B, and TNF. Third, YBSHD improved endometrial receptivity in a murine COH model. Compared to the COH group, the number of embryo implantations and endometrial pinopodes significantly increased in the YBSHD group, indicating improved endometrial receptivity. YBSHD improved the local immune microenvironment in COH mice by regulating excessive hormone secretion, gene expression of inflammatory factors, and proportions of neutrophils and macrophages. Moreover, YBSHD inhibited apoptosis in the ovaries and uteruses of COH mice. In summary, YBSHD could increase the live birth rate in patients with UI, mainly because it can inhibit inflammation and cell apoptosis, thereby improving endometrial receptivity.

子宫内膜容受性在妊娠中起着至关重要的作用,而控制性卵巢过度刺激(COH) -广泛用于不孕症患者-可能损害子宫内膜容受性和随后的妊娠结局。本研究旨在探讨益气补肾疏肝活血汤(YBSHD)对不明原因不孕症(UI) COH患者子宫内膜容受性受损的影响,并通过模块化药理学、分子对接和小鼠模型研究其作用机制。首先,我们回顾性研究了422例接受COH妊娠的UI患者。结果显示,YBSHD组的活产率明显提高。其次,进行系统的网络药理学分析,筛选黄芪散的成分和可能的靶点。YBSHD和子宫内膜容受性的主要靶点涉及激素调节、炎症反应和细胞凋亡等途径。YBSHD中的槲皮素和山奈酚活性成分与BCL2、ESR1、IL6、IL1B和TNF等关键分子具有较强的结合亲和力。第三,YBSHD改善了小鼠COH模型的子宫内膜容受性。与COH组相比,YBSHD组胚胎着床数和子宫内膜足数显著增加,表明子宫内膜容受性改善。YBSHD通过调节过量激素分泌、炎症因子基因表达、中性粒细胞和巨噬细胞比例,改善COH小鼠局部免疫微环境。此外,YBSHD还能抑制COH小鼠卵巢和子宫的细胞凋亡。综上所述,YBSHD可以提高尿失尿患者的活产率,主要是因为它可以抑制炎症和细胞凋亡,从而改善子宫内膜容受性。
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引用次数: 0
Human resources in long-term care for older adults in China: Challenges amid population aging. 中国老年人长期护理的人力资源:人口老龄化的挑战。
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2026-01-07 Epub Date: 2025-09-03 DOI: 10.5582/bst.2025.01155
Nadida Aximu, Bahegu Yimingniyazi, Dapeng Lin, Jiangtao Zhang, Mengxi Jiang, Yu Sun

Against the backdrop of accelerating global population aging, China is undergoing significant demographic shifts. Its population aged 60 and above has reached 264 million, projected to account for 40% of the total population by the mid-21st century, becoming a "super-aging society" and triggering a surge in long-term care demand. On the demand side, the overall ADL disability rate among middle-aged and older adults is 23.8% (35.4% organic), rising to 30.5% among those aged 80 and above; 17.8% have IADL impairments, and 36.44% of households with older adults are empty-nest. Combined with population aging, rising disability rates, the growth of empty-nest families, and heavy disease burdens, care demand continues to grow annually. On the supply side, 13 million caregivers are needed for disabled/semi-disabled older adults, with only ~1 million practitioners; traditional models focusing solely on basic daily assistance fail to meet diverse needs like mental health support and rehabilitation. To this end, this study aims to synthesize evidence on the structural challenges faced by China's geriatric care workforce. By analyzing demographic data, care demand indicators, and geriatric care models, it identifies core issues and proposes evidence-based strategies, with the purpose of improving the quality of life of older adults and strengthening development of professional geriatric care talent.

在全球人口老龄化加速的背景下,中国正在经历重大的人口结构变化。60岁及以上人口已达2.64亿,预计到21世纪中叶将占总人口的40%,成为“超级老龄化社会”,引发长期护理需求激增。在需求端,中老年人总体ADL残疾率为23.8%(自然残疾率为35.4%),80岁及以上人群上升至30.5%;17.8%的老年人有日常生活障碍,36.44%的老年人家庭是空巢家庭。再加上人口老龄化、残疾率上升、空巢家庭增加以及沉重的疾病负担,护理需求每年都在继续增长。在供给方面,残疾/半残疾老年人需要1300万护理人员,而从业人员只有约100万;仅注重基本日常援助的传统模式无法满足心理健康支持和康复等多种需求。为此,本研究旨在综合有关中国老年护理人员面临的结构性挑战的证据。通过对人口统计数据、护理需求指标、老年护理模式的分析,找出核心问题,提出循证策略,以提高老年人生活质量,加强老年护理专业人才的培养。
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引用次数: 0
Dementia strategies in an aging society: Policies, care, and global insights from the Japanese experience. 老龄化社会中的痴呆症策略:日本经验的政策、护理和全球见解。
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2026-01-07 Epub Date: 2025-10-31 DOI: 10.5582/bst.2025.01309
Yi Deng, Ya-Nan Ma, Katsuya Yamauchi, Kenji Karako, Peipei Song

Aging of the population has become a critical challenge globally. The proportion of individuals age 60 years and older is projected to increase from 12% in 2015 to 22% by 2050, representing more than 2.1 billion older adults globally. This demographic transition is advancing particularly rapidly in Japan, which has become the first nation to become a "super-aged society". Projections indicate that by 2060, the number of older adults living with dementia will reach approximately 6.45 million (more than 17% of the elderly population), making it one of the country's most urgent health and social care challenges. Japan has developed a comprehensive response system that integrates medical, community, and family-based care. Key initiatives include a national dementia strategy, mechanisms for early screening and diagnosis, the establishment of memory clinics, and the implementation of the community-based integrated care system, which emphasizes coordination between healthcare and long-term care services. These measures have alleviated part of the burden on patients and families while enhancing social awareness of dementia and inclusion of those with that condition. Nevertheless, Japan continues to face significant structural challenges, such as severe shortages of healthcare personnel and professional caregivers, increasing fiscal pressure on long-term care financing, insufficient dissemination of innovative therapies and digital diagnostic tools, and disparities in social support between urban and rural areas. Cross-national comparisons indicate that Japan's experience offers valuable lessons for other rapidly aging societies, particularly in policy design, the integration of community-based care, and the promotion of a dementia-inclusive society. Summarizing and adapting Japan's approaches may therefore provide globally applicable strategies to build sustainable and equitable systems for dementia prevention, management, and care.

人口老龄化已成为全球面临的重大挑战。60岁及以上老年人的比例预计将从2015年的12%增加到2050年的22%,这意味着全球老年人将超过21亿。这种人口结构的转变在日本尤其迅速,日本已成为第一个进入“超老龄化社会”的国家。预测表明,到2060年,患有痴呆症的老年人数量将达到约645万(超过老年人口的17%),使其成为该国最紧迫的卫生和社会保健挑战之一。日本已经建立了一个综合的应对系统,将医疗、社区和家庭护理结合起来。主要举措包括国家痴呆症战略、早期筛查和诊断机制、建立记忆诊所以及实施以社区为基础的综合护理系统,该系统强调卫生保健和长期护理服务之间的协调。这些措施减轻了患者和家属的部分负担,同时提高了社会对痴呆症的认识,并使患者融入社会。然而,日本继续面临重大的结构性挑战,例如保健人员和专业护理人员严重短缺、长期护理筹资的财政压力日益增加、创新疗法和数字诊断工具的传播不足以及城乡地区社会支持方面的差异。跨国比较表明,日本的经验为其他迅速老龄化的社会提供了宝贵的教训,特别是在政策设计、社区护理一体化和促进包容痴呆症社会方面。总结和调整日本的方法可能因此提供全球适用的战略,以建立可持续和公平的痴呆症预防、管理和护理系统。
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引用次数: 0
Integrative methylation and transcriptomic analysis reveals key genes linking cellular senescence and metabolic reprogramming in colorectal liver metastasis. 综合甲基化和转录组学分析揭示了结直肠癌肝转移中细胞衰老和代谢重编程的关键基因。
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2026-01-07 Epub Date: 2025-10-31 DOI: 10.5582/bst.2025.01297
Xiaochen Ma, Lu Chen, Chenhe Yi, Yitong Li, Yan Geng, Baorui Tao, Jinhong Chen

Colorectal liver metastasis (CRLM) remains lethal, and the convergence of cellular senescence with metabolic reprogramming via epigenomic rewiring is poorly understood. We integrated genome-wide DNA methylation and RNA-seq data from 10 paired primary tumors and liver metastases (GSE213402). After calling differentially methylated genes (3,399 hyper- and 9,519 hypomethylated) and differentially expressed genes (406 DEGs), we intersected them with curated senescence (n = 866) and metabolic reprogramming (n = 948) gene sets, yielding 28 differentially expressed cellular-senescence-related genes (DE-CSRGs) and 24 metabolic-reprogramming-related genes (DE-MRRGs). Machine-learning pipelines (LASSO + SVM-RFE) converged on a five-gene signature: CXCL1, SERPINE1, NDRG1, SRM and GATM, most of which are hypomethylated and over-expressed in metastases. Gene-set enrichment analysis revealed that these genes are involved in pathways such as oxidative phosphorylation, focal adhesion, complement-coagulation cascades, and PPAR signaling. Immune de-convolution revealed strong positive correlations between signature genes and immunosuppressive subsets (MDSCs, Tregs, type-1 T-helper cells; p < 0.05). Elevated IC50 values for oxaliplatin and 5-fluorouracil in metastatic samples were positively associated with NDRG1 and negatively with SRM, indicating chemo-resistance modulation. This five-gene epigenetic-transcriptomic hub identifies a molecular signature that warrants prospective validation as a potential biomarker for patient stratification and combination therapy in CRLM.

结直肠癌肝转移(CRLM)仍然是致命的,细胞衰老与通过表观基因组重布线的代谢重编程的趋同尚不清楚。我们整合了来自10个配对的原发性肿瘤和肝转移瘤(GSE213402)的全基因组DNA甲基化和RNA-seq数据。在调用差异甲基化基因(3,399个高甲基化基因和9,519个低甲基化基因)和差异表达基因(406个deg)之后,我们将它们与管理衰老(n = 866)和代谢重编程(n = 948)基因集相交,得到28个差异表达的细胞衰老相关基因(DE-CSRGs)和24个代谢重编程相关基因(DE-MRRGs)。机器学习管道(LASSO + SVM-RFE)集中在五个基因特征上:CXCL1, SERPINE1, NDRG1, SRM和GATM,其中大多数在转移中低甲基化和过表达。基因集富集分析显示,这些基因参与氧化磷酸化、局灶黏附、补体-凝血级联和PPAR信号传导等途径。免疫去卷积显示特征基因与免疫抑制亚群(MDSCs、Tregs、1型t辅助细胞;p < 0.05)之间存在强正相关。转移性样本中奥沙利铂和5-氟尿嘧啶的IC50值升高与NDRG1呈正相关,与SRM负相关,表明化疗耐药调节。这个五基因表观遗传转录组中心确定了一个分子特征,保证了作为CRLM患者分层和联合治疗的潜在生物标志物的前瞻性验证。
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引用次数: 0
APOE4 reprograms microglial lipid metabolism in Alzheimer's disease: Mechanisms and therapeutic implications. APOE4重编程阿尔茨海默病的小胶质脂质代谢:机制和治疗意义。
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2026-01-07 Epub Date: 2025-08-21 DOI: 10.5582/bst.2025.01148
Jiajie Chen, Shuoyan Zhao, Yingying Zhou, Luyao Wang, Qin Chen, Kai Zheng

The apolipoprotein E ε4 (APOE ε4) allele, the strongest genetic risk factor for late-onset Alzheimer's disease (AD), induces cell-type-specific disturbances in brain lipid metabolism. Although impacting astrocytes and neurons, its most pronounced effects occur in microglia, where it causes energy metabolism deficits and promotes the formation of lipid droplet-accumulating microglia, triggering a cascade of neurodegenerative responses. This review comprehensively examines how microglial APOE4-driven lipid metabolic dysregulation exacerbates neuroinflammation and compromises phagocytic capacity, particularly in the clearance of amyloid-β, phosphorylated-tau, and pathological synapses. Mechanistically, microglial APOE4 activates neuroinflammation via LilrB3-mediated type I interferon signaling and induces lipid metabolic imbalance through PU.1/NF-κB-driven transcriptional reprogramming and ER stress-SREBP2 activation. These disturbances exacerbate neuroinflammation, promote lipid droplet accumulation and cholesterol overload, impair lysosomal function, and ultimately compromise microglial phagocytosis. The resulting disruption of neuron-microglia interactions further amplifies neurotoxicity in AD. Furthermore, this review summarizes emerging therapeutic strategies targeting APOE4-related pathway in microglia. By synthesizing these insights, this review highlights the multifaceted role of microglial APOE4 in AD pathology, with particular emphasis on the central role of lipid metabolism dysregulation, and provides new intervention ideas for reducing its damage to brain function.

载脂蛋白E ε4 (APOE ε4)等位基因是迟发性阿尔茨海默病(AD)最强的遗传危险因素,可诱导细胞类型特异性脑脂质代谢紊乱。虽然影响星形胶质细胞和神经元,但其最显著的作用发生在小胶质细胞中,在那里它引起能量代谢缺陷,促进脂滴积聚小胶质细胞的形成,引发神经退行性反应的级联反应。这篇综述全面研究了apoe4驱动的小胶质脂质代谢失调如何加剧神经炎症并损害吞噬能力,特别是在淀粉样蛋白-β、磷酸化tau和病理突触的清除中。在机制上,小胶质细胞APOE4通过lilrb3介导的I型干扰素信号激活神经炎症,并通过PU.1/NF-κ b驱动的转录重编程和ER应激srebp2激活诱导脂质代谢失衡。这些干扰加剧神经炎症,促进脂滴积累和胆固醇超载,损害溶酶体功能,并最终损害小胶质细胞吞噬。由此导致的神经元-小胶质细胞相互作用的破坏进一步放大了阿尔茨海默病的神经毒性。此外,本文还综述了针对apoe4相关途径的小胶质细胞治疗策略。通过综合这些见解,本综述强调了小胶质细胞APOE4在AD病理中的多方面作用,特别强调了脂质代谢失调的核心作用,并为减少其对脑功能的损害提供了新的干预思路。
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引用次数: 0
Exploring the pathway of a social network in promoting the individual performance of core members of social organizations caring for the elderly: A moderated mediation model of social support and self-efficacy. 社会网络对社会养老组织核心成员个体绩效的影响:社会支持与自我效能感的调节中介模型
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2026-01-07 Epub Date: 2025-09-18 DOI: 10.5582/bst.2025.01225
Xin Zheng, Sanyuan Hao, Ziwen Xu, Jiajie Zhao, Fuqin Xu, Shuo Ding, Guoqing Liu, Shufan Yang, Benjamin Otsen, Wen Zhu, Jie Yang, Zhongliang Bai, Ren Chen

The high performance of core members of social organizations (SOs) caring for the elderly can enhance the quality of management and services, thereby improving the life satisfaction of older adults residing there. However, the factors influencing the performance of core members and their pathways remain unclear. This research seeks to uncover how social support mediates and self-efficacy moderates the association between a social network and individual performance of core members of SOs caring for the elderly. A cross-sectional survey was conducted from June to August 2023 in Shanghai, China, and data on participants' demographics, social network, social support, individual performance, and self-efficacy were collected. Hierarchical stepwise regression, bootstrap analysis, and simple slope method analysis were used to test potential mediating and moderating effects. After adjusting for confounders, the total effect of a social network on core members' individual performance (β = 0.078, 95% CI: 0.052-0.103) consisted of a direct effect (β = 0.059, 95% CI: 0.030-0.087) as well as an indirect effect mediated through social support (β = 0.019, 95% CI: 0.006-0.033). In addition, self-efficacy was identified as a moderating factor in the relationship between a social network and individual performance, with higher levels of self-efficacy diminishing the influence of a social network on performance outcomes. An extensive social network can enhance social support for core members of SOs caring for the elderly, thereby improving individual performance. Concurrently, targeted interventions should be developed to draw on self-efficacy to activate social network resources and to have a synergistic effect on individual performance.

养老社会组织核心成员的高绩效可以提升养老社会组织的管理和服务质量,从而提高养老社会组织中老年人的生活满意度。然而,影响核心成员绩效的因素及其路径尚不清楚。本研究旨在揭示社会支持如何中介和自我效能调节社会网络和个人表现之间的关系的核心成员照顾老人。本研究于2023年6月至8月在中国上海进行了横断面调查,收集了参与者的人口统计学、社会网络、社会支持、个人表现和自我效能感的数据。采用层次逐步回归分析、自举分析和简单斜率法分析来检验潜在的中介和调节效应。在调整混杂因素后,社会网络对核心成员个人绩效的总影响(β = 0.078, 95% CI: 0.052-0.103)包括直接影响(β = 0.059, 95% CI: 0.030-0.087)以及通过社会支持介导的间接影响(β = 0.019, 95% CI: 0.006-0.033)。此外,在社会网络和个人绩效之间的关系中,自我效能感被认为是一个调节因素,较高水平的自我效能感会减弱社会网络对绩效结果的影响。广泛的社会网络可以增强对养老组织核心成员的社会支持,从而提高个体绩效。同时,应制定有针对性的干预措施,利用自我效能来激活社会网络资源,并对个体绩效产生协同效应。
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引用次数: 0
Dual community-based care innovations in a super-aged population: The role of Small-scale Multifunctional In-home Care and Nursing Small-scale Multifunctional In-home Care in Japan. 双重社区护理创新在超老年人口:小规模多功能家庭护理和护理的作用在日本小规模多功能家庭护理。
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2026-01-07 Epub Date: 2025-08-07 DOI: 10.5582/bst.2025.01217
Yi Deng, Katsuya Yamauchi, Kenji Karako, Peipei Song

With the accelerating trend of population aging, Japan has become the first country to enter a "super-aged society", where the proportion of people age 65 and over exceeds 21%, making it a global model in addressing aging-related challenges. In response to the various social and healthcare issues arising from this demographic shift, the Japanese Government has implemented a series of policy measures. Among them, "Small-scale Multifunctional In-home Care (Shotaki)" and "Nursing Small-scale Multifunctional In-home Care (Kantaki)" have emerged as key components of the community-based care system. This paper explores the common challenges faced in super-aged populations and provides a comparative analysis of the functions, current status, existing issues, and future prospects of "Shotaki" and "Kantaki". By examining these two service models, the study aims to offer policy recommendations and practical insights to build a sustainable elderly care system.

随着人口老龄化趋势的加速,日本已成为第一个进入“超老龄化社会”的国家,65岁及以上人口的比例超过21%,成为应对老龄化相关挑战的全球典范。为了应对这种人口变化所产生的各种社会和保健问题,日本政府实施了一系列政策措施。其中,“小型多功能家庭护理(Shotaki)”和“护理小型多功能家庭护理(Kantaki)”已成为社区护理系统的关键组成部分。本文探讨了超老龄化人口面临的共同挑战,并对“正泷”和“kanantaki”的功能、现状、存在问题及未来前景进行了比较分析。通过对这两种服务模式的研究,本研究旨在为构建可持续发展的养老体系提供政策建议和实践见解。
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引用次数: 0
The inflammation-aging axis: Shared and distinct mechanisms in physiological gut aging and IBD-associated accelerated gut aging. 炎症-衰老轴:生理肠道衰老和ibd相关加速肠道衰老的共同和独特机制。
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2025-11-20 DOI: 10.5582/bst.2025.01279
Lichao Yang, Zhixian Jiang, Qi Sun, Kenji Karako, Lianwen Yuan, Peipei Song

Inflammatory bowel disease (IBD) and physiological gut aging present with overlapping clinical features, including impaired barrier functioning, decreased nutrient absorption, and intestinal frailty. Emerging evidence indicates that even young IBD patients can exhibit gut phenotypes akin to those seen with aging. However, the two processes differ substantially in their underlying mechanisms. Gut aging is characterized by low-grade, chronic inflammation and gradual cellular senescence, whereas IBD involves persistent immune activation, cyclical tissue damage, and accelerated degenerative changes. This review systematically contrasts physiological gut aging and IBD-associated accelerated gut aging across several dimensions: cellular senescence and programmed cell death, immune cell remodeling, alterations in gut microbiota, changes in mesenteric adipose tissue, and the evolving role of the appendix. By integrating current advances in basic and translational research, this article highlights both the shared and distinct pathways driving gut dysfunction in aging and IBD, and underscores the importance of early recognition and targeted intervention for premature gut aging in clinical practice.

炎症性肠病(IBD)和生理性肠道衰老具有重叠的临床特征,包括屏障功能受损、营养吸收减少和肠道脆弱。新出现的证据表明,即使是年轻的IBD患者也可能表现出与衰老相似的肠道表型。然而,这两个过程在其基本机制上有很大的不同。肠道老化的特征是低级别慢性炎症和逐渐的细胞衰老,而IBD则涉及持续的免疫激活、周期性组织损伤和加速的退行性变化。这篇综述系统地对比了生理性肠道衰老和ibd相关的加速肠道衰老的几个方面:细胞衰老和程序性细胞死亡、免疫细胞重塑、肠道微生物群的改变、肠系膜脂肪组织的变化以及阑尾的进化作用。本文通过整合基础和转化研究的最新进展,强调了在衰老和IBD中驱动肠道功能障碍的共同和不同的途径,并强调了在临床实践中早期识别和有针对性的干预肠道过早衰老的重要性。
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引用次数: 0
Research on precision treatment of pancreatic cancer targeted by antibody-drug conjugates. 抗体-药物偶联物靶向胰腺癌精准治疗的研究。
IF 5 4区 生物学 Q1 BIOLOGY Pub Date : 2025-11-19 DOI: 10.5582/bst.2025.01271
Xinyue Liu, Weishuai Liu, Chao Wu, Yudong Yuan, Antao Chang, Jihui Hao

Pancreatic cancer, and especially pancreatic ductal adenocarcinoma (PDAC), is extremely difficult to treat due to early asymptomatic stage, molecular heterogeneity, and resistance to conventional treatments, with a 5-year survival rate of less than 10%. Antibody-drug conjugates (ADCs), as an emerging precision therapy, show the potential to treat PDAC through the synergy of antibody targeting and cytotoxic drugs. Multiple targets (such as uPAR, Mesothelin, CLDN18.2, and TROP2) are highly expressed in PDAC, which has become the key direction of ADC development. However, the matrix barrier restricts drug delivery, heterogeneous expression leads to efficacy differentiation, and drug resistance mechanisms further limit the role of ADCs. To overcome these challenges, researchers are exploring high-stability single domain antibodies, more potent payloads and linkers, bystander effect mechanisms, and combined treatment strategies with immune, autophagy, DNA damage repair, and other pathways. Bispecific ADC, conditionally activated ADC, and penetration enhancement design have also been used to improve efficacy. On the whole, ADCs offer hope for the treatment of PDAC. Future research and development should focus on improving delivery efficiency, alleviating drug resistance, and individualized design.

胰腺癌,尤其是胰腺导管腺癌(Pancreatic ductal adenocarcinoma, PDAC),由于早期无症状、分子异质性和对常规治疗的耐药性,治疗难度极大,5年生存率不足10%。抗体-药物偶联物(adc)作为一种新兴的精确治疗方法,通过抗体靶向和细胞毒性药物的协同作用,显示出治疗PDAC的潜力。多靶点(如uPAR、Mesothelin、CLDN18.2、TROP2)在PDAC中高表达,成为ADC发展的关键方向。然而,基质屏障限制了药物的传递,异质性表达导致疗效分化,耐药机制进一步限制了adc的作用。为了克服这些挑战,研究人员正在探索高稳定性的单域抗体、更有效的有效载荷和连接体、旁观者效应机制,以及与免疫、自噬、DNA损伤修复和其他途径相结合的治疗策略。双特异性ADC、条件激活ADC和穿透增强设计也被用于提高疗效。总的来说,adc为PDAC的治疗带来了希望。未来的研究和开发应侧重于提高给药效率、减轻耐药性和个性化设计。
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Bioscience trends
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