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Introduction: Approved treatments for alcohol use disorder by regulatory agencies. 简介:监管机构批准的酒精使用障碍治疗方法。
Pub Date : 2024-01-01 Epub Date: 2024-10-18 DOI: 10.1016/bs.irn.2024.07.001
Rosana Camarini, Fábio Cardoso Cruz

Alcohol, the most widely consumed substance globally, can lead to severe adverse effects for both users and those around them. Chronic ethanol consumption may lead to alcohol use disorder (AUD), a chronic relapsing condition characterized by compulsive drinking despite negative consequences. AUD is marked by a high relapse rate among individuals attempting abstinence. Currently, only a few medications, such as disulfiram, naltrexone, nalmefene, and acamprosate, are approved to treat AUD. Moreover, genetic factors and comorbid conditions can significantly influence both the development of AUD and the efficacy of its treatment. This chapter explores the genetic underpinnings of AUD and reviews the main pharmacological treatments available for managing this disorder.

酒精是全球消费最广泛的物质,可对使用者及其周围的人造成严重的不良影响。长期饮用乙醇可能会导致酒精使用障碍(AUD),这是一种慢性复发性疾病,其特点是不顾不良后果强迫饮酒。AUD 的特点是试图戒酒的人复发率很高。目前,只有少数药物被批准用于治疗 AUD,如双硫仑、纳曲酮、纳美芬和阿坎酸。此外,遗传因素和合并症也会对 AUD 的发展和治疗效果产生重大影响。本章探讨了 AUD 的遗传基础,并回顾了可用于治疗这种疾病的主要药物疗法。
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引用次数: 0
Mesenchymal stem cells as a promising therapy for alcohol use disorder. 间充质干细胞是一种治疗酒精使用障碍的有效方法。
Pub Date : 2024-01-01 Epub Date: 2024-07-25 DOI: 10.1016/bs.irn.2024.07.002
Javiera Gallardo, Pablo Berríos-Cárcamo, Fernando Ezquer

Alcohol Use Disorder (AUD) is a highly prevalent medical condition characterized by impaired control over alcohol consumption, despite negative consequences on the individual's daily life and health. There is increasing evidence suggesting that chronic alcohol intake, like other addictive drugs, induces neuroinflammation and oxidative stress, disrupting glutamate homeostasis in the main brain areas related to drug addiction. This review explores the potential application of mesenchymal stem cells (MSCs)-based therapy for the treatment of AUD. MSCs secrete a broad array of anti-inflammatory and antioxidant molecules, thus, the administration of MSCs, or their secretome, could reduce neuroinflammation and oxidative stress in the brain. These effects correlate with an increase in the expression of the main glutamate transporter, GLT1, which, through the normalization of the extracellular glutamate levels, could mediate the inhibitory effect of MSCs' secretome on chronic alcohol consumption, thus highlighting GLT1 as a central target to reduce chronic alcohol consumption.

酒精使用障碍(AUD)是一种发病率很高的疾病,其特点是对酒精消费的控制能力减弱,尽管会对个人的日常生活和健康造成负面影响。越来越多的证据表明,长期摄入酒精和其他成瘾药物一样,会诱发神经炎症和氧化应激,破坏与药物成瘾有关的主要脑区的谷氨酸平衡。这篇综述探讨了基于间充质干细胞(MSCs)疗法治疗AUD的潜在应用。间充质干细胞可分泌多种抗炎和抗氧化分子,因此,服用间充质干细胞或其分泌物可减轻大脑神经炎症和氧化应激。这些作用与主要谷氨酸转运体 GLT1 表达的增加有关,GLT1 通过使细胞外谷氨酸水平正常化,可介导间叶干细胞分泌物对慢性酒精消耗的抑制作用,从而突出了 GLT1 作为减少慢性酒精消耗的核心靶点的作用。
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引用次数: 0
Preface. 序言
Pub Date : 2024-01-01 DOI: 10.1016/S0074-7742(24)00138-7
Rosana Camarini, Fábio C Cruz
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引用次数: 0
Insight gained from using animal models to study pain in Parkinson's disease. 从使用动物模型研究帕金森病疼痛中获得的启示。
Pub Date : 2024-01-01 Epub Date: 2024-01-04 DOI: 10.1016/bs.irn.2023.08.013
Yazead Buhidma, Joana Lama, Susan Duty

Pain is one of the key non-motor symptoms experienced by a large proportion of people living with Parkinson's disease (PD), yet the mechanisms behind this pain remain elusive and as such its treatment remains suboptimal. It is hoped that through the study of animal models of PD, we can start to unravel some of the contributory mechanisms, and perhaps identify models that prove useful as test beds for assessing the efficacy of potential new analgesics. However, just how far along this journey are we right now? Is it even possible to model pain in PD in animal models of the disease? And have we gathered any insight into pain mechanisms from the use of animal models of PD so far? In this chapter we intend to address these questions and in particular highlight the findings generated by others, and our own group, following studies in a range of rodent models of PD.

疼痛是很大一部分帕金森病(PD)患者所经历的主要非运动症状之一,但这种疼痛背后的机制仍然难以捉摸,因此其治疗效果仍不理想。我们希望,通过对帕金森病动物模型的研究,我们可以开始揭示一些导致疼痛的机制,或许还能确定一些模型,作为评估潜在新型镇痛药疗效的试验平台。然而,我们现在在这条道路上走了多远?是否有可能在帕金森病的动物模型中建立疼痛模型?迄今为止,我们是否已从帕金森病动物模型的使用中了解到疼痛机制?在本章中,我们将探讨这些问题,并特别强调其他人和我们自己的研究小组在对一系列啮齿动物帕金森病模型进行研究后得出的发现。
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引用次数: 0
Contribution of neurophysiology to the diagnosis and monitoring of ALS. 神经生理学对 ALS 诊断和监测的贡献。
Pub Date : 2024-01-01 Epub Date: 2024-04-27 DOI: 10.1016/bs.irn.2024.04.001
Steve Vucic, Mamede de Carvalho, James Bashford, James J P Alix

This chapter describes the role of neurophysiological techniques in diagnosing and monitoring amyotrophic lateral sclerosis (ALS). Despite many advances, electromyography (EMG) remains a keystone investigation from which to build support for a diagnosis of ALS, demonstrating the pathophysiological processes of motor unit hyperexcitability, denervation and reinnervation. We consider development of the different diagnostic criteria and the role of EMG therein. While not formally recognised by established diagnostic criteria, we discuss the pioneering studies that have demonstrated the diagnostic potential of transcranial magnetic stimulation (TMS) of the motor cortex and highlight the growing evidence for TMS in the diagnostic process. Finally, accurately monitoring disease progression is crucial for the successful implementation of clinical trials. Neurophysiological measures of disease state have been incorporated into clinical trials for over 20 years and we review prominent techniques for assessing disease progression.

本章介绍神经生理学技术在诊断和监测肌萎缩性脊髓侧索硬化症(ALS)中的作用。尽管取得了许多进展,但肌电图(EMG)仍是支持 ALS 诊断的关键检查手段,它能显示运动单位过度兴奋、神经支配和神经再支配的病理生理过程。我们考虑了不同诊断标准的发展以及 EMG 在其中的作用。虽然经颅磁刺激(TMS)未被既定诊断标准正式认可,但我们讨论了证明经颅磁刺激(TMS)对运动皮层诊断潜力的开创性研究,并强调了 TMS 在诊断过程中越来越多的证据。最后,准确监测疾病进展对于临床试验的成功实施至关重要。20 多年来,疾病状态的神经生理学测量已被纳入临床试验,我们将回顾评估疾病进展的主要技术。
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引用次数: 0
Non-coding genome contribution to ALS. 非编码基因组对渐冻症的影响
Pub Date : 2024-01-01 Epub Date: 2024-05-19 DOI: 10.1016/bs.irn.2024.04.002
Tobias Moll, Calum Harvey, Elham Alhathli, Sarah Gornall, David O'Brien, Johnathan Cooper-Knock

The majority of amyotrophic lateral sclerosis (ALS) is caused by a complex gene-environment interaction. Despite high estimates of heritability, the genetic basis of disease in the majority of ALS patients are unknown. This limits the development of targeted genetic therapies which require an understanding of patient-specific genetic drivers. There is good evidence that the majority of these missing genetic risk factors are likely to be found within the non-coding genome. However, a major challenge in the discovery of non-coding risk variants is determining which variants are functional in which specific CNS cell type. We summarise current discoveries of ALS-associated genetic drivers within the non-coding genome and we make the case that improved cell-specific annotation of genomic function is required to advance this field, particularly via single-cell epigenetic profiling and spatial transcriptomics. We highlight the example of TBK1 where an apparent paradox exists between pathogenic coding variants which cause loss of protein function, and protective non-coding variants which cause reduced gene expression; the paradox is resolved when it is understood that the non-coding variants are acting primarily via change in gene expression within microglia, and the effect of coding variants is most prominent in neurons. We propose that cell-specific functional annotation of ALS-associated genetic variants will accelerate discovery of the genetic architecture underpinning disease in the vast majority of patients.

大多数肌萎缩性脊髓侧索硬化症(ALS)是由复杂的基因-环境相互作用引起的。尽管遗传率估计很高,但大多数 ALS 患者的遗传基础尚不清楚。这就限制了靶向基因疗法的开发,而靶向基因疗法需要了解患者的特定基因驱动因素。有充分证据表明,这些缺失的遗传风险因素大部分可能存在于非编码基因组中。然而,发现非编码风险变异的一个主要挑战是确定哪些变异在哪种特定的中枢神经系统细胞类型中具有功能。我们总结了目前在非编码基因组中发现的 ALS 相关遗传驱动因素,并提出需要改进细胞特异性基因组功能注释以推进这一领域的发展,特别是通过单细胞表观遗传学分析和空间转录组学。我们以 TBK1 为例,指出致病编码变异会导致蛋白质功能丧失,而保护性非编码变异会导致基因表达减少,两者之间存在明显的悖论;当了解到非编码变异主要通过改变小胶质细胞内的基因表达发挥作用,而编码变异在神经元中的影响最为突出时,悖论就迎刃而解了。我们建议,对 ALS 相关基因变异的细胞特异性功能注释将加速发现绝大多数患者疾病的基因结构。
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引用次数: 0
Cannabidiol and pain. 大麻二酚与疼痛
Pub Date : 2024-01-01 Epub Date: 2024-07-02 DOI: 10.1016/bs.irn.2024.04.016
Glauce Crivelaro Nascimento, Daniela Escobar-Espinal, Gabriela Gonçalves Bálico, Nicole Rodrigues Silva, Elaine Del-Bel

Chronic pain presents significant personal, psychological, and socioeconomic hurdles, impacting over 30% of adults worldwide and substantially contributing to disability. Unfortunately, current pharmacotherapy often proves inadequate, leaving fewer than 70% of patients with relief. This shortfall has sparked a drive to seek alternative treatments offering superior safety and efficacy profiles. Cannabinoid-based pharmaceuticals, notably cannabidiol (CBD), hold promise in pain management, driven by their natural origins, versatility, and reduced risk of addiction. As we navigate the opioid crisis, ongoing research plunges into CBD's therapeutic potential, buoyed by animal studies revealing its pain-relieving prowess through various system tweaks. However, the efficacy of cannabis in chronic pain management remains a contentious and stigmatized issue. The International Association for the Study of Pain (IASP) presently refrains from endorsing cannabinoid use for pain relief. Nevertheless, evidence indicates their potential in alleviating cancer-related, neuropathic, arthritis, and musculoskeletal pain, necessitating further investigation. Crucially, our comprehension of CBD's role in pain management is a journey still unfolding, with animal studies illustrating its analgesic effects through interactions with the endocannabinoid, inflammatory, and nociceptive systems. As the plot thickens, it's clear: the saga of chronic pain and CBD's potential offers a compelling narrative ripe for further exploration and understanding.

慢性疼痛给个人、心理和社会经济带来了巨大障碍,影响着全球 30% 以上的成年人,并严重导致残疾。遗憾的是,目前的药物疗法往往不足以缓解疼痛,只有不到 70% 的患者能够缓解疼痛。这一不足引发了人们寻求安全性和疗效更佳的替代疗法的热潮。以大麻素为基础的药物,特别是大麻二酚(CBD),因其天然来源、多功能性和降低成瘾风险的特点,在疼痛治疗方面大有可为。在我们应对阿片类药物危机的过程中,CBD 的治疗潜力得到了持续不断的研究,动物实验显示,通过各种系统调整,CBD 可以有效缓解疼痛。然而,大麻在慢性疼痛治疗中的功效仍然是一个有争议和被污名化的问题。国际疼痛研究协会(IASP)目前不赞成使用大麻素来缓解疼痛。尽管如此,有证据表明大麻素在缓解癌症相关疼痛、神经性疼痛、关节炎和肌肉骨骼疼痛方面具有潜力,因此有必要对其进行进一步研究。最重要的是,我们对 CBD 在疼痛治疗中的作用的理解仍在不断深入,动物研究表明,CBD 通过与内源性大麻素、炎症和痛觉系统的相互作用产生镇痛效果。随着剧情的发展,我们可以清楚地看到:慢性疼痛和 CBD 的潜力为我们提供了一个引人入胜的故事,值得我们进一步探索和了解。
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引用次数: 0
A journey through cannabidiol in Parkinson's disease. 帕金森病患者的大麻二酚之旅。
Pub Date : 2024-01-01 Epub Date: 2024-06-29 DOI: 10.1016/bs.irn.2024.04.015
Elaine Del-Bel, Nubia Barros-Pereira, Rafaela Ponciano de Moraes, Bianca Andretto de Mattos, Thaís Antonia Alves-Fernandes, Lorena Borges de Abreu, Glauce Crivelaro Nascimento, Daniela Escobar-Espinal, João Francisco Cordeiro Pedrazzi, Gabrielle Jacob, Bruna A Milan, Gabriela Gonçalves Bálico, Livia Rodrigues Antonieto

Parkinson's disease is a chronic neurodegenerative disorder with no known cure characterized by motor symptoms such as tremors, rigidity, bradykinesia (slowness of movement), and postural instability. Non-motor symptoms like cognitive impairment, mood disturbances, and sleep disorders often accompany the disease. Pharmacological treatments for these symptoms are limited and frequently induce significant adverse reactions, underscoring the necessity for appropriate treatment options. Cannabidiol is a phytocannabinoid devoid of the euphoric and cognitive effects of tetrahydrocannabinol. The study of cannabidiol's pharmacological effects has increased exponentially in recent years. Preclinical and preliminary clinical studies suggest that cannabidiol holds therapeutic potential for alleviating symptoms of Parkinson's disease, offering neuroprotective, anti-inflammatory, and antioxidant properties. However, knowledge of cannabidiol neuromolecular mechanisms is limited, and its pharmacology, which appears complex, has not yet been fully elucidated. By examining the evidence, this review aims to provide and synthesize scientifically proven evidence for the potential use of cannabidiol as a novel treatment option for Parkinson's disease. We focus on studies that administrated cannabidiol alone. The results of preclinical trials using cannabidiol in models of Parkinson's disease are encouraging. Nevertheless, drawing firm conclusions on the therapeutic efficacy of cannabidiol for patients is challenging. Cannabidiol doses, formulations, outcome measures, and methodologies vary considerably across studies. Though, cannabidiol holds promise as a novel therapeutic option for managing both motor and non-motor symptoms of Parkinson's disease, offering hope for improved quality of life for affected individuals.

帕金森病是一种无法治愈的慢性神经退行性疾病,以震颤、僵直、运动迟缓和姿势不稳等运动症状为特征。非运动症状如认知障碍、情绪障碍和睡眠障碍也常常伴随着这种疾病。针对这些症状的药物治疗非常有限,而且经常会引起严重的不良反应,因此需要适当的治疗方案。大麻二酚是一种植物大麻素,没有四氢大麻酚的兴奋和认知效应。近年来,对大麻二酚药理作用的研究急剧增加。临床前和初步临床研究表明,大麻二酚具有缓解帕金森病症状的治疗潜力,并具有神经保护、抗炎和抗氧化特性。然而,人们对大麻二酚神经分子机制的了解还很有限,其药理学似乎也很复杂,尚未完全阐明。通过研究证据,本综述旨在提供并综合经科学证实的证据,证明大麻二酚可能被用作治疗帕金森病的一种新方法。我们重点关注单独使用大麻二酚的研究。在帕金森病模型中使用大麻二酚的临床前试验结果令人鼓舞。尽管如此,要就大麻二酚对患者的治疗效果得出确切结论仍具有挑战性。不同研究中的大麻二酚剂量、配方、结果衡量标准和方法差异很大。不过,大麻二酚有望成为控制帕金森病运动和非运动症状的新型治疗选择,为改善患者的生活质量带来希望。
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引用次数: 0
Therapeutic potential of cannabidiol in depression. 大麻二酚对抑郁症的治疗潜力。
Pub Date : 2024-01-01 Epub Date: 2024-06-26 DOI: 10.1016/bs.irn.2024.06.001
Matti Bock Guldager, Adriano Maia Chaves Filho, Caroline Biojone, Sâmia Joca

Major depressive disorder (MDD) is a widespread and debilitating condition affecting a significant portion of the global population. Traditional treatment for MDD has primarily involved drugs that increase brain monoamines by inhibiting their uptake or metabolism, which is the basis for the monoaminergic hypothesis of depression. However, these treatments are only partially effective, with many patients experiencing delayed responses, residual symptoms, or complete non-response, rendering the current view of the hypothesis as reductionist. Cannabidiol (CBD) has shown promising results in preclinical models and human studies. Its mechanism is not well-understood, but may involve monoamine and endocannabinoid signaling, control of neuroinflammation and enhanced neuroplasticity. This chapter will explore CBD's effects in preclinical and clinical studies, its molecular mechanisms, and its potential as a treatment for MDD.

重度抑郁障碍(MDD)是一种广泛存在的使人衰弱的疾病,影响着全球相当一部分人口。传统治疗重度抑郁症的方法主要是使用药物,通过抑制脑内单胺类物质的摄取或代谢来增加脑内单胺类物质,这是抑郁症单胺类物质能假说的基础。然而,这些治疗方法只是部分有效,许多患者会出现反应延迟、症状残留或完全无反应的情况,因此目前的假说观点是还原论的。大麻二酚(CBD)在临床前模型和人体研究中显示出了良好的效果。其机制尚不十分清楚,但可能涉及单胺类和内源性大麻素信号转导、神经炎症控制和神经可塑性增强。本章将探讨 CBD 在临床前和临床研究中的作用、其分子机制以及作为 MDD 治疗药物的潜力。
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引用次数: 0
Animal models of neuropathic pain. 神经性疼痛的动物模型
Pub Date : 2024-01-01 Epub Date: 2024-11-01 DOI: 10.1016/bs.irn.2024.10.004
Angela M Casaril, Caitlyn M Gaffney, Andrew J Shepherd

Animal models continue to be crucial to developing our understanding of the molecular, cellular, and neurophysiological mechanisms that lead to neuropathic pain. The overwhelming majority of animal studies use rodent models, ranging from surgical and trauma-induced models to those induced by metabolic diseases, genetic mutations, viruses, neurotoxic drugs, and cancer. We discuss the clinical relevance of the available models and the pain behavior tests commonly used as outcome measures. Finally, we summarize the refinements that have been proposed to improve the ability of animal model studies to predict clinical efficacy.

动物模型对于我们了解导致神经病理性疼痛的分子、细胞和神经生理机制仍然至关重要。绝大多数动物研究都使用啮齿类动物模型,从手术和创伤诱导模型到代谢性疾病、基因突变、病毒、神经毒性药物和癌症诱导模型,不一而足。我们将讨论现有模型的临床相关性以及通常用作结果测量的疼痛行为测试。最后,我们总结了为提高动物模型研究预测临床疗效的能力而提出的改进措施。
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引用次数: 0
期刊
International review of neurobiology
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