目前,帕金森疾病已经成为世界第二大常见的神经退行性疾病,其特点是震颤、强直和运动迟缓,主要是由于黑质纹状体通路的耗竭引起的。常规药物如左旋多巴在帕金森早期非常有效;然而,这些药物无法预防潜在的神经变性。帕金森疾病受损细胞种类单一,并且分布于特定的局限空间,药物与手术治疗难以根治,细胞治疗作为一种新兴疗法具有重要意义,其细胞来源涵盖胚胎干细胞、神经干细胞、多种组织的间充质干细胞以及诱导多能干细胞。通过神经移植,这些细胞能够替代或修复帕金森病中受损的多巴胺神经元,从而改善甚至逆转疾病的进展,为帕金森的治疗带来新的希望。为了充分发挥干细胞的治疗潜力,我们需要认识到这些细胞来源的优点和局限性。本文主要介绍帕金森干细胞治疗的背景以及不同细胞来源的治疗进展,旨在为研究帕金森的干细胞治疗提供参考。Currently, Parkinson’s disease has become the second most common neurodegenerative disorder worldwide, characterized by tremors, rigidity, and bradykinesia, primarily due to the depletion of the nigrostriatal pathway. Conventional medications like Levodopa are highly effective in the early stages of Parkinson’s;however, these drugs cannot prevent underlying neurodegeneration. The damaged cells in Parkinson’s disease are of a single type and are located in specific, confined areas, making it difficult to cure with medication or surgery. Cell therapy, as an emerging treatment, holds significant importance, with cell sources including embryonic stem cells, neural stem cells, mesenchymal stem cells from various tissues, and induced pluripotent stem cells. Through neural transplantation, these cells can replace or repair the damaged dopamine neurons in Parkinson’s disease, thereby improving or even reversing the progression of the disease, offering new hope for its treatment. To fully harness the therapeutic potential of stem cells, it is essential to recognize the advantages and limitations of these cell sources. This article primarily introduces the background of stem cell therapy for Parkinson’s and the progress in treatment using different cell sources, aiming to provide a reference for research on stem cell therapy for Parkinson’s disease.
目的:本研究应用网络药理学探究余甘子治疗临床难治性疾病GA的主要活性成分和潜在机制,为云南特色药用植物余甘子用于GA的防治提供科学参考。方法:按照《网络药理学评选方法指南》采用网络数据库TCMSP和DisGeNET等获取余甘子的主要活性成分及其相关的蛋白质靶点和GA相关病理靶点。应用Venny2.1.0获取余甘子和GA靶点的集合,继而构建PPI网络,利用Cytoscape 3.9.1基于MCC算法得到核心靶点。进一步对靶点进行GO和KEGG富集分析。结果:筛选获得余甘子有效成分18个,余甘子和GA交集39个靶点,PPI网络中Degree值排序最重要的是TNF、VEGFA、MAPK14。GO分析表明余甘子治疗GA涉及小胶质细胞分化、凋亡细胞清除的正调节等生物过程。KEGG分析表明余甘子治疗GA的关键信号通路为Toll-like受体信号通路、NF-κB信号通路及IL-17信号通路。结论:通过本研究揭示了余甘子中槲皮素、木犀草素、山奈酚、鞣花酸等重要功效物质,通过调控关键炎症免疫信号通路及蛋白靶点,降低血液尿酸水平、减轻尿酸所致关节炎反应作为防治GA的潜在分子机制。Objective: This study used network pharmacology to explore the main active ingredients and potential mechanisms of Phyllanthus emblica in the treatment of clinical refractory disease GA and to provide a scientific reference for the use of Phyllanthus emblica, a Yunnan specialty medicinal plant, in the prevention and treatment of GA. Method: According to the “Guidelines for Network Pharmacology Selection”, the main active ingredients of Phyllanthus emblica and their related protein and GA-related pathological targets were obtained using network databases such as TCMSP and DisGeNET. Venny2.1.0 was used to obtain the set of Phyllanthus emblica and GA targets, and then a PPI network was constructed. The core targets were obtained using Cytoscape 3.9.1 based on the MCC algorithm. GO and KEGG enrichment analyses were performed on the targets further. Results: A total of 18 active ingredients of Phyllanthus emblica and 39 targets in the intersection of Phyllanthus emblica and GA were screened and obtained. The most important degree values in the PPI network were TNF, VEGFA, and MAPK14. GO analysis showed that Phyllanthus emblica in the treatment of GA involved biological processes such as positive regulation of microglia differentiation and apoptotic cell clearance. KEGG analysis showed that the key signaling pathways of Phyllanthus emblica in treating GA were the Toll-like receptor signaling pathway, NF-κB signaling pathway, and IL-17 signaling pathway. Conclusion: This study revealed that quer
系统评价阿奇霉素联合头孢类药物(头孢克肟、头孢克洛、头孢呋辛、头孢西丁、头孢噻肟)与单用头孢类药物治疗慢性阻塞性肺疾病急性加重期的有效性及安全性。方法:计算机检索PubMed、Cochrane、Embase、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库和维普数据库(VIP),收集阿奇霉素联合头孢类药物(试验组)对比头孢类药物(对照组)治疗慢性阻塞性肺疾病急性加重期的随机对照试验(RCT)。筛选文献、提取资料并按Cochrane系统评价员手册5.1.0推荐的偏倚风险评估工具评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果:纳入21项RCTs,共计1591例患者。Meta分析结果显示:试验组在临床总有效率[RR = 1.28, 95% CI (1.22, 1.33), P <0.00001]、治疗后肺功能FEV1/FVC (%)情况[MD = 9.45, 95% CI (7.88, 11.03, P <0.00001]、治疗后肺功能PEF情况[MD = 11.10, 95% CI (10.00, 12.20),P <0.00001]显著优于对照组,不良反应发生率[RR = 0.81, 95% CI (0.54, 1.22), P = 0.81]与对照组差异无统计学意义。结论:阿奇霉素联合头孢类药物治疗慢性阻塞性肺疾病急性加重期的疗效较好,安全性与单用头孢类药物相当。
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