超声微泡介导靶向治疗在肾脏病中的作用

目的:深入理解超声微泡介导靶向治疗的机制,了解其研究现状,对实现基因和药物的定向治疗,并将其应用于临床有重要意义。资料来源:应用计算机检索Pubmed数据库1995-01/2006-01有关超声微泡介导靶向治疗的文章,检索词“Microbubble,gene,drug”,限定文章语言种类为English。同时计算机检索中国期刊全文数据库、万方数据1994-01/2006-01期间的相关文章,检索词“超声微泡、基因、治疗”,限定文章语言种类为中文。资料选择:资料初审后,选取符合研究要求的文章查找全文。纳入标准:①有关超声微泡介导靶向治疗的研究。②有关超声微泡系统在肾脏病领域的研究。排除标准:重复研究。资料提炼:共收集到67篇有关超声微泡介导靶向治疗的文章,排除重复或类似研究,32篇符合研究要求。资料综合:①超声微泡介导靶向治疗的主要机制:声波的空化效应导致细胞膜通透性增高,使微泡所携带的基因或药物进入组织细胞内,从而提高基因的转染效率及局部药物浓度。②超声微泡介导靶向治疗的研究现状:国内外超声微泡携带基因治疗的方法已应用于心血管、神经系统等领域的试验研究,表明该基因治疗方法是一种安全、高效的体内基因定位转染新技术。另外,采用微泡运送溶栓和抗肿瘤药物,可提高靶组织的药物浓度,降低全身毒副作用。③超声微泡介导系统在肾脏病中的应用:超声微泡系统已成功将目的基因转染多种肾脏病动物模型,转染效率明显提高,并有效保护肾功能,减轻肾脏纤维化。④研究展望:深入研究,制备高效、安全的靶向微泡造影剂,优化超声参数,超声微泡系统将具有广阔的应用前景。结论:超声微泡介导靶向治疗可增强基因转染效率,提高特定组织的基因表达水平和药物浓度,是一种安全、简便、高效的靶向性基因转染及药物治疗的新方法。     

超声介导微泡靶向治疗作用的研究进展

随着超声造影技术的不断发展和可携带药物微泡声学造影剂的研制 ,超声将从目前仅作为一种临床的诊断工具 ,进入到治疗领域。超声造影经静脉注射含有气体的微泡造影剂后 ,微泡在血管腔中保持相对稳定 ,血流动力学特性与红细胞相似 ,因此 ,可利用微泡这种只存在于血管内的特性 ,用作药物或基因的载体。为达到这个目的 ,首先 ,微泡必须能够携带药物 ;其次 ,微泡在病变部位要达到足够的浓度 ,也就是微泡对病变组织必须具有靶向作用。目前 ,携带药物造影剂的研制尚处于初期阶段。一个有前景的方法是 ,使微泡具有双层外壳 ,这样可将一定浓度的药物…     

超声介导造影微泡在炎症靶向方面的研究进展

随着超声造影技术的发展及靶向性造影剂的研制，超声介导的造影微泡的应用日益广泛，在靶向性造影研究方面更显示出诱人的前景。靶向性超声造影剂的研制目前尚处于起始阶段，使微泡具有靶向作用的方法有：①利用微泡外壳的化学和电荷特性使之滞留于病变部位；②在微泡表面直接连接特异性抗体或配体，使之结合到病变部位细胞表达的特异性抗原或受体上；③利用生物素抗生物素间分子桥作用，间接使微泡与病变区域结合，达到靶向显影和治疗的目的。超声介导造影微泡靶向性应用热点包括血栓、动脉粥样硬化、肿瘤以及炎症等的显影和治疗。     

靶向超声微泡造影剂与超声分子显像

超声分子显像是一门新兴发展的，以靶向超声微泡造影剂为显像剂，能够对体内组织器官微观病变进行分子水平的探测与显像的方法。本文对靶向超声微泡造影剂与超声分子显像的研究现状及发展方向进行了综述。     

超声介导微泡造影剂在临床诊断及治疗中的作用

超声介导靶向微泡造影属于＂超声分子影像学＂的范畴,是指将微泡造影剂通过血管途径进入靶组织,应用超声造影技术来观察靶区在组织水平、细胞及亚细胞水平的成像,借以反映病变区组织在分子基础方面的变化。特异性靶向超声微泡表面携带有对靶分子具有特异识别能力的分子探针（单克隆抗体或其他配体）,     

超声靶向微泡破坏技术介导自杀基因在恶性肿瘤中的研究进展

恶性肿瘤是全球发病率和死亡率的一个重要原因,严重威胁人类的健康。作为其常规的治疗方法,化疗、放疗和手术仍有局限性。自杀基因疗法为各种形式的恶性肿瘤提供了一种极具前景的治疗手段。超声靶向微泡破坏(UTMD)技术为自杀基因的传递赋予了新的方式。本文着重就 UTMD 介导的自杀基因转染在恶性肿瘤治疗中的最新进展进行总结并对其未来发展提出展望。     

超声靶向微泡破坏介导的纳米给药系统的研究进展

纳米给药系统是目前治疗多种疾病,尤其是肿瘤的一种很具前景的方法。基于纳米微泡结构的改变和修饰,超声靶向微泡破坏技术(UTMD)作为一种安全的物理靶向方法,可以增强组织渗透性和细胞膜通透性,帮助载药的纳米微泡进入靶组织和细胞内部,进而提高给药效率。本文就UTMD介导的靶向纳米超声造影剂(UCA)的最新研究进展进行综述。     

超声靶向微泡破坏技术介导基因转染的研究进展

基因转染技术的高速发展不仅革新了生物学和医学许多基本问题的研究,也推动了诊断和治疗的进步。基因作为核酸类生物活性大分子,极易在体内降解,因此传递基因的载体尤为重要。超声靶向微泡破坏(UTMD)技术利用超声波和微泡之间的相互作用,以及其产生的生物学效应,使微泡携基因进行转染,并与多种载体联合应用,为疾病的治疗提供了有效手段。本文就UTMD技术介导基因转染的研究进展进行综述。     

超声微泡造影剂靶向治疗现状及研究进展

1968年Gramiak首次报道了可增强显影的小气泡,即超声微泡造影剂（UCA）,它的出现开创了无创超声诊断和治疗的新领域。随着对其研究的不断深入,人们发现超声微泡造影剂不仅是一种良好的超声显像对比剂,     

评价超声联合白蛋白微泡造影剂实现基因转染靶向性的研究

目的 评价超声联合白蛋白微泡造影剂实现基因转染的靶向性.方法 选择增强型绿色荧光蛋白质粒为报告基因,经股静脉输入黏附质粒的白蛋白微泡的同时在大鼠背部脊斜肌区域经皮辅予一定强度的超声照射对大鼠脊斜肌行基因转染,转染7 d后,取脊斜肌、肝、肾、心肌组织快速冷冻切片,荧光显微镜下观察各组织内的荧光表达.结果 脊斜肌组织中可见较多特异性绿色荧光,多位于微血管周围,荧光强度较其余组织明显增强(P<0.05),肝脏、肾脏组织中见少量特异性绿色荧光,肝脏荧光强度约为肾脏的4倍(P<0.05),心肌组织中未见特异性绿色荧光.结论 静脉注射黏附质粒的微泡声学造影剂同时经体表给予一定强度的超声辐照,可以较好地实现基因的靶向转染.     

Choosing therapy for end-stage renal disease

Patients with end-stage renal disease must decide which form of therapy they want--hemodialysis, peritoneal dialysis or transplant. Each method has advantages and disadvantages. Home dialysis and related donor transplantation are generally the preferred modes of therapy, because they allow for maximum patient rehabilitation and survival. The informed family physician can help the patient choose the most appropriate treatment.     

Hospitalization in the first year of renal replacement therapy for end-stage renal disease

BACKGROUND: The requirement for hospitalization of patients on dialysis is likely to be a surrogate marker of age and comorbid diseases. It may also reflect the level of care delivered, and substantially increases the cost of this expensive therapy. AIM: To identify the factors most strongly associated with hospitalization. DESIGN: Prospective population study. METHODS: Data were recorded for all patients starting RRT in Scotland over one year, including the reasons for and duration of, each hospital admission during the first year of RRT. Factors most strongly associated with hospitalization were determined by Poisson regression analysis. RESULTS: Overall, 526 patients were admitted to hospital on 1668 occasions (median 3, IQR 1-4) for 13384 days (median 13, IQR 4-35). Formation of vascular access for haemodialysis (HD) was the most frequent reason for admission, followed by infections. Age, comorbidity, mode of presentation for RRT and primary renal diagnosis were all significantly associated with prolonged hospitalization. Attainment of UK Renal Association standards for urea reduction ratio and serum albumin concentration, and vascular access in the form of arterio-venous fistulae were associated with less hospitalization in patients treated with HD by 90 days. DISCUSSION: Patients in their first year of RRT have a high requirement for in-patient care, 8.6% of patient treatment days being spent in hospital. Vascular access formation, failure and complications account for a large proportion of this. Age and comorbidity prolong the time spent in hospital. As the RRT population continues to increase, with older patients and those with greater comorbidity, in-patient facilities must also expand.     

Dyslipidemia as a therapeutic target for prevention of cardiovascular events and end-stage renal disease

Chronic kidney disease (CKD) is an important risk factor for end-stage renal disease (ESRD) and cardiovascular events as well. Early-onset and progressive atherosclerosis is common in patients with CKD, which is caused by varieties of factors including dyslipidemia. CKD-related dyslipidemia such as increased triglyceride-rich atherogenic lipoproteins such IDL, small dense LDL and low HDL associated with insulin resistance, oxidative stress, inflammation, and malnutrition co-existing dyslipidemia such as high LDL are both causetive for early-onset atherogenesis and, possibly progression of CKD, thus are the therapeutic targets in early intervention of CKD. Life-style modification aimed for both renoprotection and anti-dyslipidemia as well as medications for metabolic disorders in CKD patients such as Ca/P imbalance is crucial for correction of dyslipidemia, and also prevention of cardiovasclular events and ESRD in CKD patients. Among anti-dyslipidemic drugs, statin, so far, is only class of drug proved to be effective for such purpose on evidence-basis.     

Combination fibrate-statin therapy for the treatment of severe hypertriglyceridaemia in renal disease

This case report describes the treatment of a patient with end-stage renal disease on peritoneal dialysis who presented with triglycerides of 35 mmol/l, cholesterol of 14 mmol/l and visible chylomicronaemia. She was only partially responsive to statin and fibrate monotherapy, so was treated with fibrate-statin combination therapy. Daily fibrate therapy resulted in a myositis, but once-weekly fibrate therapy with nocturnal daily statin therapy resulted in a reduction in total cholesterol of 49%, triglycerides of 82% and raised HDL by 52%, enabling her to achieve a target LDL of 3 mmol/l and HDL of 1 mmol/l. Combination therapy with low frequency (weekly) fibrate administration and daily statin treatment may provide a means to control the severe hypertriglyceridaemia of patients with renal disease.     

Continuous ambulatory peritoneal dialysis therapy for patients with end stage renal disease

CAPD is a method of dialysis that uses the patient's own peritoneal membrane. The semipermeable membrane that lines the abdominal organs and cavity selectively allows the passage of waste products, electrolytes, and fluids. Hemodialysis is an extracorporeal process whereby the patient's blood is withdrawn through a percutaneous needle inserted into a blood vessel. In hemodialysis, the operating principle is a cellophane membrane placed between the patient's blood and wash solution.     

慢性丙型肝炎合并肾脏疾病的研究进展

丙型肝炎病毒（HCV）感染导致的肝外损害以肾损伤多见,同时慢性肾脏病发展到终末期肾病行血液透析时可增加HCV感染风险。慢性丙型肝炎合并肾脏疾病可加速疾病的进程,造成患者的不良预后。该文对HCV致肾损伤的机制和慢性丙型肝炎合并肾脏疾病的直接抗病毒药物治疗等研究在近年所取得的进展进行综述,旨在加深临床医师对慢性丙型肝炎合并肾脏疾病患者行抗病毒治疗的认识,改善患者预后。