内质网应激与肾脏疾病

内质网（endoplasmic reticulum,ER）是细胞内极为重要的细胞器,负责蛋白质的合成、折叠、装配、转运等。内质网内环境的稳定是实现其功能的基本条件,许多因素如缺氧、氧化应激等-[1]可导致内质网内稳态失衡,形成内质网应激（endoplasmic reticulum stress,ERS）。ERS在肾脏疾病的发生和进展中起着关键的作用,具有非常重要的研究前景,     

内质网应激在糖尿病肾病中的研究进展

内质网（ endoplasmic reticulum,ER）广泛存在于真核细胞中,是细胞内合成蛋白质并进行折叠、寡聚化加工和细胞内钙储存的重要场所。病理生理条件,包括营养不足、营养过剩、蛋白质糖基化变化、ER钙含量改变和氧化应激等,均可干扰正常蛋白质折叠,错误折叠或未折叠蛋白质在内质网腔内积聚诱发细胞毒性反应[1]。因此,细胞进化出了复杂的信号系统来处理积聚的未折叠蛋白质、调节ER膜结构和分泌蛋白。     

内质网应激介导的细胞自噬与凋亡研究进展

内质网(ER)是哺乳动物中一种重要的细胞器,是细胞内蛋白质合成、修饰、折叠的场所,是储存并调节Ca2+的场所[1].由于缺氧、营养缺乏、氧化应激等原因引起的错误折叠与未折叠蛋白在ER腔内聚集以及Ca2+平衡紊乱的状态,称为内质网应激(ERS).为缓解ERS而引起的一系列后续反应称为未折叠蛋白反应(UPR).轻度ERS时,一方面,ER通过激活UPR[2]以保护细胞免受损伤,促使细胞存活;另一方面,激活的UPR可启动自噬,清除那些超出蛋白酶体清除能力的错误折叠蛋白,以恢复ER稳态,促使细胞存活[3].     

内质网应激与肾脏损伤

内质网( endoplasmic reticulum,ER)是真核细胞中一种重要的亚细胞器,其主要功能包括调节蛋白质的合成、折叠、运输及修饰.内质网功能易受环境损害的影响,例如缺氧、低糖、氧化应激和遗传突变都将导致内质网腔内蛋白质折叠异常.这些未折叠蛋门以及错误折叠蛋白的积聚引起内质网一系列功能的紊乱,称为内质网应激[1].内质网应激与多种疾病相关,如阿尔茨海默症、帕金森病、亨廷顿病、缺血再灌注损伤、糖尿病及动脉粥样硬化等.越来越多的证据提示,内质网应激在肾脏病理生理过程中亦发挥重要作用[2].本文就内质网应激与肾脏疾病的研究进展作一综述.一、内质网应激与未折叠蛋白反应发生内质网应激的细胞为能够恢复正确的蛋白折叠、阻止未折叠蛋白以及错误折叠蛋白的积聚,激活一项较为保守的适应性反应,称为未折叠蛋白反应( UPR).     

PI3K/Akt信号通路在骨代谢中的作用

骨稳态的维持需要成骨细胞的骨形成和破骨细胞的骨吸收,因骨稳态的失衡可导致多种疾病,如骨硬化症、骨质疏松症等。成骨细胞和破骨细胞内的多种分子参与到信号转导的过程中,调控着细胞的增殖、分化及凋亡,从而维持骨稳态的平衡。但成骨细胞和破骨细胞内的信号通路十分复杂,可能有多种信号通路参与到其中,并且各信号通路之间可能存在着不同     

内质网应激与脑缺血/再灌注损伤

背景 近几年脑缺血/再灌注损伤(ischemia/reperfusion injury,URI)造成神经元凋亡的机制被广泛研究.钙离子平衡发生紊乱、活性氧生成增多等因素,都可能造成内质网内大量的未折叠蛋白质或错误折叠蛋白质的堆积,导致内质网应激(endoplasmic reticulum stress,ERS)的发生.许多研究表明脑I/RI可以诱发ERS,进而导致神经元的凋亡. 目的 对近年来ERS与脑I/RI之间的联系进行综述,希望为临床治疗提供一些新的方案,也为新药的开发提供新的思路. 内容 综述ERS诱导细胞凋亡的不同途径之间的关联及其与脑FRI的内在联系. 趋向 仍需对ERS和脑I/RI之间的联系做进一步探究,以希望通过减弱ERS来改善患者的预后.     

内质网应激在慢性HBV感染发病中的作用

乙型肝炎病毒(Hepatitis B Virus,HBV)慢性感染在慢性乙型肝炎-肝硬化-肝癌的进展中起着重要作用.内质网应激(endoplasmic reticulum stress,ERS)是一种细胞的自我防御机制,适度的ERS能促进未折叠或错误折叠蛋白的降解,对细胞存活起保护作用,但持续的ERS则会引起细胞不可逆损伤甚至细胞凋亡.大量研究证实,持续的HBV复制和表达可触发ERS,ERS与HBV感染后肝脏非可控性炎症的发生发展和恶性转化密切相关,但确切的调控机制尚未阐明1-2.进一步阐明ERS在肝脏疾病中的作用机制,将对肝脏疾病的防治具有重要的临床意义.本文就ERS在慢性HBV感染发病机制中的作用进行综述.     

肠道分泌细胞内质网应激与炎性肠病

炎性肠病（IBD）的病因和发病机制至今仍未完全明确。近年来研究发现肠道分泌细胞的内质网应激（ERS）与其有着密切的联系,肠道分泌细胞错误折叠蛋白或未折叠蛋白在内质网（ER）内聚集导致稳态失衡、生理功能发生紊乱,可能引起IBD。本文就对肠道分泌细胞的ER应激、其与IBD的联系及可能的作用机制的最新进展作一综述。     

内质网应激及偶联炎症反应在糖尿病肾病中的研究进展

正糖尿病肾病(diabetic nephropathy,DN)是糖尿病的常见并发症,其发病机制十分复杂,目前尚未完全明确,给临床治疗带来很大困难。近年来研究发现,内质网膜上存在一套完整的信号调节机制,即内质网应激(endoplasmic reticulum stress,ERS)反应,内质网应激是多种代谢性疾病如慢性心脑血管疾病、神经性病变、胰岛素抵抗、糖尿病、肥胖、脂肪肝等发生发展的中     

内质网应激在高血压肾损害中作用机制的探讨

高血压导致肾损害的病因机制错综复杂,但肾脏内固有细胞的结构功能改变这一因素在其中扮演重要的角色.内质网( endoplasmic reticulum,ER)是细胞内重要的生物大分子物质,是细胞内的"重要工厂",参与细胞生存凋亡及重要功能的物质大多需要在这里生产加工.在外界如高糖、缺血、低氧等因素的刺激下,内质网可出现功...     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.