线粒体氧化应激在糖尿病微血管并发症发病机制中的研究进展

糖尿病并发症是糖尿病患者致残致死的首要原因, 而线粒体作为细胞能量代谢的中心, 其功能障碍与多种并发症的发生发展密切相关。本文针对常见的糖尿病微血管并发症, 包括糖尿病溃疡、糖尿病肾病及糖尿病视网膜病变等, 阐述其病理机制涉及线粒体功能与氧化应激的研究进展, 为靶向线粒体氧化应激治疗上述疾病提供更多的理论依据。     

线粒体稳态在糖尿病心肌病发生发展中作用的研究进展

糖尿病心肌病是一种发生于糖尿病患者中与冠状动脉疾病等其他心肌病无关的心脏功能障碍, 是导致糖尿病患者心力衰竭及最终死亡的重要原因。糖尿病心肌病的发病机制主要包括氧化应激、炎症反应、细胞凋亡和线粒体稳态失调等。线粒体稳态主要包括线粒体动力学、线粒体氧化代谢和线粒体自噬, 其受多种信号通路的调控, 在维持心肌细胞正常功能中发挥重要作用, 若线粒体稳态失调则会引发氧化应激乃至心肌细胞线粒体网络破碎, 导致脂肪酸累积, 加速糖尿病心肌病的发展。目前, 糖尿病心肌病的发病机制尚未明确, 缺少有效的预防和治疗方法, 该文从线粒体稳态方向阐述糖尿病心肌病发病机制, 为临床治疗提供新的思路和策略。     

线粒体损伤在支气管哮喘发生发展中的作用

支气管哮喘(哮喘)是一种以不同程度的气流阻塞、气道高反应性和气道炎症为特点的复杂炎症性疾病。线粒体损伤及功能障碍是哮喘重要的发病机制之一。了解线粒体结构、功能及其在哮喘中的作用机制,有助于在哮喘治疗中针对功能失调的线粒体开发新型靶向治疗药物。本文就线粒体功能及其在哮喘中的作用进行综述。     

糖尿病肾病线粒体靶向抗氧化治疗

氧化应激在DN发展中的作用越来越受到重视,发病统一机制学说现已被广泛接受,即长期的高血糖引起的线粒体活性氧产物增加是糖尿病各种致病通路的一个关键始动因子。因此有效的避免及清除这些活性氧产物的方法,有望为DN的防治提供了一个新的治疗思路。靶向线粒体的抗氧化剂可以特异性的针对线粒体发挥抗氧化效应,在DN及其他相关疾病的治疗中具有广泛的应用前景,这一新的治疗策略可能为有效地防治氧化应激引起的DN带来新的希望,也为其他疾病的治疗提供思路。     

氧化应激相关线粒体功能障碍与支气管哮喘

支气管哮喘(简称哮喘)是一种以不同程度的气流阻塞、气道高反应性和气道炎症为特点的复杂的炎症性疾病,受到遗传和环境因素的共同影响.分子生物学、细胞学以及动物模型研究提示线粒体功能障碍和氧化应激在哮喘发病中起着重要作用.哮喘状态下,炎症细胞内活性氧自由基生成增加,线粒体功能出现障碍,同时伴随气道上皮细胞损伤,并影响气道平滑肌功能.过敏性哮喘小鼠模型研究以及利用哮喘患者的外周细胞和组织进行的研究提示,抗氧化治疗有望成为哮喘预防与治疗的有效方法.本文将主要对以下方面进行讨论:①健康状态下的线粒体结构与功能;②氧化应激与线粒体功能障碍;③肺部氧化应激的来源及中和机制;④哮喘状态下的氧化应激和线粒体功能障碍;⑤线粒体靶向抗氧化剂的研究进展.     

人类疾病中线粒体异常形态的研究进展

线粒体是真核生物细胞内的“发电机”,对于细胞各种生命活动的正常进行至关重要。除了为细胞供能外,线粒体还参与一些重要的细胞活动,如凋亡、分化和增殖等。但线粒体并不是“永动机”。事实上,线粒体是对多种病理条件最为敏感的细胞器之一。线粒体功能障碍可导致多种人类疾病,如阿尔茨海默病、糖尿病、缺血性心脏病等。众所周知,线粒体形态的改变会影响其功能,反之亦然。在病理条件下线粒体会发生多种形态改变。以异常线粒体形态为特征的研究使研究者能够了解线粒体在某些人类疾病发病机制中的作用。本综述主要总结了人类疾病中线粒体形态变化的研究进展,旨在提供一定的理论概述。     

阿尔茨海默病患者线粒体功能障碍的发生机制研究进展

阿尔茨海默病（AD）是日常生活中常见的神经退行性疾病之一,其致病机制仍不明确。线粒体作为生物能量、钙信号传导和氧化还原稳态等方面发挥至关重要作用的细胞器,其功能出现障碍可导致细胞能量缺乏、细胞内钙失衡和氧化应激,从而进一步加重Aβ和Tau蛋白的影响,导致突触功能障碍、认知障碍甚至记忆丧失。随着对AD发病机制的不断深入研究,氧化应激、线粒体动力学及线粒体自噬被认为与AD的发病过程密切相关。氧化应激引起的线粒体功能障碍会进一步导致Aβ蛋白的聚集和Tau蛋白的过度磷酸化,而Aβ蛋白的聚集和高度磷酸化的Tau蛋白可损害线粒体功能,从而形成恶性循环。GTP相关的动力相关蛋白1(Drp1)表达水平异常可导致线粒体过度分裂甚至碎片化,引起线粒体功能障碍和神经元损伤,最终导致疾病的发生。线粒体自噬功能异常在AD发病中发挥着重要的作用,有多种通路介导的线粒体自噬途径参与了AD的发病,包括Aβ蛋白积聚诱导的线粒体自噬途径、氧化应激诱导的线粒体自噬途径、PINK1-Parkin通路介导的线粒体自噬途径以及受体介导的线粒体自噬途径等,均可引起异常线粒体的堆积导致线粒体功能障碍,进而诱导AD发病。     

线粒体功能障碍与心力衰竭的关系

线粒体是真核细胞内重要的细胞器,在细胞能量代谢、信号转导以及氧化应激、钙稳态和细胞凋亡调节过程中均发挥着重要的作用。因此,线粒体功能正常在生命活动中至关重要。线粒体功能障碍的机制复杂多样并相互联系、相互影响;越来越多的研究表明,线粒体功能障碍是心力衰竭进展中的关键因素之一。因此,认识和深入研究线粒体功能障碍在心力衰竭发生发展中的作用,为阐明心力衰竭的发病机制及其临床防治拓开了新的思路。     

常见DNA聚合酶γ基因突变和线粒体疾病

DNA聚合酶是细胞复制DNA的重要作用酶。DNA聚合酶γ（polγ）存在于人类线粒体中,它是线粒体DNA复制和修复所必须。DNA聚合酶γ基因（POLG）发生突变后会导致其编码的polγ功能发生改变,使线粒体DNA（mtD—NA）复制及线粒体氧化磷酸化等功能障碍,引起线粒体相关疾病。对这些突变位点及其与疾病关系的研究为线粒体疾病的发病机制及治疗等提供了线索。本文对一些POLG常见位点突变相关研究进行了综述。     

线粒体功能异常在糖尿病心肌病发病机制中的作用

糖尿病是一种代谢性疾病,是心血管疾病的独立危险因素。糖尿病心肌病是独立于冠状动脉疾病和高血压的糖尿病并发症之一,是一种多因素所致的复杂疾病,可导致较高的发病率及病死率。线粒体占心肌细胞中体积的35%~40%,心肌活动所需95%的ATP均由线粒体产生。当线粒体受损时,心脏功能可能随之出现异常。现对线粒体功能异常在糖尿病心肌病中作用机制的研究进展进行综述。     

Role of microRNAs in diabetes and its cardiovascular complications

Diabetes is the most common metabolic disorder and is recognized as one of the most important health threats of our time. MicroRNAs (miRNAs) are a novel group of non-coding small RNAs that have been implicated in a variety of physiological processes, including glucose homeostasis. Recent research has suggested that miRNAs play a critical role in the pathogenesis of diabetes and its related cardiovascular complications. This review focuses on the aberrant expression of miRNAs in diabetes and examines their role in the pathogenesis of endothelial dysfunction, cardiovascular disease, and diabetic retinopathy. Furthermore, we discuss the potential role of miRNAs as blood biomarkers and examine the potential of therapeutic interventions targeting miRNAs in diabetes.     

The Role of Mitochondria in Diabetic Kidney Disease

Despite major improvements in the treatment of patients with diabetes mellitus, many patients still suffer from progressive diabetic kidney disease. More research is needed to improve treatment and to understand why some patients develop complications while others do not. Mitochondrial dysfunction has turned out to be central to the pathogenesis of diabetes, and we will review some new aspects in this field and the potential for treatment. The conventional theory has been that the intracellular surplus of glucose leads to mitochondrial overproduction of superoxide that contributes to general cell damage and activation of deleterious pathways specific for diabetes complications. However, recent data suggests that reduced mitochondrial activity could be the basis for disease progression and complications through increased inflammation and pro-fibrotic factors. Physical exercise is a very strong stimulus to mitochondrial biogenesis, and we now understand many of the underlying signaling pathways. Clinical trials have also shown that training, especially high-intensity training, can delay the onset of diabetes and improve insulin resistance. Furthermore, intermittent fasting and various pharmacological agents are other potential options for stimulating mitochondrial function and reducing the risk of development and progression of diabetic kidney disease.     

Proteomics and diabetic nephropathy

Diabetes mellitus is acknowledged to be a group of metabolic diseases and heterogeneous in natural history, pathogenesis, response to treatment, and disease progression and remission. Diabetic nephropathy (DN) accounts for approximately 40% of all newly diagnosed cases of endstage renal disease. The complexity of diabetes and its complications requires a broad-based, unbiased, scientific approach such as proteomics. Recently, proteomics (the systematic analysis of protein identity, quantity, and function) has been applied to the study of DN. Proteomic investigations into diabetic kidney disease have identified new mechanisms of diabetic renal pathology, as well as potential urinary markers of DN. Other current proteomic advances in understanding DN include identifying the role of advanced glycation end products in decreased mitochondrial respiration and also the rapid development of mass spectrometric methods for protein and peptide markers of DN development and markers to pharmacologic therapies. Proteomic analysis has only recently been applied to the study of DN, yet it has shown substantial potential.     

Mitochondrial dysfunction as an initiating event in atherogenesis: a plausible hypothesis

It is now widely accepted that oxidant stress and the ensuing endothelial dysfunction play a key role in the pathogenesis of atherosclerosis and cardiovascular diseases. The mitochondrial respiratory chain is the major source of reactive oxygen species as byproducts of normal cell respiration. Mitochondria may also be important targets for reactive oxygen species, which may damage mitochondrial lipids, enzymes and DNA with following mitochondrial dysfunction. Free cholesterol, oxidized low-density lipoprotein and glycated high-density lipoprotein are further possible causes of mitochondrial dysfunction and/or apoptosis. Moreover, in patients with mitochondrial diseases, vascular complications are commonly observed at an early age, often in the absence of traditional risk factors for atherosclerosis. We propose that mitochondrial dysfunction, besides endothelial dysfunction, represents an important early step in the chain of events leading to atherosclerotic disease.     

糖尿病性心肌病的发病机制及治疗方法研究进展

心血管疾病是2型糖尿病的主要并发症,约占2型糖尿病患者死亡人数的2/3。血糖异常、血脂异常、胰岛素抵抗、慢性低度炎症、氧化应激、内皮功能障碍、血管钙化和高凝状态等多种病理生理过程可加快2型糖尿病患者糖尿病心脏病的进展。糖尿病性心肌病是糖尿病心脏病中较为常见的一种,可导致心功能异常并最终进展为心力衰竭、心律失常,甚至猝死。本文综述了糖尿病性心肌病的发病机制,以及当前及未来潜在的治疗方法。     

Alternative therapies for diabetes and its cardiac complications: role of vanadium

It is now well known that a cardiomyopathic state accompanies diabetes mellitus. Although insulin injections and conventional hypoglycemic drug therapy have been of invaluable help in reducing cardiac damage and dysfunction in diabetes, cardiac failure continues to be a common cause of death in the diabetic population. The use of alternative medicine to maintain health and treat a variety of diseases has achieved increasing popularity in recent years. The goal of alternative therapies in diabetic patients has been to lower circulating blood glucose levels and thereby treat diabetic complications. This paper will focus its discussion on the role of vanadium on diabetes and the associated cardiac dysfunction. Careful administration of a variety of forms of vanadium has produced impressive long-lasting control of blood glucose levels in both Type 1 and Type 2 diabetes in animals. This has been accompanied by, in many cases, a complete correction of the diabetic cardiomyopathy. The oral delivery of vanadium as a vanadate salt in the presence of tea has produced particularly impressive hypoglycemic effects and a restoration of cardiac function. This intriguing approach to the treatment of diabetes and its complications, however, deserves further intense investigation prior to its use as a conventional therapy for diabetic complications due to the unknown long-term effects of vanadium accumulation in the heart and other organs of the body.     

Cardiac mitochondrial alterations observed in hyperglycaemic rats--what can we learn from cell biology?

Diabetes mellitus is one of the most common metabolic diseases in the world. The complications associated with this disease are often responsible for a decreased quality of life in many patients. For example, the diabetic population has a greater probability to suffer from cardiovascular problems and heart failure than the general population. Due to the importance heart mitochondria have in the context of the bioenergetics of the myocardium, it appears logical to explore mitochondrial dysfunction as an important link between hyperglycaemia and heart alterations observed during diabetes. One important factor that can lead to mitochondrial dysfunction is the mitochondrial permeability transition (MPT), caused by the formation of poly-protein pores (MPT pores), occurring with mitochondrial calcium overload and increased oxidative stress, conditions already described to exist in myocytes exposed to hyperglycaemia. The MPT has been involved as determinant in the survival of myocytes after anoxia and reoxigenation, as well as in triggering cell death. The present review deals with cardiac mitochondrial alterations observed in drug-induced hyperglycaemic animals or in the GK rat, a hereditary model of hyperglycaemia. Respiration rates, susceptibility to oxidative stress, protein expression and MPT induction are altered in hyperglycaemic animals, which in extreme conditions can alter the bioenergetics of the diabetic myocardium and even cause myocardial cell death. The study of the cardiac mitochondrial function of hyperglycaemic animals offer an important insight, not only to explain cardiac alterations found in diabetic patients, but also in the design of new therapeutic approaches to reduce mitochondrial dysfunction and cell death typically associated with diabetes.     

Modeling mitochondrial dysfunctions in the brain: from mice to men

The biologist Lewis Thomas once wrote: “my mitochondria comprise a very large proportion of me. I cannot do the calculation, but I suppose there is almost as much of them in sheer dry bulk as there is the rest of me”. As humans, or indeed as any mammal, bird, or insect, we contain a specific molecular makeup that is driven by vast numbers of these miniscule powerhouses residing in most of our cells (mature red blood cells notwithstanding), quietly replicating, living independent lives and containing their own DNA. Everything we do, from running a marathon to breathing, is driven by these small batteries, and yet there is evidence that these molecular energy sources were originally bacteria, possibly parasitic, incorporated into our cells through symbiosis. Dysfunctions in these organelles can lead to debilitating, and sometimes fatal, diseases of almost all the bodies’ major organs. Mitochondrial dysfunction has been implicated in a wide variety of human disorders either as a primary cause or as a secondary consequence. To better understand the role of mitochondrial dysfunction in human disease, a multitude of pharmacologically induced and genetically manipulated animal models have been developed showing to a greater or lesser extent the clinical symptoms observed in patients with known and unknown causes of the disease. This review will focus on diseases of the brain and spinal cord in which mitochondrial dysfunction has been proven or is suspected and on animal models that are currently used to study the etiology, pathogenesis and treatment of these diseases.     

糖尿病心肌病的能量代谢紊乱

随着糖尿病发病率逐年上升,糖尿病心肌病也引起了人们越来越多的关注。然而,对于糖尿病导致的心肌损害,其分子机制现在仍未被阐明。糖尿病心肌病的发病受多种因素的影响,包括钙离子平衡失调、肾素．血管紧张素系统的激活、氧化应激的增加、心肌代谢底物改变以及线粒体损伤等。本文就糖尿病心肌病的能量代谢紊乱作一综述。     

Diabetes-associated macrovasculopathy: pathophysiology and pathogenesis

The complications associated with diabetic vasculopathy are commonly grouped into two categories: microvascular and macrovascular complications. In diabetes, macrovascular disease is the commonest cause of mortality and morbidity and is responsible for high incidence of vascular diseases such as stroke, myocardial infarction and peripheral vascular diseases. Macrovascular diseases are traditionally thought of as due to underlying obstructive atherosclerotic diseases affecting major arteries. Pathological changes of major blood vessels leading to functional and structural abnormalities in diabetic vessels include endothelial dysfunction, reduced vascular compliance and atherosclerosis. Besides, advanced glycation end product formation interacts with specific receptors that lead to overexpression of a range of cytokines. Haemodynamic pathways are activated in diabetes and are possibly amplified by concomitant systemic hypertension. Apart from these, hyperglycaemia, non-enzymatic glycosylation, lipid modulation, alteration of vasculature and growth factors activation contribute to development of diabetic vasculopathy. This review focuses on pathophysiology and pathogenesis of diabetes-associated macrovasculopathy.