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创伤性脑损伤和脊髓损伤中的干扰素:转化应用的当前证据

Interferons in Traumatic Brain and Spinal Cord Injury: Current Evidence for Translational Application.

作者信息

Roselli Francesco, Chandrasekar Akila, Morganti-Kossmann Maria C

机构信息

Department of Neurology, Ulm University, Ulm, Germany.

Department of Anatomy and Cell Biology, Ulm University, Ulm, Germany.

出版信息

Front Neurol. 2018 Jun 19;9:458. doi: 10.3389/fneur.2018.00458. eCollection 2018.

Abstract

This review article provides a general perspective of the experimental and clinical work surrounding the role of type-I, type-II, and type-III interferons (IFNs) in the pathophysiology of brain and spinal cord injury. Since IFNs are themselves well-known therapeutic targets (as well as pharmacological agents), and anti-IFNs monoclonal antibodies are being tested in clinical trials, it is timely to review the basis for the repurposing of these agents for the treatment of brain and spinal cord traumatic injury. Experimental evidence suggests that IFN-α may play a detrimental role in brain trauma, enhancing the pro-inflammatory response while keeping in check astrocyte proliferation; converging evidence from genetic models and neutralization by monoclonal antibodies suggests that limiting IFN-α actions in acute trauma may be a suitable therapeutic strategy. Effects of IFN-β administration in spinal cord and brain trauma have been reported but remain unclear or limited in effect. Despite the involvement in the inflammatory response, the role of IFN-γ remains controversial: although IFN-γ appears to improve the outcome of traumatic spinal cord injury, genetic models have produced either beneficial or detrimental results. IFNs may display opposing actions on the injured CNS relative to the concentration at which they are released and strictly dependent on whether the IFN or their receptors are targeted either via administration of neutralizing antibodies or through genetic deletion of either the mediator or its receptor. To date, IFN-α appears to most promising target for drug repurposing, and monoclonal antibodies anti IFN-α or its receptor may find appropriate use in the treatment of acute brain or spinal cord injury.

摘要

这篇综述文章概述了围绕I型、II型和III型干扰素(IFN)在脑和脊髓损伤病理生理学中的作用所开展的实验和临床研究。鉴于IFN本身就是著名的治疗靶点(以及药物),并且抗IFN单克隆抗体正在临床试验中接受检验,现在正是回顾将这些药物重新用于治疗脑和脊髓创伤性损伤的依据的时候。实验证据表明,IFN-α可能在脑创伤中发挥有害作用,增强促炎反应,同时抑制星形胶质细胞增殖;来自基因模型和单克隆抗体中和的证据表明,在急性创伤中限制IFN-α的作用可能是一种合适的治疗策略。已有关于IFN-β用于脊髓和脑创伤治疗效果的报道,但仍不明确或效果有限。尽管IFN-γ参与炎症反应,但其作用仍存在争议:虽然IFN-γ似乎能改善创伤性脊髓损伤的预后,但基因模型产生了有益或有害的结果。相对于释放浓度,IFN可能对受损的中枢神经系统表现出相反的作用,并且严格取决于IFN或其受体是通过施用中和抗体还是通过基因敲除介质或其受体来靶向。迄今为止,IFN-α似乎是最有前景的药物重新利用靶点,抗IFN-α或其受体的单克隆抗体可能在急性脑或脊髓损伤的治疗中找到合适的用途。

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