Case Western Reserve University, Rainbow Babies & Children's Hospital, Cleveland, OH, USA.
Adv Exp Med Biol. 2018;1071:159-166. doi: 10.1007/978-3-319-91137-3_20.
Myo-inositol is a highly abundant stereoisomer of the inositol family of sugar alcohols and forms the structural basis for a variety of polyphosphate derivatives including second messengers and membrane phospholipids. These derivatives regulate numerous cell processes including gene transcription, membrane excitability, vesicular trafficking, intracellular calcium signaling, and neuronal growth and development. Myo-inositol can be formed endogenously from the breakdown of glucose, is found in a variety of foods including breastmilk and is commercially available as a nutritional supplement. Abnormal myo-inositol metabolism has been shown to underlie the pathophysiology of a variety of clinical conditions including Down Syndrome, traumatic brain injury, bronchopulmonary dysplasia (BPD), and respiratory distress syndrome (RDS). Several animal studies have shown that myo-inositol may play a critical role in development of both the central and peripheral respiratory neural control system; a notable example is the neonatal apnea and respiratory insufficiency that manifests in a mouse model of myo-inositol depletion, an effect that is also postnatally lethal. This review focuses on myo-inositol (and some of its derivatives) and how it may play a role in respiratory neural control; we also discuss clinical evidence demonstrating a link between serum myo-inositol levels and the incidence of intermittent hypoxemia (IH) events (a surrogate measure of apnea of prematurity (AOP)) in preterm infants. Further, there are both animal and human infant studies that have demonstrated respiratory benefits following supplementation with myo-inositol, which highlights the prospects that nutritional requirements are important for appropriate development and maturation of the respiratory system.
肌醇是糖醇家族中高度丰富的立体异构体，也是各种多磷酸盐衍生物的结构基础，包括第二信使和膜磷脂。这些衍生物调节许多细胞过程，包括基因转录、膜兴奋性、囊泡运输、细胞内钙信号和神经元生长和发育。肌醇可以从葡萄糖的分解中内源性形成，存在于各种食物中，包括母乳，并可作为营养补充剂商业化。异常的肌醇代谢已被证明是多种临床情况的病理生理学基础，包括唐氏综合征、创伤性脑损伤、支气管肺发育不良（BPD）和呼吸窘迫综合征（RDS）。几项动物研究表明，肌醇可能在中枢和外周呼吸神经控制系统的发育中发挥关键作用；一个显著的例子是肌醇耗竭的小鼠模型中出现的新生儿呼吸暂停和呼吸功能不全，这种影响也是出生后致命的。本文重点介绍肌醇（及其一些衍生物）及其在呼吸神经控制中的作用；我们还讨论了临床证据，表明血清肌醇水平与早产儿间歇性低氧血症（IH）事件（呼吸暂停的替代指标）的发生率之间存在关联。此外，动物和人类婴儿研究都表明补充肌醇具有呼吸益处，这突出表明营养需求对于呼吸系统的适当发育和成熟很重要。
