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2型糖尿病和范科尼贫血患者的线粒体保护临床策略:线粒体功能障碍的临床管理建议

Mitoprotective Clinical Strategies in Type 2 Diabetes and Fanconi Anemia Patients: Suggestions for Clinical Management of Mitochondrial Dysfunction.

作者信息

Pagano Giovanni, Pallardó Federico V, Porto Beatriz, Fittipaldi Maria Rosa, Lyakhovich Alex, Trifuoggi Marco

机构信息

Department of Chemical Sciences, Federico II Naples University, I-80126 Naples, Italy.

Department of Physiology, Faculty of Medicine and Dentistry, University of Valencia-INCLIVA, CIBERER, E-46010 Valencia, Spain.

出版信息

Antioxidants (Basel). 2020 Jan 18;9(1):82. doi: 10.3390/antiox9010082.

Abstract

Oxidative stress (OS) and mitochondrial dysfunction (MDF) occur in a number of disorders, and several clinical studies have attempted to counteract OS and MDF by providing adjuvant treatments against disease progression. The present review is aimed at focusing on two apparently distant diseases, namely type 2 diabetes (T2D) and a rare genetic disease, Fanconi anemia (FA). The pathogenetic links between T2D and FA include the high T2D prevalence among FA patients and the recognized evidence for OS and MDF in both disorders. This latter phenotypic/pathogenetic feature-namely MDF-may be regarded as a mechanistic ground both accounting for the clinical outcomes in both diseases, and as a premise to clinical studies aimed at counteracting MDF. In the case for T2D, the working hypothesis is raised of evaluating any decrease of mitochondrial cofactors, or mitochondrial nutrients (MNs) such as α-lipoic acid, coenzyme Q10, and l-carnitine, with possibly combined MN-based treatments. As for FA, the established knowledge of MDF, as yet only obtained from or molecular studies, prompts the requirement to ascertain in vivo MDF, and to design clinical studies aimed at utilizing MNs toward mitigating or delaying FA's clinical progression. Altogether, this paper may contribute to building hypotheses for clinical studies in a number of OS/MDF-related diseases.

摘要

氧化应激(OS)和线粒体功能障碍(MDF)在多种疾病中都会出现,一些临床研究试图通过提供辅助治疗来对抗OS和MDF,以阻止疾病进展。本综述旨在聚焦于两种看似不相关的疾病,即2型糖尿病(T2D)和一种罕见的遗传病——范科尼贫血(FA)。T2D与FA之间的发病机制联系包括FA患者中T2D的高患病率,以及两种疾病中均存在的OS和MDF的确切证据。后一种表型/发病机制特征,即MDF,可被视为解释这两种疾病临床结果的机制基础,也是旨在对抗MDF的临床研究的前提。对于T2D,提出了评估线粒体辅因子或线粒体营养素(MNs)如α-硫辛酸、辅酶Q10和左旋肉碱的任何减少的工作假设,并可能采用基于MNs的联合治疗。至于FA,目前仅从体外或分子研究中获得的关于MDF的既定知识,促使需要确定体内MDF,并设计旨在利用MNs来减轻或延缓FA临床进展的临床研究。总之,本文可能有助于为许多与OS/MDF相关的疾病的临床研究建立假设。

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本文引用的文献

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Significance of L-carnitine in internal medicine.左旋肉碱在内科中的意义。
Ter Arkh. 2019 Mar 11;91(1):114-128. doi: 10.26442/00403660.2019.01.000040.
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Mitochondrial dysfunction in type 2 diabetes mellitus: an organ-based analysis.2 型糖尿病中的线粒体功能障碍:基于器官的分析。
Am J Physiol Endocrinol Metab. 2019 Feb 1;316(2):E268-E285. doi: 10.1152/ajpendo.00314.2018. Epub 2019 Jan 2.

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