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脂质介质代谢的调控作为结核病辅助宿主导向治疗的策略。

The Manipulation of the Lipid Mediator Metabolism as Adjunct Host-Directed Therapy in Tuberculosis.

机构信息

Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa.

Department of Nutrition and Dietetics, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.

出版信息

Front Immunol. 2021 Mar 12;12:623941. doi: 10.3389/fimmu.2021.623941. eCollection 2021.

Abstract

Host-directed therapies (HDTs) enhance the host response to tuberculosis (TB) infection to reduce disease severity. For instance, the manipulation of lipid mediator production diminishes the hyperactive immune response which is a known pathological feature of TB that generates lung tissue damage. Non-steroidal anti-inflammatory drugs (NSAIDs) and omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) are examples of such HDTs. In this mini-review, we recapitulate the literature available on the effects of NSAIDs and n-3 LCPUFA in TB as well as the immunological pathways underpinning these effects. Many NSAIDs have a great deal of data describing their effects and safety and in many jurisdictions are inexpensive, and sold over the counter in neighborhood convenience stores and supermarkets. The potential benefits of NSAIDs in TB are well-documented in pre-clinical studies. The reduction of pro-inflammatory lipid mediator production by inhibiting cyclooxygenase (COX) pathways with NSAIDs has been found to improve lung histopathology, bacterial control, and survival. Additionally, n-3 LCPUFA and its novel bioactive metabolites produced by COX and lipoxygenase (LOX) have been identified as safe and effective pro-resolving and antibacterial pharmaconutrients. Nevertheless, heterogeneous results have been reported in pre-clinical TB studies. Recently, the importance of the correct timing of NSAIDs and n-3 LCPUFA administration in TB has also been highlighted. This mini-review will provide a better understanding of the potential contribution of these therapies toward reducing inflammatory lung damage and improving bactericidal activity, especially during later stages of TB infection. It further highlights that clinical trials are required to confirm benefit and safety in TB patients.

摘要

宿主导向疗法 (HDTs) 增强宿主对结核病 (TB) 感染的反应,以减轻疾病的严重程度。例如,操纵脂质介质的产生可以减轻过度活跃的免疫反应,这是 TB 的一个已知的病理特征,会导致肺组织损伤。非甾体抗炎药 (NSAIDs) 和 ω-3 长链多不饱和脂肪酸 (n-3 LCPUFA) 就是这种 HDTs 的例子。在这篇迷你综述中,我们回顾了 NSAIDs 和 n-3 LCPUFA 在 TB 中的作用以及支持这些作用的免疫途径的相关文献。许多 NSAIDs 都有大量描述其作用和安全性的数据,在许多司法管辖区价格低廉,在附近的便利店和超市都可以买到。NSAIDs 在 TB 中的潜在益处已在临床前研究中得到充分证明。通过抑制环氧化酶 (COX) 途径用 NSAIDs 减少促炎脂质介质的产生,已被发现可改善肺组织病理学、细菌控制和存活率。此外,n-3 LCPUFA 及其由 COX 和脂氧合酶 (LOX) 产生的新型生物活性代谢物已被确定为安全有效的促解决和抗菌药物营养素。然而,在临床前 TB 研究中报告了结果存在差异。最近,在 TB 中正确选择 NSAIDs 和 n-3 LCPUFA 给药时间的重要性也得到了强调。这篇迷你综述将更好地理解这些疗法在减轻炎症性肺损伤和提高杀菌活性方面的潜在贡献,特别是在 TB 感染的后期阶段。它进一步强调,需要进行临床试验来确认在 TB 患者中的益处和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5698/7994275/4690b5883027/fimmu-12-623941-g0001.jpg

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