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细胞死亡机制及其在妊娠相关疾病中的作用。

Cell death mechanisms and their roles in pregnancy related disorders.

机构信息

Department of Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India.

Department of Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune, India.

出版信息

Adv Protein Chem Struct Biol. 2021;126:195-225. doi: 10.1016/bs.apcsb.2021.01.006. Epub 2021 Feb 27.

Abstract

Autophagy and apoptosis are catabolic pathways essential for homeostasis. They play a crucial role for normal placental and fetal development. These cell death mechanisms are exaggerated in placental disorders such as preeclampsia, intrauterine growth restriction (IUGR) and gestational diabetes mellitus (GDM). Apoptosis is widely studied, highly controlled and regulated whereas; autophagy is an orderly degradation and recycling of the cellular components. Cellular senescence may be initiated by a variety of stimuli, including hypoxia, oxidative stress, reduction in survival signals and nutrition deprivation. Apoptosis is regulated by two types of pathways intrinsic and extrinsic. Extrinsic pathway is initiated by apoptosis inducing cells such as macrophages, natural killer cells whereas; intrinsic pathway is initiated in response to DNA damage, cell injury and lack of oxygen. In autophagy, the cell or organelles undergo lysosomal degradation. Placental apoptosis increases as the gestation progresses while autophagy plays a role in trophoblast differentiation and invasion. In pregnancy disorders like preeclampsia and IUGR, proapoptotic markers such as caspase 3, 8, BAX are higher and antiapoptotic markers like Bcl-2 are lower. In GDM, apoptotic markers are reduced resulting in increased placental mass and fetal macrosomia. Apoptosis in the pathological pregnancies is also influenced by the reduced levels of micronutrients and long chain polyunsaturated fatty acids resulting in disturbed placental biology. This chapter describes the role of various key molecular events involved in cellular senescence and the various factors influencing them. This will help identify future therapeutic strategies for better management of these processes.

摘要

自噬和细胞凋亡是维持内环境稳定所必需的分解代谢途径。它们在正常胎盘和胎儿发育中起着至关重要的作用。这些细胞死亡机制在胎盘疾病如子痫前期、宫内生长受限(IUGR)和妊娠期糖尿病(GDM)中被夸大。细胞凋亡已被广泛研究,其受到高度控制和调节;而自噬是细胞成分的有序降解和再循环。细胞衰老可能由多种刺激引起,包括缺氧、氧化应激、生存信号减少和营养剥夺。细胞凋亡受两种类型的途径调节:内在途径和外在途径。外在途径由凋亡诱导细胞如巨噬细胞、自然杀伤细胞启动;内在途径则是对 DNA 损伤、细胞损伤和缺氧的反应。在自噬中,细胞或细胞器经历溶酶体降解。随着妊娠的进展,胎盘细胞凋亡增加,而自噬在滋养细胞分化和侵袭中发挥作用。在子痫前期和 IUGR 等妊娠疾病中,促凋亡标志物如 caspase 3、8、BAX 升高,而抗凋亡标志物如 Bcl-2 降低。在 GDM 中,凋亡标志物减少导致胎盘质量增加和胎儿巨大儿。病理妊娠中的细胞凋亡也受到微量营养素和长链多不饱和脂肪酸水平降低的影响,从而导致胎盘生物学紊乱。本章描述了参与细胞衰老的各种关键分子事件及其影响因素的作用。这将有助于确定未来的治疗策略,以更好地管理这些过程。

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