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CD26/二肽基肽酶4及其抑制剂在中枢神经系统疾病中的多方面作用——批判性综述

The many facets of CD26/dipeptidyl peptidase 4 and its inhibitors in disorders of the CNS - a critical overview.

作者信息

Bernstein Hans-Gert, Keilhoff Gerburg, Dobrowolny Henrik, Steiner Johann

机构信息

Department of Psychiatry and Psychotherapy, Otto v. Guericke University Magdeburg, Leipziger Str. 44, D-39120 Magdeburg, Germany.

Institute of Biochemistry and Cell Biology, Otto v. Guericke University Magdeburg, Leipziger Str. 44, D-39120 Magdeburg, Germany.

出版信息

Rev Neurosci. 2022 Jul 1;34(1):1-24. doi: 10.1515/revneuro-2022-0026. Print 2023 Jan 27.

Abstract

Dipeptidyl peptidase 4 is a serine protease that cleaves X-proline or X-alanine in the penultimate position. Natural substrates of the enzyme are glucagon-like peptide-1, glucagon inhibiting peptide, glucagon, neuropeptide Y, secretin, substance P, pituitary adenylate cyclase-activating polypeptide, endorphins, endomorphins, brain natriuretic peptide, beta-melanocyte stimulating hormone and amyloid peptides as well as some cytokines and chemokines. The enzyme is involved in the maintenance of blood glucose homeostasis and regulation of the immune system. It is expressed in many organs including the brain. DPP4 activity may be effectively depressed by DPP4 inhibitors. Apart from enzyme activity, DPP4 acts as a cell surface (co)receptor, associates with adeosine deaminase, interacts with extracellular matrix, and controls cell migration and differentiation. This review aims at revealing the impact of DPP4 and DPP4 inhibitors for several brain diseases (virus infections affecting the brain, tumours of the CNS, neurological and psychiatric disorders). Special emphasis is given to a possible involvement of DPP4 expressed in the brain.While prominent contributions of extracerebral DPP4 are evident for a majority of diseases discussed herein; a possible role of "brain" DPP4 is restricted to brain cancers and Alzheimer disease. For a number of diseases (Covid-19 infection, type 2 diabetes, Alzheimer disease, vascular dementia, Parkinson disease, Huntington disease, multiple sclerosis, stroke, and epilepsy), use of DPP4 inhibitors has been shown to have a disease-mitigating effect. However, these beneficial effects should mostly be attributed to the depression of "peripheral" DPP4, since currently used DPP4 inhibitors are not able to pass through the intact blood-brain barrier.

摘要

二肽基肽酶4是一种丝氨酸蛋白酶,可切割倒数第二位的X-脯氨酸或X-丙氨酸。该酶的天然底物包括胰高血糖素样肽-1、胰高血糖素抑制肽、胰高血糖素、神经肽Y、促胰液素、P物质、垂体腺苷酸环化酶激活多肽、内啡肽、内吗啡肽、脑钠肽、β-黑素细胞刺激素和淀粉样肽以及一些细胞因子和趋化因子。该酶参与血糖稳态的维持和免疫系统的调节。它在包括大脑在内的许多器官中表达。DPP4抑制剂可有效抑制DPP4活性。除酶活性外,DPP4还作为细胞表面(共)受体,与腺苷脱氨酶结合,与细胞外基质相互作用,并控制细胞迁移和分化。本综述旨在揭示DPP4和DPP4抑制剂对几种脑部疾病(影响大脑的病毒感染、中枢神经系统肿瘤、神经和精神疾病)的影响。特别强调大脑中表达的DPP4可能的参与情况。虽然脑外DPP4对本文讨论的大多数疾病有显著贡献;“脑”DPP4的可能作用仅限于脑癌和阿尔茨海默病。对于一些疾病(新冠病毒感染、2型糖尿病、阿尔茨海默病、血管性痴呆、帕金森病、亨廷顿病、多发性硬化症、中风和癫痫),已证明使用DPP4抑制剂具有减轻疾病的作用。然而,这些有益作用大多应归因于“外周”DPP4的抑制,因为目前使用的DPP4抑制剂无法穿过完整的血脑屏障。

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