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诱导昏迷、死亡与器官移植:从生理学、遗传学和神学角度的探讨。

Induced Coma, Death, and Organ Transplantation: A Physiologic, Genetic, and Theological Perspective.

机构信息

Doctoral School, University of Medicine and Pharmacy Carol Davila, 020276 Bucharest, Romania.

Department of Psychiatry, University for Medicine and Pharmacy Craiova, 200349 Craiova, Romania.

出版信息

Int J Mol Sci. 2023 Mar 17;24(6):5744. doi: 10.3390/ijms24065744.

Abstract

In the clinic, the death certificate is issued if brain electrical activity is no longer detectable. However, recent research has shown that in model organisms and humans, gene activity continues for at least 96 h postmortem. The discovery that many genes are still working up to 48 h after death questions our definition of death and has implications for organ transplants and forensics. If genes can be active up to 48 h after death, is the person technically still alive at that point? We discovered a very interesting parallel between genes that were upregulated in the brain after death and genes upregulated in the brains that were subjected to medically-induced coma, including transcripts involved in neurotransmission, proteasomal degradation, apoptosis, inflammation, and most interestingly, cancer. Since these genes are involved in cellular proliferation, their activation after death could represent the cellular reaction to escape mortality and raises the question of organ viability and genetics used for transplantation after death. One factor limiting the organ availability for transplantation is religious belief. However, more recently, organ donation for the benefit of humans in need has been seen as "posthumous giving of organs and tissues can be a manifestation of love spreading also to the other side of death".

摘要

在临床上,如果脑电活动无法检测到,就会颁发死亡证明。然而,最近的研究表明,在模式生物和人类中,基因活性至少会在死后持续 96 小时。这一发现表明,许多基因在死后 48 小时内仍然活跃,这对器官移植和法医学提出了质疑。如果基因在死后 48 小时内仍然活跃,那么从技术上讲,这个人是否还活着?我们发现,死后大脑中上调的基因与因医学诱导而昏迷的大脑中上调的基因之间存在一个非常有趣的平行关系,包括涉及神经递质传递、蛋白酶体降解、细胞凋亡、炎症以及最有趣的癌症的转录物。由于这些基因参与细胞增殖,它们在死后的激活可能代表了细胞逃避死亡的反应,并引发了死后器官存活和用于移植的遗传学问题。限制器官移植可用性的一个因素是宗教信仰。然而,最近,人们越来越认识到,为了满足人类的需要而捐献器官是“死后捐献器官和组织可以是爱的体现,也可以延伸到死亡的另一边”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e37/10059721/7f9bca153b00/ijms-24-05744-g001.jpg

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