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GIP 受体激动剂的止吐作用。

The antiemetic actions of GIP receptor agonism.

机构信息

Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States.

Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States.

出版信息

Am J Physiol Endocrinol Metab. 2024 Apr 1;326(4):E528-E536. doi: 10.1152/ajpendo.00330.2023. Epub 2024 Mar 13.

Abstract

Nausea and vomiting are primitive aspects of mammalian physiology and behavior that ensure survival. Unfortunately, both are ubiquitously present side effects of drug treatments for many chronic diseases with negative consequences on pharmacotherapy tolerance, quality of life, and prognosis. One of the most critical clinical examples is the profound emesis and nausea that occur in patients undergoing chemotherapy, which continue to be among the most distressing side effects, even with the use of modern antiemetic medications. Similarly, antiobesity/diabetes medications that target the glucagon-like peptide-1 system, despite their remarkable metabolic success, also cause nausea and vomiting in a significant number of patients. These side effects hinder the ability to administer higher dosages for optimal glycemic and weight management and represent the major reasons for treatment discontinuation. Our inability to effectively control these side effects highlights the need to anatomically, molecularly, and functionally characterize novel neural substrates that drive and inhibit nausea and emesis. Here, we discuss clinical and preclinical evidence that highlights the glucose-dependent insulinotropic peptide receptor system as a novel therapeutic central target for the management of nausea and emesis.

摘要

恶心和呕吐是哺乳动物生理学和行为的原始方面,可确保生存。不幸的是,它们都是许多慢性疾病药物治疗中普遍存在的副作用,对药物治疗耐受性、生活质量和预后都有负面影响。最关键的临床例子之一是接受化疗的患者出现的严重呕吐和恶心,即使使用现代止吐药物,这些仍然是最令人痛苦的副作用之一。同样,针对胰高血糖素样肽-1 系统的抗肥胖/糖尿病药物尽管在代谢方面取得了显著成功,但也会导致相当数量的患者出现恶心和呕吐。这些副作用阻碍了为实现最佳血糖和体重管理而进行更高剂量给药的能力,也是治疗中断的主要原因。我们无法有效控制这些副作用,这突显了需要在解剖学、分子和功能上对驱动和抑制恶心和呕吐的新神经基质进行特征描述。在这里,我们讨论了临床和临床前证据,强调了葡萄糖依赖性胰岛素促分泌肽受体系统作为管理恶心和呕吐的新型治疗中枢靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0867/11194054/e856cff349a4/e-00330-2023r01.jpg

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