Department of Anesthesiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, China; Laboratory of Anesthesia and Brain Function, Qilu hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, China.
Department of Pharmacy, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 758 Hefei Road, Qingdao, China.
Cytokine Growth Factor Rev. 2024 Aug;78:37-49. doi: 10.1016/j.cytogfr.2024.07.001. Epub 2024 Jul 6.
Almost 16 % of the global population is affected by neurological disorders, including neurodegenerative and cerebral neuroimmune diseases, triggered by acute or chronic inflammation. Neuroinflammation is recognized as a common pathogenic mechanism in a wide array of neurological conditions including Alzheimer's disease, Parkinson's disease, postoperative cognitive dysfunction, stroke, traumatic brain injury, and multiple sclerosis. Inflammatory process in the central nervous system (CNS) can lead to neuronal damage and neuronal apoptosis, consequently exacerbating these diseases. Itaconate, an immunomodulatory metabolite from the tricarboxylic acid cycle, suppresses neuroinflammation and modulates the CNS immune response. Emerging human studies suggest that itaconate levels in plasma and cerebrospinal fluid may serve as biomarkers associated with inflammatory responses in neurological disorders. Preclinical studies have shown that itaconate and its highly cell-permeable derivatives are promising candidates for preventing and treating neuroinflammation-related neurological disorders. The underlying mechanism may involve the regulation of immune cells in the CNS and neuroinflammation-related signaling pathways and molecules including Nrf2/KEAP1 signaling pathway, reactive oxygen species, and NLRP3 inflammasome. Here, we introduce the metabolism and function of itaconate and the synthesis and development of its derivatives. We summarize the potential impact and therapeutic potential of itaconate and its derivatives on brain immune cells and the associated signaling pathways and molecules, based on preclinical evidence via various neurological disorder models. We also discuss the challenges and potential solutions for clinical translation to promote further research on itaconate and its derivatives for neuroinflammation-related neurological disorders.
全球近 16%的人口受到神经退行性疾病和脑神经免疫疾病的影响,这些疾病是由急性或慢性炎症引起的。神经炎症被认为是广泛的神经疾病的共同发病机制,包括阿尔茨海默病、帕金森病、术后认知功能障碍、中风、创伤性脑损伤和多发性硬化症。中枢神经系统(CNS)中的炎症过程可导致神经元损伤和神经元凋亡,从而使这些疾病恶化。衣康酸是三羧酸循环中的一种免疫调节代谢物,可抑制神经炎症并调节中枢神经系统的免疫反应。新兴的人体研究表明,血浆和脑脊液中的衣康酸水平可能是与神经退行性疾病炎症反应相关的生物标志物。临床前研究表明,衣康酸及其高度细胞渗透性衍生物是预防和治疗与神经炎症相关的神经退行性疾病的有前途的候选药物。其潜在机制可能涉及对中枢神经系统免疫细胞和神经炎症相关信号通路及分子(包括 Nrf2/KEAP1 信号通路、活性氧和 NLRP3 炎性体)的调节。在这里,我们介绍了衣康酸的代谢和功能及其衍生物的合成和发展。我们根据各种神经退行性疾病模型的临床前证据,总结了衣康酸及其衍生物对脑免疫细胞及其相关信号通路和分子的潜在影响和治疗潜力。我们还讨论了临床转化的挑战和潜在解决方案,以促进对与神经炎症相关的神经退行性疾病的衣康酸及其衍生物的进一步研究。
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