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脑积水:病理生理学与治疗研究的最新进展综述

Hydrocephalus: An update on latest progress in pathophysiological and therapeutic research.

作者信息

Anwar Faheem, Zhang Kuo, Sun Changcheng, Pang Meijun, Zhou Wanqi, Li Haodong, He Runnan, Liu Xiuyun, Ming Dong

机构信息

Medical School, Tianjin University, Tianjin 300072, China.

Medical School, Tianjin University, Tianjin 300072, China; Haihe Laboratory of Brain-Computer Interaction and Human-Machine Integration, Tianjin 300380, China.

出版信息

Biomed Pharmacother. 2024 Dec;181:117702. doi: 10.1016/j.biopha.2024.117702. Epub 2024 Nov 23.

Abstract

Hydrocephalus is a severe and life-threatening disease associated with the imbalance of CSF dynamics and affects millions globally at any age, including infants. One cause of pathology that is wide-ranging is genetic mutations to post-traumatic injury. The most effective current pharmacological treatments provide only symptomatic relief and do not address the underlying pathology. At the same time, surgical procedures such as VP shunts performed in lower-income countries are often poorly tolerated due to insufficient diagnostic resources and suboptimal outcomes partially attributable to inferior materials. These problems are compounded by an overall lack of funding that keeps high-quality medical devices out of reach for all but the most developed countries and even among those states. There is a massive variance in treatment effectiveness. This review indicates the necessity for innovative and low-cost, accessible treatment strategies to close these gaps, focusing on current advances in novel therapies, including Pharmacological, gene therapy, and nano-based technologies, which are currently at different stages of clinical trial phases. This review provides an overview of pathophysiology, current treatments, and promising new therapeutic strategies for hydrocephalus.

摘要

脑积水是一种严重的、危及生命的疾病,与脑脊液动力学失衡有关,在全球范围内影响着数以百万计的各年龄段人群,包括婴儿。造成病理的一个广泛原因是创伤后损伤引起的基因突变。目前最有效的药物治疗仅能缓解症状,无法解决潜在的病理问题。同时,在低收入国家进行的诸如脑室腹腔分流术等外科手术,由于诊断资源不足以及部分归因于材料劣质的欠佳疗效,往往耐受性较差。这些问题因整体资金缺乏而更加严重,这使得除最发达国家外,所有国家甚至在这些国家内部,都难以获得高质量的医疗设备。治疗效果存在巨大差异。本综述表明,需要创新的、低成本且可及的治疗策略来弥合这些差距,重点关注新型疗法的当前进展,包括处于临床试验不同阶段的药物治疗、基因治疗和基于纳米的技术。本综述概述了脑积水的病理生理学、当前治疗方法以及有前景的新治疗策略。

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