Smadja David M, Abreu M Marc
Paris Cité University, INSERM, Paris Cardiovascular Research Centre, Team Endotheliopathy and Hemostasis Disorders, Paris, France.
Hematology Department, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris-Centre Université Paris Cité (APHP-CUP), Paris, France.
Front Neurosci. 2025 Feb 4;19:1475376. doi: 10.3389/fnins.2025.1475376. eCollection 2025.
Neurodegenerative diseases (NDs) and Long COVID represent critical and growing global health challenges, characterized by complex pathophysiological mechanisms including neuronal deterioration, protein misfolding, and persistent neuroinflammation. The emergence of innovative therapeutic approaches, such as whole-body hyperthermia (WBH), offers promising potential to modulate underlying pathophysiological mechanisms in NDs and related conditions like Long COVID. WBH, particularly in fever-range, enhances mitochondrial function, induces heat shock proteins (HSPs), and modulates neuroinflammation-benefits that pharmacological treatments often struggle to replicate. HSPs such as HSP70 and HSP90 play pivotal roles in protein folding, aggregation prevention, and cellular protection, directly targeting pathological processes seen in NDs like Alzheimer's, Parkinson's, and Huntington's disease. Preliminary findings also suggest WBH's potential to alleviate neurological symptoms in Long COVID, where persistent neuroinflammation and serotonin dysregulation are prominent. Despite the absence of robust clinical trials, the therapeutic implications of WBH extend to immune modulation and the restoration of disrupted physiological pathways. However, the dual nature of hyperthermia's effects-balancing pro-inflammatory and anti-inflammatory responses-emphasizes the need for dose-controlled applications and stringent patient monitoring to minimize risks in vulnerable populations. While WBH shows potential interest, significant challenges remain. These include individual variability in response, limited accessibility to advanced hyperthermia technologies, and the need for standardized clinical protocols. Future research must focus on targeted clinical trials, biomarker identification, and personalized treatment strategies to optimize WBH's efficacy in NDs and Long COVID. The integration of WBH into therapeutic paradigms could mark a transformative step in addressing these complex conditions.
神经退行性疾病(NDs)和长期新冠代表着全球日益严峻的重大健康挑战,其特征在于复杂的病理生理机制,包括神经元退化、蛋白质错误折叠和持续性神经炎症。创新治疗方法的出现,如全身热疗(WBH),为调节NDs及长期新冠等相关病症的潜在病理生理机制提供了有前景的可能。WBH,尤其是在发热范围内,可增强线粒体功能、诱导热休克蛋白(HSPs)并调节神经炎症,而这些益处往往是药物治疗难以复制的。诸如HSP70和HSP90等HSPs在蛋白质折叠、预防聚集和细胞保护中发挥关键作用,直接针对阿尔茨海默病、帕金森病和亨廷顿病等NDs中所见的病理过程。初步研究结果还表明WBH有可能缓解长期新冠中的神经症状,其中持续性神经炎症和血清素失调较为突出。尽管缺乏有力的临床试验,但WBH的治疗意义延伸至免疫调节和恢复中断的生理途径。然而,热疗效果的双重性质——平衡促炎和抗炎反应——强调了需要进行剂量控制应用和严格的患者监测,以将弱势群体的风险降至最低。虽然WBH显示出潜在的吸引力,但重大挑战依然存在。这些挑战包括个体反应差异、先进热疗技术的可及性有限以及需要标准化的临床方案。未来的研究必须专注于针对性的临床试验、生物标志物识别和个性化治疗策略,以优化WBH在NDs和长期新冠中的疗效。将WBH整合到治疗模式中可能标志着在应对这些复杂病症方面迈出变革性的一步。
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