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肌动蛋白分泌动力学及其在危重症患者中的作用:一项范围综述

Myokine Secretion Dynamics and Their Role in Critically Ill Patients: A Scoping Review.

作者信息

Jalil Yorschua, Damiani L Felipe, García-Valdés Patricio, Basoalto Roque, Gallastegui Julen, Gutierrez-Arias Ruvistay

机构信息

Escuela de Ciencias de la Salud, Departamento de Kinesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago 1270709, Chile.

CardioREspirAtory Research Laboratory, Departamento Ciencias de la Salud, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile.

出版信息

J Clin Med. 2025 Apr 23;14(9):2892. doi: 10.3390/jcm14092892.

Abstract

Myokines can modulate organ function and metabolism, offering a protective profile against ICU complications beyond preventing local muscle wasting. This scoping review aims to explore and summarize the evidence regarding the secretion of myokines and their potential local or systemic effects in critically ill patients. A scoping review following Joana Briggs Institute recommendations was conducted. A systematic search of MEDLINE (Ovid), Embase (Ovid), CENTRAL, CINAHL (EBSCOhost), WoS, and Scopus was conducted from inception to February 2023. We included primary studies evaluating myokine secretion/concentration in critically ill adults undergoing physical rehabilitation interventions. Two independent reviewers performed study selection and data extraction. Seventeen studies published between 2012 and 2023 were included. Most were randomized clinical trials (47%). Physical rehabilitation interventions included electrical muscle stimulation, as well as passive and active mobilization, delivered alone or combined, in single or daily sessions lasting 20-60 min. Twelve studies (70%) evaluated interleukin-6, while interleukin-10, tumour necrosis factor-α, Interleukin-8, and myostatin were also commonly studied. Thirteen studies (76%) reported changes in myokine secretion or gene expression, although no clear concentration change pattern emerged. Myokines involved in muscle protein synthesis and breakdown may protect against muscle waste and weakness. The study of myokine dynamics in critically ill patients highlights the systemic impact of physical rehabilitation. This emerging field has grown in interest over the past decade, offering significant research potential. However, challenges such as study design, small sample sizes, and variability in physical therapy protocols hinder a comprehensive understanding of myokine responses.

摘要

肌动蛋白可以调节器官功能和新陈代谢,除了预防局部肌肉萎缩外,还能提供针对重症监护病房并发症的保护作用。本综述旨在探索和总结有关危重症患者肌动蛋白分泌及其潜在局部或全身效应的证据。按照乔安娜·布里格斯研究所的建议进行了一项综述。从创刊至2023年2月,对MEDLINE(Ovid)、Embase(Ovid)、CENTRAL、CINAHL(EBSCOhost)、WoS和Scopus进行了系统检索。我们纳入了评估接受物理康复干预的危重症成年患者肌动蛋白分泌/浓度的原始研究。两名独立评审员进行了研究选择和数据提取。纳入了2012年至2023年间发表的17项研究。大多数是随机临床试验(47%)。物理康复干预包括单独或联合进行的电肌肉刺激以及被动和主动活动,单次或每日疗程,持续20 - 60分钟。12项研究(70%)评估了白细胞介素 - 6,同时白细胞介素 - 10、肿瘤坏死因子 - α、白细胞介素 - 8和肌肉生长抑制素也经常被研究。13项研究(76%)报告了肌动蛋白分泌或基因表达的变化,尽管没有出现明确的浓度变化模式。参与肌肉蛋白质合成和分解的肌动蛋白可能预防肌肉萎缩和无力。对危重症患者肌动蛋白动态的研究突出了物理康复的全身影响。在过去十年中,这个新兴领域的关注度不断提高,具有重大的研究潜力。然而,研究设计、样本量小以及物理治疗方案的变异性等挑战阻碍了对肌动蛋白反应的全面理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/189d/12072662/718c2f157793/jcm-14-02892-g001.jpg

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